[starflyte1]

I had a total knee replacement (front) and have full motion. A substitute therapist did the pain thing on me once. Never again. My knee is 100 percent.

[Carla B]

My therapist called it "manipulation." Beyond pain level 10.

[starflyte1]

T-Bear

How are you now?

[Tbear]

Wow, what a difference a week makes! As I reported in previous posts, the first week or so was pretty tough for me. The pain meds didn't quite hack it especially the first few days and almost any movement of the knee was associated with some degree of pain.

Yesterday I went for my post op follow-up visit with the doctor. All good news! the implant looks good and when the wound dressing was removed the incision was healing very nicely.

The last few days I have transitioned to using a cane and feel very comfortable with it. I almost feel I don't even need it, but for safety reasons I will probably use it for several weeks.

I can flex my knee with no external force to about 94 degrees; with external force ( but not the excruciating pain I felt before ) I can flex it to 113 degrees. A normal target is 120, but I should be able to get to 130 eventually which is my goal. Although less so, the knee is still swollen which inhibits range of motion. It just takes time for the swelling to go down. I ice it after exercising and additional 2 or 3 times a day.

I can walk essentially with no pain whatsoever because my knee is comfortably bending more naturally now.

I think my biggest mistake in hindsight, was to try and wean myself of the oxycodone when I really needed it the most. I actually still use it before my physically therapy sessions so I can max out the benefit of the exercise. I do plan to phase it out totally in the coming days.

I've been given additional exercises to begin to strengthen my leg as well as achieve higher levels of range of motion.

As people have commented in this thread, its up to me now to put in the work to get back into full strength and flexure.

The doc said I could go swimming next week; Unfortunately, my love of pickleball will have to be on hold for awhile!

I have some neat X-rays of my implant and would be happy to email them privately if anyone is interested.

TBear

[starflyte1]

Thank you for the update! Happy to hear all is going well.

[Carla B]

My husband has been dismissed from physical therapy. Knee flexion is 135 degrees. All is well with the knee but the back is another matter. Good luck to you and thank you for posting. What you've done is very helpful.

[Tbear]

Originally Posted by Carla B

My husband has been dismissed from physical therapy. Knee flexion is 135 degrees. All is well with the knee but the back is another matter. Good luck to you and thank you for posting. What you've done is very helpful.

Was his back issue related at all to his knee replacement or subsequent physical therapy?

[Carla B]

Back issue has been going on a long time. But went he went to outpatient physical therapy certain exercises they wanted him to do for the knee aggravated the back. He had a hard time making them understand he couldn't do some of the exercises. Regardless, the knee progressed very well.

[Tbear]

It will be 3 weeks tomorrow. I do PT 3 times a week with a PT person and the same exercises myself the other 4 days of the week.

I can flex my knee 116 degrees; with external pressure from the PT person it now goes to 121 degrees. ( grit my teeth and to the max of my pain tolerance ). A long way from 70 degrees the day I got home from the hospital.

The incision looks quite healed and much like the scar I will have going forward although it will probably blend as time goes on.

Walking exclusively with a cane; trying to re-learn my normal stride without a limp is a work in progress. Through the normal range of motion when I walk, the knee sort of feels like it has an ace bandage wrapped around it - not painful, just slightly stiff- just enough to impede a normal gait.

Tylenol is the pain med I primarily take as needed.

The knee is still swollen; Although the swelling has subsided, it still has quite a ways to go and I expect it will take another month or more to even begin to look normal again.

I ice it after the two exercise periods I do every day as well as 2 or 3 random times during the day.

I have another week of in home therapy and will then be going to an outside group - Florida Rehabilitation Specialists in Lady Lake.

I'm cleared to go in my pool now so hopefully as the warmer weather sets in this week that will be a treat for me...

This hasn't been a fun process, but I truly think when its over I will be quite happy. Before my surgery, I couldn't retract my knee more than 114 degrees under any circumstances. - and I'm already a 121 and hopefully headed for 130+.

