Bilateral TKR Stiffness

[Yerdua]

Without PT all the research and doctors say I won't get ROM . I am so confused .

 

[Jockette]

Most research online is about the aggressive approach which sounds like what you are doing, at least to some extent.

BoneSmart’s approach is much gentler, moving the knee gently and doing ADLs (Activities of Daily Living- just going about your day doing what you normally do) which really is all the “physical therapy” our knee really needs.

Many times PTs focus on strengthening the knee/leg but they don’t take into consideration the knee’s need to heal first. Doing more than your healing knee is ready for causes pain and swelling, which you’ve experienced.

Bonesmart’s approach sounds radical, especially in the US, but if you think about it, it makes more sense to slow down and heal. Knee replacement is major surgery which, while does an awesome job of giving us a new knee, it also causes a lot of trauma to our body and it takes a long time for the body to heal, so that it can take advantage of that new knee.

 

[Celle]

Without PT all the research and doctors say I won't get ROM

No. Not all the research says that. And not all doctors say that either.

For example, my surgeon doesn't allow any PT at all for the first month after a knee replacement. He says your knee needs that time, to start on its journey of healing. For that month, we rest, ice and elevate our leg, and walk around the house.
After that month, we just go to PT once every 2 weeks, where we are shown a few new exercises to do at home.
His patients all do well and achieve good ROM, as I did, and he hasn't had to do a manipulation to help with ROM for the past 4 years. I think that speaks for itself.

In addition, there are lots of us here who have done no formal PT at all, but just let our activities of daily living be our exercise.

I've had three knee replacements - a right PKR, a right revision to TKR, and a left TKR.

For the first two replacements I did very little PT, just going every 2 weeks after the first month. For my last TKR, I never went to PT at all.
Both my knees are strong and reliable. They straighten fully and they bend to about 130 degrees.

 

[Josephine]

Without PT all the research and doctors say I won't get ROM . I am so confused .

Don't be confused. We're just offering an alternative way which is just as effective and more successful than others. All those reports and discussions that say you MUST do this and you MUST do that are not commonsense. I've proved it and so have many others in this forum.

I recommend you read my recovery thread to see how little exercising I did for either knee! Knee recoveries UK style Parts I & II (Josephine)

You would also be sensible if you accepted my offer of help. You never have.

 

[sistersinhim]

I didn't do formal exercises either after any of my 11 knee surgeries.

 

[Pumpkin]

I am so confused

It is difficult with so many different opinions about needing PT not needing PT, etc. You can find research supporting either position.

The important thing is you decide what works best for you, so far the aggressive PT approach is not working.
It may be time to change direction and give your poor injured knee a chance to heal.

 

[Pumpkin]

A good approach is to Rest, Ice, and Elevate, the activities you do during your day is more than enough while you are healing.
Your poor knee is only 5 weeks out, very very early in this yearlong + recovery. Give your knee a chance and it will serve you well. Over doing will only set back your recovery.

 

[Yerdua]

I am happy to say after 10 weeks of getting Bilateral knee replacement surgery I finally got 90 rom on my right knee and 86 on my left! I was for the first time able to do rotation on a bike!
This has and is a very difficult recovery for me.
I was in Bermuda for 6 days and had to walk alot and tons of stairs.
But it actually even though at the time hurt so badly ended up helping me .
I stopped using my cane yesterday , a day after returning . I did my PT while there too. I am going to continue doing lots of stairs and walking as it is working for me. I finally see a light and hope.
So for those who are having trouble getting range of motion just be patient and when swollen ice/elevate. Then move!

 

[Celle]

Hi again @Yerdua
You'll notice that I have merged your newest thread with your original recovery thread.
For several reasons, we prefer that you only have one recovery thread:

• That way, we have all your information in one place. This makes it easier to go back and review your history before providing advice.
• If you keep starting new threads, you miss the posts and advice others have left for you in the old threads, and some information may be unnecessarily repeated
• Having only one thread will act as a diary of your progress that you can look back on.

So please post any updates, questions or concerns about your recovery here.
Don't worry that we won't see your question because, between us, the staff read all new posts every day.
If you need an urgent response to a question, just tag a member of staff.
How to tag another member; how to answer when someone tags you

If you prefer a different thread title, just post what you want and we'll get it changed for you.

Here are the instructions on finding your thread, How can I find my threads and posts? . Many members bookmark their thread, so they can find it when they log on.

 

[Celle]

I'm glad your ROM is improving. It will continue to improve, especially if you cut back the amount of exercises you are doing.
Your activities of daily living are enough exercise for your knees.

It's not exercising that gets you your ROM - it's time. Time to recover, time for swelling and pain to settle, and time to heal. Your ROM is there right from the start, just waiting for all that to happen, so it can show itself.
There's no need to rush to get ROM (Range of Motion) because it can continue to improve for a year, or even much longer, after a knee replacement. Recently, we heard from a member whose ROM had increased after 6 years.
There isn't any deadline you have to meet:
Myth busting: the "window of opportunity" in TKR

 

[Roy Gardiner]

Without PT all the research and doctors say I won't get ROM . I am so confused .

