I had TKR 12 weeks ago Dr waited no manipulation

Hi. I'm so sorry you're going through this. I totally sympathize. Not sure the definition of manipulation. What are they going to do? TKR is definitely very difficult and painful. I'm 6 months post surgery. The healing process is longer than expected. My knee is still tight and numb however with decreased pain but still having some. Went to PT for four months. Iced after exercise every time, no heat. Did specific exercises three times a day until the fourth month then cut back to twice a day and eventually once per day. PT was twice per week. Now I'm working out three times a week with weights and bought a stationary bike. The bike helps a lot for range of motion. The exercises were the same throughout PT adding weights as tolerated. Physical therapists are different. I'm wondering if you get a second opinion with another PT. Not sure if it helps you but definitely keep moving and do self massage on the joint daily. Ice after exertion. Good luck with your recovery, prayers all goes well from here on our 🙏🏽❤️

Manipulation isn’t covered under Medicare and I don’t know if you’re in Medicare or not. I make sure I find a rehab PT place that does manual work manipulation. I also pay outside and go to a guy who does MFR deep myofascial tissue release. Each establishment is different and so you must question what is going on With them rather than with us. If it doesn’t make sense to you then have them explain it to you. I go to a place that does assessments periodically so they know if I’m having more pain or starting to heal. I have stuff that won’t heal, but I have stuff that will heal, and the trick is to know the difference at 67. I am a much slower healer than I was at 37.

I had both of my knees replaced last year. I started PT within 5 days 3 times a week. Within a week I was on a bike. Each week my PT exercises increased always flaxing my knee. Maybe you should ask your Dr what he wanted PT to do for you. Scar tissue needs to be broken down. Maybe a sports medicine PT company you use.

I am so sorry for you. there are bad drs and good ones. your life depends on the good ones

I just had manipulation in November 2024 and it was covered by Medicare.

I’m still doing PT but am only 1 time a week now. I’m still only at 108 degrees bend but more worrisome is my extension of -11 degrees. This makes it very difficult to walk distances and my balance is horrible.

I do 30-40 minutes of at home PT exercises 2 times daily and ice the knee and use heat on the quad after for 10 minutes. I’m so tight and swelling is still bad, but I keep pushing hoping to see improvement. My PT said some will see improvement 1 to 2 years out. I guess I’m a bit of an unusual case per my therapist.

@grandmabv I see what I wrote was confusing. Medicare does not pay for MFR (myofascial tissue release unless the problem is due to damage originating from the spine) You can read more about it here. It seems that there is a 10 - 15 minute allowance for manual manipulation as part of Physical Therapy but again, it has to meet the requirements. https://resonancemyofascialrelease.com/is-myofascial-release-therapy-covered-by-medicare/
on top of that, you have to find someone who can do it and accepts insurance!
I am concerned that you have swelling and are tight. I don't think you should have the swelling. I'd like to suggest you see your surgeon sooner, rather than later. You shouldn't have the swelling. It also seems like you should be in PT TWICE a week. I know my PT recommends that for rehab after surgery until the muscles are strengthened. I have known NO ONE EVER who had to wait 1 - 2 years for their knees to be better. Its pretty routine and you shouldn't be feeling stiff for six months. You should have it in the rearview mirror in a year. My neighbor had BOTH knees done at 83 and was mowing the lawn 6 weeks later!!! Crazy!
Return to your surgeon for post surgery follow ups. I had those at 3 weeks, 6 weeks, 6 months and 1 year. There is only one person I knew who had stiffness, pain and swelling such that she couldn't cope with it. This is not entirely unusual and there is a treatment where they put you to sleep and then bend the knee and get it moving. She was better after that work was done. We do all heal at different rates, but its the swelling that concerns me. You sound like you are doing all the right things. looked up the procedure my friend had and its more common than I thought, so I hope you will check into MUA:
"A manipulation under anesthesia (MUA) is a non-invasive procedure that can help restore knee movement after surgery. During the procedure, you are put to sleep while your doctor gently bends and straightens your knee.
What it does
Breaks up scar tissue or adhesions that limit movement
Reduces pain and stiffness
When it's done
Sometimes performed after a total knee replacement if the knee becomes stiff
After surgery
You should follow your doctor's advice for the best chance of a full recovery
Avoid bending your knee in an uncontrolled way
Don't sleep with a pillow under your knee
Keep your knee as straight as possible while sleeping
Other tips
Use commercial breaks to help gain the bend in your knee
Sit in a chair that allows you to slide forward while keeping your feet firmly planted on the floor
Bend your knee as far as you can on your own"
Good luck!