Until next time -

Regards from Tbear

[bagboy]

Originally Posted by Tbear

It will be 3 weeks tomorrow. I do PT 3 times a week with a PT person and the same exercises myself the other 4 days of the week.

I can flex my knee 116 degrees; with external pressure from the PT person it now goes to 121 degrees. ( grit my teeth and to the max of my pain tolerance ). A long way from 70 degrees the day I got home from the hospital.

The incision looks quite healed and much like the scar I will have going forward although it will probably blend as time goes on.

Walking exclusively with a cane; trying to re-learn my normal stride without a limp is a work in progress. Through the normal range of motion when I walk, the knee sort of feels like it has an ace bandage wrapped around it - not painful, just slightly stiff- just enough to impede a normal gait.

Tylenol is the pain med I primarily take as needed.

The knee is still swollen; Although the swelling has subsided, it still has quite a ways to go and I expect it will take another month or more to even begin to look normal again.

I ice it after the two exercise periods I do every day as well as 2 or 3 random times during the day.

I have another week of in home therapy and will then be going to an outside group - Florida Rehabilitation Specialists in Lady Lake.

I'm cleared to go in my pool now so hopefully as the warmer weather sets in this week that will be a treat for me...

This hasn't been a fun process, but I truly think when its over I will be quite happy. Before my surgery, I couldn't retract my knee more than 114 degrees under any circumstances. - and I'm already a 121 and hopefully headed for 130+.

Until next time -

Regards from Tbear

With all due respect, you should ask your doctor and your Physical Therapist about your extra excercise on days when you don't have a PT session. I get the feeling that in your determination to heal and heal quickly, you may be overdoing it somewhat.
I had a TKR in 2013. I had daily in home PT the first week , along with daily walks. I then went to a rehab clinic for 3 or so weeks. I too would do exercises at home, a combination of the in home and rehab regimen. I mentioned the extra work I was doing and my therapist told me to Stop!!! He said my body and knee needs time to heal, especially after a rehab session. Too much too soon would cause continued swelling, pain, and inhibit the range of motion in my knee. Among other things. With that advise, my rehabilitation was a great success. I've read your posts from the beginning and hope for your complete recovery. I just sense IMHO that you may be slowing your recovery. Your doctor and physical therapist would be the sources to ask. Good Luck !!!

[Tbear]

Originally Posted by bagboy

With all due respect, you should ask your doctor and your Physical Therapist about your extra excercise on days when you don't have a PT session. I get the feeling that in your determination to heal and heal quickly, you may be overdoing it somewhat.
I had a TKR in 2013. I had daily in home PT the first week , along with daily walks. I then went to a rehab clinic for 3 or so weeks. I too would do exercises at home, a combination of the in home and rehab regimen. I mentioned the extra work I was doing and my therapist told me to Stop!!! He said my body and knee needs time to heal, especially after a rehab session. Too much too soon would cause continued swelling, pain, and inhibit the range of motion in my knee. Among other things. With that advise, my rehabilitation was a great success. I've read your posts from the beginning and hope for your complete recovery. I just sense IMHO that you may be slowing your recovery. Your doctor and physical therapist would be the sources to ask. Good Luck !!!

Thanks for sharing your experience and for your advice. I'll double check with the PT person Wednesday; she is well aware that I do the exercises on the " off " days and as My wife and I recall it was her recommendation. I totally agree that there is a point that I could do more harm than good. Perhaps that will come into play more when I start working with weights and resistance machines but I will definitely check and comment back to you. I should be talking with the docs office tomorrow to arrange visiting the outpatient rehab place and will ask them.

It will also be interesting when I begin with the new rehab facility the end of next week to see their philosophy.

Thanks again for your interest and response.

Tbear

[bagboy]

Originally Posted by Tbear

Thanks for sharing your experience and for your advice. I'll double check with the PT person Wednesday; she is well aware that I do the exercises on the " off " days and as My wife and I recall it was her recommendation. I totally agree that there is a point that I could do more harm than good. Perhaps that will come into play more when I start working with weights and resistance machines but I will definitely check and comment back to you. I should be talking with the docs office tomorrow to arrange visiting the outpatient rehab place and will ask them.

