BoneSmart® Hip / Knee Replacement Forum
Joint Replacement Patient Advocacy
and Online Community
  1. RATE YOUR SURGEON ON OUR NEW JOINT SURGEON LOCATOR

    Your opinion matters so please click on this announcement to find out how to rate the surgeons you have worked with

    You could also go to the Surgeon Locator via the blue nav bar at the top - find the tab "Surgeon Locator"

    Dismiss Notice

[TKR] Physical Therapy - Very Discouraged

Discussion in 'Knee Replacement Recovery Area' started by Polly2, Jan 20, 2019.

  1. Polly2

    Polly2 new member
    Thread Starter

    Member Since:
    Nov 27, 2018
    Age:
    57
    Messages:
    1
    Gender:
    Female
    Country:
    United States United States
    I had a total knee replacement on November 15th. My first physical therapist was extremely aggressive. I sobbed through many of the sessions; starting therapy immediately after my surgery. It was horrible.

    After leaving my son's home 2 weeks after surgery, I moved home & had to change therapist. My sessions are complicated because I have developed severe tendonitis in both my ankles. I have pretty much reached full extension, but now need to reach more bend. My bend is good enough that I can sit at my desk all day without a problem and do stairs slowly.

    I seem to do better when I don't go to physical therapy but do normal activities. The swelling and pain always increase after therapy. The therapists all warn of the dire consequences of not continuing. I am going two days a week now and going to include one day in a pool on my own. My co pay is $30 so this is not cheap. Sometimes it just doesn't seem worth the time and money. Any thoughts?
     
  2. Jockette

    Jockette FORUM ADVISOR Forum Advisor

    Member Since:
    Aug 29, 2017
    Messages:
    12,568
    Gender:
    Female
    Location:
    Delaware
    Country:
    United States United States
    Hi and Welcome to Bonesmart!
    Every time I read an experience like this it breaks my heart. :console2:It is so unnecessary and does more harm than good, physically and emotionally.

    Physical Therapy can be helpful, but is not necessary to do in order to recover from a knee replacement. Not all surgeons prescribe PT. It all depends on their opinion about it. And there are many opinions. Which means there is not just one way to recover. Which then means that you get to choose how you will rehabilitate your knee.

    Physical therapy is an option, not the requirement we thought it was.

    Many people have not gone to PT but have used the movements within the normal course of their activities to rehabilitate their knee. It’s done as they are able, as they heal.
    These are all good accomplishments.
    They are wrong, many members here do not go to PT, some don’t even do ANY exercises :yikes: and yet they have excellent outcomes, because they weren’t overworked by their “therapists” which caused more pain, swelling and tendinitis. (I ended up with acute tendinitis in my shoulder, one week post op, clutching the table I was laying on, because my therapist slowly continued to push my knee to an excruciating level!)

    There are better ways for you to spend that copay money!
     
  3. Jockette

    Jockette FORUM ADVISOR Forum Advisor

    Member Since:
    Aug 29, 2017
    Messages:
    12,568
    Gender:
    Female
    Location:
    Delaware
    Country:
    United States United States
    And:

    Keep in mind, it’s not exercising that gets our range of motion back, it’s Time:

    Time to recover.
    Time for pain and swelling to settle.
    Time to heal.

    Our range of motion is right there all
    along just waiting for that to happen so it can show itself.

    In the general run of things, it doesn't need to be fought for, worked hard for or worried about. It will happen. Exercise as in strength training is counter-productive and in the early weeks does more harm than good. Normal activity is the key to success.
     
  4. Jockette

    Jockette FORUM ADVISOR Forum Advisor

    Member Since:
    Aug 29, 2017
    Messages:
    12,568
    Gender:
    Female
    Location:
    Delaware
    Country:
    United States United States
    I will leave you our Recovery Guidelines. Each article is short but very informative. Following these guidelines will help you have a less painful recovery.

    Knee Recovery: 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
    elevate
    ice
    take your pain meds by prescription schedule (not when pain starts!)
    don't overwork.
    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. Here is a week-by-week guide for

    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 the 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 the member’s history before providing advice, so please post any updates or questions you have right here in this thread.
     
  5. Pumpkln

    Pumpkln FORUM ADVISOR Forum Advisor

    Member Since:
    Oct 27, 2011
    Messages:
    20,411
    Gender:
    Female
    Location:
    United States, West
    Country:
    United States United States
    Sorry to hear your first PT was out of date, putting you through so much pain and upset.
    Sounds like doing your normal activities is all you need, suggest you will do better if you skip going PT.
    You have full extension and you can bend your knee enough to sit at your desk all day with out pain, sounds like you are doing very well.
    It is your right to say NO to physical therapy if it is not providing enough benefit and appears to be setting back your recovery with increased pain and swelling.
    It is always your right to discontinue PT if it is not helpful.
    Saying no to therapy - am I allowed to?
     
