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The effect of some more stringent PT - thoughts please

Posted , 9 users are following.

Dcweather
Dcweather

Opinions welcome please. If you'e read any of my other posts you will have got the general picture that I am 10 weeks into TKR, have had little pain, can walk quite well but have limited range of movement most probably because i didn't have more than 90deg for  20 years or so (age 66 now). 

My PT up to now has been every 2-3 weeks where I have mostly just been rviewed as "!doing great" and been given exercises which I have been diligently doing. Whilst improvements all round none have made the slightest difference to my 6-90 deg other than maybe making that easier.

So at this appointment having expressed my disappointment with ROM  the PT said she wasn't worried about the bend because that is easier to get later than fully straightening. So I had my first real session from the PT. She massaged my leg a fair bit and then lying on my stomach forced my knee progressively straight by pushing down with it hanging over the bed. (An exercise I have tried a bit but just with gravity). This was quite painful, especially behind the knee which she kept massaging vigourously as she pushed down. Afterwards she claimed that she had got it to zero degrees.

So the question is how would I expect to feel after this manipulation? Because the next day (today) it is the stiffest and most aching it has felt so far. It only bends readily to 85 instead of 90 and doesn't really straighten any more unless forced and is tight behind the knee.

So is what I should expect - because it doesn't seem to have done much so far or will it be freerer when it gets over the initial shock?

Thanks for any opinions, (Chico et al)

Dave

0 likes, 23 replies

23 Replies

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  • Laura3333
    Laura3333 Dcweather

    Posted

    It's probably just your knee being traumatised after the forceful straightening.

    Whether it will have any long term effects or not on the ability to straighten it is debateable.

    my knee hasn't got a great bend, but it's good enough for me and my life.

    So although PT's have their own ideas, sometimes it's just not feasable.

    The pain pre TKR was indescribable, so give me this any day, don't let them push you too far and give you more pain.

  • philguud
    philguud Dcweather

    Posted

    No pain no gain is what they say, but if your pt is doing procedures that set progress back, it isn't good. My point; don't allow them to push you to pain like that.

    • Dcweather
      Dcweather philguud

      Posted

      In fairness she was being considerate and only allowing pain levels that I said was acceptable. Stiffness now starting to ease a bit but can't say ROM is any better than before manpulation.

  • johnny17592
    johnny17592 Dcweather

    Posted

    Hi There i have come to the opinion that physio's tend not to know what pain really is although i have stuck to my exercise regime every day i have found the days i have done that bit extra simply because we all want to get our normal lives back i have woke the next day stiff and swolen it has to be done slowly and methodically and as i have read in here from people who have been through the mill more time's than me everyone is different we all heal in different ways just let your body and your mind deal with it slowly.

  • gwen1024
    gwen1024 Dcweather

    Posted

    Your therapist should have been doing that from the start. You only have a short window of time before scar tissue sets in for good. My therapist has been stretching me like that twice a week for 8 weeks I can bend at 124 now. It's very important you you get that bent in the first 4 weeks. Yes it hurts but necessary in the end.

    • Dcweather
      Dcweather gwen1024

      Posted

      This is tyhe problem. Too many views from the professionals. She said i had no problems with scar tissues. Could you bend your knee well past 90 degrees say a year before your operation though?
    • NZJENNI
      NZJENNI Dcweather

      Posted

      That old adage - don't expect more than you had pre op - comes to mind.

    • Dcweather
      Dcweather NZJENNI

      Posted

      It strikes me that those with good ROM don't tend to say what it was before and those with poor ROM do! rolleyescheesygrin

  • lynn15111
    lynn15111 Dcweather

    Posted

    Gradual, little forcing I can tolerate, and reinforce on my own so I don't lose the improvement. If this staight leg she did for you involved 15 degrees, that's too much.  5 at a time is much more reasonable.  What I find now works for me is to use the heat of a shower on my knee when I try bending it more.  It hurts but the heat of the water sooths it and helps me tolerate leaving it bent for a bit to stretch it.  Then It always hurts to straighten it but the water helps there too.  I'm just trusting this stiffness will pass at some point.  I never wake up limber.  I have to warm up the knee first.  And I stopped pt because all the other extra exercises just made it stiffer and painful.

    • Dcweather
      Dcweather lynn15111

      Posted

      It wasn't that much! Like I said it was from 6 degrees to more or less straight though i have my doubts it was any better than 6 to 2 deg.

  • NZJENNI
    NZJENNI Dcweather

    Posted

    Ahhhh - that sounds painful. 

    I am also having issues with straightening the knee - currently 15 / 110.

    6 sounds brilliant to me smile

    I will be following this with interest. My knees have always been hyper flexible with a negative bend and the unoperated is awesome and really shows its mate up !!!

     

    • Dcweather
      Dcweather NZJENNI

      Posted

      ...... as does 110 to me at the other end Jenni eeksmile

  • CHICO_MARX
    CHICO_MARX Dcweather

    Posted

    "...and then lying on my stomach forced my knee progressively straight by pushing down with it hanging over the bed..."  LOL...  Try it with 2# and then 5# ankle weights!!!  Yes, that one is killer...BUT...it does do the job of getting you to zero degrees.  First time, I thought the guy was wearing a hangman's hood and there was The Rack in the corner of the room!!!  It's very tough.  Did it at home with an ankle weight.  Make sure you take pain meds an hour before trying it... 

    Sounds like you got a BIG stretch but then rebounded a bit.  No problem.  I did 9 weeks of PT so you have time.  And again, it might take you longer than it took me or others.  I got stuck at -4 for two weeks before I got past that plateau.  Take it as it comes...there's no linear path here.

    You gotta do what you gotta do.  Be strong...stay strong.

    • Dcweather
      Dcweather CHICO_MARX

      Posted

      " First time, I thought the guy was wearing a hangman's hood and there was The Rack in the corner of the room!!! "

      frowneeksmile

    • CHICO_MARX
      CHICO_MARX Dcweather

      Posted

      Ya gotta admit...these places should be decorated by someone from The Inquisition and the PTs dressed like Vlad The Impaler!  I'm 68 but after 44 years of hockey and all my operations, I'm pretty used to pain.  This was the worst...by far.  Feel really bad for people with low pain threshholds and the elderly.  Can't imagine doing this at 80...that would not be a good experience for me.  Waiting at least a year before I get the other one done no matter what the pain.  I want this one to be a long forgotten experience...left knee's gotta be like the TKR never happened before I do the right side.

      Still...ya gotta have a sense of humor, no matter what.  Run someone over "accidentally" with your walker...club someone "accidentally" with your cane. Feel better?  Good...  Now take your meds and sleep...  Zzzzzzzzzzzzzzzzz..............

    • philguud
      philguud CHICO_MARX

      Posted

      I'm not getting my other knee done. I'm getting a Hoover round with a Hemi!😃😃😆

    • CHICO_MARX
      CHICO_MARX philguud

      Posted

      ...and on the back, you need a big license plate that says:

      I BRAKE FOR NO ONE

      ...just like on the back of Spaceball One!!!  And, yes, I always drink my coffee while I watch Radar.  Ludicrous Speed...GO!!!!!

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