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hollyhobble

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I see a lot of variation in what a satisfactory ROM should be but do not know much about that. I had both knees replaced 11 weeks ago and am currently undergoing therapy to get my legs straighter. They do not bend much beyond 95 and 98 without extreme discomfort but are very close to being straight, within a few degrees on one and about 4 or 5 on the other. Will my ROM improve as I continue to heal? My knees are still stiff, the left one more than the right, in the front and need icing quite often to keep them from being swollen and bruised looking.

I am beginning my fifth week of off-site theraphy which can be brutal as I have a no nonsense (good for me!) therapist, but quite often while he is working on straightening my legs, it brings me nearly to tears and almost always to cursing (quietly). He assures me that it is possible to get the legs straight with the new implants, but I'm wondering just how important it is for a 62 year old to have perfectly straight legs? I am concerned about them functioning well, but the rest of my legs aren't so beautiful anymore anyway!

I really did not get enough up-front information on knee replacement, I guess, so am glad there is a forum to get other people's input.
 
I'm somewhere around 16-17 weeks (March 18) and still have stiffness, swelling and a little pain when initially straightening. My ROM "numbers" are pretty good. This healing process is as long as one year. So, for me if I figure 17 out of 52 I still have plenty of room to progress. When I was doing Pt, and even now with some of the home exercises i do, I felt pain. and I would breath through them knowing the results counted on it. If you are still taking pain meds be sure to take a dose before PT. What does your OS think about your progress? He would be a good gauge. most of all, keep working, I know it hurts, but you can do it. And give your self a break as far as comparing and "should be". 1 Year remember.
 
Jennifer -
Thanks for your input. I must learn a little more patience, I believe and have confidence that things are going well. They truly are. My OS said after my 6-week checkup to work on improving straightening, that the flexing would come and to come see him in a year! Perhaps I need to talk to him sooner than that. I certainly have made progress in five weeks of therapy! Last Friday when I went to PT, one of them said to the another "She's crying alrady!" so I definitely did have to suck it up and garner all my courage! So I did not cry or tear up but got through the rough stuff. Was able to feel the mat with my entire leg so that's progress. I do still take pain meds before sessions and occasionally after but do not need them full-time any longer.
Today is another session so I will try to breath deeply and work hard. This time next year I will be tearing around after the grandkids in great form!
 
Someone on here once recommended the following, put your leg up on a coffee table or similar, heel only, and let gravity do the work whilst you are watching TV. Eventually it will go straight. If you feel up to it, you could also hang something no-to-heavy on your knee as well the help it along.
 
I am outraged that your pt would talk about you like you aren't there. As for your crying I am sure if it wasn't causing you considerable pain you wouldn't be crying and his insensitivity is just adding to the stress you are experiencing because of the pain. I am 66, soon to be 67 and had both knees replaced a little over two months ago, May13. I progressed rather quickly but no thanks to my PT. It was only due to the PT I had when I had my knees scoped the previous year that I knew on my own what exercises I needed to do. I went to PT a total of three times after my BTKR. Each time I went I had a period of between three and five days of such intense pain that I was totally unable to do anything except ice and elevate and I am pretty tough old bird. What made me particularly angry at the PT I had was the fact that she was so out of shape there was no way she could have even come close to doing the things she was expecting me to do, and I told her so, in a nice way of course. I had trouble initially straightening my left leg as it was much worse than the right, even had a fractured tibia that the OS had to repair during surgery. He had be press down on my knee when I was doing the exercise where you are straightening your leg and flexing the muscles in the leg. Doing this I very quickly had my legs straight. As for range of motion, I ride the stationery bike everyday and I truly believe that is the biggest help to ROM. Even one of those little pedals on the floor thing that wal-mart sells for $22 would be a help. I think it is important to get back into our lives as quickly as possible and started in cooking and doing laundry and making the bed on about the 8th day after surgery, maybe the 9th. I won't say it was easy in the beginning because it was a struggle but it has gotten easier and now I am pretty much doing what I want, walking normally and have very little pain. I find my nights are the worst so far as pain goes. I will have a couple of nights when I sleep good followed by several where I wake frequently and have to change positions to stop the pain. I use the 5mg immediate relief oxycodone at night, depending on how bad the pain is and save the long lasting extended release oxycontin for the daytime. I, also, take soma four times a day and find that is extremely helpful. I am still icing once a day, sometimes twice, depends. You know you have good days and bad days, that is just life. I sure do hope you stay connected to this forum as it has been one of the biggest helps I have found throughout this whole procedure. I am going to close as I have probably gone on too long as it is, but I do hope you stick with the exercises as without them we lose ground. I figure I am going to be doing the exercises the rest of my life to keep my knees going at top preformance and since they can't just put a squirt of WD-40 in them. GOOD LUCK Rowdy
 
Rowdy, I was thinking the same thing about the comment the PT made. Unless it was all in fun and you Holly were in on it. Where I was for PT it would have been that way, we all laughed joked and told our life stories. Staff and patients alike. The peanut gallery commentary. Anyway, if you've got to cry to get through your exercises, then cry. And tell those PTs that those tears are your equivalent of to "blood sweat and tears" so give them some well earned respect! Then go home and hug the grandkids.
 
hollyhobble said:
... but I'm wondering just how important it is for a 62 year old to have perfectly straight legs? I am concerned about them functioning well, but the rest of my legs aren't so beautiful anymore anyway!

