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had tkr 8 weeks now

Hi iv had TKR for 8 weeks i first went to physio last week my knee bend was 35 degrees i knw thats not great after doing exercise physio gave me im at 45 degrees a week later, my problem is the exercise the physio tries to do to me is so painful i cant let him do it and so if i cant let him carry on this week he more or less said no point me going back,i do understand feel im wasting his time problem is i know i really need to get 90 bend in knee can anyone tell me can i acheive this doing exercise myself,its a shame as everything else brilliant also im still using one walking stick by now should i be using any.just found this wonderful forum and would be grateful for any advice please.vicky.

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  • maura 29 victoria11426

    Hi Vicky I am 6wks post op TKR. My advice is that if at all possible try n stick with physio as they are the professional. I find it v painful n after last weeks physio I have a huge bruise n lump on my thigh. However I am not disciplined enough to be so rough on myself. When I see my physio the air is blue but he def managed to get the bend. This week I feel I am on a plateau and a little sorry for myself and lacking motivation and if I didn't have a physio session planned for tomorrow i would b going backwards not forward. So reconsider physio n ask for a different physio that mayb more sympathetic to ur needs. Good luck and this forum is fab it's been a great source of info.

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    • victoria11426 maura 29

      Hi Maura i do know what ur saying i want to stick with physio the exercise he did was put me on couch legs over side and was pushing my bad knee in as far as he could but i was having to stop him because of pain i wish he could try another exercise where maybe the pain was more bearable on my part or is that wishful thinking lol i will go back monday and give it another try,thank you so much for gettin back to me,good luck with your own physio you sound braver than me lol thanks again vicky

       

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  • eileen88018 victoria11426

    Hi Victoria I'm 7 weeks post TKR yesterday I'm still not good with the bend about 85 degrees now I'm not in pain rearly just feels like I've got plaster of Paris or a vice around my knee holding me back but if your still in pain you can't possibly do the exercises that's what my GP and consultant said so need to get better medication. I stopped using my crutch about the 4th week had only ever used 1. Are you in a lot of pain ?

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  • ali95530 victoria11426

    Hi Victoria, it's vital that you do your physio. I know it's painful but make sure you dose up on your painkillers an hour before you do any exercises. You MUST go back to physio ... it will get better!

    The first physio appointment I had I almost cried with the pain when my physio pushed my knee to what felt like a bursting point ( 103 ROM ) but I knew that I had to carry on doing my exercises at home and attend my next physio appointment ... No pain no gain really is the appropriate saying after TKR! Also doing your physio will actually help with your pain and stiffness in the long run.

    At my 7 week consultants appointment I'd managed to get it to 115.  He was very happy with this and I was elated as I just couldn't have imagined this to be possible.

    Try lying on the sofa watching tv, pull your knee up towards your chest until you feel a tightness not excruciating pain. I found that the weight of my foot helped me get my max ROM and I'm happy to say that at now 11 weeks post TKR I'm at 140 ROM. It's not been easy but nothing is with this barbaric invasive surgery but I always remeber my consultant saying to me that he would give me the best possible tools for a successful knee but then it was up to me to make sure I got the maximum out of it.

    I've had my weeks of crying and wishing I'd never had it done but now everything seems to be getting better. My knee still swells and has heat but I can't turn the clock back so I'm trying to make the most of my bionic knee.

    Healing vibes coming your way.

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    • eileen15268 ali95530

      I love your text Ali. I'm 13 weeks now & my bend is 110 not brilliant but I never thought I'd ever get even there. I'm still working on it & it is still painful even at night. I'm hoping SO much that it will feel better soooon. Most days I do feel positive we really must go forward.

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  • Michelle3101 victoria11426

    Hi Victoria

    I am 10 wks post op. Speak with your Physio, ask them if there is an alternative to this exercise, I did and found one to suit me. Supported squatting, or sitting facing a wall with toes touching the wall pushing yourself with your hands into your knee? The last exercise I couldn't do and the squatting and bench sitting was my alternatives. Worth asking! Also breathing exercises greatly helped me whilst doing the bends, ask to be shown those too.

