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TKR Need better ROM, please advise.

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I had to have manual manipulation on my right knee when I went in two months ago for the left TKR. It broke the adhesions that kept my knee stuck at 100 degrees. What helped increase my ROM enormously is my recumbent stationary bike. I use it every day, moving the seat just a bit closer to the pedals each time. Now I am at 125 degrees in the right knee (and increasing) and 135 in the left.
 
Roy Gardiner said:
My apologies for appearing patronising. The comment was to ensure that newer posters didn't think only mods could post links.
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No, I didn't take it that way. I know you're always helpful. :)
 
Al, did you read the articles skigirl left you? there is one in there about the swollen stiff knee. I hope you read it because it explains all of the issues you are worried about. Of course he could get your knee bent when you were unconscious! Because it's not stuck that way, it's just swollen. Read that article and you will understand how this works.

As for your surgeon telling the PT to be more aggressive - good grief! That's just terrible and I really hope you refuse to accept this draconian approach. Trust me, the more they abuse you in this futile attempt to overcome natural swelling, the more swelling they will create and the more pain and the less flexion you will have. I'd fire them both and do it on your own.

I also say this: just like surgery, PT is supposed to be done with your INFORMED CONSENT. If they do things like forcing your knee and don't take any notice when you are in such pain you are fainting, that's not informed consent it's abuse and you don't have to tolerate it. Imagine what would happen if you went up to someone in the street and did something like that. They'd call the cops double quick because it's abuse. Don't stand for it.
 
Hi-
I just wanted to throw in my 2 cents. I had my surgery in February and I was stuck with a 113- 120 ROM for a long time. I noticed within the last 4 weeks or so I have an increased range of motion without any real concerted attempts at increasing my ROM with specific exercises, etc... I am on my feet all day and I have gone back to working out so I do have more swelling that I might if I did nothing but my point is, just going on with life tends to help out with range of motion. It is a continual process and happens slowly BUT, it happens. Good luck, it gets better :))
 
Thanks Josephine & Hayes,
Didn't realize I had a second page already!! I will read skigirls article. Yesterday my PT saw the notes from the OS asking to be more aggressive and she tried. She said I'm at 72 after 9 weeks and most people are at at least 105 plus. I couldn't help it, I broke down. Ive been killing this knee and i think its in shock. I then told her that she's not going to hurt me and I will do this at my own pace. Today is Sunday and I will give this poor knee a day off. I will only ice, elevate and rest it. My swelling needs to go down.

Hayes, you say you were "stuck" at 113-120, I wish I was stuck there, what's the effect ROM? I'm glad to know that you don't stop gaining ROM after a certain time. I guess there is hoe for me. Thanks for the encouragement, I love this place!! I don't feel alone anymore. I will be posting my progress as I achieve ROM.

Regards,
Al
 
Very good choice, it puts you in charge instead on someone pushing on your leg. You will have a better outcome if you control the pressure on acheiving more motion.
David
 
THere's a lot of trial and error in figuring out what works for each individual. I got lots of great tips when my progress was stalled but not many worked. For me, the adhesions were in the knee tethering things together. It really was not a matter of stretch or strengthening. No doubt you'll try things and figure out what works for you.
 
hurtin_unit said:
She said I'm at 72 after 9 weeks and most people are at at least 105 plus.
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Don't listen when people start talking about "most people." Everyone heals differently. It's hard (especially when your PT is comparing) but try to resist it.

I couldn't help it, I broke down. Ive been killing this knee and i think its in shock. I then told her that she's not going to hurt me and I will do this at my own pace. Today is Sunday and I will give this poor knee a day off. I will only ice, elevate and rest it. My swelling needs to go down.
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Good for you. :thumb:
 
Dear Al,
Your post gave me goosebumps. You had MUA just a few weeks after your surgery? Oh my goodness, your poor, poor leg. I'm sorry that your ROM isn't where it is supposed to be. I may be in the same boat someday, but today, it is just ice and elevate and then ice and elevate some more. This has helped the swelling and pain. I may have to remind my OS that I am a bit behind and need to go slower than the champs, so that I never find myself in the swollen mess again. I think that there are 2 camps of surgeons and PTs. Camp one is an enthusiastic group and probably do well for those that need to get back to an athletic life. Camp two are slow and easy wins the race. My OS is so proud of his work and will not allow an exuberant PT ruin his masterpiece. Anyway, my novice advice is to follow the bonesmart ice and elevate plan. I think it will eventually help your ROM. GOOD LUCK!!!!
 
