TKR Post op ROM

[Jaycey]

@mog So sorry you are in pain. But I guess now you know what forcing that knee does. We can't make the decision for you but option B sounds a much more reasonable approach to me.

anybody else had oseteopathy and or accupuncture

I did post LTHR as I had some spinal issue flare up. It was great. Gentle manipulation and for me the acupuncture really worked. Let us know how you get on.

 

[Helizabug]

Well, today, I agreed to an MUA, but I have a very clear idea of why I want to go ahead with it. If I wasn’t missing this one, important part of my life, I think I would have said ‘no.’ I really believe that gentle work, mindful of our own knees is the best way. It appears to have worked for so many people on BoneSmart.

By the way, there is an intermediate step between not saying anything and saying ‘no.’ You could ask more questions, right? You could clarify your goals and ask that surgeon consider those — though that ‘window of opportunity’ theory might make such a dialogue more complicated with some surgeons. Let the surgeon know that you’re in this for the long game, you can be patient in exchange for less trauma, that sort of thing.

Good luck figuring this out. I definitely feel a lot of relief because I feel some clarity around why I’m opting for the MUA.

 

[Celle]

yesterday tried gently stretching on exercise bike and made a massive mess up somehow managed a complete revolution!!!! OUCH looking at left leg i am guessing around 110 deg. movement. After ice ect. seemed upset but could still walk and bend a little further. Today swollen and painful to walk on and bend

@mog - It sounds as if what you did on the bike was what we call an MWA - a Manipulation Without Anaesthetic.
It forced your knee to bend further than it was ready to bend. Now you're experiencing the result, unfortunately.

An MUA would force your knee to bend even further and the pain and swelling you would experience afterwards could be worse than you have now.If it were me, I'd tell the surgeon what happened, how you could bend your knee further, and how much pain and swelling you now have.
Tell him that you'd like some more time, to see how your knee is after that event, once the swelling has gone down some more. You never know, you just might have increased your ROM a bit, even if it was by accident.

Say you'd like at least another month before making any decision about an MUA. There's no time limit on when an MUA can be done, even if your surgeon tells you there is.

You have plenty of time to achieve ROM, since it can continue to improve for at least a full year post-op.

 

[Roy Gardiner]

tried gently stretching on exercise bike and made a massive c%$k up somehow managed a complete revolution!!!! OUCH

Move the saddle on the bike up so that you are only pedalling with your tip-toes and can barely reach the pedals, then try again. You may well be able to make a revolution without pain, but do press gently. You may find pedalling backwards gives you more control.

 

[mog]

Thanks for all the input. Good luck Helizabug fingers crossed for you.
Celle MWA we have to laugh(after we have stopped crying in pain)

Roy Gardiner it is a cheapy bike so i have got a floor one- bloody brilliant a lot safer(best £35 spent for a while).
I had my meeting with OS and got 90 degrees . But now have 3 weeks to get 100 degrees !!! so lots more GENTLE exercises and i WILL get there, i think i did get my point across that NO mua i am going forward only NOT backwards(i hope).

 

[Helizabug]

Well done @mog! Just keep at the ROM gently, and you’ll likely get there your way.

 

[mog]

OMG just got back from consultation with surgeon and fuming is putting it mildly! Great start waiting for over an hour to be seen(i know the NHS is stretched an accept some wait) only to be greeted with oh you can't bend enough I AM DOING AN MUA ! bearing in mind i already told him i don't want one and i have guidance from 4 other people(2 consultants) stating MUA will not be beneficial for me, he then started to tell me " I am the best around here and my stats are 1 to 2 steps above everybody else" and I am condemning myself to a permanent stuck knee. Then he decided to pick on my PT saying i am changing yours they are no good and you will use my preferred physio who is a knee specialist(whish i asked him why he didn't do this sooner if he is a miracle worker).

If i can give anyone advise--listen to people here as when i do HIS exercises knee swells and can't walk, let it rest,daily activities with minimal exercises and hey presto less swelling and i can walk!!

Good luck to all see you soon
(when i have calmed down hopefully).

 

[Jockette]

I’m sorry your surgeon thinks so highly of himself and has no consideration for individual recoveries. I would be fuming, also!


This is what @TortiTabby experienced. (Just so you know, ADL means Activities of Daily Living, which means just go about the normal things you do in the course of your day, and not doing a “list of exercises.”)

