TKR

You tell me! My usual pt guy on vacation. Saw another woman today. She manipulated my leg for 45 minutes despite my protests of severe pain. She kept doing this to measure; not satisfied she carried on and same thing until our time was up. Told me "not to worry about strengthening excercises and just bend my knee all day long. I am calling BS. I haven't been this excruciating sore in weeks and my knee looks like a watermelon. Sorry just venting. Glad my own pt guy is a physical therapist and not a physical terrorist I saw today!

It's really worrying that physios can do damage!  I've had experience of physios a couple of times in the past when my GP sent me for back problems and both times they caused more damage.  I know some think it's not a good thing that we're sent home from the hospital here after TKR with a DVD and sheet of exercise, but I have to say it worked for me and I've been able to go at my own pace, even if I did push it too much a bit sometimes and had to phone the hospital and ask for advice - which was DON'T push it so hard for a couple of weeks!  Could this be why it's been pretty much a pain free experience after the first couple of days for me?  Just makes me wonder?  But we can only go by our own experience and maybe for others a physio is needed.  This brings me to another question.  I never expected to get more of a bend with a knee replacement than I had before the op.  I measured the bend in the unoperated knee, which would be about the same as the one that's been operated on before it was done, and that's about 130.  Do people expect as much bend as they had before, eventually?  And is the best bend they're going to get likely to be over a longer period as swelling goes down, or before swelling has gone down?

Chris, difficult to say. From personal experience I will tell you that my home therapist that came twice a week after surgery to week 5 was excellent. She took my pain and swelling into consideration at every session and adapt around that. That does not mean that she excused me from exercises that hurt (everything hurt then!). We would less reps or she would concentrate more on soft tissue and stretching. She was great. First (and ended up also the last) appointment with outpatient therapist- she told me that I had one week to get 120 or I will be "crippled" for life. That window is a myth but at the same time there is a time frame to keep in mind for best flexion. She ended up hurting me so bad I was down for 4 days. My OS fired her. When I got my new therapist he wasn't as aggressive but still too much for my leg to handle. I sat him down one day and told him that we need to adjust my treatment. He was completely open and he is very careful know. Getting swollen like a watermelon and having severe pain for days after was counterproductive. He also told me NOT to over-medicate for pain before a session. He does need some feedback as to what your "breaking point" is. If you took so much pain meds you feel less pain and the next day you pay dearly for it. You are doing fantastic -keep doing what you are doing! The proof is in the pudding. Don't hold yourself to the 120 degrees. Try and get as much as you can doing what you are doing now. I have read posts on here with some reaching 134-137. Many factors influence this I am sure- age, how bad the knee was before surgery; how much flexion you had previously. For me the physical therapist was an absolute must- especially because I had complications. But also for breaking the scar tissue. But yes, I do not agree at all with aggressive pt. I bet it looks good for them if they get "good" numbers in a short period but at the expense of bad inflammation and swelling and severe pain for the patient which affects other aspects of healing.

Keep increasing that flex if you can.

BTW - now I am not sure who had the infection and second TKR but I think it is between OldFatGuy, Martinavelo or Clive.

Dentist tomorrow! It's going to be great not to have toothache!

Thanks for that Milla. It's very helpful.  I'm looking forward to seeing the hospital physio on 18th April, to be signed off and also ask any questions I might have to see what their response is.  I'm not getting pain at all really.  I'm still being a bit careful not to push to the point of that pain in the back of the knee but relaxing about it a bit gradually and sitting with knee bent up to 112 as I watch tv, keeping it like that for 10 minutes at a time, so it's going well.  Good luck with the dentist!!!!!

Hi Milla I loved the end of your message, the physical terrorist! Laughed so much about that I had tears in my eyes!!

Your experience is true to that, over here physiotherapists no longer have so much of a hands on approach. You get an exercise sheet. The only hands on I got was when she showed me how to massage the scar & knee.

I'm sure a private physiotherapist would be more hands on, but they are regulated still as are NHS physios.

I hope you are ok now, & it went well at the dentist. That I do know a little about, from the front desk view anyway!

All the best

Marilyn

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