TKR Physio left me disheartened

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If you could get a 4 wheel walker would be the best. Using this type of walker allows you to regain your normal gait pattern. I stress to my population, one of the most important activities is to walk with a normal gait. An abnormal gait leads to problems in the hips and back.
Keep moving forward moderately
David
 
Thanks, David. That's exactly the kind of thing I intend saying to the physio tomorrow regarding the crutches. I think it's more important to learn to walk normally again, even with a degree of support, than to be all gung-ho and lurch around without them. Bi'm sure it'll pay dividends in the end.

Today has gone well so far. I slept well, had a couple of Paracetemol, breakfast, ice, etc, then later on had a shower and dressed...totally unaided. As I mentioned in an earlier post the clothes are being picked purely for comfort and ease of dressing at the moment, hence the fact that today I am resplendent in a pair of old shorts, a hippie-style top, and a cosy woollen cardigan that makes me look like a yak. All of this is set off nicely by some pink 'comfipumps' (worth Googling!). I've done my exercises and they were so much easier today. I wandered around, did a bit if tidying, lay back down, did some knitting and killed a few zombies on my iPad. Following a visit to my fish in our courtyard pond I am currently on the settee (leg elevated) watching rubbish on TV. So far, so good...
 
Hi @Lizzie Pearson - sounds as though you had a good day! I particularly loved the description of your clothing choices :heehee:. I used to do the same thing .......... the worse the outfit, the more likely a friend would drop in unexpected!

Sorry I said 'Hello' and then dashed off, but I was en route to the second trip to IKEA in 2 days. A circuit of IKEA is a workout in itself.

On the crutch debate - I had a zimmer (no wheels) for the first 48 hours in hospital. Home with 2 crutches and a warning not to even attempt to 'fly solo'. Once I could go round the block with 2 crutches, I reduced to doing it with just the one. (BTW I hated just one crutch I felt very uncomfortable and lopsided). If my memory serves me correctly at about 5 weeks my physio told me to ditch the crutch, as evidently I was 'flapping it around like a handbag and not using it'. I was told that it was important to get the gait right, before losing the aids.

Thankfully, I was able to leg lift quite soon - but when I had my first op in my 20's I had big problems. We solved it similarly to the way David suggested. The physio helped me raise the leg and then lessened her support until I was holding it there on my own. She then told me to lower it by a few inches, then raise it by a few, and kept doing this - all the time her hands there ready to take the weight of my leg. When my muscles were giving out, I started to wobble and she helped me lower my leg slowly to the bed again. Soon I could lift easily on my own.

It is my experience since having the replacement, that you are not told in advance quite how long and involved recovery can be. I was told I would need an early TKR when I was in my late 20's - and I have 'made do' ever since, with things slowly getting worse and worse. My surgeon has been treating me for some time and knew the chequered history of my knee - but even he didn't say anything pre-op about slower recovery or limitations. It was only after the op that he said I had to take things 'slowly and gently' and not rush things or overdo. That it would take at least a year to recover. That 120 degrees ROM would be a good result for me, given the state of my knee pre-op (no kicking my rear with my heels!) My physio then told me that previous trauma often caused more difficult recoveries than arthritis alone - and my recovery had not been expected to be straightforward.
Personally I would have preferred to have known all this beforehand, so my expectations were not as high or as great - but then that's me and I realise that everyone is different.

I have told several folk on here that I did my exercises 'little and often' by associating them with certain things. Eg Each time I sat on the loo I tried to bend my knee as far back as I could; when I passed the stairs I did a few lunges; waiting for the kettle to boil I balanced on one leg, stood storklike and bent the TKR raising my ankle as far as I could; in the morning and last thing at night, I'd sit on husband's desk and dangling my legs, try to bend the TKR as far backwards underneath as possible (OS's favourite bending exercise). I would do heel slides all the time the adverts were on TV. Before getting out of bed in the morning I would do 10 heel slides and 10 hamstring curls (I still do this). It worked for me, and didn't mean dedicated sessions of multiple exercises and multiple reps.

Soon you will start to notice little things that are easier to do, every day in every way you will get better and better, you will start to do things without thinking and then think .......... I wonder if I could do -------? You try and you will find that you can!

Take care
XX

PS - BTW - I have Devon affection by proxy. My daughter did her first and second degree at Exeter Uni - she loves Devon with a passion!
 
I used a walker for the 1st 4 weeks - OS orders. Then moved to a single forearm crutch and then quickly to a cane. My gait has always been good & I have the heel-toe walk down pat after the BTHR. Each OS is a bit different, mine was adamant about 4 weeks on the walker then progress as I saw fit based on my walk pattern.

And to your question of age - my 87 year old mother had her 2nd TKR in January, 2014. And she did waaaay better than me! My OS told me it was cuz she was older with looser ligaments, muscles, tendons etc. But her swelling receded in 5 weeks and her flexion is better than mine will ever be!
 
Dog wheels, your post made me giggle, especially the bit about sitting on the loo because I do exactly the same! Then when I come downstairs and sit on the settee, which is quite low, I slide my foot up and down on the laminate floor!

I'm doing ok now with the leg raises...I do them morning and evening, but in between I'm letting that leg down gently over the side of the bed, and supporting it a bit less each time when I move it off the settee (which is quite low). As I said before I have dozens of stairs in my home so that's constant practice. It's gradually getting stronger.

