TKR Recovery Gone Wrong?

[FCBayern]

Now that I can drive, I’m going to outside PT and the second session nearly killed me. I was laying on the table crying while the PT was pressing on my knee to try and straighten my leg. My leg swelled up and the pain got worse. Fortunately, for me we had bad weather and I didn’t go to PT for another week. I told PT that I could not repeat that type of manipulation; that it sent me back weeks in my recovery.

In my opinion PT is setting back your recovery @GrrrrTKR. Stopping that kind of PT isn't being a quitter, it's listening to your body and allowing it to heal on it's own time line. If you want to continue outside PT I would suggest you approach your PT with these guidelines so that the PT is beneficial to you:
This is what one of our members suggested you say to your PT therapist:

• I expect discomfort. I DO NOT expect actual significant pain.
• The definition of what is painful is owned by me, not you.
• When I say stop, we're crossing the line into pain. I expect you to immediately stop.
• Trying to force me past the pain point or not listening to me will completely break my trust in you.
• I want us to be partners in this. I'm willing to try almost anything, as long as I can continue to trust you.
• If I trust you, I will go right up to the line between discomfort and pain. If I do not trust you, I will likely start tensing up as soon as any discomfort starts. At that point I may as well get a new therapist.

This is my personal story regarding PT. Prior to my TKR I was aware of the BoneSmart gentle approach to recovery as opposed to rigorous PT. I was lucky enough to find the site before my TKR. Even though I knew about the BoneSmart approach my OS was all about PT and "whatever ROM you have when your scar turns silver is all the ROM you will ever have." He was the trained surgeon that has done many, many replacements, he must know what he's talking about right? So off I went to my first visit to PT, about 2 weeks out from TKR. The next day when my knee was more swollen and I was in much more pain I opted for a BoneSmart recovery. I never went to another PT session. That was one of the best decisions of my life. Not only did I suffer less pain, but my ROM has continued to improve over two years. It took me a full year to reach 120 degrees of flexion, and I was still 4 degrees from straight. By the end of the second year I was over 140 and past straight. I've been hiking over rough terrain for miles, scuba diving, and just living a happy active pain free life with more ROM than I ever thought I would have again after many painful years. I've now had a hip replacement with equal success following a BoneSmart approach. You don't have to suffer needlessly to have an amazing recovery.

 

[GrrrrTKR]

@FCBayern That is such good advice. I wish I had found bonesmart sooner. I’m coming back from a week off from PT. I had to start taking pain meds again and was afraid to drive and it turned out to be a good decision. I went to my primary care doctor and she wrote an order for sciatica treatment, x-rays and MRI. The x-rays only confirmed what I already knew, scoliosis, and degenerative disc disease, which prior to surgery were asymptomatic, and neither of which started overnight. My surgery and the rough PT are the root cause of my sciatica and increased pain. Funny thing, while doing my eval for sciatica, the PT told me that when treating for sciatica, we do not want to have pain, but when treating for knee replacement, we do want to have pain. I had told them in my first eval for the knee replacement that I had sciatica, and during the eval, the manipulations they were doing were causing my sciatica pain to increase. But they insisted they cannot treat me for sciatica and seemed, oblivious to the fact that the knee manipulations were increasing my pain level. I’m done with all that. Thank you thank you thank you.

 

[ski_bum]

I am eight weeks out from my surgery. I had home PT for about six weeks, which in hindsight may have been too gentle. Now that I can drive, I’m going to outside PT and the second session nearly killed me. I was laying on the table crying while the PT was pressing on my knee to try and straighten my leg. My leg swelled up and the pain got worse. Fortunately, for me we had bad weather and I didn’t go to PT for another week. I told PT that I could not repeat that type of manipulation; that it sent me back weeks in my recovery.

My surgeon tells me I have a short IT band and tight hamstrings. I also have severe pain in my lower back, and when I move my knee, my femur rubs against the sciatic nerve which sends pain from my lower back to my toes. I also have some numbness and tingling in my leg.

At this point, I’m very discouraged and certainly regretting my decision to have TKR. Before TKR I walked or swam daily and had no back problems. I have trusted the professionals with my care and I’m not sure how we got off-track.

I’m going to PT three days a week and a chiropractor twice a week for the back pain. I am doing lots of stretches and keeping my hammies under a heating pad. Exercise is just too painful right now. I don’t know whether I should rest or work my muscles. I know that irritated nerves and swelling require RICE, but my recovery requires a quick turnaround lest I have to go back into surgery for manipulation.

@GrrrrTKR I have everything you are experiencing. First R knee, IT Band was / is a big issues
I earlier suggested the roller. That IT Band does not pop as much during my morning 40 minute walk.
Second knee against my better knowledge, the surgeon place a button under knee cap to help slide easier as not to affect the IT Band. Only somewhat better. Still milder popping.

My Family Doctor has booked me in for Nuclear Bone Scan, blood tests for infection & Allergies to Metal.

