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TKR Struggling to Bend

jessicarogers36

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I had surgery to replace my right knee July 29th. I'm really struggling with getting my knee to bend. I'm so frustrated I was at a 90 bend which I guess I'm behind on where it should be. But now I could only get it to 87 degrees. This is by far the hardest thing I've ever done and wasn't prepared for how hard this recovery would be. Any advice on how to help bend my knee would be appreciated. I do not want the manipulation surgery.
 

Jockette

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Hi and Welcome!

Please try to relax about the bend. It’s only been a month since you had this very major surgery. Healing takes a long time, as long as a full year, for complete healing. It also takes a long time for swelling to go down, and that is what will improve your bend.

How often do you go to PT and what do you do there? What exercises do you do at home, and how often do you do them?

Sometimes, overdoing PT can maintain our swelling.

Regaining our ROM is more about Time than repetitions of a list of exercises.

Time to recover.
Time for pain and swelling to settle.
Time to heal.

Our range of motion is right there all
along just waiting for that to happen so it can show itself.

In the general run of things, it doesn't need to be fought for, worked hard for or worried about. It will happen. Normal activity is the key to success.
 

Jockette

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I will leave you our Recovery Guidelines. Each article is short but very informative. Following these guidelines will help you have a less painful recovery.

Just keep in mind all people are different, as are the approaches to this recovery and rehab. The key is, “Find what works for you.“ Your doctors, PTs and BoneSmart are available to help, but you are the final judge as to the recovery approach you choose.

Knee Recovery: The Guidelines
1. Don’t worry: Your body will heal all by itself. Relax, let it, don't try and hurry it, don’t worry about any symptoms now, they are almost certainly temporary
2. Control discomfort:
rest
ice
take your pain meds by prescription schedule (not when pain starts!)​

3. Do what you want to do BUT
a. If it hurts, don't do it and don't allow anyone - especially a physical therapist - to do it to you​
b. If your leg swells more or gets stiffer in the 24 hours after doing it, don't do it again.​


4. PT or exercise can be useful BUT take note of these

5. At week 4 and after you should follow this

6. Access to these pages on the website

The Recovery articles:
The importance of managing pain after a TKR and the pain chart
Swollen and stiff knee: what causes it?
Energy drain for TKRs
Elevation is the key
Ice to control pain and swelling
Heel slides and how to do them properly
Chart representation of TKR recovery
Healing: how long does it take?

Post op blues is a reality - be prepared for it
Sleep deprivation is pretty much inevitable - but what causes it?

There are also some cautionary articles here
Myth busting: no pain, no gain
Myth busting: the "window of opportunity" in TKR
Myth busting: on getting addicted to pain meds

We try to keep the forum a positive and safe place for our members to talk about their questions or concerns and to report successes with their joint replacement surgery.

While members may create as many threads as they like in the majority of BoneSmart’s forums, we ask that each member have only One Recovery Thread. This policy makes it easier to go back and review the member’s history before providing advice, so please post any updates or questions you have right here in this thread.
 
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jessicarogers36

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That's what I tell the therapist but they tell me I need to have it bending already or the doctor will do it for me. I thought I was doing good. I can lift my leg and walk with no assistance most times. I go to PT 3 times a week. I say I'm trying and get told you can't just try you have to Do. So I get frustrated
 

Suziep

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Hi , I'm in exactly the same position as you , I had my TLKR on August 2nd.
I had my first session on Wednesday and only got to 80 degrees. My PT said that was average for this stage, so I'm not too worried, just frustrating isn't it. I did a few mild exercises yesterday and I've got up this morning stiff as a board, it seems 2 steps forward and 3 back at the moment.
I've ordered an exercise bike from Amazon to try and help things along.
I don't know if it will help ? But I'm willing to try anything right now.
Good luck in your recovery , let's hope we loosen up soon lol.
 
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jessicarogers36

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Thank you so much! Yes it is very frustrating. I really hope once it's all healed it's worth it. Good luck to you as well
 

Jockette

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I’m sorry that you have “therapists” who are putting so much pressure on you. You are doing well, according to what you just said you are able to do.

Why don’t you consider taking a break from going to PT? By now you know some good bending movements which you can do at home on your own. Gentle bends and short walks are all you really need.

Saying no to therapy - am I allowed to?

Are they bending your knee for you? Past where you can bend yourself? If so, this is not in your knee’s best interest.

I do not want the manipulation surgery.
It is far too early to be thinking MUA, or for anyone to be recommending it. You need time to heal, and that timeframe is different for each of us. Also, having that procedure is your decision, not theirs, they can’t do it unless you sign a consent form, and you have the right to say no.
 
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jessicarogers36

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Yes they bend it for me it's extremely painful and I scream and tell them to stop. It's not that I don't want to I can't!
 
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jessicarogers36

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I do feel better after PT don't get me wrong. I feel loosen up and stronger I just dread when they want to measure how far I can bend. I get anxiety about it and I think tense up worse.
 

Jockette

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Yes they bend it for me it's extremely painful and I scream and tell them to stop. It's not that I don't want to I can't!
That is the wrong kind of treatment and I won’t even call it therapy. You don’t have to let them to do that.

If it was me, I’d either find another office with a better rehab approach, or I’d do my own rehab at home. We have members who don’t go to formal PT and they do just fine.

