TKR up date

[maryo52]

There is a wonderful lady on this forum who once lashed out reflexively when her PT hurt her, striking the physical therapist. The PT cried out, "That hurt!" She replied, "What you did hurt too!!"

Josephine calls it assault. And it is. Bearing this in mind will help you set boundaries in PT. Can't wait to hear about your next session!

 

[Deedles8]

Um idiot is an understatement....being swollen makes all the difference in the world. I think you need to get a different therapist.

 

[pbro51]

Well I'm 5 wks post op on my left knee replacement and I went back to see the dreaded PT on Friday. He said i was behind and my knee bend was only at 80%. He said I have to try harder this week and if I don't have 90 or 100, he will need to start pushing and bending my knee himself when I go for my next appointment next week. I went to my doctor last week and he said I'm having panic attacks as I was feeling sick or vomiting when I had to go out of the house. I told him I didn't want to go back to the PT, but he said I have to as it's a big part of my recovery. I'm still worried about going back even though I have tried more with my exercises since my last visit.

 

[Travlingirl04]

Sounds like it's time to get a new PT! Mine has been great to work with and she has repeatedly told me that I should push to the point of uncomfortable, but not to painful. Therapy is important to recovery...you need someone you're not afraid of seeing.
I'm wishing you the best as you move through this at the pace that is right for you.
Joyce

 

[Deedles8]

Do Not let that PT force your knee....go find a new PT but them forcing your knee is wrong!!!! You are still very new post op....(2weeks ahead of me) so the "forced" ROM isn't necessary. Your body is still swelling and the muscles are still protecting.

Maybe Josephine can give more information.....heck if I were being forced I'd have anxiety too. I'm far more eager to get my knee moving than my PT is. It's is your knee that sets the rules on how it's ready to move!

 

[pbro51]

Thanks, Joyce, for your wishes. I have read a lot of posts on here and I know what everyone says that ice, elevate and rest are best. But then most of them have had manipulations. So that makes me wonder if they had exercised more would they have needed this doing. You hear some people saying one thing and then some saying the complete opposite. Its very confusing.

 

[Travlingirl04]

Hi pbro, I'm just two weeks post-op tomorrow, so I'm certainly not an expert, but I don't think most people end up with an MUA. What I have come to learn is that while we have things in common, everyone's recovery is different and we have to let our bodies move at their own pace. The first week I got increasingly nauseous every day and couldn't exercise much. Finally my OS took me off morphine and gave me something else and it made a huge difference for me. Now I'm doing my exercises 2x on most days, but I've been prone to overdo and have to back off again. However, as I mentioned before, my PT has been so supportive and encouraging and not at all pushy, which has really helped. I have seen others on here who had PT's that are threatening and it just seems to me that approach is not very successful and that you shouldn't have to be fearful as you move through this challenging process. Hopefully one of the experts here can give you some advice that will help. I'll be sending you lots of good thoughts.

 

[Celle]

N0, pbro, most of us have not had manipulations. Most of us have had the same worries that you have, but have continued to work on reducing the swelling and doing gentle exercises.

It is important not to let your physiotherapist force your knee ir do anything that causes more than discomfort. Why? Because doing more than that irritates the tissues that are trying to heal, and that causes more swelling.

You can't make your knee bend by working harder at exercises. That's a lesson that many here learned the hard way. Your knee is in charge of your recovery and it will heal in its own sweet time. You can help it best by icing, elevating (toes above your nose) and continuing to do gentle exercises.

Best wishes,
Caryl

 

[pbro51]

Thank you for all the advice. I will take on board all that you have said. Im icing and elevating as i type.

 

[Jamie]

I have read a lot of posts on here and I know what everyone says that ice, elevate and rest are best. But then most of them have had manipulations. So that makes me wonder if they had exercised more would they have needed this doing.

I'm not sure where you've been reading on BoneSmart that you would come away with the idea that most people here have had manipulations. That is simply NOT the case!! Only a very small number of people require this following a knee replacement. Most do just fine with what we recommend as the BoneSmart Mantra - rest, ice, elevate, take pain meds on a schedule if you have pain and gentle stretching and bending exercise for the first couple of months; no pain equals lots of gain. Stick with this routine and you'll be just fine. Some folks just heal slower than others. But at this early point in your recovery, you aren't even in the "slow" stage. You're just fine.

There are many, many therapists out there. Not all of them are the best with joint replacement and they can take too aggressive an approach (treating your healing more like recovery from an injury than a major surgery). If your therapist insists on pushing you to meet numerical goals, find a new one. Under no circumstances allow this person to physically push on your knee past the point of slight discomfort. Tell him/her that BEFORE you start your next session. You are in charge here. You're the customer with the pocketbook. You have rights and can insist on proper treatment.

