Physiotherapy after TKR

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I would like to ask a question re Physio.  Some of you seem to think your PT has been superb.  Can I ask what he/she does with you.  I feel that mine has been a total waste of space and I'm not sure what to do yo try to improve the angle of the bend in my knee.

I go back on Thursday to see my surgeon, it will be 7.5 weeks since the op.  I want to be able to speak honestly to him about my experience.

I have to say that without this forum I would have been lost.  It has been the best source of information for me.  I trust all of you as you have been through the same experience as me and we understand each other.  They do say 'A problem shared, is a problem halved'.  Too true I say.

Today I went into town with my daughter and 5 year old granddaughter.  Hitchin is an old market town with cobble streets and lots of steps up and down on and off pavements.  I went without a stick, big big regret.  I am almost 7 weeks post-TKR.  My leg was in agony and I couldn't wait to get home.  That was really depressing as I thought I was doing so much better.

This is a long slog and I just wish I had realised that fact.

good luck everyone.

Liz

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  • Posted

    Liz, it's very important not to overdo...PT is one thing,,,but walking without your stick today probably wasn't a good idea.  I just went to the neighborhood grocery store without my cane and it was brutal, so I can just imagine your pain after shopping today.

    Now I'm sitting with a heating pad on my knees and intend to do the at-home exercises I was taught to loosen up the knees.  I had both done 7 weeks ago.  I go to outpatient PT twice a week and they first apply heat, then stretching the knees from side to side....using a belt wrapped around the foot, slowly bring the knee up as far as it will go and hold for a count of 5.  Then lay on your side and raise each leg up for a count of 10 for a series of 3.  Then, straight leg raises while either lying down on your back or sitting up with a pillow propped behind you...pull the toes in and raise your leg up straight for a count of 5 and lower to mat. Yesterday they wrapped 2lb weights around each ankle to do my exercises and I could feel the stretch in the knee area. When I go back next week, I am starting the stationary bicycle.  

    This is is not an easy surgery, but you have to push yourself as much as you can to keep that knee loosened or else it will continue to be tight and painful.  Getting out of bed for me is the absolute worst!  Plus, I stopped all my pain meds this week, so I am determined to get through this, but it does take time to heal...so no sense rushing it.

    Have your 5-yr old granddaughter pamper you. 😍

    Good of luck with PT.

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  • Posted

    Don't worry liz its normal it takes time I had a TKR two years ago and at seven weeks I could cycle better than I could walk ...it takes time it will never be as good as your own knee but the pain will disappear in time and you will look back on these problems as bad memories ..try to use the bike in the gym it will help you ..please remember liz you have had a major operation it takes time for the wounds to heal and get used to the new implant ...good luck liz ..you will get there 
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  • Posted

    7 weeks is still early in your rehabiliation. I've been told that it will be six months to a year to really totally recouperate

    I'm 7 weeks post op also. The hospital had my leg on a CPM machine for 12 hours a day for each of the 3 days I was in the hospital. That was a huge help gaining flexion. After coming home, I had a physical therapist come to my house 3 days a week. They give you a day of rest in between therapy because it will get painful and swollen those first few weeks. She had me doing presses of my knee against the bed or a rolled towel to get the leg straighter. She had me use my bathrobe tie to sling under my foot and pull on it while bending my knee. She manipulated my knee cap and she also pressed my foot and toes back to stretch the hamstring muscles. She had a small bike pedal device that she put on the floor in front of a chair that I sat in and she had me pedal that bike for a few minutes. She had me do leg lifts. She stood at my side as I was on the bed and bent my knee slowly to improve flexion. After two weeks, I began out-patient physical therapy in a facility three days a week. This is when you really get to use some equipment like the reclining bike and leg stretching. They also manipulate and massage the knee cap and the suture line. Then they do the bending and flexing which is pretty painful but helps to get that leg flexed to over 100 degrees. After that they ice it up. I always take a pain pill an hour before any physical therapy. There's a lot you can do at home, like the bathrobe belt assisting the knee to bend while reclined. You can also put one foot on the second step of your stairs and lean into it while keeping your back straight, This will further stretch the hamstrings and increase the degree of bend in your knee. There's a few good videos on youtube that will demonstrate some good exercise.

