Will ROM continue to improve

[dar]

Will my ROM continue to improve after I stop going to Therapy sessions? I've done six weeks of Out Patient Therapy and have two more scheduled, so that would be a total of eight. They told me they would contact my insurance company to see if I could have more. They have forced my knee to 112 and they tell me the goal is 120 and I'm progressing well. I can ride my exercise bike fairly well, I've spent the evening walking around my apartment with no cane and today I even walked up stiars - like a normal person, one leg after another. I haven't done that in so very, very long, that accomplishment has made these six weeks worth it. I can't wait to see what lies ahead. Anyway - back to my question. My biggest concern now is getting back to work full time and because I live in the country and drive to town it is a three hour commitment for each session and that is time away from work. I want to continue if it is a good idea. I'm 43 and want to get as much as possible back in movement from my knee. I don't want to short change myself at all, but if I'm going to continue to improve anyway should I just tell them I'm done after these two weeks? Or is it a better idea to continue as long as insurance covers it.

 

[Doug]

Dar,
I would recommend you continue P.T. as long as you possibly can. Then, you probably need to have a stationary bike of some type at home.
With any physical accomplishment, there is an old saying "If you don't use it you loose it".
I practiced martial arts which required lots of flexibility. If you don't keep up with stretches you will get tighter.
With your knee, you will gain some flexibility as swelling continues to go down. I'm at 5.5 months.
However, If you don't do any exercises, you will not gain strength in the supportive muscles around the knee.
As for the magic number for ROM. Increase it until you can function as you want to.

 

[Josephine]

 

[Rowdy66]

Like Doug Said If You Don't Use It You Lose It. I Have To Exercise Every Single Day And While I Can Take The Occasional Day Off The Exercise Bike I Do Better When I Do It Everyday As Well. I, Also, Do Stretches Several Times A Day Whenever I Am Sitting Down And That Really Helps To Keep Me Flexible. I Have Done That For As Long As I Can Remember. Inability To Sit Still For Once Has Paid Off After A Lifetime Of People Telling Me To Stop And Sit Still. Thank God For Antsyness I Suppose. Rowdy

 

[dar]

Well, it seems that I've come to the realization that I've been trying to get back to the world and schedule I had -- which is no longer possible. And I don't acutually even want. The old is limpy, sit around and groan, able to do nothing but sit at my desk and work. The new will have to change her schedule to exercise daily, walk around, join the group .... oh - I get it, the new will have a life worth living. I'm slow at getting there, but maybe I'm suppose to have a new mindset along with this new knee!

 

[Doug]

dar,
We've all been there and done the "limpy,sit around and groan" thing. It will get better, lots better. Just work hard and give it some time to heal.
One day, and remember I said it, you will be walking along not even thinking about your knee. Then you'll step up on a curb with your new knee and then smile at your self....just wait. Its coming.

 

[referee54]

PT is not something that you sort of ease up on---I have found that it is a way of life for me now---it is a change in the way I think and approach things.

I teach, and when I went back to school, I went tstraight to PT after school at least twice a week, and to a gym the other days. Now I ride a bike at least six days a week---sometimes seven. I commuted to and from school this past spring on my bike (also cut down on gas $$$)

As the others have said, the harder you work, th more yo will gain. I will not say it will be quicker, as it took me about four months to stop limping (I had a bilateral done in November)---but in less than a week after outpatient PT I was back on the baseball diamond calling balls and strikes.

AS long as your insurance covers it, I would go---they know what they are dong and will challenge yo in new and creative ways. Then, after you finish, you can go to a gym and recreate what they had you do. Inactivity is not a good thing for us.

You got the TKR to become active again...as the ad says, "JUST DO IT."

Tim C.

 

[Newwoman]

If it helps any Dar, my surgeon told me we will increase rom until about the 18 month mark. That does not hold true for how straight you can get your knee so be sure and work on that. Like Doug and the Ref say PT is important and do it as long as your able. When you sessions start to dwindle do what I do and that's schedule fewer visits per week so I can assimilate myself back into a normal life and then they check my progress. I am 5.5 months out on a trkr.
Good luck and hang in there around the 5 month I woke up and my knee wasn't the first thing I thought of, you will get there I promise.
Cathy

 

[Gretchendz]

Hi. I'm almost 8 weeks out, and I made my biggest gains in PT in the last week.

I know everyone is different, but I started with really poor ROM. So, my experience is, keep with the PT as long as there is progress to be made.

We had to struggle to get me to -8 on extension for weeks. Suddenly, last week, (after a couple of very painful PT sessions), I can reach -2 with much less effort!

Now we're working on flex. But here again, we had to work to get me to 90 two weeks ago, now my starting point is past 90.