  6. sistersinhim

    sistersinhim FORUM ADVISOR Forum Advisor

    Member Since:
    Dec 4, 2015
    Messages:
    17,742
    Gender:
    Female
    Location:
    Virginia
    Country:
    United States United States
    Many of us never took formal PT or did exercises. I am one of them. I had 11 knee surgeries, 2 of them kneecap removals and 1 tkr. Even after those I never took PT. But, I didn't just sit around and do nothing. I took care of myself, my house and yard as my knee allowed me to do. As I healed, I did more. But, my knee was always in control! This was enough therapy for me and would be for any tkr patient. All the awful pain of PT is so unnecessary.

    All you have to do is use it in your daily living! Your knee knows how to rehab itself and doesn't need anyone telling it how. Just use it and it will come back like new! You have to be patient, though, it doesn't happen quickly! ADL,(activities of daily living), going to the bathroom, brushing your teeth and bathing, fixing a light meal, getting something to drink and or a snack, those kinds of things will be all the exercise your knee needs. If you just use it daily in your living, you can have a less painful recovery. We know what works, we've been there!
     
  7. Larryhg3

    Larryhg3 senior

    Member Since:
    Mar 5, 2018
    Age:
    53
    Messages:
    281
    Gender:
    Male
    Location:
    Connecticut
    Country:
    United States United States
    PT stories like yours make me sad and angry. There is no need to be put through pain in the name of helping you recover. PT should not be painful, discomfort is common, but pain is a no go for me. From your description you are doing well with every day activities. Many here don’t take therapy at all because of therapists like yours. If you can’t find a therapist that will use a less aggressive approach maybe walking away from PT is the right call for you. Regardless the wonderful people here will support you through this journey.
     
    • Agree Agree x 1
  8. Dolly Girl

    Dolly Girl junior member

    Member Since:
    Dec 22, 2018
    Age:
    66
    Messages:
    80
    Gender:
    Female
    Country:
    United States United States
    Oh you poor thing! You're doing well in spite of PT. I would can that immediately and use daily living and short walks as rehabilitation. Pool is great. Good luck!
     
    • Agree Agree x 1
  9. Denny39

    Denny39 senior

    Member Since:
    Dec 23, 2018
    Age:
    79
    Messages:
    274
    Gender:
    Male
    Location:
    South Carolina
    Country:
    United States United States
    I had LTKR December 10. I had firmly stated 6 years prior that there was “no way” that was gonna happen. But the realization that I was headed for a wheelchair made it at quality of life issue, and left me with no real choice.

    I went into it with no real fear or concern over the surgery itself, but with morbid dread of the rehab and recovery stage, because I had heard so many horror stories like yours. The first thing almost everyone said when I mentioned TKR was, “You be sure and do everything exactly as they tell you afterward, or you could be worse off than you are now”. And of course, I had heard a lot about how painful the PT could be. While I do not consider myself as being “Feint of Heart”, I readily admit to being a common, everyday, ordinary chicken, and I am not particularly fond of pain.

    I was very blessed to have had outstanding team, both surgical and recovery, working with me. I was also very fortunate in finding the Bonesmart forum (after my surgery). I read all of the articles that addressed my questions and concerns. Even with the excellent team I had, I still had to define some of my own limitations. Forcing pain causes swelling; swelling restricts movement and causes more pain. My PT’s respected my wishes and worked around them without letting me slack off. They did give me a set of exercises to go through twice daily. Those exercises were in line with the bonesmart guidelines of not putting significant force through the knee, but moving it and gradually increasing ROM. I have made very good progress, although it is still way below my original (uninformed) expectations.

    I am 6 weeks today, walking mostly without a cane, but still keeping it close. I still have moderate pain and stiffness in my leg, and I still have to fight the impatience and anxiety of not being back to normal and enjoying my new, improved, trouble and pain-free knee as soon as I thought I would. (I missed that guess by a long way!) I still, as many of us do, have major sleep issues. This takes time, and we’re all different in spite of having pretty much the same assortment of pains, wierd effects, and concerns.

    Hang in there. Hang on to “Little Victories”, those small but important improvements. You will get through this and be you again.
     
    • Like Like x 2
    • Agree Agree x 1
  10. Mom2Lucy

    Mom2Lucy senior

    Member Since:
    Aug 19, 2018
    Age:
    58
    Messages:
    277
    Gender:
    Female
    Country:
    Canada Canada
    Therapy that makes you person is cruel. If anything else made you person, would you continue to do it?

    I went once to physio and never returned. And I am fine, as I just saw my surgeon and his physio, 3month follow-up. Both were very pleased with my progress and ROM. Healing is the key to increased ROM.

    The “dire consequences therapists” warn about .... I think it’s their jobs disappearing as more people realize the therapists are largely not needed. And they don’t get paid without patients, so of course they’re quick to try and instill fear.

    And the pool is great, especially if you just go on your own and do basic exercises and walking.
    Listen to your body, BoneSmart, and tune out all the ”advice” swirling around.
    :console2:
     
    • Like Like x 1
    • Agree Agree x 1
  11. Josephine

    Josephine FORUM ADMIN, NURSE DIRECTOR Administrator

    Member Since:
    Jun 8, 2007
    Age:
    77
    Messages:
    84,910
    Gender:
    Female
    Location:
    The North
    Country:
    United Kingdom United Kingdom
    I'd really like to offer you some structured advice but in order to do that, I also need to ask you some questions. Are you willing for me to do that?
     

Share This Page