Physical Therapy

[yukismom]

How soon did everyone start their pt? I have exercises that they gave me to do in the hospital but mt first appt. with pt is on Dec. 3. Isn't that sort of far is or is that OK? Just wondering if I should call the doctors office to complain?

 

[Josephine]

yukismom, can you keep your questions all in the one thread? It makes for continuity of your story when new members and guests are reading. I'll leave this one but if you could keep it all in one place it would be so much better!

As for the PT, it's not uncommon for surgeons to prefer people to have 3 weeks 'off' to commence recovery from the surgery before starting PT. There's no rush to get to it and it gives the swelling a chance to settle and for you to get to grips with the pain management.

Just do your heel slides, foot rotations and ankle pumps in the meantime, plus a little walking around the house. That will be quite enough to start off with.

 

[Tykey]

Just do your heel slides, foot rotations and ankle pumps in the meantime, plus a little walking around the house. That will be quite enough to start off with.

Many people don't even bother doing anything more than this and still recover very well. Rushing into PT might even delay recovery, so don't worry you are missing out on something important.

 

[loribee59]

ice, ice, ICE that knee! icing is the key to successful PT. it keeps the swelling down so you CAN bend your knee.

I started PT about 2-3 weeks after my revision, but when I had my right knee done last year (2009) I had home therapy a week after my surgery, and then graduated to regular PT. I'm now doing pool therapy independently at a therapy place and work out my knees at my own pace.

everyone is different...but make sure the focus is on stretching the knee, not on ROM or numbers!

good luck!

 

[REK]

I guess everyone and every doctor is different. I had my knee done on a Monday with some PT in the hospital. I was dismissed on Wednesday and started my outpatient PT on Friday. I had three full months of PT three times per week. The therapist started out quite gentle but soon the therapy became more aggressive and more time exercising with walking, etc.

 

[jerseychick]

I had my LTKR on June 9th and I started with in-home PT the next week for about 2 weeks and then started out-patient PT 3 times a week for 3 months. Then PT twice a weeks for 2 months. I "graduated" from PT three weeks ago and now I am back in PT for a torn rotator cuff in my shoulder. If it is not one thing it is another! :shk:

 

[Josephine]

Last chance to do the forum survey
If you haven't done it, please do it now
It will be gone by Monday​

 

[kneesrus]

Hi Yukismom,
Starting your rehab on 12/2 is not late. You have to heal. You can be helpful on the recovering by working on obtaining full extension. The most important motion to achieve is extension. Why? Because this keeps both legs the same length. If the knee has flexion in it, your legs will not be the same length, cause you to limp more. The second most important element is swelling. ICE and elevation. The reduction in swelling will allow your knee to bend more. I like my patients to ice for 15min every other hour. If you can take charge of those two areas, hopefully you will have a better recovery.
Best of Luck,
David

 

[Josephine]

I like my patients to ice for 15min every other hour.

Is that all? At the start, I iced about an hour every other hour.

 

[kneesrus]

Hi Josephine,
Too much ice causes a reverse reaction. Your body will protect against frost bite, so it tries to help the tissues. Just is the same for heat, too much heat is not good for the physiology. Everything in moderation.
David

 

[Josephine]

Oh I know that, my friend! But I can assure you it never got anywhere near frostbite. At first the ice wrap had a towel underneath and wasn't applied directly to the skin until it was nearer just being cold!

 

[skigirl]

Jo, I iced for 15 to 20 minutes every hour and a half or so. I think too many people put emphasis on the ice and not on the elevation--which I think is so important in those first two weeks. Keeping that leg elevated helps the swelling resolve more than anything else--in my opinion.

I think that you can see that there is no consensus on what docs recommend after this surgery. I had my surgery on a thursday, started pt the following Monday. I always went to outpatient pt--but, I like the gym and spend a lot of time there, so it was natural for me to want to go to the gym.

