Hi all. I'm 9 wks post TKR & curious about other people's experience with PT. My therapist is very good & experienced & I know it's painful for everyone. Sometimes, however, I feel that he holds the stretch too long (sitting up or on my stomach) & the pain is excruciating. Often, those times I continue to have pain the rest of the day. Although my progress has been slow, it's now fairly steady and I'm at the point now that except for PT my pain is manageable & usually don't even need meds. I'm trying to live a more normal life, but those sessions can ruin my whole day.
Say stop when you know you have reached your own capacity, in my opinion! It is not necessary to suffer needlessly!
My approach has been that while I chose the surgery and understand the long term benefits, my knee does not see it that way and knows only that it has been hacked! Bearing this in mind, that this is an injury, as far as my knee is concerned anyway, (even though willingly inflicted), my knee needs love and compassion.
It doesn't need needless aggravation..it is already distressed. For this reason I would not personally allow anyone to force it...only myself, and I would gently encourage, just a tiny bit. Not force, nudge, persitantly! Little and often, every day, several times a day, but always sensitive to the knee and to myself.
Terri ur post made me smile my physio sits on my foot when my knee is bent and last week he had me lying on my stomach with my foot stuck between his legs (I tried to block the vision out) whilst he ran a metal pole up my leg to find trigger points it is so painful and I feel the pain before he even starts. And I had physio on Monday and I still feel very tender in some areas where he increased pressure.
Yikes, talk about your physical terrorists! Sorry, but they sound rather radical. I understand the need for pressure to expand and bend but it's a process. Maybe it's like our dog trainer used to say- use a female vet to get the dog's hips xrayed. She won't pull so hard whereas a male will pull those hips so tight he can cause a dislocation. Not saying all male PT's are trying to prove out as Ironman but...
My, lady PTs, were no softies either but understood the use of constant pressure. She would brace my foot on her shoulder then apply pressure to keep straightening. Oh yeah, it hurt but didn't make me feel like it was being abused. The bend was pushed beyond what my at-home comfort level but that's why go there. But there is definitely a limit and it all takes time. They also refused sessions without a day in between to "heal" as it were. I went home exhausted, took a Percocet, elevated, iced and slept for two hours. But by nine weeks was pretty much done with formal PT but still do at-home excercises even two years later.
"Extend" not "expand...duh!
Thanks for your perspective. Although I had a female at home after the hospital. She was pretty much the same. Don't know if you watch Scandal, but I used to call her Huck (he is a torturer).
Yikes! Mine sounds gentle compared to that. I guess we all have to hang in there & trust that they know what they're doing
Yup...join the club. Some people take meds BEFORE a PT session but if it's an opioid, they can't drive. PT hurts...period...but it's the only way to break down the scar tissue.
My PT's were all "hands off" apart from very gently supporting limb. I think the systems must be very different from country to country. I got a lot of physical therapy which i feel very grateful for, but it was always fun...yes, FUN ...i made jokes about torture but i never let anyone cause me agony. However no one tried to cause me pain. I was in charge of what I did and did not do.
Hands off? No chance of that. The way they do it here...
1. Lay you on your back. Put your heel up on a block of wood. Push down on the knee...and again...and again...
2. Lay you on your stomach with your knees just on the edge of the table. Let the bad knee just hang there letting gravity do the work.
2a. Same thing but put a 2-pound ankle weight on the bad leg and let it hang...and hang...and hang...
3. Lay you on your stomach and bend the bad leg's heel towards your butt. Mmmmmmmm.....tasty...
Yes, they all wear a dungeon master's cowl and there's an Iron Maiden in the corner. Straight out of The Inquisition. They even have a portrait of Torquemada, their hero, hanging on the wall.
😀😁😃😄
I am very glad I am in UK!
Gravity is good..I used that a lot..
Also used to kneel on my bed ( yes, and say my prayers!). I was very keen to be able to kneel, which I can do now with knee pads, so I can do my very gentle yoga,
It was something to set my mind to!
