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training session for TKR

Posted , 9 users are following.

angela52217
angela52217

I have attended my training session ready for my TKR.   Some of it was useful, some of it a bit depressing.

However, the physios were listing the things that had to happen before you could be discharged.  In addition to the usual things such as getting up and down stairs, washing and dfressing yourself etc theyt sais you had to reach 90 degree bend a straight leg.   I am sorry but reading on here I just do not beleive it.  They say they are able to achieve this by really pushing you.  As they reckon to discharge you one, two or three days after op wonder how they are going to achieve this.  Did anyone reach 90 before discharge?

I am finding this board the most usefu thing and will probably be around for months.l.

1 like, 22 replies

22 Replies

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  • ElaineA
    ElaineA angela52217

    Posted

    Hi Angela. Are you in the UK? I think rules vary from country to country and Consultant to consultant. I doubt I reached 90 degrees, but I did have to go up and down stairs. On my discharge day I couldn't do the stairs so they wouldn't let me go home. That kicked me into gear. I could certainly do it all the next day! I was so desperate to get home. At 18 weeks post op I am up to 95.
    • angela52217
      angela52217 ElaineA

      Posted

      Hi Elaine

      Yes I am in the north of England.   It just seemed to me that there was this attitude "you will make 90 degrees whatever the struggle".  They said they pushed you harder than you would push yourself!!!!

      I suppose some people waltz through without difficulty but there is an undertone of bullying I feel.

      Angela

  • chrishappy
    chrishappy angela52217

    Posted

    Hi Angela, I'm 8 weeks post op TKR and have 100 deg bend, when I left hospital after3 days I had about 60 deg bend. The physios I had in hospital were so driven by numbers!!! When you've had such major surgery I found it left me very tired and emotional and I had a very bossy physio and occupational therapist. I know they have to do their job but obviously mine hadn't experienced any kind of surgery themselves. I went into a bit of a meltdown with one of them and my nurse came to my rescue and chased them. Rest is part of healing too especially in the first couple of days. Don't worry about numbers, I compared myself to everyone else on the ward and drove myself mad!!! Next time when I have my second TKR if the same should happen I will just be polite to them but no way will I allow them to bully me again. After discharge I went to a physio knee club weekly and progressed well. They told me it can take up to 12 months to get a good bend. So please don't stress or compare, just do the exercises they give you, do them slowly so you get a good stretch and make sure you drink plenty of water to keep your muscles hydrated , they work better that way and take your pain meds regular don't come off them too soon. This is a progressive journey not an instant fix, and it is well worth it especially with the encouragement of the people on this forum, they cheered me up and encouraged me every step of the way. Good luck and stay in touch 😀
    • ElaineA
      ElaineA chrishappy

      Posted

      Chrishappy, I was so pleased to read your comment and that it can take 12 months for a good bend. That has reassured me that's for sure. Thank you.

       

    • angela52217
      angela52217 chrishappy

      Posted

      Hi Chris

      Thanks for your comments.   I was just slightly worried that there was an undertone of bullying there and that worried me.   Although I have every intention of doing lots of exercise I do not want to be pushed too far.

      Angela

  • pam1313
    pam1313 angela52217

    Posted

    I definitely wasn't at 90 degree bend when I was discharged from hospital - I had op on 24th March and was discharged on 27th March this year.  Admittedly I only(!!) had new pastic knee cap and metal trochlea (the bit behind it) but I still had the same length scar as pkr and tkr patients on my ward.  I found that I could sit out in a chair at the side of the bed and my knee did bend - not as much as my unoperated one but I could sit fairly comfortably - although I've no idea what the degree of bend was!  Just do your best, if you can't manage 90 degree then so what - I very much doubt they're going to keep you occupying a much needed hospital bed just because you're not reaching the required bend!.

    One thing I would recommend for exercise (before and after op) is to purchase a little exercise bike - the type where you sit on your dining room chair and just pedal away on the machine.  I bought mine from Argos (about £40) - the day after my discharge I couldn't do a full revolution, so just rocked pedals backwards and forwards on it.  About a week later I found I could do a full revolution........and I've since moved on to a full size exercise bike - in fact my lounge currently looks like a gym, but who cares.

    Take every medication offered, exercise, rest, elevate, ice - it's a mantra you'll be repeating in your sleep!

    This forum is wonderful - there's always someone, somewhere who is suffering the same as you and offering advice/support - it's a godsend to me.

    Try looking at the post from ElaineA - "Tips for 'must haves' when coming home froom knee op - it's full of wonderful info!.

    Good luck.

    • angela52217
      angela52217 pam1313

      Posted

      Thanks Pam.  You know they mentioned rest and rehydration but did not mention elevate and ice, yet that seems to be very necessary from what |I read on here.  I will think about a pedalling machine.
  • tracey59320
    tracey59320 angela52217

    Posted

    I had less than a 90 degree bend. At best it was 80 and that made me feel sick and i wanted to stop asap. Nor could i do a straight leg raise or push the back of my knee down onto the physios hand. My ROM isn't much better now.
    • angela52217
      angela52217 tracey59320

      Posted

      Thanks Tracey.  They did also hint that the ones in at the moment they did not feel were trying hard enough.    Golly we have enough to think about without worrying.
    • tracey59320
      tracey59320 angela52217

      Posted

      First time the physios came out after my surgery they pretty much took my arms and pulled me up into a standing position which caused me to throw up over myself. I was still in a bit of a morphine stupor and they should probably consider themselves lucky that i was! I was ready for their next visit and I was going to take control of what happened no matter what but luckily i got two different people and they were much more sympathetic. They were still trying to push me to do things but in a more encouraging way.
    • patsyrose
      patsyrose tracey59320

      Posted

      How awful that first experience was for you!  It's a shame that you weren't sick all over them.  It sounds a bit like the first time I was in...the physio lifted my leg up, as I couldn't and then let go of it!  It does make you wonder what kind of training some of them have had.