Stop the emails please !
On Fri, Feb 21, 2025 at 5:54 PM Mayo Clinic Connect < nf+319299ae+38899114@n1.hubapplication.com> wrote:

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> *Comment* posted by @grandmabv
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> on discussion "I had TKR 12 weeks ago Dr waited no manipulation ".
>
> I just had manipulation in November 2024 and it was covered by Medicare.
>
> I’m still doing PT but am only 1 time a week now. I’m still only at 108
> degrees bend but more worrisome is my extension of -11 degrees. This makes
> it very difficult to walk distances and my balance is horrible.
>
> I do 30-40 minutes of at home PT exercises 2 times daily and ice the knee
> and use heat on the quad after for 10 minutes. I’m so tight and swelling is
> still bad, but I keep pushing hoping to see improvement. My PT said some
> will see improvement 1 to 2 years out. I guess I’m a bit of an unusual case
> per my therapist.
> VIEW & REPLY
> < https://connect.mayoclinic.org/notification/38899114/?redirect_to=b3e835cc7a614a0cb26f%3Ahttps%3A%2F%2Fconnect.mayoclinic.org%2Fcomment%2F1242485%2F&utm_source=connect.mayoclinic.org&utm_medium=email&utm_campaign=new_comment&gt;
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Thank you but your response is very late
On Sat, Feb 22, 2025 at 10:25 PM Riitta Gugliotto < rgugliotto27@gmail.com> wrote:

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>> *Comment* posted by @grandmabv
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>> on discussion "I had TKR 12 weeks ago Dr waited no manipulation ".
>>
>> I just had manipulation in November 2024 and it was covered by Medicare.
>>
>> I’m still doing PT but am only 1 time a week now. I’m still only at 108
>> degrees bend but more worrisome is my extension of -11 degrees. This makes
>> it very difficult to walk distances and my balance is horrible.
>>
>> I do 30-40 minutes of at home PT exercises 2 times daily and ice the knee
>> and use heat on the quad after for 10 minutes. I’m so tight and swelling is
>> still bad, but I keep pushing hoping to see improvement. My PT said some
>> will see improvement 1 to 2 years out. I guess I’m a bit of an unusual case
>> per my therapist.
>> VIEW & REPLY
>> < https://connect.mayoclinic.org/notification/38899114/?redirect_to=b3e835cc7a614a0cb26f%3Ahttps%3A%2F%2Fconnect.mayoclinic.org%2Fcomment%2F1242485%2F&utm_source=connect.mayoclinic.org&utm_medium=email&utm_campaign=new_comment&gt;
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Everyone heals differently and it also depends on how debilitated you were before surgery. Rehab for TKR takes time so be kind to yourself. PT manipulation as part of a PT program is absolutely a covered service for Medicare beneficiaries. Maybe your doctor expected you to be farther ahead than you are, so what. It should not change anything and you should continue with rehabilitation for your knee. Stop judging yourself against others and allow your body to heal with therapy and home exercise.

Great advice Bev, thanks.

You mention one thing that a lot of people miss - ice is far better for joint pain than heat. Ice reduces inflammation and pain. Heat feels good but actually increases inflammation and eventually, more pain.

I had a great chiropractor who told me to never apply heat, anywhere. Ice is always better, even though it's initially uncomfortable. Over the years, I learned the hard way he was right.

Joe