Hi Nyland,
You are absolutely right about the two camps. My OS is the official OS for the Chicago Cubs, when they're here in Arizona for spring training. He may be expecting too much. Never thought about that until you mentioned the camps. Elevate, ice and rest my poor knee is what I'm doing today. I'm not athletic, much less a baseball player. No rush, I wont abuse my knee anymore - "less pain, more gain".
Take care,
Al
 
Hi Al!
I'm not an athlete, either. So what if you are a day or 2 behind, right? I hope your day of rest helped very, very much. I am so uncomfortable and achey at this time of night. I used to love bed time, but not anymore. I really hope this bedtime dread isn't a very long stage. Here's hoping tomorrow is a better day!
 
Hi Al...I noticed you are from Phoenix, pool country! Ask you doctor if you can get in the water. There are many exercises that can be done in the pool. Keep it slow and easy.Focus on your knee and how it feels as you exercise. Good luck
 
hurtin_unit said:
Hi Nyland,
You are absolutely right about the two camps. My OS is the official OS for the Chicago Cubs, when they're here in Arizona for spring training.
Al
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Mine is the guy for the White Sox. A Cubs doc would not be a selling point for me. Ha! GO SOX!
 
Hi Dmgkag,
You're right, it seems nearly every household has a pool here, also for a state that has no beaches, just lakes, you see more boats in driveways than in California. I have a pool but haven't gone in since my TKR. Neither my OS or my PT have mentioned it. I have PT this afternoon and I will ask. I'm using a cane and I'm still lifting my hip with each step, kind of dragging my foot a bit and didn't think it was pool time yet but lets see what they say today.

Jen, funny that you have the OS for the Chicago white sox and I have the one for the Chicago cubs. These guys sure don't have the mentality of "less pain, more gain" - they want to work you hard and get you back on the field ASAP, even if they have to get you a gorilla to bend your knee. Good thing we are bonesmarties and now know differently.
 
hurtin_unit said:
Jen, funny that you have the OS for the Chicago white sox and I have the one for the Chicago cubs. These guys sure don't have the mentality of "less pain, more gain" - they want to work you hard and get you back on the field ASAP, even if they have to get you a gorilla to bend your knee.
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Aha, I know the technical name for these people. They are known as "idiots".
 
Roy Gardiner said:
Aha, I know the technical name for these people. They are known as "idiots".
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I agree - but I have been biting my tongue here, trying not to be too disparaging about these professionals.

I've long been uneasy about the rush to gets sports people back on the field, using heaps of physiotherapy. It's always seemed to me like a short-term fix for something, which frequently causes a problem later on. Even with sports injuries in fit, young athletes, soft tissue needs time to heal. A too-early return to sport can have repercussions later - how many former athletes now have long-term problems related to injury when younger? As for steroid injections to get the player back on the field - don't get me started on that!

I'm old-fashioned. I believe in letting nature take its course. Slow and steady, etc. Physiotherapy can help, but should not try to rush any healing process.

See the similarity between sport injuries and joint replacements? Good things take time!
 
Hi Al....I see that you are about 8 weeks out from surgery. The requirement for going in the pool is that the incision needs to be completely healed. It is usually ok around 6 wks. but you need to check with your doctor. If he says yes, now is the perfect time to start water exercises. There are several threads on this forum about exercising in the water . Just start off slowly. Do leg lifts,go up on your toes and back down, gentle stretching. Walk in the water..heel first then toes. Some use a noodle in the deep end and do the bicycle. Any gentle stretching is good . Try to kick yourself in the rear and hold.If you have a railing and steps, try going up and down steps with the goal of alternating legs. Hang onto the railing and sit back. You can lift your leg with the knee bent and then extend it. Don't forget to exercise both legs. The exercises are much easier to do in the water than out of the water. The warm water( a given in Az!) will relax your muscles making it easier to move your knee. Focus on how your knee feels as you exercise. Slowly take it just to the point of discomfort, not pain. Slowly you will see progress with your ROM and finally you can have some fun after all you have been through. Don't forget the hat, sunscreen and the shades...I am sure you know this living in Phoenix!
 
Roy, i had to laugh when I read your technical definition ... Followed by Celle's comments, you're not being critical, just sincere. We believe in slow & easy versus rush, rush, push,push.
Dmgkag, my ROM is only 72 now but my incision is healing so good you can barely see it. This means I will be ok to go In the pool and try those exercises you recommended. Youre right, the water is always warm, this week we will average 115 degrees temp. I have the sunscreen and shades ready to go. I went to my PT today and she concentrated on gentle stretching exercises and moving my knee cap up, down, left & right. I'm not afraid of her now that I talked her into being more gentle and not abusing my knee. Now that I've been getting lots of advise and I'm reading from the library I sound like I know what I'm asking about..lol.
 
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