Become an Insider

TKR On the other side of surgery

Thank you @newlybionic I had not thought of that. I have seen my OS once at my 2 week post op and do not go back for 4 weeks. So he has no idea of the tightness/stiffness I am having. Although the PT facility is part of the ortho dept and in then same building I doubt the therapist has reported back to him since I have only had 2 rehab sessions. Can't hurt to ask.
 
Colleen, it's still less than a month since you had this major surgery. It's normal to still feel tightness and stiffness.
Even though you're younger than most of us, your knee did have the same surgery and it won't heal any faster than our older knees.

Did you realise that tightness and stiffness are other forms of pain? It could be that you are not taking sufficient pain medication.

thecoll said:
So beyond frustrated. Just left my 2nd outpatient therapy appt and my leg is just not wanting to bend. After 6 minutes on the bike they thought it would be loosen up. Wrong. So we spent 20 minutes bending it while hanging off the table. The ROM only got to 66. Really over it, when home PT was coming it was at 80. I know it will take time but I feel like a failure.
Click to expand...
I saw this post, from a few days ago.

Sweetheart, it's still such early days! You have plenty of time to achieve ROM (Range of Motion). There's no need to rush, and no excuse for your therapist letting you think you aren't doing well. Your knee probably bent less at your PT session, simply because you had been more active.
At the moment, it is swelling that prevents your knee from bending, so concentrate on reducing the swelling, with lots of rest, ice and elevation, and less exercise. Your knee will gradually start to bend more, as the swelling goes down.

It isn't exercise that increases ROM. It's time, rest and healing.
TKR: work “smarter” and not “harder”

There's no need to rush to get ROM, no "window of opportunity". ROM can continue to improve for a year, or even longer, after a knee replacement.
Myth busting: the "window of opportunity" in TKR
ROM: it's never too late to get more ROM!
 
@Celle True I do need to remember I am only a month out. To be honest I did not stop to think tightness and stiffness are a form of pain. Starts to make sense as this week I have backed off on the pain meds. I was taking 1 pill every 4-6 hours round the clock and now I am taking 1 every 8 hours so that is 3 a day. Thank you for reminding me that there is no rush and with time the ROM will improve. This is exactly why I love this site! I so appreciate the advice, insight, encouragement of everyone and it helps that we have or are going thru the same journey were as our Dr's and PT staff have not experienced what we are.
 
We're glad to help. We've walked this path before you and we understand how frustrating it can be, especially when progress seems slower than you would like.
 
I had my 3rd outpatient PT today. Felt good on the eliptical bike and then stretching on the step. She showed me the proper way to walk with a cane. Then we moved to the flat table and worked on my ROM using a leash strap thing for heal slides. This was a different therapist, each time has been a different therapist, she said my extension was great but my flexion not so great. I then laid on my stomach (first time since surg) and used the leash strap and pulled to get bend. Then she started to desensitize my scar and showed me how so I can start doing this at home. Some areas much more sensitive than others. She then iced me while she went to get copies of home exercises. I was feeling positive, then she came back..... I was then informed my ROM was only at 70 and I am almost 4 weeks out, my window of opportunity is getting smaller and I need to get this to 90 as soon as possible or I will need a MUA. She also told me my steri strips should be off by now. I lost it and cried like a big baby. She said she was not trying to scare me but wanted me to know. She recommends doing 1 extension and 1 bend exercise every few hours and only do them 3 times each and hold for 30 seconds. Unless the knee is swollen then do not do them, duh! She was going to report back to my OS that I am only at 70. She wants me at 80 at the next visit, I told her it is tomorrow and she said I can do it. She said rehab needs to be my full time job. So there I go another day of frustration and let down. What a kill joy.
 
Oh, I'll let the experts way in on this!!! In my humble opinion, it is so simple. The swelling has to go down to get the ROM. Don't let them upset you. They are wrong. There is no window and its too soon for a MUA. I am angry at them for you. I'm so sorry she upset you so. Shame on her.
 
