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Outpatient PT at 3 weeks

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dw6928

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I am rehabbing my 2nd TKR (8.26.08). I was released from rehab last week and was prepared for at home PT for a couple of weeks prior to the rigors of outpatient PT (that was the set up on the first knee). My OS feels that at home will be a waste of time and any good rehab is done in the facilities of a good outpatient (equipment, better physical therapists etc). I am just a bit leery of starting outpatient at only 3 weeks out. Any one with similar experiences at 3 weeks? ww
 
ww,

I had BTKR starting with the right knee on Aug. 25 the left was on Aug 28 but had to have re-surgery on 4 Sept.. I was released (escaped) from the hospital Sept 8 and my first out patient PT was Sept 10. Nothing to it, just take your meds a hour before hand and you'll do great.

God Bless,
Rick
 
what kind of exercises did your therapist use that early in your post-surgical recovery? when I had the first one, I was at 5 weeks and they went full tilt
for flexion and rom plus weight machines. I can't imagine that happening this early.
 
Wayne,

I came straight home from the hospital both times. The first time, I had in-home PT for 2 full weeks and though the therapist was good, I felt that I wanted things more aggresive the second time around. I went to outpatient on day 8 after my second surgery and felt this was a much better way to do it. It got me out of the house and moving much faster. Just getting out of the house will raise your spirits, that is, if you don't overdo it and walk all over the city!!! :D Karen
 
ww,

The exercises you do depends on your ROM in both Knees. After my first surgery I was on a CPM and when I left the hospital my right knee was at 95 degrees my left was only at 60 degrees but that was because I had to have two surgeries on it and it set me back, plus I had to have five (5) units of blood between my first and second surgery on my left. Now at PT I do quad exercises and passive ROM and use the bike just rocking my left knee. I have 86 degree ROM in my left and 106 in my right after three (3) out patient PT. I also have a CPM unit for home which helps me greatly.

Rick
 
I started outpatient PT at 2 weeks. I did leg lifts in different positions, had a thera-band around my knees and pulled them apart, rocked the bike pedals back and forth, the therapist worked on my developing scar tissue, and then I had e-stim and ice. It was great, actually.
 
Wayne,
I had my RTKR on Thursday July 3, came home Monday July 7th and
went for my outpatient rehab eval on Tuesday afternoon. Therapy started
the very next morning. At first it was just trying to do straight leg raises,
(I could not do those until the next week after he put a tens unit on my leg and woke up those quads). If I remember correctly, my therapist had me hang my leg off the side of the table, and gently kick my leg out. There were other exercises I did while on the table, but after my staples came out, I was moved to the machines, doing squats, stairs, treadmill etc.... not all at once, but in due time.
Like Rick said, alot depends on your ROM.
Best wishes to you in your PT.
 
I never had PT at home, and I had my first outpatiend PT on the third day I got home from the hospital. I did really well and only had to go to PT a total of three times. I, quite frankly, was amazed that people got in home PT. I guess it is nice to be able to go that route but as long as you have someone to drive you to PT I can't see any reason to have someone come to your house. The first visit at PT which was nine days after my BTKR I was put on a stationary bike that you had to get up to a certain speed before it would even register time and I had to do six minutes. Took me about 15 minutes to get the six minutes done but I did it. The second visit, five days later I had to ride the bike longer and they put me on a squat machine, (probably not the correct name) and I had to do three sets of fifteen. That on top of all the other exercises. I was wondering if having someone come to your home was something that was dpne in some areas or if it just depends on your surgeon or insurance. Either way I did fine. Hope this helps. Rowdy
 
I am stunned that you were able to do a full rotation on a stationery bike after 9 days! You were way ahead of the learning curve on that one. Well done.
The down side of in home PT is the lack of equipment. You can't compare your living room to a fully equipped PT center. I have the CPM flex up to 125 and am walking unassisted, can do full squats and leg raises but the stiffness above the knee (the cut quad) and the outer side of the knee is most uncomfortable.
And I would give my kingdom for one night of 8 hours of sleep; how about 2 hours! Thank you everyone for your insights and concern. This is why I came back to the forum having learned so much with the first TKR in January (those famous Winter Knees Group).
 
