TKR Rehab begins!

[Jockette]

My bend at 19 months is better than it was at 12 months, and better than it was way before that.

I really don’t know what my own numbers were my first 6 months because I was never measured for what I could do myself.

I do know my own bend back then was not impressive. But my leg did not freeze. It’s more relaxed now because I’ve had 19 of healing.

Yours will heal, relax and bend, also.

My surgeon had me so stressed about ROM. And here I am bending fine. On my knee’s schedule, not his.

 

[Softtail]

Wow Mopa tough call. I was at around 90 at 3 week mark , and now at 6 , I am close to 120, but that aside I judged my Rom by how close I was coming to a normal walking gate, and not the degree measurement. I could tell iI was gaining on it cause I could put my knee more comfortably on floor as weeks progressed. Not all doctors are as concerned about hitting a specific bend at a specific time in your recovery, so as Navy says, time for a sit down. Best of luck going forward.

 

[sistersinhim]

if I don't get up to around at least 114 degrees in 3 weeks she is saying she would have to do a MUA.

90 degrees at 3 weeks is great! Most OSs don't expect that until that until the 6 week mark. Your OS is being unreasonable. You will continue to increase that bend without even thinking about it or working on it. It comes naturally as you use it normally in your daily life.

 

[mopa]

90 degrees at 3 weeks is great! Most OSs don't expect that until that until the 6 week mark. Your OS is being unreasonable. You will continue to increase that bend without even thinking about it or working on it. It comes naturally as you use it normally in your daily life.

Thanks for your encouragement! I love this forum.

 

[sistersinhim]

 

[mopa]

I have just finished my 4th week post op and am making good progress. In outpatient therapy my ROM is now 4-104. The strategy of my PT team is low pressure but many reps through out the day of stretches that increase ROM. It seems to be working without aggravating the knee and its healing progress. My surgeon who gets weekly updates on my progress from the PT is very pleased and has my goal within the next 2 weeks to get to 0-114. The PT thinks we will get close but believes the surgeon will be OK as long as I make progress.

My surgeon has had me take 2 cortisone packs to reduce inflammation and also am applying a creme on the knee that contains nsaids absorbed through the skin. I think these two treatments have helped some because the swelling has improved. This morning I feel like all of a sudden I feel much better as far as pain and walking. I have my fingers crossed that maybe I am crossing that threshhold where I can start weaning of pain medication and resume driving soon. I have felt better at times to only fall back to where I was before.

Good luck to all with swift recovery and no pain!

 

[Larryhg3]

@mopa I have to say you seem to be doing great. Your OS is great in that they take such an interest in your ROM week to week. Most surgeons that I have heard about don’t get involved at that level. It seems like your PT has guided you relatively gently to this point. What I don’t see is what your goals are? What do you want to be able to do once you are on the other side? Personally I hate those numbers because I find focusing on them can be counterproductive. Keep plugging along listen to you knee

 

[flsungirl]

@mopa I can attest to the set back of an aggressive physical therapist. My surgery was September 10 and was done as outpatient. I initially enjoyed going to PT because I always felt good after the sessions. That was until last Wednesday. I was sitting on the table with my legs bent and he was gently pushing backwards and forwards. An exercise we’ve done plenty of times without incident. Next thing I know, he pushed very hard backwards and i almost got sick. I made it through that push and a few seconds later he did it again! I screamed both times! I have now been pretty much immobile due to swelling and knee pain. I feel better today, not as well as before that last session though.

It seems you have a handle on the situation but NEVER let anyone dictate how far along you are in recovery. It took years to get the knee Problems and it it will take awhile to retrain most of your body how to walk. We’ve been using other parts of our body to compensate for our wonky knees! So there are other parts of our body that are adjusting as well. Time is our friend!

I wish you a healthy recovery! BoneSmart is a great place to connect with people who have been through what we have. Most doctors and physical therapists have NOT had a joint replaced and tend to not have a realistic idea of what this surgery entails. If it hurts...don’t do it.

 

[traceys]

Hey @mopa

Following this thread closely as I currently am in a battle with my rom as well (everything in my thread).
I am week 7 and about 75-80 on a good day and very down on myself I’m not way further and causing myself a lot of stress. Sort of at a crossroads.

Look forward to reading how you are doing and the choices you are making!