Best of all, I can often walk with little or no limp. When I do limp, it's usually becuase my non-surgical knee is acting up

 

[bumleg]

Hi yall. Before I had TKR I was using one of those exercise bands to help stretch my L quad muscle to increase the bend in my knee. I could only get it to go so far and then it wouldn't go any further as if something was stopping it. Same thing for straightening it out. After TKR extension is 0 and I can grab my toes and stretch the leg fully. The bending is whats giving me a problem. I am 8 days post op and reached 95 degrees yesterday with a lot of force. Everyday it seems that I am starting all over at the beginning with the flexion. My therapist told me theres a small window of opportunity after surgery to get the complete bend back. After that the knee will need a manipulation to function normally. I am stressed out over this. Will things get better after my staples are removed? The knee is still very tight but I manage to make it stretch. She also told me that my insurance will only pay for 10 PT visits. Called the OS office yesterday to see if I could have stronger pain med for therapy. NO, but I can take 2, 5/500 Lortab every 4 hours instead of the prescribed 6.Good thing I have a small stash left over from another recent procedure. I see OS on 4/3 I'll ask him in person. I doubt that his nurse even bothered with that one. Plus the med prescriptions is all I was sent home with. Thankfully I was able to get a cyro cuff to ice my knee with. I have a rocking chair so I can do constant motion with the knee, it just won't be passive. This is driving me crazy. Maybe I'm just being impatient and need to take a breath and relax. I'll be contacting my insurance company Monday because 10 days doesn't seem like enough PT after a TKR. Just curious, how long does your therapist stay in your homes per visit? Mine helps me through 1 set of reps per exercise and watches me walk (this takes about 1/2 hr) and then I'm supposed to do the rest on my own seemingly at my leisure. My gut is telling me that I need to be more agressive on attaining the knee flexion. Is it possible to work the knee too hard? 4-5 of my exercises are to strengthen my thigh muscles and 2-3 exercises to help increase ROM in the knee. I guess I'm looking for suggestions as how to force the ROM to increase.

 

[Josephine]

First of all, 8 days is very early to be expecting significant results from PT. PT goes on for months and as someone said elsewhere today, improvement can continue for up to 8-12 months. Don't let the PT's negativity about a manipulation put you off. It's not that common to need one.

Yes things will be better when the staples are removed.

As for the pain meds, will your personal doctor not prescribe for you if the OS office won't? You'll need something for at least 3 months maybe more.

I recommend that you chill out a bit - do what you can with your physio and remember that it's the activity over a period of time that produces results, you don't get significant results on a daily basis. Another wise comment by one of the members here was that it didn't take your knee 8 days to get into a condition where you needed this TKR so it's not going to take 8 days to get back to normal! Not even 8 weeks! This is a long term project so don't let yourself get stressed out by making you expectations too high.

 

[1jt@atime]

bumleg, you know 95 degrees at 8 days is actually quite good and something to be proud of. Also know that the stiffness is not going to go away overnight. You have to restretch everytime you get up and move and that's what is important, that you restretch that knee everyday and several times a day at that. It will probably take about 4 months before you realize that stiffness is almost, but not completely gone. So, please understand that it's normal. I agree that you will probably need more pain meds. Do remember to take it before you exercise so that you can get further with the stretching. Good luck and remember we are all here to help. Karen

 

[bumleg]

Hello all. I'm back after a few days break from the computer. I reached 102 this past Thurs, my last day of formal PT. I'm on my own now. After reading Josephine"s post I think I'll talk to my GP about stronger pain meds so I can continue to increase my ROM hopefully without my crying towel. I have only taken Aleve for the last two days instead of my Vicodin to see what my pain level actually is and to see if it is helping or if its as useless as it was a week ago. The jury is still out.
I was trying to reach 102 again this morning and felt a burning sensation in my incision. It stretched a little bit but is still intact so now I'm taking it easy for a day or so to make sure I don't bust the thing open. I have a glider rocker that I call my torture chair. It has been a helpful piece of equipment in working my knee to maintain the ROM I have reached and keep the stiffness at bay. I am walking outside with a cane and without knee pain. I am a lot less stressed over the manipulation thing. I am glad to hear they're not all that common and that I won't be needing one of those. I have also been using heat before I do the stretching and it seems to help. Like the rest of you I'll keep plugging away at it until I get where I want to be. Its also nice to know that Rom can keep increasing up to 18 months. It gives me something to look forward too. Thanks for your input and support.
For those of you who are in the same boat, it will get better. It takes hard work and determination but it will pass. Better days are on the way.

 

[Josephine]

Always good to test things out so you know what is working and what's not. No point in taking useless meds, eh?

As for that burning sensation, whilst you were wise to ease up a bit, don't let it put you off too much. The early scar tissue is very inelastic and ungiving. Like having a length of twine in your skin instead of the nice stretchy stuff that nature puts there! But it will soften up with time.

 

[bumleg]

I called my GP and he gave me was forty 7.5/500 Lortab 1 every 4 hours. I'm thankful he gave me that. How much stronger is it really? Is the 500 part the Tylenol or is it the narcotic? I'm beginning to feel like a drug seeker when all I want is enough relief so I can rehab properly. Its frustrating since I don't have a history of abusing narcotics. Useless meds is why I had the stash left over from my meniscectomy last Dec. They didn't help the knee so I didn't bother with them. I couldn't see taking them for stiffness in other joints when NSAIDs took care of those. I took one of the 5/500 Vicodins the other day and four hours later it still hadn't helped so I took 2 more out of desperation. After I took those it wasn't long before the pain subsided. I was able to give my knee a good ROM workout. Since my docs aren't going to give me anything majorly effective I'll have to do the best I can with what they give me. Its been hard for me not to show my butt and get nasty with the OS but I don't think that will accomplish anything. Docs can be so spiteful when provoked.
I have been massaging my scar . I took it easy a couple days and the scar feels ok other than being a little tight. No more burning sensation. I guess I'll get the med thing figured out eventually. After reading other posts on here it could be worse. I won't be recommending the OS to anyone else though simply because of his post op pain management.