    Good luck

    Michelle

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  • chris00938 victoria11426

    Vicky, were you given exercises to do at home, from the day of the operation?  Sliding your foot backwards and forwards, either on a chair or on the bed (if you're on a sheet or on carpet, a tray under your foot makes it slide easier).  That's the most important exercise.  I sit on the recliner pulling the leg up as tight as the knee will go just trying to get it as bent as possible, every evening, for a couple of hours, but you need to find what works for you.  Some of us have found that moist heat helps - when I was finding it difficult because of pinching/cramping feeling at the back of the knee I tried hot wet flannels, wrapped around the knee covered with a bath towel to keep the heat in, and refreshed the flannels with hot water a few times so they were on around 15 minutes and that relaxed the knee to help the bend.  I often use my hands to pull the thigh up more to get an extra stretch, or if you're sitting on a chair sliding your foot on the floor, you can use your other foot against the ankle to push it back a bit more.  You might find it useful to use Voltarol for a few days too, to take some of the inflammation away.  That might help.  As for the walking stick I was told by my hospital that I had to go back at 6 weeks and show i could walk without a limp unaided as in no sticks or anything, but we all heal at a different pace, so if you feel you really NEED the stick, then use it, or try indoors, for very short periods walking without the stick - I started by just leaving it off when I went in the bedroom and then gradually increased it until I realised I'd left it in another room and had to go and look for it, but still used it outside for a bit longer until I felt confident without it, but it depends on if it's a mental crutch or physical, if you know what I mean.  Also, massage the scar because if that's tight, it won't be helping you.  I use emu oil but others use bio oil or vitamin e or all sorts of things like that.  I hope this might be useful:-)))

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  • marilyn10235 victoria11426

    Hi Victoria

    Yes I'm afraid physiotherapy can be quite barbaric, let alone the surgery! It's a double whammy I'm sorry to say!

    Yes, ask for other exercises you can do.

    yes pain meds 1 hour before Physio, also take them regularly at home be proactive & keep on top of the pain, don't wait until it's there! Make sure the meds work for you, not everyone reacts the same to them. If you need a different medication see your GP & ask for something that works for you??!

    Massage helps no end, give the knee a really good deep massage, it will hurt at 1st but persevere it really pays off & heat the joint before you work it.

    Perhaps when you go to Physio, rub & warm your knee ready for the work. After all those of us who regularly attended aerobics & gym classes were told to ALWAYS warm the muscles & joints up BEFORE commencing the hard work & this IS hard work.

    The aim of the game is to bend your knee not rupture yourself!!

    Good luck with it all

    Marilyn

    XX

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  • melanie49919 victoria11426

    Hi don't be too hard on yourself . Pain is subjective . Have you taken your meds before you visit your physio that might help. Also it might be worth going back to see your Dr as they could look at doing MUA to break up any scars formation. My physio suggested swimming / walking in water to make it easier some pools have hoists to help you in the pool if a little frightened . So in a nut shell find out if structure is ok . Look at pain meds . And don't give up . Good luck .

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  • martinarvelo victoria11426

    35 at eight weeks is really reason for worry.  It seems that you have only just started physiotherapy, and that seems very strange to me.  they started on me on day two with a machine which bent the knee just a little bit more each time. have to say it was very painful . . Regarding can you get the 90 bend by yourself, yes, of course. . . but only if you push yourself.  without a degree of pain, you will not achieve 90, which really is a minimum acceptable outcome.I gave up with the physiotherapist because  I couldn't stand her hurting me that much . .and found I was able to hurt myself much more easily,.  during the day, though, I was pushing the knee pretty well all the time. . first sitting with it bent to the point of pain, but not agony, exercises for an hour lying down at least three times a day (heel slides, leg lifts, leg side to side.  sitting on bed and seeing how far back I could get the foot was good practice too.  Don't listen to people who say "Don't worry, it will come".  It will NOT come unless you really try to get there.  Someone else mentioned pain control, and it's essential . .i had tramadol, and it helped me a lot.  Yes, there is still pain, but it made it possible instead of feeling like wobbly blancmage.  good luck . . it's worth it in the end, honestly.  At two weeks the surgeon said I was heading to manipulation under anaesthetic, and six weeks I had achieved about 85, and now I'm at 135, and not bothering to try for any more. 

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  • cynthia89958 victoria11426

    I'm 4.5 weeks out of surgery and have had a difficult recovery. My knee is super tight and swollen and bending has been painful to the point my BP drops low and I would pass out. I am no wimp, borne my children without help and had other ops and conditions with rarely ever a pain med. But the pain has been intense neuropathic pain from this and I have not felt well on the meds, though they do not remove all pain. I have had my knee checked and deemed OK.

