Physical Therapy Unexpected Results

Gluteal medius and minimus tears in my left hip (undiagnosed at the time) took me to the ER in severe pain about 10 wks ago. Morphine was administered after my 2nd same-day visit to ER and a heavy tapered dose of prednisone reduced inflammation from that episode. Subsequently, a hip MRI ordered by my orthopedic hip doc was done. Interpreting the MRI a few days later he expressed sympathy telling me surgery was not an option. He prescribed 'conservative PT', warning that PT is successful only about half the time. It's a bummer and I was told not to push through pain. I've had only 4 sessions but am now having unexplained pain and stiffness in my right knee. At 75 I have mild to moderate osteoarthritis contributing to pain and stiffness on a regular basis. I plan shortly to begin a 3 X daily course of Bromelain, a pineapple stem extract, at the suggestion of my arthritis doctor. Does anyone have experience with this OTC supplement?

@bluelizard I also have a full thickness near complete glute minimus tendon tear with fatty atrophyed minimus muscle because I’ve had this sense 2017 wasn’t found till 2025. Was told nothing could be done but there is a salvage surgery where they use a cadaver tendon and a Maximus muscle transfer. Post op surgery is grueling for about 6-12 weeks. I don’t know how much this surgery has been done each year but would love to hear if it’s worth having it done

A discussion with "unexpected" in the the title is sure to elicit responses about horrible outcomes. I don't like adding to the negative side, but problems we face are filled with lessons, and folks who are considering these surgeries can benefit from knowing about pitfalls. After my TKR my therapist did an about face: before surgery he was careful, always warning me not to push through pain with my badly damaged joint. After surgery he was constantly telling me to push through the pain. I ended up with long term repetitive strain injuries which delayed my recovery by a full year and cost me thousands of dollars out of pocket for shockwave therapy. Too late I found out that shockwave therapy can start right after knee surgery. Had I known that I would have been miles ahead. Shockwave works, and without side effects. My surgery and/or bad physical therapy also left me with a blown saphenous valve in the vein of my surgical leg. Without good circulation you cannot heal. The constant repetitive strain from over aggressive therapy gave me months of unnecessary pain and held back healing by creating a huge level of unnecessary inflammation in addition to the normal surgical inflammation. I did not know enough going into the surgery about the poor communication between surgeons and therapists. My surgeon was horrified when she found out how I was treated, and went down and yelled at them! The misinformation that many therapists seem to work under is widespread. No, there is not some magical twelve week cutoff point for reaching 120 degrees bend, no matter what they say. The warning that you will not walk right ever if you don't make the deadline is incorrect. Lots of shoulder injuries require you to be immobile for months, but range of motion DOES come back with proper exercises AFTER the incisions have healed. A stiff knee with poor flexion is NOT automatically a case of scar tissue getting out of hand; it's often swelling that's out of hand. If the new knee is put in properly, then the knee will bend when the swelling goes down. Finally, these old wives tales that only slow up healing are being contradicted. Look up the "quiet knee" approach to TKR recovery. Find a physical therapist with specific training in TKR recovery. Don't push torn up leg tissues and nerves as if you are doing a gym workout. Surgery is massively destructive. Gym workouts aim for micro not macro tearing of tissues to stimulate inflammation and lead to the building of stronger muscles. Surgical recovery needs a therapeutic approach to rebuilding, which should not be the same as a gym session. There are many kinds of exercises. Tailor the exercise to the desired result. Yelling in pain and swelling up a lot during and after therapy is a sign of poor therapy. If only I had known ahead of time. Maybe the pitfalls described in this discussion will help someone else prepare better for TKR and heal faster afterwards.