Total Knee 5 weeks PT excruciating Pain

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I am 67 and have/had a high pain threashold I.e. kidney stones, parentitus, many surgeries. Am 5 weeks post surgery with PT 3x/wk. every visit they push m knee back further causing screaming in pain. Last Wednesday after pushing for 90% to 93% therapist said it has to be 120%. Each session leaves me in pain off the charts then two days to recover only to do it again. No one else is screaming except me. Yesterday he moved it once with me yelling in pain then again FOUR more times bragging on 103%. I can’t take any more! I understand weights, steps, treadmill etc but should I be crawling like a crab to get away? I get extremely anxious walking into therapy especially now fearing he will continue this nightmare. Everyone thinks it is all in my mind but I know it truly is killing me. No one deserves this! Please help me understand. 

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  • Posted

    Welcome to TKRville where every day is an adventure.  Can't take it anymore?  WRONG!!!  Lie down on the table and say to the PT: "Thank you sir.  May I have another!"  We've all been there.  Two things to try...

    1. Take your pain meds one hour before the session.  Have someone drive you.  It helps a lot of us.

    2. Try some of these...

    https://patient.info/forums/discuss/tkr-rom-work-at-home-620053

    On "average", it takes 10-12 weeks of PT to achieve close to a 0 / +120 ROM.  After that, the mandatory gym work to rebuild you atrophied quads, glutes and core will help with the ROM some more.  Took me 10 weeks of PT plus the work at home to go from -14 / +84 to -1 / +123.  It's painful and discouraging at times because there are advances, setbacks and plateaus.  All part of the game.  I got stuck at -4 for a few weeks before breaking through.  The scar tissue MUST be broken down or you'll walk with a limp and a cane for the rest of your life.

    I'm 2 years postop TODAY and I can tell you it was all worth it.  Have fun...  Oh...this is for your fridge...

    https://patient.info/forums/discuss/the-reality-of-a-tkr-recovery-in-one-picture-626038

    Leave all your expectations and timelines behind.  You are going where you've never gone before.  Learn from the journey...you're stronger than you think you are...

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    • Posted

      We will have to agree to disagree. The weights, treadmill etc is all good and necessary. Pushing my knee backward even when I say Stop! No More is torture. I go forward then due to forcefully pushing on my leg/knee each time I am worse than my first days at home. I am a retired nurse and understand pain but not this intense. Thanks 
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    • Posted

      That May be the case where you come from ,but everyone is different ,every knee is different ,every person's tolerance of pain is different .You are not meant to go through excruciating pain,not according to my hospital nurses and physio.TKR is a very brutal and major operation,cutting through skin,bone,muscle etc.it takes along time for the knee to fully recover .Yes i agree excercise is the key ,but not In a way that you are in excruciating pain.slowly slowly catchy monkey !!!!

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    • Posted

      After reading almost 4,000 posts on here over two years, I have to agree and disagree...

      Yes, no one should have to endure excruciating pain.  The problem is, for some people, their pain tolerance is absolutely lower than others.  All very individual.  Lots of people take meds an hour before a session to lessen that pain.  After a session, more meds, ice and elevate.  Day or two off...repeat.  Some people meditate, others scream. Again, individual...just as everyone's DNA creates more or less scar tissue than others.  The point is that the pain is very temporary...maybe ten weeks out of an entire lifetime.  Don't want the pain?  get an MUA...you will STILL have to do the PT afterwards.  There is no escape.

      Disagree...  Regardless of your pain sensitivity, there are very few ways to break down that scar tissue.  The two biggies are PT (including the work you do at home) and an MUA.  That's it.  If you choose NOT to eliminate the scar tissue, you will limp, walk with a cane and never climb stairs correctly for the rest of your life.  So it comes down you a personal choice: put up with and get past the pain or pay the price for your decision.  Again...your choice.  "Excruciating" is a very subjective term.  I was absolutely out of my mind with pain the first few weeks...then I dealt with it.  I've had four knee scopes, two shoulder scopes, a hip replaced, two spine fusion, two spinal laminectomies and FOUR KIDNEY STONES!!!  THIRTY ops requiring general anesthesia in the past 18 years.  You think I don't know pain?  But you're right...the knee was by far and away the worst.

      On the emotional side, my first wife died of breast cancer at age 34...our daughter was five.  I married my current wife eight years ago...six months later she had a brain aneurysm...  Try and escape that kind of pain...

      In the end, youzeguyz can believe and/or rationalize anything you want.  The fact of the matter is completely dichotomous: you find a way past the pain and get to live a normal life again...OR...you go the other way and live with the consequences of your decision.  Again...personal choice...

      Personally, it made me a stronger person in the end...

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    • Posted

      It took me longer to get 110 .....3months for bith knees Signed off from physio after one visit each time. Said sod it I'll do it myself slowly. Also I'm an ex nurse and we both know what to do my husband became my instructed lol. Good luck

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    • Posted

      Chico- your posts on this forum are insightful and 💯 plus correct.  There is no easy way to deal with scar tissue- the PT used body weight and a yoga

      Ball to break mine after the septic infection and then a year later

      When they finally did the total knee.  Yes it hurts but no choice if you ever want to drop a cane or walker and get your life back.  Without going overboard I can’t believe you and Kate lost her mom so young and that you experienced watching your wife deal with her condition.  I am soon celebrating 37 years of marriage.  I almost died in 2017 with the septic infection and it was so hard on my family and my strong husband.  There would be no words for your pain and strength.  The first time I used this forum you answered and I felt maybe I wasn’t going crazy and there would be an end and I would have a future. I agree- tell the PT thank you and I will have one more treatment please!!  I credit my PT for teaching me

      To walk again- 2 times in one year- and oh- wasn’t fun for him either.  I agree- I am stonger but ..... I am sorry to hear of

      Kate’s mom and I am so glad your wife is improving.  TKR is a cakewalk compared to emotional loss.  I agree with everything you posted.