And...this afternoon I realised that instead of sitting with my leg rigidly out in front of my, it was bent! Not a lot, admittedly, but comfortable, and a definite bend!

I live about 60 miles from Exeter...which is lovely, but we occasionally go there by train for a shopping fix!

Dtmbf: that's made me feel even more convinced I'm doing the right thing with the crutches, so thank you. I do the heel/toe thing ok, and it's more convenient to use one crutch round the house with all the stairs, but my gait is far better with two. I think it'll be another couple of weeks or so before I graduate to one crutch or a stick outside, and I'm comfortable about that.
 
One thing that has struck me is that most people on this site appear to be in their 50s and 60s, yet many people a decade or two older at least have hip and knee replacements. In my opinion I just can't see how most elderly people will be able and/or willing to focus on a recovery programme...or am I being a bit harsh?

My mother had both knees replaced, one in her early 80s and one in her late 80s. She did very well both times. She didn't seem to have any problem using crutches, although she didn't use them for very long and she refused to use a stick, saying that they were "for old people!" She made a good recovery. Although she wasn't at all athletic, she was able to take part in stage performance of her "golden oldies"choir.

I'll be 73 next month and I'm having my second knee replaced next week. I think I'll be able to focus OK.
I hope to recover well, as I intend to continue travelling - my daughter lives 36 hours' of travelling away and I want to visit her every year. I'm still pretty active. Although I don't go to the gym, I run a household (and organise a husband) and I still do a bit of gardening.
 
Wow! Your mum sounds just like mine! When, a couple of years ago we started trying to get her to use a walking frame because she'd started having falls, she replied that she wouldn't because they made people hunch over them and people would think she was old. She was 92 at the time, and has only just agreed to use one!

I love gardening and I was really struggling before my op, so am hoping to get back into that properly soon. I also like swimming, so as soon as it's ok I'll start that again too.
 
I hated the walker from the git go----it was ugly and I had to pick it up around corners!! The nurses at the hospital made me use it, so I dragged it along behind me. When I got home, I got tired of carrying it around and used it for one hour or so!!
 
Well, I went to physio, and I have to say it went well! I saw the same man as last time and when he asked me how I was, I said that in my opinion I was doing ok, though he may not think so! I then explained my reasoning behind use of the crutches...and he seemed to understand!

He checked the bend and announced that it was: 'brilliant' and that I'd obviously worked hard! Apparently the bend was 50 degrees last week and is now 70 degrees! Still some way to go, I know, but it's only four weeks since the op and as he said if I keep making that sort of progressI should be ok. I reminded him what he said about surgical intervention and he smiled and said he now thought that was unlikely!

He also seemed surprised and impressed that I am doing so well with the leg raises and heel lifts...especially as I could do neither a week ago. We talked about how to increase them and he seemed happy for me to decide whether just to add lifts or do repetitions of ten...I'll probably do the latter.

I don't have to go again for two weeks, and then he expects me to 'graduate' to the Friday afternoon 'knee class' which involves cycling, etc. He also said I should be ok starting swimming again.

So, all in all I'm pleased. My advice to anyone feeling bullied by their physio would be to listen to your body, do it the best way you can in order to see results, and be politely firm about what you're doing and why. It worked for me!




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Hi @Lizzie Pearson - so glad your physio appointment was more positive this time and more encouraging to you. I was going to physio weekly and was told that all they wanted to see was a constant forward progression, even if it was only by a couple of degrees. So I am not surprised that your PT was pleased with what you have achieved.

Further down the line, those stairs will be your exercising friends. On one of my final PT appointments I asked if I should do 30 mins on the bike each day for stamina and for the knee. She told me that 3 lots of up and down stairs 'properly' (not 2 stepping the stair) would do me more good. So you will have a daily workout just walking around your house!

Take care and hope you have a lovely weekend.

XXX
 
Thanks, both! Funnily enough, a couple of years ago we moved away for eighteen months and lived in a bungalow, whilst renting this out. When we came back we could hardly walk for a couple of weeks as we'd got used to having no stairs! It's like having our own private gym!
 
Dog wheels, your post made me giggle, especially the bit about sitting on the loo because I do exactly the same! Then when I come downstairs and sit on the settee, which is quite low, I slide my foot up and down on the laminate floor!

That was my main exercise for bending, too! My bathroom floor has squares marked on it and I would try to pull my foot back to the next square.
 
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Well done @Lizzie Pearson !
I'm so glad your physio appointment went well. :yes!::yay:

You're experienced enough listen to what your own body needs and there are no prizes for getting rid of crutches too early. Use them until your walking is balanced and then wean off them gradually.

Who knows? Your discussion with the PT may even have made him a little more understanding .

Hats off to you! :cheers:
 
He was certainly a bit more smiley than last week!

Who'd have thought that bathroom floors could be so useful?!
 
We are all proud of you. You have to respect healing. Cycling usually requires about 100deg of flexion, just a FYI. When the body feels things are safe, you will be able to do more activities.
You are on your way to an improvement of quality of life.
David
 
Really? On, thank you! I suppose I'm just stubborn really! Every day I can see an improvement, however slight, so as far as I'm concerned it's working. One thing I am convinced of is that resting is at least as important as the exercise, and it's now getting quite productive in terms of reading, knitting, sewing, etc!
 
One thing I am convinced of is that resting is at least as important as the exercise, and it's now getting quite productive in terms of reading, knitting, sewing, etc!

Now you've got the right idea!!!:yay:
 
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