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TKR SeptemberZen's Bionic Journey

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Further to the comments regarding expectations following TKR this has just been published:
Women with OA had more accurate TKA outcome expectations, greater decision readiness
Although both men and women with osteoarthritis had poor estimates of total knee arthroplasty outcomes, women experienced more accurate total knee arthroplasty outcome expectations and greater decision readiness compared with men, according to study results.
https://www.healio.com/orthopedics/...tcome-expectations-greater-decision-readiness
 
@SeptemberZen i believe you can feel things in your gut that tell you what's right for you, so even though I think pt is important for me, that may not be the same for you. We all know by now that all of our journeys are different. I'm surprised your pt didn't say what your flexion is, since they're so big on that. My OS says 112 is average even though the pt tries to go for 120-125 as a goal. I would only suggest returning to find out what your range of motion is currently....just so you'll know if it's increased over time. My activity at pt includes bike, wall slides, steps, weights and much more to come over next 6 visits, but your pt sounds rather limited to things you can do at home without their assistance, but they may have a different strategy. Best of luck to you on whatever you decide. Do you have to answer to your OS? My surgeon is big on pt. I'm just happy to be :bath:this weekend:wave:
 
I quit PT after 10 weeks for similar reasons: some of the early advice was helpful, but later they didn't have me do anything -not one single thing- that I couldn't do on my own at home or at the gym. Oh, my PT's favorite thing was digging into my IT band (behind my knee), which was extremely sore at the time. Now that I've stretched everything out it isn't sore anymore. You'll be fine. :thumb:
 
@praise1989 - Yeah, I really do feel comfortable with my decision. :) And I love my surgeon! He's tops in his field and the hospital is consistently rated in the top 10 in my state, yet he took the time to come by every day to spend a few minutes with me. I know several people who never saw their surgeon again after the procedure! He encourages PT but I don't really feel I "answer" to him, but I know you meant. :)
I trust my medical professionals but I have always felt that I have the final say in what happens to my body. My PT just isn't giving me enough to do and when I've asked, the response has been, "Just do 10 more sets of leg lifts" or they want to take my knee or leg and push it to the point of pain, rather than varying the routine by letting me use a bike or practice on steps. I'm not worried about it; I think I'll be fine.
 
Clipless said:
I quit PT after 10 weeks for similar reasons: some of the early advice was helpful, but later they didn't have me do anything -not one single thing- that I couldn't do on my own at home or at the gym. Oh, my PT's favorite thing was digging into my IT band (behind my knee), which was extremely sore at the time. Now that I've stretched everything out it isn't sore anymore. You'll be fine. :thumb:
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That's exactly what I mean, Clipless! I like medical professionals who work WITH me. It's not that I don't respect their knowledge or experience, but I'm an intelligent woman: If what you're doing or saying doesn't make sense to me or doesn't appear to be beneficial, I have a problem with it.
 
I hear ya.......so thankful for capris. My knee has hurt since my last PT on Wednesday.
 
If you don't feel good about the PTs, you probably are not getting much out of it. if you continue to do your biking and stretching, pushing the ROM a little every day on your own, I bet you'll be fine.
 
Hi ya September..just wanted to stop by and say hello! Hope you had a good weekend...I go back to the Nurse Cratchet PT tomorrow, but today I was able to move my knee more so maybe she will be pleased and back off..My husband loves her..I told him that he wouldn't love her if it were HIS knee she was man handling! Here's to a great week!
 
Spencieca said:
Hi ya September..just wanted to stop by and say hello! Hope you had a good weekend...I go back to the Nurse Cratchet PT tomorrow, but today I was able to move my knee more so maybe she will be pleased and back off..My husband loves her..I told him that he wouldn't love her if it were HIS knee she was man handling! Here's to a great week!
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Stand your ground, @Spencieca! Don't let her "woman-handle" ya! :-)
 
Wanted to share something that might be helpful for others:
I'm almost 8 weeks post-op. I have pain mostly at night so I often skip doses during the day unless I am very uncomfortable. My biggest issue is stiffness. ROM is pretty good but stiffness forces me to rely on my cane when I'm out and about, which is fine because I just discovered something interesting.

Several weeks ago when I first started going out for short walks or shopping, I was clutching the cane tightly and holding myself rigidly and slightly hunched because I was terrified of falling. Walking for just a few minutes was exhausting. I noticed that when I was at home, I didn't always use the cane but I tended to swing my leg and sort of half-hop around the apartment when cooking, etc. I'm planning to go back to work in 3 weeks, so now I'm practicing on improving my gait: I use my cane to steady myself but I don't hold it in a "death grip" like I used to. I sloooow down when I'm walking around a store and make myself walk as normally as I can, making my stiff knee bend as I go (this doesn't hurt). When I swing my legs out of the car or get up after sitting at a restaurant, I stand there for a full 5 seconds and pull myself up straight before I take a step in order to break the habit of looking down and being hunched over.