It will also be interesting when I begin with the new rehab facility the end of next week to see their philosophy.

Thanks again for your interest and response.

Tbear

That's great !!! I wish you nothing but the best in your recovery.

[Tbear]

Originally Posted by bagboy

That's great !!! I wish you nothing but the best in your recovery.

Well I had a chance to check about the frequency of exercise/PT and it seems to play out like this....

Both my doc and the therapist advise doing the PT exercises everyday twice a day - ice after each plus 2 or 3 more ice sessions during the day. What is clear, however, is I'm not to do anything more or DIFFERENT than they are prescribing. In other words, don't go on the internet and come up with additional and different exercises that promise to quicken your recovery.

As I mentioned, I begin PT with an external group on the 21st so it will be interesting to see both what exercises they give me ( it will be at the 4-1/2 week mark ) and their recommendations for frequency.

As of this morning, my PT lady can ' force ' the knee to 123 degrees ( ouch); I can force it to 121 degrees using a strap; and I can achieve 116 just using my leg muscles.

Every degree gained is both a struggle and huge accomplishment...

Regards from..

Tbear

[Tbear]

Week 4 - Well I had my last in home PT today. I can retract my leg to 120 degrees; the Therapist can force it to 127 ( my maximum threshold of pain tolerance ).

Her assessment was that I am walking quite naturally now ( don't need the cane, but she still insists that I use it ).

Off all meds although I do take some Tylenol before my PT sessions in anticipation of her stretching my knee ( ouch ).

Only feel a slight tightness during the normal range of motion needed to walk. Although the swelling continues to subside, the knee is still not back to normal and does vary based on the exercises that I do.

Friday I will begin therapy with Florida Rehabilitation Specialists in Lady Lake. If anyone has had experience with them, please let me know..

The incision area and scar looks really good and continues to blend with the knee. I'm applying Maderma once a day to the scar to facilitate its healing. I'm also applying suntan lotion since the area is quite susceptible to sunburn.

Tbear

[Tbear]

Five weeks - The knee continues to heal without complications. No more cane; walking normally now with no discernable limp or abnormal gait. Scar looks very good; blending in with the skin nicely. I'm putting Maderma on it once a day and also massaging it with cocoa butter.

The main surprise, was that when I began with my new out of house therapist, he has continued my treatment with a totally different approach moving forward.

First of all, no more tear jerking yanks of my knee to see how much flexion we can squeak out. He feels that I have plenty of flexion for 5 weeks and over the coming months as the swelling continues to subside I will get more flexion as the result. Instead, he is concentrating on stretching my hamstring.

He explained to me that the hamstring is the key to flexion of the knee and we would work on improving that for awhile.

A typical session consists of a few minutes of ultrasonic treatment of the knee followed by a targeted massage of specific areas of the knee to continue to break up scar tissue. He then stretches my hamstring in a controlled fashion by laying out the leg straight and while pulling in my toe, compresses the knee. I can feel the stretch, but this is far less uncomfortable than when my previous therapist pulled my knee towards my butt.

I am ending the session now with 10 minutes on a type of machine where you sit and push pedals first with one foot than the other. Its call a stepper, but not the kind you stand and climb on. I've never been one to use machines so most of you probably know what I am talking about more than I do.

He is suggesting that I take 20 minute walks - in a pool every other day! I'm already taking 2 twenty minute walks around the neighborhood every day.

Although I feel like I can be more active, he explained that the bone is re-modeling ( growing into ) the serrations on the surface of the implant. That together with strengthening my muscles is what needs to happen before I get back to sporting activities. The doctor said I can chip and putt at six weeks; play doubles pickleball at 12 weeks.

I really feel the worst is behind me and I just have to put in my time and follow the advice of the doctor and therapist and things should be fine...

Tbear