 

[flsungirl]

Good morning @traceys I think mine is , or should I say was, around 90-95. Now I can barely bend it while laying down. All thanks to Wednesday’s PT session. Going to try some mild exercises today and see how that goes. I’m truly debating going back to PT.

Please don’t be down on yourself. You’ll get where you’ll need to be when you’re knee is ready. How is everything else going? I didn’t sleep soundly last night but nothing like the insomnia i experienced during weeks 3-6. My hip is still not cooperating and hurt all night last night. I want to be more active but can’t due to pain. Hope to get back soon to my upward recovery. It’s been a 6 day setback and it’s depressing.

Take care and have a great Monday!

 

[Celle]

My surgeon who gets weekly updates on my progress from the PT is very pleased and has my goal within the next 2 weeks to get to 0-114. The PT thinks we will get close but believes the surgeon will be OK as long as I make progress.

You're doing just fine! Making steady progress.
It's just too bad if your surgeon isn't OK with your progress. What's he going to do about it anyway? It's your knee and he can't do anything to it without your permission.

You are in charge of your recovery - not your surgeon and not your PT. They may have goals based on fast increases in ROM, but your knee may have other ideas and it will improve at its own pace. That's OK.
There's no need to rush to get ROM because it can continue to improve for a year, or even much longer, after a knee replacement. There isn't any deadline you have to meet:
Myth busting: the "window of opportunity" in TKR

Complete recovery from a TKR can take a full year, so there's no need to rush. You have all the time in the world and your knee doesn't have to comply with an artificial deadline set by your surgeon or PT.

As long as you're making slow and steady improvement in mobility, strength, and ROM, all will be well.

 

[mopa]

You're doing just fine! Making steady progress.
It's just too bad if your surgeon isn't OK with your progress. What's he going to do about it anyway? It's your knee and he can't do anything to it without your permission.

You are in charge of your recovery - not your surgeon and not your PT. They may have goals based on fast increases in ROM, but your knee may have other ideas and it will improve at its own pace. That's OK.
There's no need to rush to get ROM because it can continue to improve for a year, or even much longer, after a knee replacement. There isn't any deadline you have to meet:
Myth busting: the "window of opportunity" in TKR

Complete recovery from a TKR can take a full year, so there's no need to rush. You have all the time in the world and your knee doesn't have to comply with an artificial deadline set by your surgeon or PT.

As long as you're making slow and steady improvement in mobility, strength, and ROM, all will be well.

Thanks for your words of wisdom. The surgeon wants me to be moving quickly on ROM for what reason I don't know. I am thinking maybe she is just using psychology to make me work hard because she talked about MUA if I did not make good progress. I am thankful for the PT team I have whose philosophy that pain is not good and do not work it too much on the stretches. The PT's think the OS is not being realistic but will plan my therapy to slowly work to increase ROM without aggravating the knee. I have 5 more weeks with outpatient therapy and they are confident I will do well but probably won't reach a ROM that this OS is shooting for. The PT's have relieved my worries and stress with their encouragement that I am doing fine.

 

[mopa]

Hey @mopa

Following this thread closely as I currently am in a battle with my rom as well (everything in my thread).
I am week 7 and about 75-80 on a good day and very down on myself I’m not way further and causing myself a lot of stress. Sort of at a crossroads.

Look forward to reading how you are doing and the choices you are making!

Hi Traceys! Don't get discouraged on your progress because everyone is different. If you are seeing a PT tell them you want to gently work the knee without pain and do many reps during the day. Pain and inflammation slows the healing process and just takes you backwards. I will look up your thread. Thanks for your response and the best of luck to you!

 

[Larryhg3]

Mopa sounds like your PT has you on a great path. Pain is not good, swelling is not good and neither yield the results your surgeon is looking for. A nice gentle program that offers a little challenge is what I am using with my PT and am very happy. Have only measured ROM once at the assessment and was told it is just fine for where I am currently time wise. Not sure why some doctors are so hung up on ROM numbers

 

[mopa]

@mopa I can attest to the set back of an aggressive physical therapist. My surgery was September 10 and was done as outpatient. I initially enjoyed going to PT because I always felt good after the sessions. That was until last Wednesday. I was sitting on the table with my legs bent and he was gently pushing backwards and forwards. An exercise we’ve done plenty of times without incident. Next thing I know, he pushed very hard backwards and i almost got sick. I made it through that push and a few seconds later he did it again! I screamed both times! I have now been pretty much immobile due to swelling and knee pain. I feel better today, not as well as before that last session though.

