dugndot
new member
Currently 6 weeks post TKR. Sure has been a roller coaster ride...many ups & downs. I'm really struggling to balance my recovery expectations against reality. This forum is helping me put things in perspective.
TKR Newbie - Right TKR on 11/13/2020
- Thread starter dugndot
- Start date
@dugndot Welcome to BoneSmart and the other side of surgery. Now you know why BoneSmart was created. So many surgeon fail to set realistic expectations. Stick with us - we will help you through this journey.
Here are some basic guidelines.
Knee Recovery: The Guidelines
1. Don’t worry: Your body will heal all by itself. Relax, let it, don't try and hurry it, don’t worry about any symptoms now, they are almost certainly temporary
2. Control discomfort:
3. Do what you want to do BUT
4. PT or exercise can be useful BUT take note of these
5. At week 4 and after you should follow this Activity progression for TKRs
6. Access these pages on the website
The Recovery articles:
The importance of managing pain after a TKR and the pain chart
Swollen and stiff knee: what causes it?
Energy drain for TKRs
Elevation is the key
Ice to control pain and swelling
Heel slides and how to do them properly
Chart representation of TKR recovery
Healing: how long does it take?
Post op blues is a reality - be prepared for it
Sleep deprivation is pretty much inevitable - but what causes it?
There are also some cautionary articles here
Myth busting: no pain, no gain
Myth busting: the "window of opportunity" in TKR
Myth busting: on getting addicted to pain meds
We try to keep the forum a positive and safe place for our members to talk about their questions or concerns and to report successes with their joint replacement surgery.
While members may create as many threads as they like in a majority of BoneSmart's forums, we ask that each member have only one recovery thread. This policy makes it easier to go back and review history before providing advice.
Here are some basic guidelines.
Knee Recovery: The Guidelines
1. Don’t worry: Your body will heal all by itself. Relax, let it, don't try and hurry it, don’t worry about any symptoms now, they are almost certainly temporary
2. Control discomfort:
rest
ice
take your pain meds by prescription schedule (not when pain starts!)
3. Do what you want to do BUT
a. If it hurts, don't do it and don't allow anyone - especially a physical therapist - to do it to you
b. If your leg swells more or gets stiffer in the 24 hours after doing it, don't do it again.
4. PT or exercise can be useful BUT take note of these
5. At week 4 and after you should follow this Activity progression for TKRs
6. Access these pages on the website
The Recovery articles:
The importance of managing pain after a TKR and the pain chart
Swollen and stiff knee: what causes it?
Energy drain for TKRs
Elevation is the key
Ice to control pain and swelling
Heel slides and how to do them properly
Chart representation of TKR recovery
Healing: how long does it take?
Post op blues is a reality - be prepared for it
Sleep deprivation is pretty much inevitable - but what causes it?
There are also some cautionary articles here
Myth busting: no pain, no gain
Myth busting: the "window of opportunity" in TKR
Myth busting: on getting addicted to pain meds
We try to keep the forum a positive and safe place for our members to talk about their questions or concerns and to report successes with their joint replacement surgery.
While members may create as many threads as they like in a majority of BoneSmart's forums, we ask that each member have only one recovery thread. This policy makes it easier to go back and review history before providing advice.
My surgery was on 17/11/20 .After 6weeks,there is improvement but not easy by any means. Still having pain, swelling and stiffness but every week it gets better. I wasn't that prepared for what to expect so it's been overwhelming but this forum has been a saviour .
And another way to look at it:
Ny grandma
junior member
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I wasn’t prepared either, I thought I was going for a second opinion on pain management but here I am! Mine was 11/10/20. I agree with you it hasn’t been easy but it is a definite improvement.good luck
dugndot
new member
Thank you all for the replies!!
I really appreciate the information provided through this forum. Each of us has our own journeys but we all seem to share a lot of the same issues and feelings, so in that I find comfort.
A bit more about my journey....I'm am now 7 weeks post-op and per doctor's order, I am seeing a PT 2 to 3 times a week. A lot of the exercises they have me do seem to make sense for strength building and do not involve a lot of pain, however, each session ends with a massage and hands on working on ROM followed by stim & ice. This includes cranking the knee in both directions until I can't stand it. We have been able to get to 95 with one PT pushing while another takes the measurement. I don't think it makes sense to have to push past what I can do myself to take the measurement. Seems like a false positive to me.
I am scheduled back to the Dr at 8.5 weeks post-op and he indicated if we don't see improvement in ROM then he is recommending the MUA. After reading a bunch on this forum, I see that the philosophy of bonesmart is no painful PT and no MUA, just let your body heal on its own. I like that train of thought but have to admit I am hesitant to jump on the bonesmart bandwagon and disregard what the Dr and PTs are recommending. As I read this forum, I can't help but wonder how we can have such different approaches to recovery.
I really appreciate the information provided through this forum. Each of us has our own journeys but we all seem to share a lot of the same issues and feelings, so in that I find comfort.