@thecoll I'm so sorry .. :( I agree with Floridagal, the swelling has to go down to the get the ROM. I had the same exact thing happen to me at 3 weeks but in the surgeon's office, once they started talking MUA, I lost it and my husband almost passed out because I was in so much pain when they tried to force the bend and I was only at 70 degrees. I then started laughing (more at our situation) because I was on an emotional rollercoaster. I was so swollen and sore. They too told me that I had to do the heel slides every hour and hold, as much as I could. I tried for days but it hurt & I was frustrated. Eventually, the swelling went down & I got to 90. It takes time...hang in there...everything will work out fine!! :console2:
 
Colleen, your rom is low because of the therapy. I honestly cannot believe the therapist has you doing the strap pull. The harder the therapist works you, the more swollen your knee becomes and will not bend. Think of your knee as a garden hose, full of water it is hard to bend or roll, but let the water out and voila! The hose bends with no problem. When your knee isn't swollen it will bend. Your pt is taking an aggressive approach to your pt, then you're having 3 pt sessions in 4 days. That's a recipe for disaster. Cancel tomorrow, rest, ice elevate and don't do the strap exercise or use it for heal slides. My OS showed me how to do heal slides by pushing my foot ever so gently with his foot about 2 inches.

Are you on a stair stepping elliptical?
 
Colleen I agree with the others, you are doing way too much PT and it definitely is not gentle...you need to let your knee rest so that the swelling can go down, they wanted me to go three times a week, I only went twice a week, for about 3 weeks and never forced the knee with a strap.

Don't allow them to threaten you with the OS, so what!!! Relax, let your knee heal :flwrysmile:
 
Go back and read the articles Celle left you about window of opportunity and ROM. Whenever you feel down re-read them. You are doing fine. Let you give you my two different attempts at rehabbing your knee
I tried rehabbing after a TKR two extremely different ways. The first time I did every exercise I was given. If they said do it twice I did it four. I was determined that I could get my knee back in shape but pushing through pain. My PT and OS were both telling me that's what I had to do. What I got from that was extreme pain. Poor range of motion. And then I started to feel depressed because I thought I was a failure. Instead of getting better I got worse.

The second time I had found this forum. It seemed very counterintuitive to me that the best way to rehab my knee from a TKR is to NOT exercise. I don't mean just sitting around doing nothing but just walking where and when I need to. I spent a lot of my early days with my knee elevated and with ice on it except to use the bathroom or to grab something to drink. I still ice whenever my knee swells and some days over night. I also took my pain meds for as long as I HAD pain. Eventually I missed some doses because I slept through them.

I would strongly suggest that you give this a try. You have nothing to lose. You might want to change your PT sessions to twice a week at most. Skip steps and squats and don't use straps to pull on your leg. Don't let a PT threaten you into doing anything you feel is wrong for you. When I asked my current OS about what types of activities I should do he told to 'not do anything that hurts'. BTW I can bend my knee to 130 which was better than my OS had predicted.
 
I agree with all the other responses. You can't bend because you're swollen. You're swollen because pt has been way too aggressive with your knee. Take off a month from all exercises. Just do your daily living stuff. Your swelling will go way down and your bend will go way up. I know from experience that doing no pt works!
 
Colleen,
I can't suggest too strongly that you stop going to PT for a while and concentrate on doing nothing but
rest, elevate, ice and take your pain meds by the clock.

It is all this pushing and pulling that you are doing at PT that is preventing your knee from bending. It is never a good idea to use a strap to help with bending your knee. It is irritating and inflaming your knee and making things worse - and that poor knee is trying to heal, after a huge operation. The last thing it needs is lots of pulling and overworking.
BoneSmart philosophy for sensible post op therapy

It's all too easy to fall into the trap of thinking that the harder you work the better results you will get. That isn't true for recovering from a knee replacement.
Knee recovery - Lose the Work Ethic!!
TKR: work “smarter” and not “harder”
 
Check out @sheliac 's thread. She's 15 days out, only had gentle therapy, walking around her home and had a ROM of 117. Everyone is different, it takes some longer, but patience and tlc is the way to go.
 
