PKR Surgeon Locator

[lm945]

Has anyone here used a physiotouch, or had one used on them?

I just had my second PT (5 weeks after partial knee replacement). I’m curious as to how effective this is, and what I can expect.

 

[Jockette]

Hi and Welcome to Bonesmart!

I have never heard of PhysioTouch, so I can’t comment on it much. I did google it and it looks like it’s some kind of massage tool.

Do you feel it was helpful?

 

[Mutti3]

I googled it as well, it looks like a tool used to reduce lymphadema. Check with your physical therapy provider to make sure your insurance covers this treatment. Or if is billed as part of treatment provided.

 

[Celle]

Hello @lm945 - and

Please will you tell us the date of your knee replacement, so we can make a signature for you? Thank you.

I have also never heard of Physio Touch, but it appears to be a tool for use with lymphodaemia, which is a chronic swelling.

I don't think it's appropriate for your knee, since swelling is normal after a knee replacement. Your knee has been through a major operation and swelling is normal. Ha e you been icing and elevating your leg? That will help reduce the swelling. There are articles about how to do those things in the reading list I am giving you.

Here is the post-op reading list we give to everyone who has a knee replacement. There's a lot of wisdom in the articles.
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
elevate
ice
take your pain meds by prescription schedule (not when pain starts!)
don't overwork.​

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

the BoneSmart view on exercise
BoneSmart philosophy for sensible post op therapy​

5. Here is a week-by-week guide for Activity progression for TKRs


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

Please don't be overwhelmed by the list. The articles are not long and they and contain information that will answer many questions and help you make your recovery much easier on your knee and on you.

We are here to help in any way we can: answering questions and concerns; supporting and encouraging you from start to finish.

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 a 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 history before providing advice.

 

[Jamie]

Lymphatic massage can be a good way to reduce swelling and generally make your knee feel better after surgery. It's done manually as a gentle massage to move fluid in your leg toward your torso where it can be expelled. You don't really need a therapist to do it. I massaged my own leg after my second TKR.

I don't know anything about this machine. I see the program is now called Lymphatic Touch. It may or may not help you. Please don't feel this is necessary for you to have a good recovery. But I don't see how it would be harmful.

 

[Josephine]

I have a young lady come every fortnight to give me lymphatic drainage massage for my swollen feet and legs. From what I've read on that website, I think her treatment is every bit as effective.

 

[lm945]

I'm 2-months post partial knee replacement of my right knee, and I'm getting muscle spasms in the back of my thigh and in my foot. They come on simultaneously. Is this normal, or should I be concerned?

At my 8-week post-op check-up last week (partial replacement of my right knee), I asked a question my surgeon couldn't answer. 40 years ago, I had a patella realignment on my right knee. (I have Ehlers Danlos Syndrome, which causes my knees to not track properly.) While I have no pain from the new implants, I am now experiencing intermittent pain at/from my 40 year old pin, radiating across my leg to the anterior side, approximately 3" below my patella. Apart from the initial post-op pain, and pain in cold weather, my pin has been relatively pain free.

Has anyone else had both of these procedures? Is this a normal reaction to the two procedures? If it is, how long before I can expect it to stop?

My surgery was performed at Cedars Sinai in Los Angeles on March 8, 2018. My surgeon was Dr. David Golden.

I found the Physio Touch to be very helpful. In addition to using it on either of side of the incision, he's also used it on the back of my knee, after I overdid it and pulled a muscle.

 

[Celle]

Thank you for telling us your surgery date. I've made a signature for you.

I'm glad to hear that the Physio Touch helped you.

 

[Celle]

@lm945

You'll notice that I have merged your two newest threads with your original recovery thread. Please don't keep starting new threads.

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]

Now, to answer your questions:

I'm 2-months post partial knee replacement of my right knee, and I'm getting muscle spasms in the back of my thigh and in my foot. They come on simultaneously.

Is this normal, or should I be concerned?

I don't think you need to worry about these muscle spasms.

While I have no pain from the new implants, I am now experiencing intermittent pain at/from my 40 year old pin, radiating across my leg to the anterior side, approximately 3" below my patella. Apart from the initial post-op pain, and pain in cold weather, my pin has been relatively pain free.
Has anyone else had both of these procedures? Is this a normal reaction to the two procedures? If it is, how long before I can expect it to stop?

I think this is a question that @Josephine could answer more fully than I can. I know that I have read somewhere that metal hardware should usually be removed, but your case may be different.

