Physical therapist is concerned about scar tissue

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I don't know what more I can do. The therapist pushed as much as she could today to get flex,and straighten, but when it bought me to tears even with oxycodone an hour before she backed off. I do my exercises at home. Leaning in to stairs, heel slides. Letting the leg rest on headboard to straighten and then slide it down . I ice all the time, but as soon as PT is done my flexibility is worse. I'm on 4 weeks post op. I see my surgeon in 9'days. He isn't going to see 90 flex that's for sure. I was better before the surgery and I couldn't stand up straight then. Help!

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  • Posted

    Hi - there is so much healing still to be done at 4 weeks. Just keep going slowly as your body allows and you will improve. At 5 weeks i am 15 of straightening but PT says that can still improve over the next few months if I perservere.

    Take care it is a slow game we are playing smile

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  • Posted

    I am right there with you. 8 weeks post-op and have never broken a 100 degree flexion, and it's agony to try to do so. When I see the physical therapist tomorrow, I'm going to ask about a manipulation. I met a guy in the waiting room at PT last week that had one, and he is SO happy he did it! No pain, and you have to do some pretty rigorous PT for the next 3-5 days but sounds worth it to me. I have major swelling which I think blocks my progress with the bending. Still waiting to hear from my surgeon on what to do about it, can't seem to get it under control.

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  • Posted

    Sorry to hear that, but I think you're doing all the right things and your body is healing at its own pace.  Screw the surgeon.  I think they all do that.  If he complains, tell him you're doing all the exercises and going to a PT.  What more does he suggest?  Honestly, unless you have an exception, they just want you to get better so 1) they don't have to see you any more (They're really only intersted in the surgery itself, not the patient care), 2) you won't blame them for difficulties if recovery takes longer than epxected, and 3) they'll get your referrals when you'll make them look good when your friends say how well you look after surgery.  If the makes you feel bad about your not reaching 90, throw it back at him and say, "I'm doing what I'm supposed to do.  What can you do to help me other than criticize me?"  These comments come from my own and others' experiences, BTW.

    My rant aside, lighten up on yourself and lower your expectations a bit.  I've discovered that I lose a day and a half of exercises when I go to the PT because it's such an intense workout that I'm too exhausted and sore to do anyting the rest of the day, and the next day I'm too sore.

    How are you sleeping?  Are you walking well, without a cane?  How are your stairs.  You might have some small victories in there that will keep you going and not feel so concerned.  I think 4 weeks is entirely too early to start beating yourelf up.  The fact that you're hanging with it and doing the things you need to do is tremendous.  Good for you!

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    • Posted

      Thanks kgunch! I get a few hours a sleep a night? I end up in my recliner icing usually by 4am. I walk with a walker a little. My therapist told me too soon for a cane. But I walk to bathroom without anything, just with a limp. I had some limp before surgery, so no different now. I go up the stairs, but not one foot ahead of the other. Just going to keep plugging away .Not sure how fast scar tissue grows, but I don't want it to hold me back.

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    • Posted

      Sleep?  Try some of this...

      - Melatonin or Diphenhydramine (cheap, generic Benadryl) an hour before bed.  Make sure you're not allergic first.  The latter is the same ingredient in all "PM"-style products.  

      - Also an hour before bed, turn off ALL electronics (computer, TV, cell phone, etc.).  Prepare your body for sleep.

      - Prepare the room to be completely dark.  Drapes or blindfold.

      - Go to the bathroom and empty your bladder.

      - Apply some Voltaren Gel (RX in the US).  Best topical anti-inflammatory out there.

      - If you are having a problem with site sensitivity rubbing against your sheets, wrap the knee loosely with an ACE bandage or slip on a knee sleeve. 

      - Read a book for a half hour then lights out.  Great way to let go of the day and become drowsy.

      - I enjoy listening to some Native American flute music.  Very calming.

      - Get a diffuser and some lavender oil.  Mmmmmmm.....

      - Against my doc's recommendation, I elevated and iced for the first month or so.  Your call on this one.

      If none of this works, call Warner Brothers and have them send over Wiley Coyote with the giant mallet he tries to use on The Roadrunner...or the 16-ton weight he drops off the cliff, through your roof and onto your head.  Those will definitely work!!!