    ​Before surgery I could not straighten or lift  my leg, now it is straight and I can lift and the bend is the problem instead.I was told that the worse your leg is before will take longer to achieve results after. I regret having this done at present although before was bad, I could live a life  with it. Maybe this will change with time, presently one step fwd and 2 back.

    ​The last few years have been tough and this I think was too much on top of other illness, a head injury and stressful events.

    ​From my research, there are different schools of thought re knee recovery - the aggressive approach and the more gentle and there seems to be pros and cons. Too aggressive an approach where you have extreme pain can hold back healing or cause further injury, even manipulation under anaesthesia has to be done with skill or damage to bones can result. You need to trust the person doing your physio and perhaps find another if it does not work out.

    ​We are all different and having worked in health most of my life, I know that professionals also have different levels of skills and abilities too.

    ​Good luck and I hope you manage to get the right support to move forward with your healing (myself too) and on the plus side, many ppl have found they continue to improve over months after surgery - it is not all linear with healing. Some knee patients can go line dancing in mere weeks, but mostly it is a slow journey.

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    • martinarvelo cynthia89958

      The neuroathic pain is the real killer isn't it!  I honestly didn't know that pain like that existed until it hit me. . . and nothing. . . but nothing . .seems to stop it!  thank heavens in my case after about six weeks it stopped and has just been replaced by numbness, tingling and a light burning sensation . . perfectly bearable!  I hope you'll find a big difference after six weeks. . I think a lot of us have had that experience. . six or seven weeks. . Still a long way to go, but a definite great leap forward!

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    • ali95530 martinarvelo

      Yes you're absolutely right, 6 weeks was a turning point for me too!

      My gloomy tearful days stopped and the pain became tolerable. The first 6 weeks are definitely the worst.

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  • CHICO MARX victoria11426

    I started PT 3-4 weeks post-op and did it for 10 weeks.  Went from -14 / +84 to a very good -1 / +123.  IT WAS NOT EASY!!!  There are advances, setbacks and the dreaded plateaus.  I was stuck at -4 for weeks.  BE PREPARED FOR ALL OF THAT!!!  No kidding.  The PT literally puts your heel up on a block of wood and pushed down on the knee.  Absolutely medieval!!!  ...but it's what they have to do to break down the scar tissue inside the knee.  Absolutely mandatory.

    Remember the chest-waxing scene from The 40-Year Old Virgin?  Yup...that's it...and worse.  Gotta go through it...no choice.

    Here's some help...

    https://patient.info/forums/discuss/zero-degrees--517809

    https://patient.info/forums/discuss/tkr-heel-slide-exercises-526213

    You are at the beginning of this journey...it will take a long time.  Be prepared for a year of work...no kidding...

    https://patient.info/forums/discuss/the-tkr-recovery-bell-curve--563756

    Good luck..."Kneebie"...

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    • terri59470 CHICO MARX

      God, that sounds brutal! I've had 2 TKRs and a Revision TKR all in 2 years, and they NEVER did that to me!! The closest they came was with TKR 2, when I was really struggling with extension, and they GENTLY pushed down repeatedly on my knee whilst I was laid on a couch - a bit like CPR on my knee! It was painful all right, but I guess only a fraction of the pain experienced using your PT's method! It took a while, and a lot of work both at Physio sessions and at home, but I got there!

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  • lawrence34984 victoria11426

    use the "Stick".... the last thing you want to do is fall.

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    • CHICO MARX lawrence34984

      And if someone asks why you aren't doing better, beat the everloving crap out of them with it!!!!  I'll pay your bail.  Worth it.  In Brooklyn, we'd even have some nails sticking out of the bottom for extra emphasis. 

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    • cynthia89958 CHICO MARX

      biggrin Haha! Exactly.

      ​I was not sure how the physiotherapist survived unscathed actually. My self defence skills nearly kicked in and put them in a headlock a few times. The stick has nearly been deployed on many occasions too - LOL

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    • ali95530 CHICO MARX

      OMG love it Chico! 

      When my physio pushed me hard on my first session I didn't know whether to punch him, kick him or throw up on him, plus there were definitely tears in my eyes.

      I think he saw my face which must have been grey/green and didn't do it again 😂

      I think all TKR physios should have had 'the' op then they might have some understanding of the excruciating pain involved. 

