TKR Surgery yesterday morning>

[Celle]

I agree with KarriB.

Your knee will bend much more easily when the swelling has gone down. It's a bit like a hosepipe filled with water. That can't bend easily, but get rid of the water and the pipe bends much more easily.

Exercising and forcing your knee to bend just makes things worse, so stop doing that.
Instead, concentrate on lots more of this:
- rest, elevate, ice and take your pain meds by the clock
and this:
- if it hurts, don't do it and don't allow anyone - especially a physiotherapist (PT) - to do it to you. Exercise only gently
- if your leg swells more or gets stiffer in the 24 hours after doing it, don't do it again

There's no need to rush to get Range of Motion (ROM), because it can continue to increase for a year or more after a TKR. You don't have to meet any deadlines.
Myth busting: the "window of opportunity" in TKR

You don't have to accept an MUA if you don't want to, either. It's your knee and you have the right to choose what will happen to it. Just tell your surgeon that you would like a little more time.
Saying no to therapy - am I allowed to?
In any case studies have show that having an MUA early in your recovery has no beneficial effect on teh eventual outcome.
MUA: the ineffectiveness of early MUA (JBJS)



This is the approach to physical therapy that is recommended on BoneSmart.
BoneSmart philosophy for sensible post op therapy

 

[BBCG]

Hi Dem, I was in your same boat! But, I have gradually improved and my knee's swelling is going down bit by bit. I was also "threatened" with the "dreaded MUA" too, and stopped letting my therapist push my knee so much, and still icing it every night all night, elevate it whenever I can. I call myself a "sweller"! I just swell up at the drop of a hat, or the walking around on a playground with grandchild, or the walk through Target, etc. So, when my knee is swollen inside (it might not look that swollen on the outside), there's no way it will bend much!

I love Celle's image of a hose filled with water! No way can it bend, right?! You can go read my anxious queries a month or so back when I was also facing the same issue, and I didn't let them do the MUA, backed off on my activity level as much as I could, iced more and longer, even during the evenings, and when I saw my OS, I just said I was making progress and I understood why I was getting there slowly (in my case I'm on my feet at work alot) and he was cool with that, after my fearful days and nights.

I stopped letting PT force my leg to bend and I just stopped fretting about it and said it'll get there when it gets there! Just this week I think I finally am about 90 degrees, too! At almost 4 months... but I'm back doing Pilates, walking some, being very conscious about HOW I walk, practicing some of the very helpful exercises my PT gave me, and doing pretty well. Hang in there and know that it's YOUR knee! You direct the process, not anyone else!!! Sending you strong, taking-care-of-yourself energy!!

 

[Roy Gardiner]

He said that by 21 days if i cannot get 90° i am to call him and may need a manipulation.

Very, very early to be suggesting this. MUA is only done if there are adhesions within the knee as a result of the surgery, which are surprisingly rare.

I am at an approx 70° bend...little more with pt pushing it. Its extremely painful to try to bend further than the 70°.

Don't do it! Pushing past the onset of pain is counter productive.

My leg would barely bend before surgery.

There's your answer. Your soft tissue will have adapted to this and shortened; this means that a programme of stretching exercises will be needed to regain ROM and will take time. My guess (and to be fair it is only a guess, I have no formal qualifications here) is that MUA would be damaging in these circumstances.

I get very upset during physical therapy. I WANT to bend it...it is just so very stiff and painful to bend.

Don't worry, probably nothing is wrong and it will simply take time and gentle exercises to regain ROM.

 

[DEM8869]

I have been icing quite often...several times a day. I ice the front and back of my knee because i have alot of swelling behind it. Surgery was on oct 14. Since then..i have had PT 3-4 times a week. I try to alternate between elevate/ice..bending...and straightening throughout the day. I am not up on my feet for any long period of time other than the other day when i made the trip to the Dr. And then a 15-20 minute trip to the store. It Has been pretty swollen all along and does swell rather quickly once on my feet. Always has...even before Surgery.
Thank you for all of this information. It makes sense to ME...i wish my Dr. And PT felt the same way. I'm going to show it to my therapist. I am very glad that i found this forum. (even though posting here confuses me..lol)

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[Jaycey]

Just say no to MUA! Far too early for this. And please do cut down or stop all that PT. It is counter productive. Rest, ice and elevate. Then easy stretches. No need for all that pushing and forcing.

 

[DEM8869]

Thank you! Ill keep you all posted.

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[DEM8869]

Thank you so much!! I feel a little Better now. I really appreciate the encouragement!!!



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[Roy Gardiner]

It Has been pretty swollen all along and does swell rather quickly once on my feet. Always has...even before Surgery.

It's swelling now for a different reason, the trauma to the soft tissues during surgery not being healed yet. This swelling WILL GO AWAY. How cool is that?

Since then..i have had PT 3-4 times a week.

PT should consist of gentle stretching and guidance on (for example) posture. No pushing, pulling, straining, heaving or any of that sh of that stuff. NO PAIN.