Don't be confused; as everyone is saying, the message is wrong.

 

[sistersinhim]

Why not listen to us and thousands of others that have been on this site after having a tkr. We know that very gentle movements while doing our daily activities is what rehabs our knees the best. Not PT. We have all been through it! The vast majority of PTs and OSs have not have a tkr. Experience is much better than book learning!

 

[Yerdua]

I am 3 months out from bilateral knee replacement surgery and my ROM is only 96 right knee and 88 left knee. Why especially after walking or standing only 5 minutes do my knees still get incredibly stiff and ligaments tight and hurt?

I find after doing heel slides on the wall they get incredibly painful for days after. The only times I achieved more ROM is after a day or days of walking miles and doing a lot of stairs. Heel slides on my bed are ok but anywhere else like sitting in a chair or on the wall sets me back to pegleg!

Am I wrong in feeling that now PT is hurting me instead of helping me?

I see my surgeon on the 5th and I know he will be unhappy with my ROM. But my last visit 8 weeks ago I was only in the low 70's. If he says MUA I will refuse as every week I get a little more ROM. From all I have learned at bonesmart many people have had trouble like me but do get the ROM just takes much longer.

I just don't understand why this week (Tuesday with PT did intense wall heel slides) I feel such a set back with pain, stiffness hard to bend when walking

Advice?

 

[Pumpkin]

@Yerdua,
You'll notice that I have merged your newest thread with your original recovery thread. For several reasons, we prefer that you only have one recovery thread:

• That way, we have all your information in one place. This makes it easier to go back and review your history before providing advice.
• If you keep starting new threads, you miss the posts and advice others have left for you in the old threads, and some information may be unnecessarily repeated
• Having only one thread will act as a diary of your progress that you can look back on.

So please post any updates, questions or concerns about your recovery here. If you prefer a different thread title, just post what you want and we'll get it changed for you.
If you need an urgent response to a question, just tag a member of staff.
How to tag another member; how to answer when someone tags you

Here are the instructions on finding your thread, How can I find my threads and posts? . Many members bookmark their thread, so they can find it when they log on.

 

[Pumpkin]

Your ROM is fine almost 90 degrees on the left, and 96 on the right, both knees are slowly improving, and will continue to do so for quite awhile going forward.

Am I wrong in feeling that now PT is hurting me instead of helping me?

From reading the rest of your post it is time to Quit PT, it is only aggravating your poor knees. For example: this quote.

PT did intense wall heel slides, I feel such a set back with pain, stiffness hard to bend when walking

I find after doing heel slides on the wall they get incredibly painful for days after.

From the two above quotes, it seems heel slides are your downfall, QUIT doing them.

The only times I achieved more ROM(Range of Motion is after a day or days of walking miles and doing a lot of stairs.

This is what you should be doing, listen to your knee so you do not over do, a little will go a long way.

I will refuse as every week I get a little more ROM.

You are right to feel this way about MUA, you are making slow but sure progress.

 

[kneeper]

I think you are right when you say week by week. Don't look for change day by day.

 

[Yerdua]

Thanks for the advice. I am worried about how little my knees bend after 3 months and the stiffness in my muscles . I pray it will keep improving but what is the deadline that MUA won't work? How much time do I give this before considering it?

 

[sistersinhim]

There is no time limit for achieving ROM or having a successful ROM.
https://bonesmart.org/forum/threads/myth-busting-window-of-opportunity-in-tkr.6895/

 

[sistersinhim]

Also, look at just 2 of our members who logged their recovery process:

One of our members, Bertschb, kept a record of his ROM process. He agreed for us to post it for those of you that are afraid you're stuck. The key is to have patience! Bertschb says:

I'm 12 months out from my surgery and have some advice based on my experience:
1- Stop going to PT (all it will do is make your knee swell and reduce ROM)
2- Don't worry about your ROM
3- Be patient - VERY patient!!!

Here is my ROM history (more or less):
1 month - 60 degrees
2 months - 80 degrees
3 months - 85 degrees
4 months - 90 degrees
5 months - 90 degrees
6 months - 110 degrees
7 months - 120 degrees
8 months - 125 degrees
9 months - 130 degrees
10 months - 135 degrees
11 months - 140 degrees
12 months - 140 degrees

I spent waaaaay too much time worrying about ROM. I thought I'd be riding my bike a couple months after surgery but it took SIX months! Looking back on my surgery, if I knew then what I know now, I wouldn't have wasted my time with PT and I wouldn't have worried about ROM.

This is what one of our members wrote about the slow development of her ROM. (Thank you, @Campervan ) As you can see, her flexion continued to improve for a long time.

"I had a slow recovery. Here's my flex measurements at various points:
92 - 8 weeks post op
105 - 10 weeks
107 - 5 months
110 - 6 months
112 - 7 months
116 - 9 months
119 - 11 months
118 - 1 yr
120 - 1yr 2 months
125 - 1 yr 8 months
128 – 6 years "

 

[Josephine]

I'd really like to offer you some structured advice but in order to do that, I also need to ask you some questions. Are you willing for me to do that?