Just an update for those who are apprehensive about gaining ROM:
It has now been 26 weeks and all I do is ADL and this is what my ROM has done:
3.5 wks: 75
6 wks: 85
7 wks: 90
10.5 wks: 95
14 wks: 100
17 wks: 105
20 weeks: 110
26 weeks (where I am today): 120!!!
I did it! My goal of 120! No "pushing through pain", no PT after the first 3 visits, and most importantly to me: No MUA! My surgeon who said I would never get beyond 85 ROM without pushing through pain was wrong, wrong, wrong. I'm excited to see if it gets even better.

 

[Lindylee]

Ooh, he does have a high opinion of himself. If his physio is that good it does make you wonder why you weren't referred to them in the first place. Stick to your guns and go with your gut instinct.

 

[sistersinhim]

I AM DOING AN MUA ! bearing in mind i already told him i don't want one

He is not your boss, you are HIS boss and he has to do what you say.

I am the best around here and my stats are 1 to 2 steps above everybody else" and I am condemning myself to a permanent stuck knee.

My goodness, he doesn't need anyone else to praise him. He's doing enough of that himself. He might be a good surgeon, but certainly doesn't know much about rehabbing a joint replacement. For the vast majority of people, aggressive PT sets the recovery back and is likely to cause adhesions when gentle movements do not.

Then he decided to pick on my PT saying i am changing yours they are no good and you will use my preferred physio who is a knee specialist(whish i asked him why he didn't do this sooner if he is a miracle worker).

He can not tell you where to go or even make you go anywhere at all. I never took PT after any of my 11 knee surgeries and my OSs never said anything about my not going. Any surgeon should be more happy with a patient's function rather than numbers!

 

[mog]

Thanks for all the support guys and gals.
If you take notice of YOUR body it tells you what is enough and after 20 years of pain i don't intend to add to it just for 'better stats' at nearly 48 yrs. Old i think i can decide for myself. I will try most things once because nobody knows what works until you try but if it doesn't i am not ashamed to say thanks but no thanks.

 

[henrietta]

I see my surgeon next Friday, 5 weeks on. If it’s like last year he will say very little (my poor french is a factor, but not the only one, last year I went with a list of prepared questions, won’t this time, just the thank you letter) he mentioned ice, I remember and looked at knee but that was it. When I asked, said I could drive and swim.
That’s France, ok, but glad I’d found this site, too!

 

[Summer2020]

I had my 6 week followup appt with my OS on Monday. He wasn’t happy with my extension so he wrote a script to go to 3 times a week PT. I had just gone down to 2 times per week last week

after meeting with my doctor I had PT and I had a different one than the one I’ve been working with the whole time since my surgery. She had me ride a stationary bike. I could do the rotation cuz my flexion is at 120 but it still hurt ALOT! I asked twice during the 5 minutes to stop and she would reply with ‘oh you can do a little more you’ve got this!’ NOW 2 days later I sit here with a lot of swelling and a lot of pain. I will NOT be riding that bike again! No way! Maybe my own bike outside this summer but no more at PT. I’ll stick to the nustep which loosens up my knee with no pain. I’m definately learning that these PTs don’t always know what’s best but I KNOW what my body can take. Hang in there. One thing my OS said was ‘ no you don’t need a certain ROM by 6 weeks. I’ve seen the most improvement of ROM happen between 6-16 weeks.’ So there’s a plus there!

 

[mog]

hello everybody, i hope we are all well and staying safe. just an update on my knee, i have beend to my osteopath(extra paid by me but so worth it). and after he loosend up my whole leg muscles as everything was tight. i went to bed and rolled over OH MY GOD what a massive 'CLONK' and suddenly i noticed an immediate reduction in pain,swelling and easier movement!! i have since had PT and i have gone from 25 straight 72 bend to 10 degrees straight and 86 degrees bend it appears my knee cap was catching on scar tissue and relaxing everything has caused it to pop back in position- no nedd for MUA . so yet again the advice on hear to relax and listen to your body is spot on.
Onward and upwards- with no crutches .
Stay safe my friends

 

[Jaycey]

@mog What a wonderful, positive update! Well done on listening to that knee and moving at your own pace. This is just the beginning. Keep up the good work!