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  • Posted

    Dear Liz,

    Physio is absolutely essential. My physio was very demanding, to the point of being brutal, but she was right. The exercises were designed to achieve two outcomes: first to rebuilt muscle power - so lots of leg raises etc - and then to increase flexibility. This involved lying on your back and drawing your foot up as far as you could towards your bottom, sitting forward on a chair and sliding your foot back under the chair. About 15-20 reps of each, the whole regime taking about 20 minutes, every two hours!

    Tough but it works.

    Good luck.

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  • Posted

    Hi Liz,  At 7 1/2 weeks, your bones will have just knitted together, your nerve ends realising they need to work and your scar tissue just beginning to tighten.  Your physio perhaps wants to get your movement going slowly.  You may want to go as fast as you can but they are under the directive of your surgeon.  At this stage do you really want to undo all the good that has been done?  Going out without your stick is silly at the best of times, but on coble stones, all that wobbling going on inside your leg.  Not good.  If you really want to do your own physio, try a bicycle, on the loosest gear and the saddle so high your toes only just touch the pedals and go SLOW, work your quads (no weights)  All this may seem slow to you but it is so essential.  You may want to be ready for Christmas, but please think more of next Christmas.  The more you push now, the further back you push your recovery.  Please take it easy and enjoy Christmas, hang onto your daughters arm (even if you have your stick with you (very important) when out shopping and stop frequently.
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  • Posted

    Hi Liz I had left TKR Feb this year it was hell the swelling was the worse my leg was approx 3 times more than the other. It took 4 months before I was pleased with op and glad I had it.

    I had my right 5 weeks ago and boy it is so much better. Right from the minute I came out of the theatre I knew it was different.

    P. T. I had 3 appointments with first op, just to measure. I did exercises four times every day. I can now touch my bottom with the heel, in the swimming pool. Lovely job at the end of a horrible journey. 

    Right knee P.T. Once! and he signed me off because I am doing all the exercises that were in the booklet and on line. I have had no real input at all. But I am very strict with myself and if ieither knee is stiff I exercise,

    I had 100 bend in hospital and can bend it right back now. My straight is not 100 percent on right knee yet but I am working hard on it.

    it still gives me pain and I still take tramadol twice a day with paracetomol if I need.

    i am now able to walk 1:5 miles have a sit down and walk the 1;5 miles back home 2 - 3 times a week. The other days I walk approx 1 mile at least. I use 1 crutch out side because of uneven pavements. 

    Hubby encourages me, and he does cooking etc so I can rest after my walks.

    my advice is exercise, ice, rest and be very kind to yourself use you cane. Don't risk a fall. 

    i wish you a speedy recovery you will get to the point you will be glad you had the op. X

     

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  • Posted

    Sorry you arent getting satisfactory results from you therapist. I have been with the same one through all of my rehab work. He has doctorate in PT and was a Div 1 university soccer player so has a good feel for the field he's in. When I first started with him after my 1st tkr 11 years ago he laid it right on the line..........to recover from this surgery its a parternership, 15% therapist and 85% patient. He has always started slow with work on ROM and then into strengthening. He is considerate toward me as a person but relentless when it comes to pushing the program. He has gotten to know me as a person, understanding I have a rather unique situation as my wife is in advancing stages of Parkinson's disease and that I have to care for her as much as possible. He always shows utmost concern when I have a set back. His wife, also a pt, has lupus and is having health issues so we have something in common even though has close to 40 years my junior. I think the mutual respect thing is very important in any relationship. I watch the other 8 therapist in this office and see each of them taking a very personal interest in their patients. I don't know how things work in your part of The world but I wouldnt be afraid to ask for someone different.
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  • Posted

    It is a long slog! Really 6 months your 1 st marker but a good year to feel like you again. My TKRknee is 2.1/2 years old now and one pice of advice keep building the strength in your knee to the very best you can long term!!

    I obviously thought I had, but had a THR( new hip) 6 weeks ago on the other leg & my knee hasn't liked it and is in big trouble , torn hamstring for 5 weeks so far! All because it was weak to take the strain!