Josephine isn't very well herself right now, but she will answer as soon as she can.

 

[lm945]

Is there any consensus on what causes migrating muscle spasms and how to treat it? They only occur in my right leg, so they’re definitely related to my surgery.

 

[Josephine]

I am now experiencing intermittent pain at/from my 40 year old pin, radiating across my leg to the anterior side, approximately 3" below my patella.

When you say 'pin', what exactly are you referring to? Because the tibial transfer you describe is mostly, in my experience, actually fixed with one or two screws!

Is there any consensus on what causes migrating muscle spasms and how to treat it? They only occur in my right leg, so they’re definitely related to my surgery.

Why do you describe it as "migrating" spasms?

I would also dispute that they are inevitably related to the surgery.

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?

 

[lm945]

Pin may not be the proper term. It's closer to a staple. Three teeth, toward the interior side of the knee, 2-1/2-3" below the patella.

The spasms are only in my right leg, the same as my surgery. I suggested to my therapist it might have something to do with my lymphatic system. He didn't rule it out. I went to my chiropractor, he came to the same conclusion, that my lymphatic system in my right leg is not moving properly. It's responding to treatment (compression sock, acupuncture, lymphatic drainage massage, dry brushing and hot/cold shower).

The lymphatic problem has set me back a couple weeks, which brings me to another question.

My flexion is at 134-135 degrees, which is where my therapist says I'm supposed to be. However, my knee is still stiff and painful when I first get out of bed, and when I've been sitting awhile.

I'm doing everything I'm supposed to. Ice, compression, elevation, exercise. How long before this passes?

 

[SusieShoes]

It may take a few months and maybe up to a year. Your knee still has swelling (and healing) going on inside the joint. It’s a compact space, so the stiffness. You’re headed in the right direction!

 

[lm945]

Thank you. I'm just a bit concerned because I also need to have my left knee replaced. The longer this takes to heal, the longer I have to wait.

I'd been dreading replacement surgery for years (I've had three prior knee surgeries). I've tried everything to avoid this. Once it became inevitable, I wanted it over as quickly as possible.

Plus, my recovery from my other surgeries went fairly quickly. Of course, I was a lot younger then. My first surgery, the patella realignment, was when I was 17.

 

[Celle]

Knee replacements take longer to recover from than most other knee surgeries, so you can't compare them.
Complete recovery from a knee replacement takes a full year, no matter how much you wish it could take less time. There's nothing you can do to speed that up. Your age doesn't matter - it takes an 18-year old knee just as long to recover from a TKR as it takes an 80-year old knee.

The knee stiffness can linger for 6 months or more. It's a normal part of recovery. You feel stiff in the morning, or after resting for a while, because while you are resting your knee is not making the synovial fluid that lubricates the joint. When you get up and walk around a bit, the knee starts making the fluid again - it's like putting oil on a rusty hinge.

 

[sistersinhim]

Tibia pain is pretty normal. Remember that bone was cut off, drilled hammered and the implant forced into it. Mine is still tender when pushing on it.

 

[Josephine]

It's closer to a staple.

Ah yes! Something similar to this

My flexion is at 134-135 degrees, which is where my therapist says I'm supposed to be. However, my knee is still stiff and painful when I first get out of bed, and when I've been sitting awhile. How long before this passes?

That's quite normal and will last a goodly while. Maybe even another 6-8 weeks. After all, you are only 10 weeks out yet. Still very early in the process.

 

[lm945]

A friend of mine is married to a retired orthopedist, who gave me advice that literally no one has mentioned.

Walking heel/toe/heel/toe. He said the lymphatic system in the legs pumps from the bottom of the foot, and that it's important to walk this way.

While walking from my car to the office this morning, I made a conscious effort to walk heel/toe/heel/toe. By the time I got off the elevator, I could feel tingling in my lower leg.

By taking it slow, thinking about my steps, walking heel/toe/heel/toe, I can walk without a limp AND without the cane.

This should be standard advice for everyone, not just those recovering from knee or hip surgery.

Similar, but not quite. Mine has a flat surface, with three shorter teeth.

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?

Ask away.

 

[sistersinhim]

Walking heel/toe/heel/toe. He said the lymphatic system in the legs pumps from the bottom of the foot, and that it's important to walk this way.

You must have have read many threads. We have stressed this gait all along. There's even an article in the library about it.
https://bonesmart.org/forum/threads/extension-how-to-estimate-it-and-ways-to-improve-it.9529/