I only went to PT once for second knee and again, I say try the roller for IT Band and sciatic.
I will post my out come on my site when I have all information.
Good luck

 

[Scaredycat10]

I have a roller but can't use it on the floor as I'd never get up without a hoist.
Any tips from non floor users of a roller for IT band?
Thanks

 

[benne68]

the PT told me that ... when treating for knee replacement, we do want to have pain.

Oh my goodness, that PT clearly doesn't know the difference between strength training and post-surgical recovery.

You should never be pushed into pain this early in recovery from a knee replacement. A little bit of discomfort and a sensation of stretching is okay, but pain is not. If PT causes you pain, your knee is telling you that it has not yet recovered enough from the trauma of the surgery to be able to do what you are asking of it.

Please read this article before you go another further with painful PT: Myth busting: no pain, no gain

 

[shr]

One thing that I found very helpful was walking backwards. It stretches all the muscles in a different way and it helps your leg to straighten. Just be careful you don't tip over! I do that by the couch so I have something to grab, and I try to take 100 backward steps a day.

Great suggestion. I try to do 10 minutes of backward walking several times a week. You definitely need to take care to avoid tripping!

 

[hawk2go]

You've gotten some good advice @GrrrrTKR. I hope it's good enough to change your name to YAYtkr ... eventually. Your knee is the boss and your sciatica is riding shotgun. Do what they say.

 

[GrrrrTKR]

Not ready to change my handle yet. Going to see a pain management doc tomorrow. Hoping for a better strategy besides having a pity party and taking pain meds daily. I believe my sciatic nerve was damaged, as the nerve pain in my low back and leg has only worsened as time goes on. Fired my PT. I am getting back to daily workouts. 45 min of lap swimming x 3 days and 45 min of strengthening and flexibility in the pool x 3 days. Working out feels good but it’s still painful afterwards. Thanks everyone for all the helpful advice and encouragement.

 

[Jockette]

Working out feels good but it’s still painful afterwards.

This is telling you that you are not healed enough to do this much rehab at this point, especially after aggressive PT at an earlier date. At 3 months post op you are only 25% healed, in this year long recovery. Consider cutting back, a lot, until you feel better, then add things back in gradually.

 

[eaglemom]

I certainly don't want to keep repeating what has been written, but you are doing far too much on that baby knee. I realize you think it feels good, but then hurts afterwards - that's the key here - its too much.

While I certainly applaud your workout ethic try to cut it way way back. Maybe just walk in the pool instead of lap swimming, and 30 minutes at the longest. Do some very lite stretching in the pool - 10 minutes is more than enough, IMO. I would follow this up with ice and elevation for at least 45 minutes. I know its not what you want to hear, but we are here to help you personally I think your knee isn't ready for the routine you‘re doing.

Try less and see how you feel pain wise. In a month increase the times slightly and see how the pain is. If you do fine then slowly increase again. Don't be discouraged, I think its amazing your doing so much.

 

[Gracealone713]

Hi Again! Our situations are almost identical. I've conquered the sleeping! But here's the thing about PT. My insurance pays for PT, and I pay for my insurance..
NO ONE will force me to do anything I don't want to do, have a explanation why they want we to do it, or it hurts! My PT person asked me to stand up from a chair without pushing off, hahaha
I'm 63, was an OTR Trucker, and told her I didn't do that before surgery and she can scratch that off the list! I just found BoneSmart today and believe this website should be in the material provided by every Dr and hospital that performs knee and hip replacements. I had no clue the difficulties I would encounter. I cried at night due to sciatic nerve pain, now I ice it, put a pillow there to keep me off of it and I put a tennis ball under it and do my own massage but moving over it. Works great! Now, I'm dealing w/restless leg syndrome and will evaluate my research and pick the best option for me. What I do know is that recovery is different for women vs men and that when my surgeon says all the complications are "normal" I say horse hocky...they are normal because we accept them as such. All these issues should have been discussed and worked through PRIOR th surgery. I blame myself! One other thing..check into hydrotherapy

 

[ski_bum]

I have a roller but can't use it on the floor as I'd never get up without a hoist.
Any tips from non floor users of a roller for IT band?
Thanks

@Scaredycat10
I was told to raise my leg above my heart and only roll down rolling to my hip.
I did that at first and it helped, then I just rolled it standing up, rolling to knee from hip.
My knee is not, was not swelled and I was told it was to stretch the IT Band.
Good Luck

 

[Jockette]

@Gracealone713

Welcome to BoneSmart!

Why don't you start your own thread and tell us a bit more about your situation. Our members are here to support you. Here's a link to Starting a new thread and posting .

 

[Layla]

Hello and Happy Four Month Anniversary!
Wondering how your visit with the pain doctor went? Hopefully well and your pain is easing.
I'm sorry to read of your struggles and hope you're able to enjoy the holidays and are pain free in the New Year.
Stay in touch, we'll be here.
@GrrrrTKR