    Lesson to be learned!!

    Ironic. Hip great! Thank goodness .

    Use ice all the time on off

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  • Posted

    Thank you all so much for your advice and comments.

    Let me say first of all that it was my PT who told me to try walking without the stick and expects me to do without as of Thursday.  On this basis I think I will buy myself a stick as walking outside is definitely so much better with some sort of aid.  Indoors I don't need anything.

    I have been doing leg raises and sitting on a chair pushing my leg back as far as it could go.  I do these 4 times a day.  The raising the leg he said was good so not go concentrate too much on this.  I am with him for 5-10 minutes maximum, which doesn't seem much to me, but maybe he is doing enough.  I am just I think very disappointed in the bend on my knee as I think it is still just about 90 degrees.

    I am in the unfortunate position of not being at home, not even in my own country, go home on 2nd January.  I can't wait.  I will then be able to go into a pool and plan on seeing the PT at the gym who does hydrotherapy.  I have also another  PT in mind who is praised by all and think I will see him for a couple of sessions.

    I have cut back on my meds but do take them in the evening, I really don't feel I need them the same during the day.  I am sleeping a lot better, but only in short sleeps, but overall I get about 5 hours and I am happy with that. 

    Thank you you all again for being there for me.  Once again you have reassured me that I am not doing too bad with my exercising and perhaps I just need back into my own home and routine and see a PT I trust then perhaps I will start to see an improvement in the bend.

    in the meantime I will be outside with a stick, keep doing my exercises and add a few more in for good measure.

    thank you.

    liz

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  • Posted

    Meant to add that I do ice it, but possibly not enough.  I also use heat.

    Liz

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  • Posted

    I've just done my exercises with a few extra.  I found sitting in bed and pulling my leg in really hard and could not manage a few as the pain in my ankle going up towards my knee was really bad, the outside of my leg and ankle.  Has anyone experienced this?

    Thank you

    Liz

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    • Posted

      Liz , your personal feeling of security is so much more important than some but case trying to go by the book. An extra few weeks with a cane while regaining balance is not going to set you back in the total scheme of things. I've been through this thing so many times that I can't imagine a therapist using the calendar instead of common sense as the guide line. I am in month 6 since My last replacement. This took place after staph forced the removal of the revision and I was immobilized and on a walker for 4 months with no weight bearing. I still keep my cane handy and go to PT weekly as I continue to rebuild. If I were to be told to put the cane away I would tell the therapist where it was going for storage and it wouldnt be in the closet. Do what you have to do to feel safe and secure. Its you that will be hurt in a fall, not the therapist
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    • Posted

      Thank you, you always have good sensible advice.  This is my first TKR so was not sure what to expect. From now on the cane is going to be with me.  I have to fly on the 2nd and am thinking it would probably be sensible to get assistance to get on plane (using the lift) as think the steps might be a bit difficult to negotiate.  What do you think?

      i do think when I am back home it will be easier, got my own GP, not seen one at all since the op and can build a relationship with the PT.  I am so lucky to have caring family here, but you can't beat your ownenvironment and I am missing my life there.  Hubby arrives on Wednesday so I can get a wee bit of a hug and cuddle when I am down.

      you seem to do a fabulous job and as well as care for yourself, care for your wife.  An example to all.  Good luck and thank you.

      Liz 

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    • Posted

      Before you fly discuss it with the surgeon. DVT is still a. Possibility and you sure don't want to compound your problem with a blood clot. Ask about TED hose ( the long white surgical hose) at least for the trip. Walk the aisles every hour or so and increase your fluids. If its going to be a long flight take every precaution. We hit really bad weather after taking off on my 1st flight after my synovectomy. I was told to walk every half hour but we were confined to our seats for almost 2 1/2 hrs. Fortunately all went well but I was quite concerned
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    • Posted

      My surgeon already knows my circumstances and has given me the ok to go home.  I do have to get up and walk about every half hour or so and will do this if possible.  I plan on wearing the compression stockings they gave me in the hospital to wear for six weeks, I think this is sensible.

      it is a 4.5 hour flight and I will be very glad to get off the plane I think.

      again many thanks.

      liz

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