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TKR Patience Is A Virtue

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I am glad you spoke up for yourself. If they ever do not listen it is technically an assault. Not that you want to have them arrested but it is a fact that if you do something a patient does not want and says no = it is assault. They are full of themselves and not really interested in learning.
 
I am so confused now. I really appreciate everyone's advise. But all 3 of the therapist in this office is saying opposite. Maybe I should talk to my doctor.
 
It wouldn't be a bad idea to talk to your doctor. I think sometimes the challenge is that PTs think when you say you don't want to be hurt, that you don't want to do your exercises at all. :(
 
sanflo1309 said:
I am so confused now. I really appreciate everyone's advise. But all 3 of the therapist in this office is saying opposite. Maybe I should talk to my doctor.
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That's quite possibly due to them all being trained by the same source, or read the same book. I thought these thought went out many years ago, the world has moved on without them.
Nobody here is saying they shouldn't be helping you to bend your knee, but FORCING your knee to bend further than it is able is the issue. There IS a possibility of adhesions building up which would cause long term restrictions to bending. We do see this on here from time to time, but this seems to cause problems with only a very few who seem prone to this problem. If this does turn out to be a problem, then it is easily solved by forcing the knee to bend and breaking these adhesions ie an MUA (Manipulation under anaesthetic). That's an easy painfree successful process, normally carried out after about 3 months, if a problem actually exists.
The issue with your PT's is they seem to assume EVERYBODY will need it at some time, so do it to everybody WITHOUT anaesthetic, and at a stage before your knee has healed enough both to heal and probably form adhesions.
So what is being recommended on here is to allow the knee to heal, and only if adhesions are a problem, then do an MUA after healing has taken place.
It's the fact that they do it to everybody, regardless of need which is the issue.
I would talk to your doctor, and ask him to find a team of physiotherapists who have kept up to date.
 
Its entirely possible the doc would agree with the PTs, though. That still wouldnt make it right for them to hurt you.

I had wonderful PTs who spent a lot more time reining me in than pushing me. Its TRUE that they bought into the "window of opportunity" myth that says there's only a finite interval early in recovery to reach desired ROM. It's true that I was pushed just past discomfort more than once. It's also true, though, that they never HURT me, always stopped when I said stop, and were happy to discharge me when I reached MY goal for my ROM, which was to have enough bend to get on my horses from a mounting block and ride without difficulty. I was still shy of the 130 bend they wanted for me but that was fine by them. I was done with PT roughly 5 weeks post op, if memory serves.

Its also a fact that surgeons dont necessarily know squat about physical therapists and their qualifications/training. My very own OS, who I LOVE and who I consider to be a good doc, was completely baffled by my PT's 2 week report to him, not because of content, but because it was signed Joe Blow DPT. Neither my OS of the medical student tagging along after him could figure out what DPT stood for. I informed them it meant Doctor of Physical Therapy--they had no idea PTs have PhD level education in order to be licensed.
 
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I love my surgeon also. He is excellent. So I will talk to him on Monday. What I will share with him is that I am not disagreeing with their exercise just the forcing of bending my knee. I have read most on the articles provided on this site which gives me insight on my situation. If my PT could have provided an explanation that made sense about the process I probably would have continued. But as I explained to her it was out of her mouth that my knee was not bending because it was swollen due to the surgery. So if that is the case why are you trying to force it to bend? They are hurting me. I originally had a in-home therapist that I believe I was making more progress with. However, my insurance would not cover it after 2 weeks. He got my ROM up to 95 without killing me. So we will see how this plays out. I am so glad I found this site. If I hadn't I would be suffering undue torture for a lack of ignorance.
 
