I wonder, would you be kind enough to detail exactly what 'on your terms' actually involved?
It would be so very helpful to know
@Josephine, initially the hospital case manager scheduled home PT visits that were to begin my first week out from surgery. During the second visit the therapist asked me to scoot up to the edge of the chair. She had me place my foot on a hand towel on the floor and instructed me to move my foot back bending my knee as far as I could. I brought it back to where my knee was pulling pretty good but stopped at 'discomfort'. With no warning and before I had time to stop her, the therapist pushed my leg back fast and hard. The pain was unbelievable and shot right up through my hip. I pulled back away from her and with a raging flush in my face asked her what she was doing. She responded 'increasing your flexion'. I told her she had hurt me and I should have been informed of what she was going to do first. She went on to explain there was going to be pain in gaining ROM and I said, 'not for me, not now'. I told her that was all the therapy I felt like doing that day.
I had learned enough on bonesmart by that time to know that PT wasn't necessary. So the first 'on my terms' was ending the home PT order.
I didn't feel like doing any exercises the next 4wks so I was content with the necessary activities around my house. I did work on my gait taking short heel to toe strides. I paid the most attention to staying on schedule w/ pain meds, icing and elevation.
At 6wks I had my first post-op visit with my surgeon. He measured my flexion at 50*s and I perceived that he was sincerely concerned. He asked me how my PT was going and I told him it wasn't- that I was concentrating my efforts on reducing the swelling and allowing the healing of soft tissue and other surgical damage to heal. He was disappointed by that which concerned me but I didn't let it intimidate me.
During that appointment he told me he would need to go back and fix my limited flexion and I shook my head 'no'. He then told me that if I didn't get at least 90*s by 8wks he hoped I would consider an MUA. He said he wanted to recheck it in 2wks and I could let him know at that time what I wanted to do.
I left concerned that if I refused the MUA and couldn't get my flexion back say in 6 months that my health insurance company might take that opportunity to deny coverage due to my noncompliance. I felt really torn so I decided to give PT a try for the 2wks leading up to the next visit with my OS.
I'm sorry this is getting lengthy but I feel it important you know what has led me to where I am now.
During my first PT visit a few days later I sat down with the intake person and told her what I would & would not tolerate. No one was to touch me without informing me first. That there would be no pushing my knee in manipulating a 'better' flexion. That the real number would come from what I could actually bend. And that I was willing to do gentle bending exercises through to the 'discomfort' point but would not tolerate outright pain. I would stop doing any exercise I felt painful. And I also told her there would be no weights on my knee to increase extension- no squats- none of the unhealthy exercises this early in recovery that I've learned from you Josephine.
I then asked her if they would provide PT on my terms and she agreed they would. I came home after my first visit with a few simple stretch exercises but I didn't do the recommended reps- I did them to where I felt discomfort and stopped. So this is how I have handled my 7.5wk knee recovery in regards to PT on 'my terms'.
I probably could have handled these things better but at this point I'm just a bonesmartie 'wanna-be'!!