I am so, so, so grateful for this forum and all the wisdom here.
The physical therapist I saw on Monday was about 38% physical torturist, 35% following a cookie cutter approach to physical therapy, and 28% willing to listen to me. Thanks to what I've read here, I felt comfortable in refusing to keep my knee in a heel slide which was forced by use of one of those elastic bands. I told her not to use too much pressure from her hands when she was trying to get a lower extension angle. And when she took me over to the exercise bike and asked me to do five minutes on it, I said no. I did get on it, though, and moved the pedals back and forth just as far as was comfortable. I stayed on it for a few minutes, and gradually increased the degree of my pedaling until I was moving about 270 degrees of the full circle.
My home physical therapist measured my flexion at 95 degrees. She estimated my extension when I extended my leg from a sitting position, and said it was OK. The surgeon just eyeballed my extension and flexion, and said it was fine. So I was somewhat alarmed by the physical therapist's reaction. She wasn't happy with my flexion, even when I scooted my heel back as far as I could. Using the elastic band, I was able to get it to 120 degree -- for a second, not the 30 seconds she wanted. I relaxed my grip on the band even though she wanted me to hold it. She said my extension was at 10 degrees, and started to push down on my thigh and calf to see if it would go lower. I told her to reduce her pressure. Luckily, she didn't insist on forcing it.
She noticed that my operated knee was warmer than my non-operated one. And she demonstrated how to massage the scar and adjacent area with medium pressure from fingers going across the scar. She suggested using Johnson's Baby Oil with Vitamin E for the massage, several times a day.
She went over a number of exercises, which she want me to do two or three times a day. She asked if I was walking 30 minutes at a time. I said no. (I think the longest I've walked has been 20 minutes, and that's not every day.) She encouraged me to aim for 30 minutes.
@Josephine,
@Roy Gardiner and others: Here are the exercises she gave me:
Page 1 is seated or lying down exercises.
AROM hip/knee fix (heel slides) with scarf: 1 set of 10 reps twice a day. Perform 1 rep every 4 seconds.
Stretch knee fix prone (moving knee back toward buttocks using ankle of uninvolved behind foot to increase stretch): 1 set of 5 repetitions twice a day. Hold each for 30 seconds.
Stretch knee ext supine (ankle supported on rolled towel): 1 set of 5 reps twice a day. Hold 30 seconds.
Straight Leg Raise (supine): 1 set of 5 reps twice a day. Hold for 30 seconds.
She also put sketches or notes of some other exercises, which I'm not sure I understand. One appears to be a variation of the stretch knee prone, where you bend your involved leg 90 degrees while prone at the end of the bed. There's a very ambiguous sketch next to the notation hip abduction. I have no idea what she wants me to do there. The word quad set are circled, with no diagram or explanation. I'm guessing she wants me to do isometric muscle tightening exercises.
Page 2 is standing exercises.
AROM hip abd uni stand: 3 sets of 10 reps once a day, resting 1 minute between sets. Perform 1 rep every 4 seconds. Do this once a day.
AROM hip ext stand: move involved leg back 3 sets of 10 reps once a day, 1 rep every 4 seconds.
AROM knee squat bil partial, bending knee to 45 degrees: 3 sets of 10 reps once a day, 1 rep every 4 seconds.
Sketches and notes:
Heel raises.
Tandem standing heel to toe.
Single leg standing, hold for 10 seconds.
Side Step Walking
I haven't done all of these exercises as prescribed. I did a set of three or four stretch knee ext supine twice that day. One was without weights. For the other, I used rice-filled flannel hot packs as weights. I did some stretch knee extensions prone without involving the opposite foot to extend the stretch. I did about three straight leg raises. I did a set of hip abd uni stands, some heel raises and single legs standing. I scattered these exercises throughout the day and evening.
I also massaged the area adjacent to the scar a couple of times. I was icing over 50% of the time. I elevated about half the time I was icing, the other time I had my leg flat on the mattress.
I had a rough time with tummy pain (thank you, Percocet and uncoated Tylenol) and a knee which was a bit more swollen and sore thanks to Monday's torturcises.
I sent out an SOS email to local friends looking for someone who could replenish my supply of saltines, bananas, etc., and pick up some coated Tylenol. But my knee, which was stiff when I woke up that morning, was decidedly more flexible by the time I went to bed.
Today (Wednesday) my knee was a little swollen and one or two movements hurt. Mostly when I lay on my tummy with my legs over the side of the bed and then bent the knee up with a slight movement to my right. The pain was probably ligaments or muscles, which makes sense because pre-surgery the knee had been vargus, probably leading to some shortening.
I had a discussion with my OS, via his nurse, about whether I was on the appropriate pain medication (yes) and whether taking more Zofran anti-nausea meds when I took a Percocet or with the Tylenol would make a difference (no). I was able to switch to a different physical therapist for my next appointment.
This afternoon, a friend came over and we went to my condominium's pool. I was able to get in and out OK thanks to gentle cement steps and a railing. I did some of the exercises (leg to side, leg to back, high step up, maybe a couple of others) and walked in the water some. I took things slowly, and rested or chatted with my friend or watched kids having fun in the water between short sets of exercises.
I iced and elevated maybe 40% of the day.
My knee is a bit more swollen than it was yesterday, and the ligaments and/or muscles a little more sore. I'm definitely going to take it easy tomorrow!
I read several things on here a while back about massaging the scar. But I've got the posts a bit muddled in my memory. Am I right in remembering that
@Josephine doesn"t think it is necessary. I'm 5 weeks out. Is it too soon? Is it necessary? It felt good when the physical therapist did it. It feels nice, not good, when I do it. There are no signs of a keiloid (sp?) forming. But along the lower quarter of the left scar, the skin on the lefthand side is slightly higher than the skin on the right. Is it common for one side's tissues to be a bit more irritated or inflamed than those on the other side?
Do you think I should postpone my next physical therapy appointment (currently set for next Wednesday)? I'm with an HMO. They don't have a policy where the surgeon writes a prescription for X numbr of weeks of physical therapy, but my experience with prior injuries is that I only got 3-6 visits before I'm discharged to continue them on my own.
Thanks for reading this long, long post.
United States
Vent all you want. That's what we are here for and the support is great. If I had never found this site I would be lost. It's nice to know others are going through the same thing
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