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    • CHICO MARX ali95530

      Mine wore a dungeon master's cowl and had a humped back.  Pushing down is the way they break up the scar tissue.  Gotta get done or you limp forever.  I'd rather have the short-term pain.

      Think of the chest-waxing scene from The Forty-Year-Old Virgin with Steve Carell screaming "Kelly Clarkson...Richard Nixon".  I actually did that...had the whole place laughing while I was crying.

      The other "goodie" is when they have you lie on your stomach with your knee barely on the table.  That's it. Your bad leg dangles in the air and gravity does the work.  Then they put a 2-pound ankle weight on your calf...  Yeah...not fun.  However, it is a GREAT thing to do at home.  Edge of the bed and just let gravity lower your leg.  I suggest a few shots of Jack before you try it.  Hurtful but effective.

      I did 10 weeks @ 2x/wk.  -14 / +84 all the way to -1 / +123.  Has to be done...

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  • Milla2017 victoria11426

    V,

    Unfortunately physical therapy is painful. It does get easier. I had my surgery December 16, 2016. Started physio in hospital and still going x2 a week. I am finally at 119 degrees. After lots of ups and downs. I take extra pain meds before each session.

    Obviously you get physical therapists with a too aggressive approach but physical therapy after this surgery is painful no matter what. The recovery is brutal but you can do it.

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  • jenny80029 victoria11426

    Had you been exercising at all before you saw the physio?

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    • victoria11426 jenny80029

      Hi Jenny iv had been doing exercise from a booklet i got from hospital and since being at physio been working really hard im back at physio today see how i get on but i feel he's not willing to try another exercise and the pain from the one he uses is unbearable iv took on board everything everyone on this forum has said but right now im just a bit down i know there's people a lot worse than myself if i had more of a bend i wouldint worry as much but on this forum i havent came across with anything like 45 bend after 8 wks,il see what happens today wish me luck lol.thanks again to everyone.vicky.

       

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    • chris00938 victoria11426

      Victoria, I certainly do wish you luck for today.  Have you got a goniometer at home to test your bend?  I bought one on amazon - they're very cheap to buy and it might just give you some guidance as to what's happening between your physio visits?  Only a thought. 

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    • victoria11426 chris00938

      Hi Chris thats a brilliant idea i was saying to my husband wish i could measure bend myself i do feel a slight difference myself but wont know till i see physio today,iv gv myself a kick up the backside no point being all doom and gloom i gt hip replacement 9 yrs ago age 46 and it was amazing from day one think i was expecting same from knee,im going to get goniometer ordered right now thanks so much.

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    • victoria11426 chris00938

      Chris i also got bio oil and havent been using stick in house or walking local but il use it today as physio a bit away from my home ,my 6 week app back at hopital got cancelled as lady i was to see was off sick so my next app is 29th may,thanks for advice i have took it all on board vicky

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    • chris00938 victoria11426

      Oh good:-))))  I'm so pleased to have come up with something useful:-))))  Don't do what I did and get addicted to measuring every five minutes LOL!  But they certainly are useful.  My physio asked how I knew what bend I'd been getting at home and was SO impressed when I told him I'd bought a goniometer!  I hadn't heard of them until they were mentioned on this group:-)))

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  • Julia-NewKnee victoria11426

    Hi Victoria, I'm just reading your post, and all the great responses! Especially Alli, I felt exactly as she said:

    I've had my weeks of crying and wishing I'd never had it done but now everything seems to be getting better. My knee still swells and has heat but I can't turn the clock back so I'm trying to make the most of my bionic knee.

    I'm 13 weeks out now. I'm finally to 101 degrees of bend. I started out low at 45 degrees of bend at my two weeks from surgery so I feel your frustration. As all have said taking the pain meds before physio was key. It doesn't completely make it pain free, but certainly helps you get thru it!

    How are you getting on now, at this week?

    I found purchasing a Therapy strap on Amazon for 8.99 was great for me. They have them at PT and I wanted one to slip over my foot or ankle as I do heel slides or foot pulls to my butt. I found a great used recumbent bike for home. I could not pedal a bike till 7 weeks out. Hope all the advice here gives you hope. One Truly has to accept for themself, it's YOUR LEG JOURNEY. It's done. You have to be pro active and make it happen. Keep doing on your own stretching, moving, figure what you can do. Slow is ok.

    Cheers to your healing! XX. JULIA

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