A bit more about my journey....I'm am now 7 weeks post-op and per doctor's order, I am seeing a PT 2 to 3 times a week. A lot of the exercises they have me do seem to make sense for strength building and do not involve a lot of pain, however, each session ends with a massage and hands on working on ROM followed by stim & ice. This includes cranking the knee in both directions until I can't stand it. We have been able to get to 95 with one PT pushing while another takes the measurement. I don't think it makes sense to have to push past what I can do myself to take the measurement. Seems like a false positive to me.
I am scheduled back to the Dr at 8.5 weeks post-op and he indicated if we don't see improvement in ROM then he is recommending the MUA. After reading a bunch on this forum, I see that the philosophy of bonesmart is no painful PT and no MUA, just let your body heal on its own. I like that train of thought but have to admit I am hesitant to jump on the bonesmart bandwagon and disregard what the Dr and PTs are recommending. As I read this forum, I can't help but wonder how we can have such different approaches to recovery.
The painful pushing on your knee that your PTs are doing is wrong. How can forcing and hurting your knee like that, when it has recently been through major surgery be a good thing?
All it will do is keep your knee irritated and inflamed - and more swollen, which will prevent it from bending.
It's your knee, not theirs, and you are the only one with the right to say what happens to it. So please say NO to treatment like that.
Saying no to therapy - am I allowed to?
In any case, the degree of flexion they are measuring doesn't count. The only valid measurement is what you can achieve with your own, unassisted muscle power.
I knowhow hard it is when you are being given advice that seems contradictory. All I can say is this: We are advising you from personal experience (we've all had joint replacements) and not from theory, and we also have the experience of hundreds of other people who have been BoneSmart members who benefitted from following our advice.
In spite of what I'm sure you've been told, there's no need to rush to get ROM (Range of Motion) because it can continue to improve for a year, or even much longer, after a knee replacement. There isn't any deadline you have to meet:
Myth busting: the "window of opportunity" in TKR
One more thing: Not all surgeons believe the same as your surgeon.
My surgeon doesn't allow any formal PT at all for the first month after a knee replacement. He says your knee needs that time, to start on its journey of healing. For that month, we rest, ice and elevate our leg, and walk around the house. The walking is our exercise and we increase it a little each week.
After that month, we just go to PT once every 2 weeks, where we are shown a few new exercises to do at home each day.
His patients all do well and achieve good ROM, as I did, and he hasn't had to do an MUA for the past 4 years. I think that speaks for itself.
jtstag
junior member
Question about different approaches for longtime Bonesmart people. Does it seem like the U.S. in general may have different approaches than the U.K. and other parts of the world ? Just by reading different comments it seems like that maybe the case.
I'm not a long time member but I live in Australia. The physios that I met never pushed the exercise but rather taught me how to do them correctly and to work at a level that is manageable without pain. They also said that if it's painful take time off and restart when it's better. Hydrotherapy was recommended as it's much easier on the joint. I never felt pushed and if I said I'd had enough they gave me water and told me to rest or go home. Ice was also offered.
jtstag
junior member
My feeling is the U.S. is much less progressive when it comes to this. My PTs (physios) were much more militant about therapy. I even had one bring up (threaten?) a future MUA at three days post op ! I thing we are behind the times.
We do recommend painless PT, so our body can heal.
We are not totally against MUA, rather, we feel sometimes they are done too early. An MUA will address adhesions, which is totally different from scar tissue, but it won’t do much for you if the reason ROM is slow to come is because of just swelling. Swelling and the body’s time frame for healing varies for each of us.
What Bonesmart recommends really is different from what many of us are told. No one outside of Bonesmart ever told me to relax and let my body heal, and the ROM would come.
All these different approaches are just that, different approaches and different opinions. But as Celle said, it is your knee and you have the final say what happens to it. I will never again allow a PT, or a surgeon, to hurt me again, now that I know they both did that, only because of their opinion.
I was blessed to have a surgeon that never pushed PT. He gave me a prescription for it, which I threw away and never went. When I went for my 3 return checkups, all he wanted was to see what my knee would do. Never one question about PT! Of course, he knew I was a divorced lady that had to take care of myself, so obviously he trusted that I would not be just laying around all the time.
After 12 knee surgeries, I know that I do not need PT, and neither does anyone else if they do their own daily activities. My knee recovered just fine all on its own with only my daily activities. I didn't have the terrible swelling or agonizing pain that so many have after taking formal PT either. I knew the Bonesmart way worked before Bonesmart was even thought of. My surgeries started in the early 80s and I never went to PT even back then. I just didn't see the need for it. Bonesmart was formed around 2004. By then I had already had 6 knee surgeries and rehabbed the Bonesmart way!
After 12 knee surgeries, I know that I do not need PT, and neither does anyone else if they do their own daily activities. My knee recovered just fine all on its own with only my daily activities. I didn't have the terrible swelling or agonizing pain that so many have after taking formal PT either. I knew the Bonesmart way worked before Bonesmart was even thought of. My surgeries started in the early 80s and I never went to PT even back then. I just didn't see the need for it. Bonesmart was formed around 2004. By then I had already had 6 knee surgeries and rehabbed the Bonesmart way!