Another important point. I sometimes experience something I read about here in the forums: You're walking along doing whatever, when just for a quick second, your bionic knee feels like it's buckling and you have to catch yourself to keep from falling. The thing is, it's not the knee, it's the quad. My quads still have a ways to go to recover their full strength and occasionally they "forget to fire", just for a second as I'm walking. Almost made me trip in a store yesterday but luckily I had my trusty cane with me and I wasn't moving too fast.

Anyway, The Boyfriend remarked yesterday that I am walking faster and my gait is starting to look more normal. Yay! :)

Mind you, doing this isn't always easy. If we're out for the better part of the afternoon, I have to ice, elevate and sometimes take a pain pill when we return home. And sometimes my hips ache a little from the effort, but I feel more and more confident, just a little, each day and I thought it might be helpful to share this. The lesson here: don't be too quick to toss those canes away! They can be your best friend right now.:snork:
 
SeptemberZen said:
I'm planning to go back to work in 3 weeks, so now I'm practicing on improving my gait:
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"Mechanics is muscle memory"----take your time and focus on the correct way---it may feel weird at first, but once you correct it, the mechanics of the gait will feel more and more natural and normal.
 
Have to say that my first PT would only check my ROM if I asked and sent me packing after 6 weeks or so....it was only after 3 months that I decided to try a different PT .....I have found the best guide to ROM is what you can do without difficulty. ...you need somewhere around 110+ to descend steep stairs with ease....my OS has a goal of 120 for people and most of us cannot achieve more after surgery than we had before.....they also tell me that they have never had anyone with a true 130 unassisted post op...I am trying to be the first and it is not easy as I get to 128 with much struggle.....we are also restricted by our anatomy as people with thicker legs or heavy muscle may not get that much without a good deal of struggle unless you are a power lifter who can squat with a lot of weight.....and you are right about the quads @SeptemberZen they get weak .....all in all I love my new knees bigtime ....

Vinny
 
My PT's initially checked my ROM at the first appointment, and they would check it from time to time.

What they were more concerned about was what I was doing---was my gait correct (in the early days, absolutely not!) could I go up and down stairs, etc.

My PT's were more concerned about the qualitative rather than the quantitative.

ROM is a number. We do not worry about numbers, except at tax-time.

I never thought, while I was umpiring, "Hey, my ROM is great and I can get into position to see the pitch." I just did it.

What matters most is not ROM---it is what you can do and can enjoy after you are fully recovered.
 
Good morning! Good to hear about your gait...when I was reading your post it was like reading my own! I just had this exact same discussion with my husband, the swinging of the leg and all! I am getting a cane today as I am done with the walker and do not feel comfortable going out and trying to do any type of walking unassisted ..I have PT and feel good about it..yesterday my knee seemed to be a bit less painful! I can bend it without as much pain..I did experience the buckle and it freaked me out a bit, but totally agree that it is the quad...Hope you are having a great day!
 
See, this is why I dumped the new PT. Unlike my in-home PT, no one at the new facility ever took out an instrument to officially measure my ROM. All they did was have me move my leg as straight as I could, then bend it as far as I could and while they were impressed with my current ROM, all they wanted to talk about was "how much work" I would have to do, and how "scar tissue" would build up immediately if I didn't let them do whatever they wanted. It almost seemed as if they lost interest when I was resistant and gave them some pushback on what they wanted to do. They had me doing 3 sets of 10 leg lifts and stretches with the long strap hooked on my foot but not much more. I was interested in working on an exercise bike and working on my gait along with the stretches and exercises. But it seemed that were unwilling to deviate from their regular agenda.

That's when I realized I might be better off on my own. To my way of thinking, improving ROM is like dieting: it's a mistake to focus on getting to a certain number on the scale; a better barometer is how you feel and how you look in your clothing.
 
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Hi SZ. I take a cane with me when I go out but I hold it and only use it occasionally for slopes or steps. You are right re ROM...addressing strength and general flexibility will give you ROM. Maggie x
 
You were correct to discontinue pt. At that stage they should have you doing the bike, total gym, step ups and balancing among other things. I also ratcheted up my leg on a machine that pushed my knee twoard my chin. I controlled the tension and there was a ruler type thing so I could check my progress.
They should have spent at least 10 minutes massaging the knee before exercise. Not only does it loosen the knee, it breaks up scar tissue and it just plain feels good and gets you more rom. I do things on my own like walking, in the gym I go to pool class, bike for 30 min, leg press and hip abductor machine. Once in a while I don't do anything. I over did it and went shopping for 4 hours, came home cooked and did dishes. I had to take a 7.325 Vicodin and still do sometimes so don't feel like you are alone in that. I am surprised your pain is at night only since mine is in the day. I don't take meds at night and haven't for a while.
I too had to consciencely practice my gait, really concentrating on it. Marching in place and holding onto the counter and swinging the leg helped. To test your gait, step in water and walk on the cement. Turn around and look at your footprint and check the distance. Have you tried sit to stands for the quads? Sit in a regular chair, Cross your arms, put them flat on the chest. Stand up, this helps the quads. Hang in there, we are going to be graduates before you know it!
 
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