I really did not get enough up-front information on knee replacement, I guess, so am glad there is a forum to get other people's input.
Click to expand...

Welcome to the forum. From my experience and reading other posts, I believe that ROM measures can vary widely. At six weeks, my numbers are not nearly as good as others, but my therapist keeps telling me to stop beating myself up. However, at my 6-week checkup today, my Dr. thought my left leg, at only 88 ROM and -12 extension, needed a boost, so I am having a maniupulation next Tuesday.

As for your comment on how important is it to have perfectly straight legs: you will find that it will become very difficult to stand for long periods of time unless you can fully straighten your leg. Mine has been bent for over a year due to arthroscopic surgery, and standing becomes very painful without a leg that will fully straighten. I think it's definitely worth working on. And yes, PT is pure hell! Cry if you have do. Sometimes I just get a towel and bite it to keep from screaming.

Good luck to you.

Sharon
 
Sharon, My first tkr was at -15 when I had the MUA and it's now between 0 and -2 so that MUA is really going to help you. What a difference it's made for me.

Holly, My legs aren't so pretty either but it really makes a difference to have straight legs so that you can stand and walk without pain. Hang in there! Karen
 
Thank you everyone for your encouragement. Today was another tough day with my PT but my left leg is now at 112 and almost staight, the right leg uncooperative at about 98 and having a lot of discomfort, etc. But I was given a stretchy band to use at home which will help me further straighten the legs. Hoping to show the therapist what I can do at home as well! I was in tears again today but assured that there are quite a few people who cry or swear or QUIT therapy so they are used to it. I am really glad that he doesn't let up on it but sometimes I feel he is the biggest bully in the world.

I hadn't thought about the standing at long periods of time as being a benefit of straight legs, but will keep that in mind. We do like to travel and a lot of that time is spent rummaging around national parks, woodlands, etc., so need to be able to stand the moving about, sitting in cars, in lines at the airport, etc.

I certainly will try the tip about putting the heels on the coffee table for added straightening. Although it's been quite a battle thus far, I am so thrilled that I have new knees and will not end up on a Hoveround or the like. Thanks everyone for your encouragement and helpful advice. It certainly is wonderful to know there are so many that are going through the same pains, triumphs and set-backs as I have experienced!
Holly
 
When he was working on my back, I would always tell my chiropractor that he had the sharpest elbows in the world! (he always pressed on trigger points with his elbow as a form of acu-pressure) But eventually it did the trick and my trigger points were no more!
 
My PT uses his knuckles on the back of my legs to further loosen me up. OOOOOOUCH! Also he tends to put his thumbs directly over the area on the inside of my knees where I am most tender so if I can direct his thumbs away from that area, it is slightly less painful. Next week I will have a substitute therapist so hope that whoever that is also works me hard but figures out a way to make it not quite as severely grueling! I know no pain/no gain but I am looking forward to that day when he says that I'm there!! I think we are looking at 123 as my magic number. One knee has 11 degrees to go, the other about 25! So it's still a struggle but yipee!! I will be able to dance by Christmas, I'm sure.
Holly
 
Holly I really admore your determination and have no doubt you will reach your goals. It is important to be able to straighten your legs so you can stand comfortably so you will be glad you endured. Good luck to you. I hope that the alternate therapist is good but has a different way of doing things so you can see how it is possible to make progress without being in agony. I will keep you in my prayers. Rowdy
 
The point being, Holly, that he is using a form of acu-pressure to treat the painful structures. Believe me, when the pain diminishes, he can do that and you won't find it half as excruciating.
 
Rom

Reading these posts the variation in physical therapists is interesting. I have an excellent PT. He will push it but always asks if I am ok and if I don't exactly answer him, he goes by my body language and does easy up a bit. I do think they need to push things but they don't have to be mean and nasty about it.
Since PT is so important is there another therapists you can request or even go to another place. Before BTKR I investigated the place most people go for PT as it is the largest one in town and part of the hospital. I was not impressed at all and went looking. I live in a rural area and there are not that many choices. I investigated a private PT and he was excellent. The other advantage I found with the private practice is I always see the same person while with the larger group you get whoever is available which I don't think is a good idea.

I also had trouble with extension, it was -15 to start (I had a preop 10 degree flexon contracture). I am now at -2. The exercise that has helpe me the most is laying face down on the bed with my knees off the edge. I put a weight on the leg (the closer to the knee the least pressure) and just hang there. The object is to move the weight as close to the ankle as possible. In fact anything with gravity will help.

