Well I've had a truly disappointing day. I met with my Doctor and he wants me to improve ROM 20 degrees a week so that when I see him in 3 weeks my ROM will be at 120. I've been stuck at 60 since my last therapy appt. on Nov 15th in spite of resting, elevating and icing most of the day and nite, doing some knee bends on a step and some heel slides and stretches. I'm inbetween a rock and a hard place. I know I won't make 120 in that time but maybe I'll have some improvement. He wants me in PT twice a week, which actually doesn't start until 12/6 and that week I only have one. He said to take my pain pill so that when I go in, my body is relaxed and they will be able to help me move more.
Forgive me saying this, but I think your surgeon is very impatient and he is wrong. Since we know that ROM
can continue to improve for a year, or even much longer, after a knee replacement, there is no need to rush. There isn't any deadline you have to meet:
Myth busting: the "window of opportunity" in TKR
To be expecting a bend of 120 by 9 weeks is ridiculous. Some people may achieve it, but the rest of us take a lot longer - and we're all normal.
He's also giving bad advice, telling you to take pain pills so you can get through PT by forcing your knee to bend. Pain is a warning sign that you are doing more than your knee is ready to do. If you artificially dampen down the pain, you may inadvertently damage your knee.
Frankly, I think you'd be more relaxed if he stopped hassling you about ROM!
He showed my husband and exercise he can help me with which is: I sit on the bed with my leg handing down and push against my husbands hands while he holds my ankle, holding for a count of 5 and then I release and my husband pushes my ankle back as far as he can without me going into horrid pain and then releases it into an extension to relax it. He said that would be the one that would really help me through this stuck place and that I might hear the scar tissue tearing, etc. The doctor did it and it was a lot of pressure and it kind of hurt and what also hurt was my outer quad muscle which I guess is getting stretched since it has not been used to bend my knee back in 6 weeks.
Please don't do it! Forcing your knee like that can upset and inflame it more, causing increased swelling and loss of ROM.
Remember this:
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.
There is no need at all to rush this. Give your knee lots of rest, ice and elevation, so the swelling can go down - and your knee will start to bend more, as if by magic.
Don't get trapped into thinking that working harder at exercises will increase your bend. It won't:
Knee recovery - Lose the Work Ethic!!
TKRs and our fast food society
The doctor said we did loose some ground when my hematoma stopped all activity for 2 weeks and then the surgery to remove it but it didn't seem to stop him from saying that I should be at 120 by 9 weeks.
Yes you did lose some ground, but so what? There's no need to rush.
@KarriB had to keep her leg completely straight with no exercise at all for a month, and yet her knee ended up bending normally, with no manipulation needed.
My surgeon doesn't even allow any 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.
After that month, we just go to PT once every 2 weeks, where we are shown a few new exercises to do at home.
His patients all do well and achieve good ROM, as I did, and he hasn't had to do a manipulation to help with ROM for the past 4 years. I think that speaks for itself.
You've probably been working like crazy at exercises, thinking that will help increase your ROM and it hasn't worked. So, why keep on doing the same thing?
Your knee is wounded, not lazy or unfit. It needs time and gentle treatment, so it can heal.
It's not exercising that gets you your ROM - it's time. Time to recover, time for swelling and pain to settle, and time to heal. Your ROM is there right from the start, just waiting for all that to happen, so it can show itself.
Give your poor knee a rest. It's already had one MUA and that did no good. Why contemplate having another? It will only re-injure your knee and make it more sore and swollen.
You are allowed to say no to the MUA. Did you realise that? It's your knee and you are the only one who has the right to say what will happen to it. No one can do anything to it without your permission and you are allowed to say you want to wait a while.
CONSENT: what it means and how it can be used
Saying no to therapy - am I allowed to?
United States
