Physical Therapy after Partial Knee Replacement that was Jan 6th.

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I am 42 yrs old and had a Partial Knee Replacement done on Jan 6th...outpatient...went to first PT the next morning. Wasn't too bad...2nd was a little rougher and I was in more pain. 3rd visit had a different therapist and she pushed me beyond what I thought I was ready for. She basically forced bended my knee and forced straighten it..said it's to keep scar tissues from interfering with recovery...this was extremely painful. I am curious to if this is normal protocol on your 3rd visit of PT..which was 7 days post op...I was in soo much pain I could not go to my next PT. Plus I have bruising on my ankle from her force bending with her body weight...I figured I would go back on Monday when my normal Therapist will be there....I have made progress with bending and straightening and don't think I should be rushed like that...I am still in alot of pain but am able to walk around house without crutches. I have been icing and elevating along with doing my homework PT...any suggestions or advice is welcomed since this is all new to me and I don't Know of anyone who had this done. Thanks

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  • Posted

    No one should ever be so rough with you that you bruise. I would ask for another therapist, and report that. Seriously, that was way out of line!! Good luck!, Keep us posted!
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    • Posted

      Thanks, she was a fill in therapist for the one I have because he had to take some days off for personal reasons...he will be back on Monday so I am going to show him my ankle and talk to him about this force bending stuff...I think us as patients should be doing the bending with guidance. I know I am the patient and if I say I can't handle anymore she should stop which she did not. She kept insisting this was normal so that is why I am trying to get some input on what to expect during PT.
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  • Posted

    1st of all....as crippled and slow as I was, they couldn't have run fast enough to catch me if they told me they were going to do it outpatient. You deserve a patient medal of honor for going through that.11 years ago when I had my original tkr the protocol was a 20 min warm up on a bike then lay face down in a very firm table with the therapist grabbing the ankle and gently but firmly trying to hit you in the back of the head with your heal. I don't mind telling you, I was a 67 male in years during many of those sessions untill I said enough is enough. Due to a tumor I had already had 4 surgeries and 30 rounds of low dosage radiation and my leg was already a mess. Fast forward 9 years and the tumor had returned and caused the prosthesis to break loose, moving around whacking up against nerves every time I moved. This required a revision.....the day after I fell and broke my femur requiring more surgery and a plate. Eventually the plate was removed" staph , more rehab, rerun of the staph infection, removal of the prosthesis, 4 months without a knee, finally 3rd knee and more rehab which is where I am today. The law 4 times going through rehab it's a whole new world. Instreatch on I recumbent bike for 20 min t he do the usual additional stretching with a belt, work on an inclinecboard and other stuff to rebuild strength. Your therapist is correct that you have to minimize the biggest culprit off The rehab world......scar tissue but overdoing can cause you to be in so much pain at 1st you can't work on your own in between visits. Did he/she advise you to take pain meds as directed and always take a proper dose 1/2 to 1 hr prior to therapy. Drink an extra quantity of fluids especially prior and after therapy. Dehydrated tissue just won't stretch like well lubricated tissue. Go slow.....rushing just causes more discomfort and more set backs. I don't know wherevyoubare but in my part of the world if you really feel uncomfortable with your therapist you can request a change. Sometimes a new face is a. Positive step to proper recovery. Its bad enough to have to go through this without building up fear and hate of your care provider. Stay with this group. They understand and have all been through the process. Plus you meet people from all over the world that have been exposed to different methods. BTW, I'm in the central US and now have a surgeon that is a professor at a teaching medical center.
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    • Posted

      Thanks for your advice. Sorry to hear all that you have gone through. I guess one of my problems is I never did any research on the recovery so I wasn't prepared for this kind of pain. I wasn't aware how long pain pills would be needed through the healing process either. But after the few Physical therapy sessions and what I have been reading I think my doctor will definitely need to give me a refill. The doctor has me going to Physical Therapy 3 times a week and Physical therapy has me doing some simple exercises at home as well. I have learned a lot from this site so I am glad I found it.
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    • Posted

      Recovery is the phase Dr's slide by when discussing tkr's. Its "out of sight-out of mind". They cut and paste and send you out the door expecting nothing but the very best to happen. Hang in there and in a few weeks it will start to shape up. Don't be surprised if you have small set backs. It seems to go with the territory.
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  • Posted

    Hiya Carol,

    I'm a 71 year old male, had a UKR (partial knee replacement of the right knee medial compartment) on 6 Nov 2015. I elected my own surgeon based on his reputation and had surgery as an NHS patient in a private hospital. I was sent home on 9 Nov. I was up and walking with crutches the afternoon of the day of surgery with some ankle exercises and knee bends to follow. The next day the PT's really got me into the exercises proper. The process was to get the patient walking and climbing stairs and a 90 degree bend before being discharged and I to had been forced but not to the extent you have been - thats not on. Yes the PT tried to force me but once I realised the pain involved and the amount of pain killers I was on in hospital I said no more ! End of! I increased the frequency of the exercises and pushed myself to the point of onset of pain then backed off. I've always grown up with the view that pain is the point at which the body announces it is in a state of dis- ease and to ease up.