Good luck with your surgeon, but don't forget to ask yourself if you actually want/need ANY physiotherapist. You really DO get normally get better without them as long as you do your home exercises.
 
sanflo1309 said:
my PT told me this was going to be a painful recovery
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Yes it is but there's no reason to make it even MORE painful!
sanflo1309 said:
They were not happy when I told them no stretching the knee today.
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I bet they weren't. But it still remains that they never had knee replacements - we all did! We know whereof we speak!
sanflo1309 said:
I need to read up on the scar tissue issue and what to do to avoid or eliminate it.
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Trust me, you don't have 'scar tissue'. The only reason there is difficulty is because your knee is SWOLLEN! You are also only 4 weeks out which is far too early to be talking about 'scar tissue' (adhesions).
sanflo1309 said:
I am so confused now. I really appreciate everyone's advise. But all 3 of the therapist in this office is saying opposite. Maybe I should talk to my doctor.
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Please do. Your PT's have it so wrong. Did you read the articles Tim left you?

Especially these
Myth busting: no pain, no gain
Swollen and stiff knee: what causes it?
So What Is It Going to Take? The Five “P’s” of Knee Recovery
Work “Smarter” and not “Harder”
 
Thanks Yes I have read the articles which have been very helpful. I have spent this weekend keeping my knee elevated, iced and resting. I am doing my exercise at least once. I have notice the swelling is subsiding. I am lightly bending my knee back. I notice it is slightly stiff in the morning but as long as I move it gently it loosen up.
 
Good job doing the gentle movements to regain motion and the icing/elevation to get the swelling down. I found the pretty constant icing/elevation and gentle motions worked for me for both times when both knees were replaced. Keeping the swelling down enabled me to get the motion I needed without real pain. Lee
 
I spoke to my doctor today. He had knee replacement last year. He went through the same process and explained he ended up being tortured eventually. He did offer to send me to another therapist unfortunately my insurance won't cover it. So he is going to talk to the PT that is handling my case about the exercise that is causing me the most pain to back off and gradually work up to it and we wil
 
sanflo1309 said:
Is there anything I can do when I get up in the morning with my knee being stiff?
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Not really, just get on with life. There is another thing, not go to any PT again, and just let nature take it's course.
Time, patience and the body's own healing mechanism are all you need.
 
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I usually just did a few gentle heel slides to "warm up" before getting out of bed. But overall it just takes time.
 
I was the opposite---after I went back to the classroom, my knees felt great in the morning but would slowly stiffen up during the day---they teased me for a while!
 
Thanks I am know experiencing lower back pain. I know it is probably the way I am sleeping. I am a side sleeper but have had to sleep on my back so I can keep my leg elevated. So I re-read the article on the proper way to elevate. I saw I had my pillows wrong so I am trying it the right way. I have regulate my pain meds to 1 5mg narco every six hours. I am still going to Pt but they are more gentle now. I have one more strip to fall off of my incision. My PT did recommend the amazing ointment for the scar Aquaphor. I have been using it in the area that has been exposed early and it is good for dry skin (my feet). This is a journey so glad I have someones :thankyou: To share it with.
 
sanflo1309 said:
I am so confused now. I really appreciate everyone's advise. But all 3 of the therapist in this office is saying opposite. Maybe I should talk to my doctor.
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Many PT's unfortunately, treat a TKR or a BTKR recovery the same way that they would treat an ACL or some type of athletic injury.

The truth of the matter is that a TKR surgery/recovery is very, very different than an ACL recovery or an athletic injury, and needs to be handled quite a bit differently.

This is not a case of the familiar, "no pain, no gain," but rather, "no pain, more gain." "Less is more" and it works better for a TKR recovery. It is not, how hard one works; it is how smart one works.

I was lucky---there were two sets of PT's where I went; one worked with athletic-type injuries and one worled with joint replacements. They never crossed over to the other type of patients.
 
You can try sleeping on your side. I did by about 4wks and actually found it more comfortable especially if I turned so the operated leg was the one closes to the mattress and the other knee a bit forward of it or a pillow between the two. If I elevated and iced before going to bed and even if I started the night on my back I would turn on mys ide after a while. It was a nice break to sleep on my side and since I rarely slept the night through anyways, the next time I woke up and if my knee felt swollen I would turn on my back again but if not and I was more comfortable on my side I would stay on my side. It was heavenly after a bit to be able to change positions to be on my side. It was easier turning like a log with the operated knee the one closest to the mattress so there was no chance of twisting. Lee
 
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