TKR Waking up screaming

[hotjam]

TKR was July 18 and I am diligent about exercise so was pleased to hear I was ahead of the curve at PT 1-week.

A different PT did week2 and different things like using the peddler for ten minute warm up, pulling my ankle to bum with strap and some sort of pressing down on my leg with both hands leaving the kneecap clear.

Uncomfortable to the point that I have changed therapists BUT woke up I screaming in pain next dawn. Felt like knee cap has shifted right and is pressing down on something, to the point of fainting. It hasn’t corrected despite ice; pressure makes it worse, and it comes and goes. Any advice?

I have put a call into my surgeon but it's a holiday weekend.

At this point I think the patellar button has come loose or or, or,

 

[Jaycey]

@hotjam Welcome to BoneSmart!

A different PT did week2 and different things like using the pedlar for ten min warm up, pulling my ankle to bum w strap and some sort of pressing down on my leg with both hands leaving the kneecap clear.

In all honesty I am shocked at this treatment. You are just days out of surgery. This should never be allowed! Please do not go back to any more PT. It will only set you back and could indeed injure you.

Please keep icing and elevating as much as you can. You need to get let that knee settle. Our Nurse Director recommends 45-60 per icing session, several times per day.

Are you taking any pain medication?

I'll leave you with some guidelines for this recovery. I hope this pain eases very soon.

BTW - which knee did you have replaced? I'll pop your surgery date into your signature for you.

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. At week 4 and after you should follow this Activity progression for TKRs

6. Access these pages on the website

Oral And Intravenous Pain Medications
Wound Closure​

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 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.

 

[kneeper]

Terribly rough treatment and totally unnecessary. I agree with ice like crazy this weekend!

 

[Pumpkin]

I agree with Jaycey, the treatment you received is unacceptable. Now is the time to let your knee heal, no need for PT this early, if at all.
Glad you called your surgeon, hope you get in soon to have it checked out.

 

[Josephine]

pulling my ankle to bum with strap and some sort of pressing down on my leg with both hands leaving the kneecap clear. BUT woke up I screaming in pain next dawn. Felt like knee cap has shifted right and is pressing down on something, to the point of fainting.

I've heard of things like this before and as a rule, they are the result over aggressive manipulation by the therapist. Pain that severe can indicate a torn muscle or ligament for which you need to get early attention, preferably an untrasound scan and clinical examination by an experience doctor/surgeon.

In the mean time, please ensure you rest your leg completely and ice, elevate and take pain meds though you might not find the latter very effective.

 

[Celle]

I'm sorry that PT therapy has caused you this much pain.

The others are correct - rest, ice and elevation is what your knee needs, not lots of exercise.

If sounds as if you've been told that you have a deadline to met, to achieve Range of Motion (ROM). That's an old myth that should have died long ago.
There's no need to rush to get ROM (Range of Motion) because it can continue to improve for a year, or even much longer, after a knee replacement. There isn't any deadline you have to meet:
Myth busting: the "window of opportunity" in TKR

It's not exercising that gets you your ROM - it's time. Time to recover, time for swelling and pain to settle, and time to heal. Your ROM is there right from the start, and it will gradually increase as your knee heals.

 

[Jockette]

If sounds as if you've been told that you have a deadline to met, to achieve Range of Motion (ROM). That's an old myth that should have died long ago.

Not only was my ROM better at my one year check up than it was in the early weeks, it has even improved since the 2 year mark.

If I had totally believed that it would continue to improve this long I would have done things very differently in the beginning, like backed waaaaay off the PT that only caused me set backs.

 

[eaglemom]

As others have said I'm really disappointed in the PT you were receiving. Way to much for such a baby knee. that explains the pain your suffering from for sure. I've found the ice/elevating to also fundamentally help with pain also. Maybe its in my head? I don't know but you need to be doing nothing but icing and elevating. Hang in there.

I just had another thought. I know my legs have been so restless, wiggling around when I'm suppose to be sleeping. Even though its summer I've tried putting a very lite weight blanket on my legs when I'm in bed. For me that oddly seems to have helped. Its strange because I usually don't like the sensation of the sheet on my knee. Go figure. Its all trial and error what helps besides ice/elevation.

 

[winemama]

@eaglemom i too found a weighted blanket helped, I have a 20 lb one, the weight never bothered my knee, and kept me from moving around
@hotjam I’m so sorry you went through that pain with your PT. Be your own advocate, when it doesn’t feel right, don’t be afraid to say STOP. Good luck

 

[hotjam]

A giant grateful thank you to you all for the input. You have certainly confirmed my instinct to stop and heal with ice and elevation. I DID have a schedule put out by gov’t that ROM shld be 80% normal by 5 weeks, but I will work at my own pace now. I was surprised as I did months of pre-hab work. I talk to my surgeon tomorrow :/

 

[kneeper]

"Prehab" can help with muscle tone and things like that, but post surgical swelling is a whole different thing. Swelling will impede your bend. Most of us find as our swelling comes down our bend goes up. Gentle motions taking the knee through its bend are all I did. Nothing forced or to the point of severe pain.

 

[hotjam]

So when does everybody usually progress? I have read the timeline and all the rime advice- does it take two years to get back to normal?

 

[kneeper]

Everyone is different. I'd say at 6 months I was in good shape but there was still low level recovery going on for a full year. With knee #1 I'd say it was a bit over a year and knee #2 just about a year to feel completely "normal."

 

[InkedMarie]

Have you talked to your Surgeon? Regarding PT: if there is one you like, make your appointments with that one and tell the scheduler you will only work with that therapist.