This is what one of our members, TortiTabby, experienced:

(Just so you know, ADL means Activities of Daily Living.)

“At my six week appointment this is what my OS wrote in my visit summary: "She reads an online website called Bone Smart which states to not push through pain following knee replacement. If she were to follow this direction, she will have to learn to live with a knee that only reaches to 85 degrees of flexion. I believe this website is very misleading."
It has now been 20 weeks and all I do is ADL and this is what my ROM has done:
3.5 wks: 75
6 wks: 85
7 wks: 90
10.5 wks: 95
14 wks: 100
17 wks: 105
20 weeks (where I am today): 110
I am so thrilled it keeps improving and improving and I know now that I will get to my goal of 120 (or even better, dare I say!) :egypdance:
So, if a OS or PT bullies you into thinking your ROM will not improve over time they are wrong. By the way, I haven't been back to see the OS since that horrible appointment at 6 weeks, but I sure am going back when I reach 120 just to say, "Ha! You were wrong, BoneSmart was right!" :yes:

And,

“Just an update for those who are apprehensive about gaining ROM:
It has now been 26 weeks and all I do is ADL and this is what my ROM has done:
3.5 wks: 75
6 wks: 85
7 wks: 90
10.5 wks: 95
14 wks: 100
17 wks: 105
20 weeks: 110
26 weeks (where I am today): 120!!!
I did it! My goal of 120! No "pushing through pain", no PT after the first 3 visits, and most importantly to me: No MUA! My surgeon who said I would never get beyond 85 ROM without pushing through pain was wrong, wrong, wrong. I'm excited to see if it gets even better. :happydance:
 

MrsJW

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Yes they bend it for me it's extremely painful and I scream and tell them to stop. It's not that I don't want to I can't!
This sounds awful!! I am 5 weeks post op and can bend just over 90 degrees now although some days it’s stiffer and much more difficult. I have been doing my exercises at home but have decided not to put myself under too much pressure. I’m trying to treat my knee gently. I have been worried about the stiffness and swelling but a lot of the articles and info I’ve read on here say that it’s a long process and not to worry too much.
I’ve been for physio but nobody has forced or manipulated my knee - just encouraged me to move it. It does ache inside after I’ve exercised but I suppose that’s normal. Try not to worry, it is still early days for us xx
 
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jessicarogers36

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Thank you so much. This helps a lot. I will not let them push my knee into a bend anymore. From the beginning to where I am now I'm proud of myself. So they will have to go my pace. I'm only at a 87 degree bend by myself but I was at 55 at the very beginning.
 
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jessicarogers36

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Thank you. I just wish sleeping positions were easier lol. I'm knocked knee so it's such a weird feeling having my leg/knee straight. Also my hip isn't used to it either so it gives me pain as well.
 

Jockette

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Things will settle down as your body adjusts to it‘s new normal, but it will take time. :bored:
 

Rain Dancer

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Thank you so much. This helps a lot. I will not let them push my knee into a bend anymore. From the beginning to where I am now I'm proud of myself. So they will have to go my pace. I'm only at a 87 degree bend by myself but I was at 55 at the very beginning.
That is a great improvement in flexion, and you should be proud of yourself! I know that it is hard to believe that because of how awful your therapists are. It sounds as if they are taking the cookie cutter approach and not tailoring therapy to your needs. I echo what the others have said and what you are prepared to do—don’t let them push your knee! I am slower to regain flexion too. At five weeks, I am up to 85 degrees and seem to improve by about 5 degrees a week. It is frustrating, but I know that I will get there, and you will too! Good luck.
 
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Gingerbread

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Yes they bend it for me it's extremely painful and I scream and tell them to stop. It's not that I don't want to I can't!
I had my RTKR July 22.
I'm barely at 90 degrees and that's only with the PT forcing it there.
Yesterday I was on the bike and she kept holding me at a higher and higher rotation and I nearly passed out, despite me telling her to stop. When on earth did no stop meaning NO?!
She was excited and said "Next time you'll make it all the way around!" Next time is tuesday! I think if she forces that rotation I will possibly vomit or pass out, that is the God's honest truth, the pain is that bad.
I understand and commiserate with you. It is literally panic invoking. I wanted to slam her head into the side of the bike last night when she wouldn't stop, it was so bad!
 

sistersinhim

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Yes they bend it for me it's extremely painful and I scream and tell them to stop. It's not that I don't want to I can't!
Just think of what is happening on the inside of your knee. Closing stitches. Look at all these layers of stitches you have. What happens when that therapist pushes your knee past where it is really to be searched. Those knitting together tissues are being pulled against all those stitches. Some of those tissues probably even tear some. That leads to inflammation which leads to pain and swelling. That swelling, along with your pain, is keeping your knee from bending more than it can. By the way, your bend is fantastic for less than a month out. Most OSs expect 90 degrees at the 6-week mark, and that is only on a less swollen knee.

I think you and your PT are more concerned about numbers than function. I always judged my knee by what I could do and did not bother with measuring it. If I were you I'd stop going to PT or if you still want to go, tell that therapist "hands off of my leg, I don't care about the ROM, just the function"!
 
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jessicarogers36

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The PA I seen after my surgery I haven't seen the surgeon yet said I should have 90 at 2 weeks.
 

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