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    • Posted

      Chico, I really apppreciate your wisdom, insight and caring. I have saved your links.

      In my experience, a good PT is needed for progress and healing. PT is challenging and painful enough without having one who doesn't care or worse applies a goal in a one size fits all without taking into account age, weight, overall health, mental attitude and home support. PT's that are young usually lack an understanding of how age affects seniors. I know that as a young athletic RN I believed that all a patient had to do was have the willpower and discipline to heal. Used to be the fastest walking nurse in the hospital! Now at 67 with arthritis and joint issues, I have learned firsthand just how difficult it is to push oneself, it's more than willpower and discipline. Because of my post op complications and a poor PT for three months, I have been in a wheelchair for almost 10 months. Learned how challenging it is to live alone and have to depend on others for  driving, etc. But last September I was fortunate to find a very good PT who came to my home 3X weekly and a massage therapist experienced in breaking down scar tissue using a Gua Sha tool with magnesium lotion and gradual stretching. I've written particulars about what I did to avoid surgery and miraculously break up scar tissue to extend and flex my knee normally. Now of course, I have to rebuild the atrophied muscle and stamina and to be able to stand up straight and walk with crutches is a miracle. My left leg is strong and pain free now! My goal is to be able to walk with crutches (right knee is too painful to support weight) and strengthen the muscles. I'm going to start walking in a salt water pool as part of that. Necessity is the mother of invention. In a normal surgery, your program is great! But there are also other ways to heal, as I am learning. I hope to follow your program for the right knee in August and have saved all the links you graciously shared. 

      You are an inspiring example of discipline, determination and perseverance. Thank you for sharing! 

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    • Posted

      If you say stop and they don't, I would have thought it brings things into the physical abuse realm! For they don't have your consent to touch you at all unless you give it.

      ?

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    • Posted

      Yes I let them bully me into touching it once but not five times in a row. I do not trust them any longer. I already walk without assistance but no driving as Right leg. Up until this forum they made me feel like a baby when 15 stomach surgeries and 9 kidney stones don’t even touch my pain. I also just lost my mother then my stepdaughter three days later. Moved Feb 2 and surgery the 7th! No release for me. Should I request the other therapist referred by my doctor?
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    • Posted

      It's your decision. A good relationship and good communication with a sense of working cooperatively is important.

      If you have tried talking, shared your feelings and perspective, and done all you can to make it work positively for you to no avail, then I guess it might be worth trying another option if one is available to you.

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  • Posted

    Well if that is therapy it’s disgusting. I’ve had 2 knee replacement 6 months apart, 1st went really well, got the straightening and Rom per schedule, it was uncomfortable but not agony doing the exercises. 2nd completely different very very slow doing exactly the same exercises, gently pushing but never agony that is so wrong and probably causes great swelling. Do the exercises but not to cause agony, slowly slowly catche monkey, take your time, keep to the exercises, every knee is different, 6 months I’m still not there, but getting there, do not be bullied, give the knee a chance, a lot of healing going on there., brutal op.

    good luck 😀😀😀😀😀

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    • Posted

      Jackie, sounds like you understand my situation and your comments helped me allot. I’ve always been afraid to say “No!” This will change. I will call my doctor’s nurse and office PT and go from there. I am relieved because I thought I was being a baby. In fact staff from their office agreed I was! Thanks
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    • Posted

      You have every right to ask for another therapist. Not every therapist is right for every patient. When I went I had two different therapists (depending on what day of the week I went) One therapist was a total gym junkie and pushed herself at the gym every day and she brought that same attitude to her job. "No pain, no gain" but the big difference is we are recovering from major surgery, not going to flatten our abs or bulge our biceps. Every time I went and she worked on my knee I hurt for days after, never having enough time to heal before my next session. The other therapist went slow and steady. Same excercises but much slower so it wasn't so painful. She'd bend my knee, hold it until I relaxed, then bend it a bit more. It may have taken a bit longer but I would get a better bend on her days then on days with my other therapist. In the end I made it a point to schedule pt when I knew the more patient therapist would be there. Doing excercises that cause you so much pain just makes you tense up more and in the end you don't get the full benefit of the stretch. Good luck with your recovery.

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    • Posted

      I understand your fear of PT due to pain. I had that too. I thought I was going to flip out if they pushed leg anymore. Finally, they stopped and let me do most of the pulling knee in then asked if they could push a little further. This was helpful to me because it put me in control of the exercise vs being tortured. It was hard for me to make this known but it was essential. It’s very important I feel for the patient (us) to be able to get our heads into the game of recovery. Pushing us to places of severe pain and fear is not going to help us, in fact, makes it worse. I did PT for almost four months and dreaded it each time. I was relieved so much to be done. Since finishing I have been diligent in exercising and doing things at my own pace and have continued to feel better and improve. 

      It takes a lot of time and you need to be your own cheerleader! You can do this smile it continues to get better! Take control of your recovery and embrace the process. 

      BEST wishes for continued success ☺️

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    • Posted

      Well said it should hurt yes but not that bad. What's all this about numbers do the exercises twice a day and you get there a bit like the rabbit and turtle story 😁😁😁😁

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