I think that iin the first two weeks, it is more important to work on the swelling than to worry too much about pt. If you do the exercises from the hospital, that keeps your knee moving and helps to prevent clots (ankle pumps) Kelly

 

[yukismom]

Just wondering how much movement you had when you first started PT? I'm knee is nice and stiff and bending my knee hurts like the dickens!! I need to take my time and slowly bend my knee. Just wondering if that is normal? I am doing my exercises but still, can't really bend my knee.

 

[Tykey]

You sound absolutely normal. I could get 90deg when I left hospital, which soon got worse for a week or two, perhaps to 80deg. Stiffer and sorer as well!

It slowly improves over a few weeks as the swelling reduces and the healing improves. That's why rushing into PT isn't the thing to do, because it makes the swelling worse, not better.

Stop worrying

 

[Josephine]

Gal, you are not even two weeks out yet, it's going to hurt. But ...................... if it hurts, take your pain meds!

Jo, I iced for 15 to 20 minutes every hour and a half or so. I think too many people put emphasis on the ice and not on the elevation--which I think is so important in those first two weeks. Keeping that leg elevated helps the swelling resolve more than anything else--in my opinion.

Oh for sure, Kelly!

For all the readers out there, when we say 'ice' we also, by definition, mean elevation as well. Not one without the other, okay?

I think that you can see that there is no consensus on what docs recommend after this surgery.

Kelly, if I ever heard two docs coming to an agreement about anything I would pass out cold!

 

[yukismom]

I try to ice and elevate but it hurts. From the first day home, I complained to my doctors office that the front of my shin would hurt whenever I tried to elevate my foot. My leg was so wrapped in so much padding at first that no matter how much ice I used, I couldn't feel a thing. Even now, whenever I have my brace on, I find that it is hard to feel the coldness from the ice. Of course, half of my knee being numb from the incision doesn't help either. So, I do elevate and ice but not as much as I probably should.

 

[Josephine]

Which hurts? Icing or elevating? And are you elevating with the brace on? That's tough. Can't think what to suggest for that.

 

[Tykey]

Having a brace on seems most unusual, I only used one on day 1 in hospital, until I proved I could get to the toilet without falling over.

Are you sure you need it?

 

[JCCHASE]

Hi: Some rhetorical questions for both you and your physician.

Why are you wearing a brace at all? I wore a brace until the femoral block wore off, then never again.

Why is your incision bandaged so heavily? Except for immediate post-op, mine was never bandaged.

Elevation results are best achieved by putting your leg on a big pillow so that your knee is higher than your heart.

For icing, I used frozen peas in 3 separate baggies - one for each side, one on top - with a cloth towel between skin and ice.

In your recovery, try to stay calm, take your medication and if your are still in pain, ask for more. The control of pain is essential to recovery because this is a painful operation.

Also, your recovery is your recovery meaning that it is unique to you. Don't worry about where you think you should be, but where you are! Do a little bit at a time, rest, relax and let yourself heal.

Take your meds on time, rest a lot, elevate and use ice to help reduce swelling. Soon enough, you'll be feeling much better and so glad you made the decision to fix your knee with a new one.

Good luck!

 

[referee54]

I, too, am interested in you brace...I had a BTKR and no braces on either leg; however, different doctors have different protocols. Make sure that you are taking you pain meds---as Josephine and others have said, if you take them when you are in pain it is too late. Make sure that you communicate your pain to the ortho so that they can possibly adjust your pain meds accordingly.

As stated in the previous post, your recovery is simply that---your recovery. We all heal and rehab at different rates and at different times. When I started mine, I had very little movement. The in-house PT's at the hospital had me simply doing heel slides and other stuff; your major gains will come when the swelling goes down.

I purchased several large re-usable icing packs---about 11X18, I think---others use bags of peas or Cryo-Cuffs. To each, their own; whatever works is truly what is important. Icing is very important in reducing swelling. Hang in there, these early rough times will improve.

Tim C.