Wow. I'm so sorry pt is intimidating you. Please dont let them. From everything I've seen here the Bonesmart way works, and does not cause undo pain, which causes swelling, which creates this viscous cycle.

Keep thinking HOSE FULL CANT BEND!
 
Oh, thecoll. I am so sorry you are being tortured. There is no excuse. I wouldn't hesitate to cancel (I just did!). I had been following the Bonesmart recommendations religiously and on day 14, I was walking 1/4 mile, climbing 14 stairs 3 times daily, and have 117 ext and 0 flexion. The only exercises I did were gentle heel slides (NO strap/towel), and heel pumps a lot. I walk (focusing on gait, not speed) about once an hour (to bath, kitchen, around the condo). I ice and elevate whenever I sit, which is a lot. Tuesday was the first time I really deviated from Bonesmart (PT had me stand on my operative leg while holding up the other leg -- sort of a modified Tree yoga pose). I won't deviate again!

From what I've learned here, we need to ice and elevate to keep the swelling down. Walking, with a focus on normal knee bending with each step, using a cane to help focus, is the best exercise. I was really worried I wasn't following instructions (those pages of PT exercises)-- but the proof is in the pudding for me. I KNOW if I had done all those ridiculous exercises (there are even stair lunges in those pics!) I would still be swollen and miserable.

You've given "their" way a good try. I hope you will consider trying the Bonesmart way-- I am now a complete believer and will NEVER be threatened by PT again!


Shelia
RTKR - 8/23/16
LTKR - 9/20/2016
 
So I went to my PT appt today although I came close to canceling it. My knee was still somewhat swollen so I wanted them to see it to believe it. So they started me off on the elliptical bike for 10 minutes to loosen the knee up. As I pedaled she told me they talked to my Dr yesterday telling him I was only @ 70 on the ROM. I was then told I must reach 90 by my next appt or he will have to do MUA. I got kinda pissy and said you see my knee stays tight and swollen so how am I to bend it, also used the water hose analogy. I said how am I expected to get to 90 when my next appt is Mon? She said not your next PT appt but your next appt with the Dr. Boy did I felt stupid. Ok so that appt is Sept 23. We then proceeded with her massaging lotion on the entire outside of the incision which she said will help loosen up my extremely taunt tight skin. Then we did heel slides. At the end ofbthe session my ROM was 75. That was 5 degrees improvement. For once I feel like I accomplished something. I actually felt like I can get to 90 by my Dr appt in couple weeks. Came home and I have been elevating and icing for the past 3 hours. Felt good to get the leg elevated!
 
As many have told you I'll tell you, too. You do not have to have a mua if you don't want to. It's your knee and your decision only. You are the payer and their employer! Let that swelling get down and the rom will come!
 
When I was going to PT my ROM was not bad, but I took one week off when we went to the beach, I iced, elevated, I had a very low toilet seat in the room, so that was my PT for the week,lol. When I went back to PT, my ROM had gone from 105 to 120 in 10 days because the swelling had gone down, this was at week 5, I saw MY OS at week 6 and told him I didn't want to go back to PT and he said OK. Why don't you take some time off from PT, you can always go back. Give your knee a chance for the swelling to go down!!!
 
@sistersinhim You are correct, it is my knee and I ca not be forced to have a MUA. My husband said the same thing today. I believe I will not need one as I am going to get there in my knees own time. Once the swelling dies down the range will come.
 
You must log in or register to reply here.
Active Antimicrobial Hydrogel
Corganics CBD

Members online

Total: 929 (members: 1, guests: 928)

Latest posts

Back
Top Bottom