Wayne,

I came straight home from the hospital both times. The first time, I had in-home PT for 2 full weeks and though the therapist was good, I felt that I wanted things more aggresive the second time around. I went to outpatient on day 8 after my second surgery and felt this was a much better way to do it. It got me out of the house and moving much faster. Just getting out of the house will raise your spirits, that is, if you don't overdo it and walk all over the city!!! :D Karen

Karen,
The city walks are on hold until my PT assesses my "situation". Only today did the stiffness and swelling begin to return to where I was before the walk. The horrible hematoma on my ankle which was causing me to fear some clots has disappeared. I am still going for a Doppler on Wed, just to add some additional billing and testing that may or may not be necessary. I am out of the house at least 3 times a day, in the car, out with the dogs (backyard) or doing some light gardening.
 
Rowdy, having read your post about your success on the stationery bike so early after TKR, I figured I would see if I could get any rotation at all. Lo and behold, I was able to do full rotations! I guess using the CPM at 110-125 degrees has really increased the ROM. It's the small things in knee recovery that delight us. It made my night.
 
ww,

Way to GO!!! I can hardly wait until that day comes when I can get the wheel to go round and round. You are on your way, GREAT JOB!

God Bless,
Rick
 
Thanks Rick. I think I overdid it a bit yesterday on the CPM and in-home PT. I really "ripped" the notorious area above the knee where the quad was resewn on the CPM (which in turn allowed me to "go round and round" later in the day.
The downside however is a bit of stiffness today. I will lower the ROM angle on the CPM today just for stretching. I don't want to be stiff for my first out patient PT tomorrow.
 
Today is my 7th week from rt tkr.(7/29/08). I was dc'd from hospital post day #2 and then had 2 weeks of home PT. I then started with outpt therapy. I agree with your doc regarding home health at this point. You will not get any benefir at this point. I am also an RN and Discharge Planner at my hospital. At home you would just be given exercises like quad sets etc. You should be ready for much more. Good luck.
 
Although I hate the stationary bike, I have to admit that for my first 4/5 months of recovery, it was my best friend. Start with the seat high and just keep lowering it.
 
I think I am going to use my TENS machine today on the sore/swollen areas. I am getting minimal relief from any of the over the counter ointments and my beloved Solaraze gel is running low. I have trouble stretching 3 tubes over an entire month. Well, 3 weeks ago today I was on the surgical table so things are definitely on the upswing.
 
Gosh, DW, you are only three weeks post op, you are doing great. Glad you could manage a full rotation on the stationary bike. I had no idea so many had problems making a full rotation. When I went to pt the first time the way the therapist acted I thought everybody could do it and probably a whole lot better than I was capable of doing it. I was amazed that they weren't happy that I could make a full rotation, I had to make it so that the bike registered a certain speed or no time registered. Like I said it took me about 15 minutes to get 6 minutes to register. I was so pi$$ed and in so much pain the rest of the visit was a blur other than the therapist being consoled several times for losing her partner and worrying about if she was going to lose her house. While I empathized with her I did feel as though my therapy was taking a back seat to her emotional turmoil and it remained that way throughout the three weeks I went there. I didn't have a lot to say because I felt that I was in an emotional state myself and may regret it later. In retrospect I am glad I didn't add to her pain and her turmoil, I ended up okay and am almost back to normal. By the way I am really impressed you got on the bike after having a workout with the PT. Glad you could make a rotation. Doug, once again, gave the best advice, and what he described is exactly what I did. Now I can sit in the same position my husband sits at so he doesn't have to adjust the seat any longer every time he rides the bike. Keep up the good work and good luck. Rowdy
 
Guy's I have question for you at what Rom are you capable of riding a recombant bike? I would love to start doing this but it appears to be so far away??
 
I don't know the origin of the TKR expression: 3 days, 3 weeks, 3 months but
today is 3 weeks since my TKR (#2) and it is the worst pain day since the first week. Perhaps my mobility has increased so dramatically that I am up and down and sideways a bit too much for the baby knee and the sewn ligaments and muscle that surround it. I can clearly remember how much better 3 months felt.
I am going to tap my PT tomorrow to stretch some of this aching stiffness out of my leg. I have it badly today above the knee, on both sides of the knee and, this is a new one, to the right side of the thigh, directly alongside the quad muscle of the right leg. That spot is killing me. No ice pack I can devise is denting the ache.
 
That outside of the thigh thing is a demon. For many of us, it the infamous IT band. Deep tissue massage helps. I also think muscle relaxants help. Sometimes those operated muscles just knot up and won't let go!
 
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