 

[pbro51]

Thank you Jamie for your message. I must admit these last 5 weeks have been the hardest of my life and its very confusing all the information coming through. I have been following the bonesmart mantra with ice, elevate and pain meds. It has worked well with the swelling. I have done some stretching and light exercise and thought i was doing well. I think its everytime i go to the PT that i always come away with doubts because he is always negative. I am not going to let him bend my knee on Wednesday and im going to take it at my own pace. I might be wrong but he asked me which OS i was with and when my follow up appointment with him was. I think he could be worrying that if im not at the right point when i see him he might get into trouble.

 

[Celle]

This PT is not doing you any good. Several of us have advised you to change to someone else, and stop going to this one. Even when he's not hurting you, he's giving you negative messages. He is totally trained the wrong way to deal with knee replacements.

I'll say it again - get rid of him.

 

[pbro51]

Hi im having a lot of stinging right round my knee. I just wondered if anyone else had experienced this. Thanks for listening.

 

[pbro51]

Hi bonesmart friends, I don't know if anyone has experienced this but would be glad of your input. It seems that every time I either get up to walk or do any kind of exercises the whole of my knee turns black and blue. Then it goes when I sit down again.

 

[Jaycey]

pbro51 can you please tell us a bit about your situation. Have you had knee surgery or are you waiting for it? If so what date.

 

[pbro51]

sorry Jaycey i have posted on here before but didnt know how to link them together. I had a LKTR 6 weeks ago.

 

[Josephine]

​

I merged your threads, pbro One thread for your recovery please?​

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I think its everytime i go to the PT that i always come away with doubts because he is always negative. I might be wrong but he asked me which OS i was with and when my follow up appointment with him was. I think he could be worrying that if im not at the right point when i see him he might get into trouble.

Doesn't usually work that way. But you can either a) ask the physiotherapy manager for a different physio or b) do it on your own at home using this Home physio (PT) and activity progress: suggestions. I never had any physio after my TKR and I did just fine.

It seems that every time I either get up to walk or do any kind of exercises the whole of my knee turns black and blue. Then it goes when I sit down again.

I'm afraid I can't help with this. I would say it is bruising but bruising doesn't usually come and go like that. I think you should speak with your GP about it.

I also have some questions to ask you:
1. what are your pain levels right now? (remember the 1-10 scale: 1 = no pain and 10 = the worst you can imagine)
2. what pain medications have you been prescribed, how much are you taking (in mg please) and how often?
3. how often are you icing your knee and for how long?
4. how high are you elevating your leg, how often and for how long?
5. what is your activity level? What do you do in the way of housework, cooking, cleaning, shopping, etc., and
6. what kind of PT are you doing? How much and how often?

​

 

[pbro51]

Hi Josephine

My pain level is about a 4.

I'm taking nefopam 30mg 2 three times a day and 3 before bed also paracetamol 2 four times a day.

I elevate toes above nose for 30 minutes 5 times a day.

I sometimes prepare meals. Put the washing machine on and fold clothes when they are dry.

I go to physio once a week. I don't do much there, he just wants me to show him what I've been doing then he tells me what my rom is or what he wants me to do at home.

At home I do heel slides, stretching and lie with a strap around my ankle to pull my knee up which is what he wanted me to do this week.

I also walk up and down my living room 6 times. I do those twice a day.

 

[Nomorepain67]

Hi pbro51
I am 10 days post BTKR and can relate to several of your issues. First regarding the burning sensation, I only have this when I am pushing an exercise too far or move too far unexpectedly. The hospital PTs were much more aggressive and I was too timid, doped up or wanted to please that I did not tell them to stop when pain became too intense. My in-home PTs have done much more with massage, gentle movement and asking me if I think I can go a few more seconds or degrees before forcing me to do so. Now that I am regulating my pain meds I am much more in control and not dropping off to sleep randomly as before. Even though I had read many posts on BS, I still wasn't clear what was acceptable movement / pain levels or that really the first few weeks it is all about rest, elevation and icing. I was feeling great so Fri/Sat did all my exercises, pushed my limits and even sat up in a straight chair to fold some laundry. By last evening, my left knee was the most swollen it has been since even coming out of surgery. So needless to say today I am on the couch reclined and doing nothing but resting, icing and elevating.

Regarding being black and blue, I have had very little discoloration on my right leg, but on my left leg it seems to move around daily. Since purple is my favorite color, I even have purple highlights in my hair, it has not alarmed me, but rather surprised me how it moves around so quickly. Even my left foot/ankle have been purple at times. Most are now turning the lovely shades of yellow and green, but others, often dark purple, continue to pop up unexpectedly.

 

[pbro51]

Hi
Im 7 weeks post op now and im getting more than a little scared. I read lots of posts on here and people are getting a lot more rom than i am at my stage. Im only 85 and im worried that im not moving much from this point. I know i have to be patient and everyone doesnt recover at the same time. I know things are very painful but i take my nefopan and paracetamols by the clock. I ice and elevate to try to keep swelling down so dont know what im doing wrong. Sometime i think im just been lazy and not doing enough exercise.