Confusion with Knee Replacement Rehab.

Posted , 10 users are following.

Today, Thursday May 18, 2017 marks the 13th week after my Knee Replacement surgery. I have to admit I was a bit naive as to what to expect with my recovery. I'd previously had a hip replaced and mistakenly figured recovery would be similar. Not so.

One of my surprises was the disagreements as to how to best proceed post op to achieve a quick, successful rehab. Doctors, Nurses, Physical Therapists, fellow patients, friends...seem to contradict each other, all very confident their way is the correct way.

I'll speak of my experience and confusion. I came to the decision I needed to stop "googling" for answers because the answers, opinions, etc., always left me with more questions.

I was shocked by the amount of pain from this surgery and the efforts to control it. For pain meds I was initially given Percocet, that seemed to work ok but my blood pressure kept dropping and I became dizzy when standing. Eventually after trying something else I can't remember, I was prescribed 50 mg of Tramadol. That stopped the dizziness but did little to curb the pain. Even after leaving the Hospital I had difficulty controlling the pain, that was until I accidentally (from reading someone's story) came across a controversial, natural herb that did the trick.

The biggest confusion has been with the right way to handle Physical Therapy and rehab exercises. Even the Therapists disagree on this. Some believe the aggressive, no pain no gain approach is the best, others feel that does more harm than good and could actually impede recovery. I had four different Therapist working with me, two were "aggressive", two were "gentle". Across the Internet from what I can see, opinions are split on this. I've had lots of advice but at the time I'm writing this I'm still unsure of the best approach. One Doctor or Therapist will list the best exercises to do at home and the next will say half of them are dangerous. I've read where walking is good for you but I've also read where walking increases swelling and should be avoided during early recovery.

Then there's the icing and elevation. Sounds simple but for how long, how often? Yesterday someone who should know said I need to ice for at least an hour and repeat 4-5 times a day. I'd never heard that before, most professionals say 15-20 minutes.

For me I'm doing the gentle stretches with the occasional "nudge", I ice, elevate for about 20 minutes 4-5 times and walk about a mile every day but who knows? Only time will tell. I think most of us reach our destination in the end, the only question is, how long it took and how much difficulty we had.


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  • Posted

    I agree. So much info. So contradictory, You just try to do what you're told as it works for you and that sounds like what you're doing. We have to stay active. Use it or lose it and healing will come with time. I'm 16 weeks post bilateral TKR and I'm getting there. It's not as fast as I thought but it will happen. Luck and orayers??🙏

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  • Posted

    Interesting post. Listen to the knee, be kind to it, but challenge it a bit too, has been my

    Motto. Discomfort and minor pain acceptable. Angry knee is angry for a reason,

    So ease back a bit and try again later, has been my personal policy. I think

    It is so easy for people to get anxious, but forget to trust their own body knows how to heal. I guess in the end, as with all

    Things we negotiate a way through. Fear does create the tendency to over do things, yet complacency probably results

    In not getting a steady rate of progress. I think the reasons why people take the approaches they do are very interesting!

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    • Posted

      Thank you, yes, a balancing act, for sure. At ten weeks now my knee feels fantastic, quite bionic!

      Very pleased! My issue is the rest of my body which is near permanently exhausted. The only comfort

      I take in it is that I understand my body is sending all its resources into healing my knee! Apparently this kind of energy drain

      Is normal but I am anaemic and with a cold now too! ah well, going in the right direction! Happy healing to you!

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  • Posted

    Great post Ozziegee makes good reading. I am only day 10 post op left TKR. My experience would seem to be different to the "norm" I've had minimal pain was up from day one managing in shower etc. Went home day 3 and have gone from strength to strength. Minimal pain and now walking with 1 stick. Not been outside yet though other than. To be taken for appointment. Am doing my physio exercises and pushing hard as my physio pushes me but not too hard. Am finding I have that tight band feeling and my thigh is twinging now which I feel maybe because my gait has altered. I have been massaging my thigh with a sports roller to try and help. Am struggling to straighten my leg but do appreciate it's very early days.

    Was good to hear how your doing and good to read your post

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  • Posted

    Firstly - 'quick, successful rehab' - dont think there is such a thing as truly 'quick'.  My op was 1st March and while I FEEL normal now, I'm sure there is still a lot of healing going on!

    We've seen from this group that physios vary HUGELY.  They seem to be two extremes - bully the patient until they're in tears, or go about it gently!  Not sure if the tears are necessary with some - don't know the answer to that one, but can only say for me, not even having any physio other than the day I was in hospital, and a leaflet, was the best outcome.  I made fast progress and have been utterly happy with it.  Certainly googling does leave you with questions so you need to be careful where you get info from.  Anyone can say anything on the internet, but studies done are often the most reliable information.  Or NHS sites etc.  Or stuff published in medical journals.

    Interesting about the 'natural herb' that helped your pain.  What was it?  Even though it's a natural herb, I'd still suggest looking up side effects etc. and checking it out, but it sounds interesting!

    As far as ice and elevation go, in the first few weeks I was icing virtually all day (stop it before doing bending exercises) and elevating virtually all day too.  It worked well for me!  I started the bike at just before three weeks and gradually got more active at that point.  But people are all different.  By about five weeks I'd stopped icing completely - it wasn't making any difference then, but STILL elevate when I sit down at home.  I should clarify though - I used the ice cuff which meant moving the ice from one side down to underneath the knee and then to the other side (I never iced over the scar because I reckoned that needed the blood flow for healing faster) so it was rotating all the time.  So it probably was 20 minutes out of the hour as it went round to the three positions.  I've not rushed to walk any particular distance.  Partly because the other knee is so bad, but I reckon initial period is about flexibility and healing rather than strength.  Having said that, I am doing the bike for 7 or 8 minutes a day and a treadmill for the same period.  I'm using the bike at level 7 or 8 now, whereas before the op I only did level 1!  But I think it all comes down to what suits the individual best!  And physios don't seem to really keep that in mind - they seem to have a 'one size fits all' approach and not be that flexible to each person!  So in the end we're left with finding what works best for us all personally.  Those of us who have had babies will tell you its just the same then - each midwife has their own ideas and you get conflicting information.  It's human nature LOL!  But good luck to you!:-))))  I wish you a good recovery:-))))

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