I use a pedaler (looks like bike pedals but you sit in a chair) for 5 minutes every couple of hours and I think that helps. I am working up my minutes little by little.

According to what I read and what my PT and OS said, your preop ROM is a pretty good predictor of the post op ROM especially if you have a problem long term.

Good luck

Simon
 
You guys are a blessing. Having had 10 PT visits post op there is a lot that I have missed out on. If it weren't for all of yall I'd be in one H of a mess. Thanks to all of you I know what to do when I run in to snags. I can force my left leg to straighten totally out but it won't do it on its own. I'm glad to say that my ROM is good. I can bend it with effort as far as the right one. It still has discomfort from stretching but nothing I can't tolerate with pain meds. I have started going down stairs with the TKR leg first to test the ROM. This is relatively painless. Even though I still have some pain and discomfort doing that gives me encouragement that I'll eventually get back to "normal" although at times there is some confusion as to which one is the "good" leg. I see light at the end of the tunnel yall.
 
hollyhobble said:
My PT uses his knuckles on the back of my legs to further loosen me up. OOOOOOUCH! Also he tends to put his thumbs directly over the area on the inside of my knees where I am most tender so if I can direct his thumbs away from that area, it is slightly less painful. Next week I will have a substitute therapist so hope that whoever that is also works me hard but figures out a way to make it not quite as severely grueling! I know no pain/no gain but I am looking forward to that day when he says that I'm there!! I think we are looking at 123 as my magic number. One knee has 11 degrees to go, the other about 25! So it's still a struggle but yipee!! I will be able to dance by Christmas, I'm sure.
Holly
Click to expand...

Hey Holly--I feel your pain--literally :)

My PT does the same. I had my most painful session ever last Friday--I was almost sobbing as I went out the door. I recently went back to work and had not been exercising it as much (desk job, meetings, lots of driving). I ached all weekend. But Tuesday when I went back--most progress EVER with hardly any pain. My advice--take as much pain pills as you can before and don't direct the PT away from the area. The more he/she hurts it now, the sooner it will get better :)

Hang in there :)
 
I feel I have taken a couple steps backwards this week. They added more weights on Monday and 2 new exercises and my knee swelled up like it was right after surgery. My ROM has decreased. Should you continue to do your home exercises when it is so swollen or let it rest? I have sat for 2 days icing it down without much results. I put heat on it last night and it is down this morning. Also woke up several times in pain which also has not been going on as much lately. I was doing so good. I get frustrated because I want to go back to work within a month and I am learning you can not go on how you feel now because that can change in a days time. I have PT this morning and I know it is going to be swollen again. I guess this is all just PAR for the course.

Sue

I see where you are talking about your PT's using their knuckles. My PT hardly ever does anything with my knee. Should she be massaging it? Would I be getting better results if she were?
 
Can I throw out a couple of suggestions? Your recovery is not going to be linear.... you will progress and then slide backwards. That is normal. Those of us who had our knees done last winter compared it to the stock market with its ups and downs.... but you have to stay in there for the long haul. If you take too much "time off" you will backslide and then it is too easy to give up and you must never do that!

I can't remember how far out you are--- but my PT (who pushed me but always seemed to know what I needed and how far to go) had me alternate heat and ice--- 20 minutes at a time-- to knock back swelling and inflammation once I was past the very early days and was allowed to use heat. He also massaged my knee during the swollen days--- it "hurt so good" and really helped. Why don't you just say that it feels like massage might help and ask your PT to do it and show you how to do it yourself?

Good luck.... keep at it and you WILL get better. I can't tell you how wonderful it is to be able to have my life back again. You haven't gone this far to give up now!
 
Just got back from PT. I started first with the stationary bike. It took me a while to get going. It kept hanging up. I have a lot of pain just to the left of my knee cap (inner side of my right knee). My OS said that he shaved down the ligament on that side because it was too tight and my knee cap's tracking was off. This is what is giving me so much trouble but after a while the pain got better with the work out.

Thanks for the advice and I'm not giving up. No way I want my life back. I know it will be worth it in the long run.
Sue
 
We all just have to be like the Little Engine that said "I think I can, I think I can" and tough it out. My incision marks are going to truly be badges of courage after this ordeal is over. I just found out that I can have as many therapy sessions as I want/need now that my deductible is met, so I'm hoping that I can "graduate" sooner rather than later and then probably just go for the pool therapy for awhile after that. That part is fun, relaxing and very good not only for my knees but my butt too so don't mind that a bit. I've never been one to want to either endure or inflict pain so it's been tough. Of course I would like to sock the therapist in the nose a couple of times, but find that when the pain is at it's worst, the results are at their best so if he doesn't mind my tears and/or cussing, it's going to continue.

I do have days that make me feel that I've stalled or gone backwards so it's comforting to know that we all do and that even on down the line, there will be good days, great days and not the best days.

We'll all hang in there and have the most wonderful knees possible. Thanks for your support y'all!

Holly
 
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