It seems you have a handle on the situation but NEVER let anyone dictate how far along you are in recovery. It took years to get the knee Problems and it it will take awhile to retrain most of your body how to walk. We’ve been using other parts of our body to compensate for our wonky knees! So there are other parts of our body that are adjusting as well. Time is our friend!

I wish you a healthy recovery! BoneSmart is a great place to connect with people who have been through what we have. Most doctors and physical therapists have NOT had a joint replaced and tend to not have a realistic idea of what this surgery entails. If it hurts...don’t do it.

Thanks flsungirl for your post! I will take your advice and not let the OS or PT take me where I don't want to go. I am sorry the PT did such a horrible thing to you and hurting your already damaged knee. My home PT lady did that to me twice and I knew it was coming but made me scream in pain. I am fortunate that now I have an outpatient PT clinic that has the same philosophy as this forum. Best of luck to you with a painless recovery.

 

[mopa]

@mopa I have to say you seem to be doing great. Your OS is great in that they take such an interest in your ROM week to week. Most surgeons that I have heard about don’t get involved at that level. It seems like your PT has guided you relatively gently to this point. What I don’t see is what your goals are? What do you want to be able to do once you are on the other side? Personally I hate those numbers because I find focusing on them can be counterproductive. Keep plugging along listen to you knee

Hi Larry! I agree with you on ROM goals because it just causes stress and worry. I want the best ROM I can achieve because I am a very active person by walking ,bicycling and and doing things with my Grandkids. But I will be satisfied with what ever the outcome is in the end as long as I do the required exercises. When I finish this knee journey I plan to RV with my wife to see the country in our old 2001 motorhome. I love taking my Grandkids on vacation in the RV to places like Disney World. Best of luck to you!

 

[mopa]

Hello I have not posted for awhile so thought I would let all of you know where I am. My flexion has increased to 114 but the extension seems stuck at 4 degrees. The PT team is having me concentrate on the extension but I don't seem to be making any progress. I got ambitious and started coming off the pain meds on my own so I could drive and have driven some with no problems. Last night I couldn't sleep well because I started having some pain and tried to hang in there but I gave in and started back on the pain meds. I really don't sleep that well anyway because like most of you I just can't seem to get comfortable. I usually go to bed around 11:00 and sleep off and on listening to podcasts with ear buds while sleeping and awake. I listen to Coast to Coast AM sometimes and if it is interesting will stay awake. I usually give in and get up around 4:00 and go downstairs for coffee and get in the Lazy Boy with my Shih Tzu terrier mix in my lap. He is a such a good puppy and helps me deal with this knee deal. My best sleep comes in the afternoon taking a 2 hour nap after my stretches. I really look forward to my nap time. I am coming up on 6 weeks post op now and thought I would be much better by now with walking and pain. I get depressed some but keep trying to keep my eyes on the goal post. I am so thankful that I am retired and don't have to worry about work. Well I wish all of you recovering souls a speedy and painless healing time.

 

[Jockette]

Your extension will come along fine in time. Its too early to be concerned about it, you have lots of time for it to improve. Surgeons and PTs think we have to get everything back right away, but our body doesn’t work that way, and it doesn’t recognize their timetable, it’s on its own.

It’s nice you have a sweet puppy to hang out with you!

We all think we should be further along than we are, no matter how far post op we are.

Hang in there, you’re coming along fine.

 

[Softtail]

Mopa my biggest gains seemed to come between 6 to 8 weeks so there is plenty of time to gain on things. At week 2-3 I was 90 to 100 flex .Extension +5. At 8 weeks I am at 130/0. That’s what PT measured but I kinda question extension since knee still feels a bit tight whewhen fully extended. Nothing I can’t do normal walking wise ,so I am not concerned if it’s actually 0 or not. I wouldn’t be at all concerned at this point, since it will come along with longer walks sitting more comfortably, if that is problem too. It was for me, but is much better now.

 

[kmak81230]

It literally took me 6 months to get my extension to close to 0 -- partly because it was not even close to 0 for years prior to surgery so all of the muscles, tendons, etc, were not used to having to stretch that much. Extension for some takes much longer to achieve but eventually it will come. There are some resources here on improving extension. Continued patience for this long journey. Hang in there.