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  • Posted

    Angel

    Can u get into a pool. Doing my exercises in the pool helped me get my rom (130) quickly - it really works! Best wishes. Barb

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  • Posted

    You're in control of your rehab. Don't let that therapist ever put you in that much pain! I'm 8wks post op and I just got 85 degrees range of motion today. I have been dealing with stiffness too. Your progress will come in time. I Have done everything asked of me and it didn't work. I got my cpm machine and it helps better than going to therapy but I still go. Ask for a cpm at home and use it at night. You will see the results in time. Keep your head up.

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  • Posted

    Hi angel

    i went to physio today and told him exactly the same thing i have more bend than you and i can straighten my leg im at 5 weeks post op but i still get very stiff when exersising or walking he told me at my stage this is perfectly normal dont over do the exercises it doesnt help try small amounts a couple of times a day it will get better good luck.

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  • Posted

    Everybody heals from this surgery different from what I have experienced. Yes, 4 weeks is way too early to really judge your progress. Unfortunately some people have more scar tissue than others and I myself had that problem. I just could not get my bend past 90 degrees so I had a manipulation. I believe my doctor waited too long so if you think you need a manipulation I would not go more than about 8 weeks. I went 3 months and it helped but I still have to exercise every day. I can walk fine but not for long periods of time. Its been a year and 3 months since my surgery and I still have pain. I hope you have a better outcome than I did.
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  • Posted

    Four weeks???  And you're doing that well???  Be prepared for the road ahead...

    http://patient.info/forums/discuss/the-tkr-experience-or-wish-i-had-another-kidney-stone--524499

    I started PT in the 3-4 week range at -14 / +84.  Took NINE weeks of PT 2x/wk to get to -1 / +128.  In that time, there were advances, setbacks and plateaus...all totally normal.  I got stuck at -4 for two weeks before breaking through that particular knot of scar tissue.

    Listen to all the veterans here...this is not fast, this is not easy.  It takes work, determination and patience.  Love the pool idea (worked great rehabbing my hip replacement in 2009) but my doc said no water immersion for two months.  Bummer.  Maybe you'll have more luck.

    I'm almost 7 months p/o now.  No pain, no meds, no walking aids, sleeping great and 0 / +131 ROM.  Yeah, I'm still a bit wobbly standing up after I sit for a while plus there's still some stiffness and clicking.  Those last two can take 12-18 months to go away...or maybe never go away at all.  Who knows...

    Deep breath...stay strong...this is gonna take a while...

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  • Posted

    I understand how you feel. I too posted on here feeling like my progress was slow (even though my physiotherapist said I was doing excellent) I felt like I should have been further along than I was. Thanks to lots on encouragement from people on this site I started to feel better. You are only 4 weeks post-op so give yourself time. You cannot rush things even though I know we want to be able to. I am almost 6 weeks now and still plugging along - there are good days and bad days but I do finally feel like things are moving in the right direction. Hang in there.
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  • Posted

    Please don't beat yourself up! You're still healing. And don't let the PT ever make you cry again! Just say NO. Don't let them hurt you anymore. It only makes things worse cause then you can't walk and are in excruciating pain. Ice ice ice! And elevate. Rest and it will come. Listen to your body and go slow. It's going to take time. Prayers and hugs.

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    • Posted

      Thanks Renee. I got an email back today from my doctor. He said getting ROM back is going to be tough because I couldn't straighten my knee before the surgery so I have to keep working hard to stretch the soft tissue.That the bones and new knee platform were now in proper place to allow for that. He told me not to take too much for narcotics because they are addictive. I wanted to say " I know, but I didn't think 5-10mg of oxycodone 1hr before PT was bad because that's what you told me to do". I don't even take it everyday. I hate taking meds anyway. So this really stinks!

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    • Posted

      Why do the doctors think we all want to become drug addicts! It's ridiculous really. I had to keep calling and crying to get my pain meds. If you're in pain you need to take them everyday as prescribed. Just keep taking them. Over the counter drugs don't work for severe pain. Good luck and healing prayers sent your way.

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    • Posted

      Good news! I am at exactly 4weeks PO today and improved to -10/+73 from -12/+60all last week. I had gone backwards because I had been at +67 and went down to a +60, so seeing +73 today was exciting. It hurt like heck for a couple of minutes today, but it was worth it to make progress.!
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    • Posted

      That's awesome!. I am 8wks post op and I am at +5/85. I can pedal a bike backwards and I can walk up the stairs. Keep up the good work. I have my cpm machine to thank. I have been using it and at first I didn't think it was doing any good but this week, the stiffness is starting to loosen up. I read the posts on here about it take time and be patient and now I see what you're all talking about.

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