      I see a local physio now and she has so much empathy.  She's been with me through both of my knees and is so disappointed for me that I've got to go back again, because of the suspected excess scar tissue.  We chat about all different things whilst I'm there...and we both love the theatre...so it's a really nice session all round (as I live alone).

  • cheryl90571
    cheryl90571 angela52217

    Posted

    Hi Angela!

    I ABSOLUTELY DID NOT achieve 90 degrees before discharge! It was a good two weeks after leaving the hospital that I reached that point , and THEN I had a period of intense swelling where I could NOT achieve the 90 degrees and straightening wasn't happening EITHER!

    I told a PT the first night to STOP TOUCHING ME when she started to push on my leg! It felt like SKIN WAS RIPPING. (Turns out that when my ANGEL NURSE, Cassie, changed my dressing the next morning, I was indeed BRUISED all where the PT started to push my leg. AND the VERY PAINFUL PLACE was where DRAINS had been inserted.

    I was VERY HAPPY that I put my foot down (actually my LEG!) and said , "Don't DO THAT!"

    ALSO, prior to all THAT, these two CRAZY PTs kept pushing me to STAND UP AND WALK when I TOLD THEM I felt like I was going to FAINT!

    FORTUNATELY, my ANGEL CASSIE happened to come in, see clearly that I was UNSTABLE and literally put her body between the PTs and ME, gently eased me into a sitting position on the bed, VERY GENTLY eased my legs onto the bed and got me safely back in bed.

    Within seconds she had a blood pressure cuff on me, a cold cloth on my head and reported to EVERYONE (Crazy PTs especially!) that my blood pressure was 80/60 and THIS PT SESSION WAS NOW O-V-E-R!!!!

    Just so you know...I am doing GREAT eight weeks post op! I am able to ride the stationary bike successfully and have received great reports from the PTs at rehab. The Home-care PT showed me several ways to do my OWN stretching and easing into my BEND WITHOUT HAVING ANYONE force my leg. I will be HAPPY to explain these in detail for you if you want.

    You just have to make it very clear to them that you WANT to succeed, that you WANT to progress, but THEM forcing YOU and PUSHING YOU while the swelling is so great (and it WILL BE A LOT early on!) is just NOT ACCEPTABLE!

    Be strong!

    Be your own advocate for SANITY!

    TRUST that you know your own body!

    Don't let ANYONE ABUSE you just for the sake of a NUMBER!

    • angela52217
      angela52217 cheryl90571

      Posted

      Thanks Cheryl

      I would be delighted if you would explain what the Physio told you.

      Many thanks.

    • cheryl90571
      cheryl90571 angela52217

      Posted

      The first one can be done anywhere there is a step and a railing for you to hang onto. Step up on the step with the leg you want to bend. Lean into the stretch while supporting yourself with the railing. Hold this for 20 seconds. Relax and KEEP BREATHING REGULARLY.

      Go again and lean in a bit more. You will feel your knee bending more as you deepen the stretch.

      YOU DECIDE how far you go, and YOU DECIDE when you have had enough.

      I usually do this for about five minutes each time I pass the steps. That way I spread it out throughout the day, I get continuous practice bending, AND it is convenient, so I remember to actually DO IT!

      I like this exercise so much because the gradual stretching can be felt and you feel like you are accomplishing a lot. YOU ARE! It loosens up your knee very effectively without SCARY PUSHING by some sadistic individual!

      The second one can be done anywhere you have a chair with arms.

      Sit down in the chair. Breathe deeply. Use the arms to hell you rise a bit from the chair, slide the foot of the leg you want to work on back about an inch. Now gently sit down in the chair using the arms to keep you in control of your sit.

      Hold this for 30 seconds AS you continue to breathe. Do not hold your breath. When you are ready, repeat, placing your foot BACK another inch.

      I make it a competition between my non-surgical leg and my SURGICAL leg. The first time I did the exercise, moving my foot five times total, I actually MATCHED my SURGICAL leg to my non-surgical leg. I was able to increase my bend by about 15 degrees!

      Happy bending!

    • ElaineA
      ElaineA cheryl90571

      Posted

      This is a brilliant tip! I will do this. As of today I am 97degrees. I bought a goniometer from Amazon so that my hubby can measure my progress.
    • angela52217
      angela52217 cheryl90571

      Posted

      Cheryl thank you so much for that.  I have made a note of both exercises ready.

      I am sorry to have taken so long to reply but we moved house a week ago and only got my computer back and working yesterday.

      Angela

    • cheryl90571
      cheryl90571 angela52217

      Posted

      Glad that the exercises will be helpful.

      Moving can be WEEKS of confusion, so you are ahead of the game getting that much done already!

      Take it easy. TRY not to overdo it. (I am the QUEEN of overdoing things, and then I SUFFER. I am also stubborn. Bad combination!)

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