    So yes they tried to do this to me but I put my foot down. I achieve the targets anyway by the time I was discharged on 9 Nov.

    That all said, I did pay for private PT treatment in the 8 weeks leading up to surgery in order to strengthen my right knee and leg in readiness for the surgical trauma that would follow. This served me well. I persisted with all my 'at home' exercises and stretches right up until my 1st review by the surgeon on 29 Dec (7 and half weeks). At that point he announced that I could drive my car again, I could shed my crutches inside the house but use only one outside for 2 weeks (in fact I was fine with no crutches at all - inside and out) and return to work. I drive a mini bus between an airport and a railways station on a shuttle service.

    Certainly by 7 and half weeks I was pain free (unless I inadvertantly overdid the exercises). As a matter of interest I had my dressing removed on 19 Nov. I had my only hospital PT review on 24 Nov, they put me through the hoops again but basically agreed that I was where I should be at this time post op. They would not comment on shedding the crutches, said that was surgeons decision. Then, as I said, my surgeon review on 29 Dec. Even now I have to say that at the end of each day, regardless of the level of my activity, I always elevate and ice for 20  minutes or so. I am still pain free and have only one minor moan, which I vented at the surgeon, was that slightly to the right on my incision line and centre of the knee cap I have a tightness, a stiffness in a band running from the centre of the knee cap down to about an inch below the knee cap. Surgeon reckons I need to work on my hamstrings and my private PT agrees and am doing exercises to this end. Yes, there is some slight improvement. Bend continues to improve and can now sit and get up easily from low seats. I'm now at 10 weeks post op and am fine with it all - but still have swelling and would expect this to stay but gradually diminish over the next 12 months.  My next review by surgeon is on 29 Feb 2016 which will be at 16 and half weeks. I have alot of lower back pain and pain/discomfort from the right sacriliac joint - which is also slightly improving the more I mobilise, but I still get my private Chiropractor to monitor things and give me a bit of treatment. I had these problems for at least the last 8 years all of which are largely due to the aging process and  my original knee problems - so I'm certainly not blaming the surgery here - just commenting for your info. I am wondering if you are still on pain relief medication even though you are doing 'homework' ? I can only have Co-Codomol 30/500 and if I over do the exercises or if my back pain is somewhat aggressive I still take 2 tablets at a day. My advice would be if you still have pain when exercising then continue with pain relief before you attack the exercises, and elevate and ice, immediately on finishing the exercises.

    Jan 6 is not long in the scheme of things, you might be being a bit ambitious - I was in pain right up to about 3 or 4 weeks post op. Then it began reducing, and continued to reduce quickly after that.

    I must say that some people have issues with scar tissue forming and some have to return to hospital for 'a manipulation' under general anesthetic to break up scar tissue.

    Anyhow, hope all this rambling helps.

    Good luck.

    John

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    • Posted

      Thanks for sharing your story and giving me advice I am sure it will come in handy. I should had done some research on the recovery part but I didn't, but glad I found this site. I am learning alot from all the different stories on here. My doctor has me going to Physical therapy 3 times a week and PT has me doing exercises at home as well. I do know I am not going to over do it because I want to continue to move forward in this recovery.
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  • Posted

    Forgot to say I return to work on 26 January. First two weeks I'll be working half days and of that the first 3 days I'll be with another driver being monitored. Then the next 3 weeks I'll be on my own - so, for the first 5 weeks I'll be on probation. If all is well by that point then I return full time to my old job.
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    • Posted

      Congrats on returning to work. Hope it all goes well for you. My doctor says if all goes well I can expect to return to work in 8 weeks...not sure how that will go yet.
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  • Posted

    Having undergone two lots of surgery for pkr and two lots of arthroscopy, your experience at physio doesnt sound like something that would normally happen. Although you are going to experience some degree of pain it shouldnt be cause for concern. I always found the various physiotherapist very supportive. Shame you had a negative experience.
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  • Posted

    Well had my 4th Physical Therapy session with my original therapist and it was better than last one. He agreed the substitute therapist was a little rough but said he can see a big difference in the improvements of my bend and straightening. So, I am hoping that I don't have to endure that pain any more. Well it seems as if I am getting a sinus headache and I would think with being on pain medicine it would help it, but unfortunately it isn't. I took some sinus medicine so hopefully that helps. Hopefully I can have a good night of sleep tonight.
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  • Posted

    hi caroljr i would have a different view from the others on this . i think i would have been happy for her to do that because sometimes we are too nice to ourselves when bending /straightening ,abit of rough would do the job ,then maybe im just  pushing myself soooo long with my knees over 3yrs id be glad if someone could just do it !!!!!! sorry but like you said your doing fine with bend/straightening  maybe she did you a favour you are walking around without crutches keep moving and my advice dont avoid her next time take care you are doing great
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