Interesting the difference in approach. I sense a touch of exaggeration in amongst the humour...However there quite clearly is a variation of approach.
I think a key thing is how the therapy makes the person feel. Feeling simple pain is one thing. Feeling violated or abused in some way is another. You made me laugh, but i am seroiusly glad i never had to suffer that approach to my rehabilitation.
The advantage with patients taking the reins of their own exercise regieme at home with minimal PT input, is that they feel fully in control of the work which needs to be done, and realise the responsibility falls on them. The disadvantage is that some people will not have the ability or drive to push themselves sufficiently I guess. But there is so much information around on the internet now.
Yet I suppose in USA patients still expected to do things at home?
I think I was very fortunate, because my PT really was a pleasant experience. But then I had no complications and a straightforward surgery. I had also so much PT before the knee replacement that I was all geared up. I never expected to be pain free post op.
I was the only one who caused myself any pain post op, and I liked it that way. The dungeon masters cowl never fitted! So I never put it on! 😀😁😃
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It really is interesting. Yes, we are definitely expected to do the exercises at home. The first few weeks were so painful that I probably didn't do enough & spent too much time relaxing with my leg up, which definitely affected my progress. I hope I never have to do my other knee, but if I do, I'll definitely be more prepared.
I haven't even attempted kneeling, but I think I'll try. I would love to get back to yoga. Thanks
I just started driving. Before that I took opioids & my husband drove me. However, I'm also the one that posted about opioids not working for me so it didn't even help. Boy do I wish they did. 😞
I actually was thinking if that myself. I'm going to have a talk with him before my next session. Thanks.
There are many excellent physical therapists around with a lot of experience of TKR, but as with any field of work, quality and experience varies. I felt I was the best judge of how much was right as only I could feel it. And then if it was clear I had done too much, I would back off and give it a break until it had calmed down a bit. Impatience and fear are very unhelpful.
Opinions do vary as with in all things. A good relationship with a physical therapist is respectful both ways I think. There certainly is no place for complacency, however, the knee is healing, and as well as ensuring range of motion does progress, there needs to be rest and attention given to reducing swelling. I had excellent physiotherapy on the NHS, in UK, both from the hospital and community physiotherapy, plus a follow up class of six sessions, which was actually great fun, and caused a lot of laughter and banter. This was therapeutic in itself, and yet gave suitable challenges as well.
Take a peek at my profile and maybe visit my blog. I have devoted one of the pages to my own TKR story. It is very long. Skim reading recommended! But possible to just dip in and out of, as with this forum!
I can do yoga now, but funnily enough it is the unoperated leg which I am finding weak. The one with the replacement is fantastic! Just started going to Osteopath who has got their hands on my legs! Balancing things out a bit! I always adapted the yoga before the op, so it isn't much different. My child pose isn't held so long or so deep, and I only kneel in short bursts! I am now four months and one week post op! 😊
I will definitely check out your blog. Child's pose!!? That really gives me hope. Was wondering if I'd ever be able to do that.
Can you send me a link to your blog?
Hey Terri,
I'm just over 7 weeks post TKR and have not had PT put me on my stomach. The only time she touches me is when I'm sitting on the table and pulling my leg back, she will gently push it a bit further to get more flexion. If it hurts too much she stops. I'm in the Midwest USA. We pretty much do the same thing each session. Elyptical bike with minor resistance for 10 minutes, total gym for maybe 5 minutes, then over to the balance bar and work with BAP boards for another 10. End with flexion, resistance pushing and minor stretching seated on table. Maybe stomach is yet to come?
It's obvious that every PT is different. Mine had me on my stomach as soon as I started with him at 2 wks post TKR. I also do it at home with 2lb ankle weights & pulling up with a strap. He says that stomach is the truest measure of flexion. Maybe his opinion.
Have you made good progress with the more gentle approach?