Knee Replacement: Discharged from PT due to insurance

Posted by dkapustin @dkapustin, Apr 16, 2019

I was released from PT due to insurance reasons with ROM ending up being 111/0. All they said was to stay active so I didn't loose what I had. In addition to the bike, what else do you do to improve and/or keep your ROM? Heel slides haven't improved my ROM in weeks so I am taking them out of the daily exercise routine. (I may do 15 in the evening if I feel stiff but I can't live a life doing them so I think at 3 months PO, it's time to say good bye to those) Also, I'm still limping along with a cane so I'm in the process of trying to figure out how to get in and out of a pool for therapy safely with just the cane. TIA for any tips and advice.

Hi @dkapustin – I'm so sorry about your insurance issues. In answer to your question about pool access – my pools at the wellness center and the community pool have a handicapped seat that allows access for those who can't get in or out via the steps. Have you checked out your pool? Could you talk to the managers of the pool for more information?

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“my” wellness center is geared toward seniors, has a portable lift chair, 2 sets of wide, shallow steps with double handrails, and one standard ladder to get out of at the deeper side. Depending on how deep your pool is, and your confidence level in the water, I would just sit on my butt on the pool apron at the shallowest point and sort of slide into the pool. The water takes a lot of weight off your leg/body, so I don’t think you’d need a cane to get in. As far as getting out, doing the 1-step even on a standard pool ladder should work, if you have your cane handy to pick up once you are out. Pretty much every pool ladder has 2 handrails, so that should make it possible to use it reasonably safely. I’m already looking forward to the deep, long, outdoor pool with a diving board!

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@debbraw

Hi @dkapustin – I'm so sorry about your insurance issues. In answer to your question about pool access – my pools at the wellness center and the community pool have a handicapped seat that allows access for those who can't get in or out via the steps. Have you checked out your pool? Could you talk to the managers of the pool for more information?

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@debbraw Yes, my gym does have a lift but I looked at the pool closely today and if I park a sturdy walker by the steps/rail I should be able to get out. I’m going to hire a trainer for additional help with other things too. PT always worked on several people at once. I never really felt like I was given 100% of their time

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@dkapustin

@debbraw Yes, my gym does have a lift but I looked at the pool closely today and if I park a sturdy walker by the steps/rail I should be able to get out. I’m going to hire a trainer for additional help with other things too. PT always worked on several people at once. I never really felt like I was given 100% of their time

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@dkapustin There used to be a handicapped woman who came to the water classes and the women in the class were always there to help her get out of the pool. I'm sure if you went to a class you would find the same.

I have never heard of PT with more than one patient. That really does not sound good to me.
JK

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@contentandwell I'll give that a try. I've been to many PT clinics in addition to skilled nursing facilities (in patient rehab) for many members of my family and friends, and in Florida, they all work that way. They work with one person at a time but always have 2-3 people they are working on at the same time. So they set you up for a exercise, tell you how may sets and reps to do, and then move on to the other person. It's very standard. I see my OS tomorrow for my 12 week PO and I need answers as to why I"m in so much pain and am so sore most of the time. I know it takes a year to heal but I feel, for as diligent and I've been with PT, that I should be doing and feeling better than I do We shall see. Thanks for the feedback. Hope you are doing well.

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@dkapustin

@contentandwell I'll give that a try. I've been to many PT clinics in addition to skilled nursing facilities (in patient rehab) for many members of my family and friends, and in Florida, they all work that way. They work with one person at a time but always have 2-3 people they are working on at the same time. So they set you up for a exercise, tell you how may sets and reps to do, and then move on to the other person. It's very standard. I see my OS tomorrow for my 12 week PO and I need answers as to why I"m in so much pain and am so sore most of the time. I know it takes a year to heal but I feel, for as diligent and I've been with PT, that I should be doing and feeling better than I do We shall see. Thanks for the feedback. Hope you are doing well.

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@dkapustin There not must be enough physical therapists in Florida to accommodate all of the patients. I have been to 5 different physical therapy places and at every one, the time you have scheduled is for you alone.

I hate that you are still in pain and sore. It just does not seem right at this point. I agree, it does sound as if you have been very diligent. I presume you haven't overdone it, have you? My ortho said to do five days on and take two days off for recovery.
JK

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@contentandwell Actually that’s exactly what I’ve been doing per my OS. I saw him today and he took new x-rays and reviewed my exercise regimen. He said that at three months post op, I should only be working my lower body every other day at most. He firmly believes that I’m over exercising and that’s why am in so much pain. I made the mistake of joining Facebook groups for knee replacements, and although the people meant well, they were Nazi exercisers! I kept hearing things like “no pain, no gain, and I just thought that more was good. Starting today, I’m only going to do lower body every other day and just stretch and practice walking on the in between. Hopefully, that will help. Thanks for responding to my post

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@dkapustin

@contentandwell Actually that’s exactly what I’ve been doing per my OS. I saw him today and he took new x-rays and reviewed my exercise regimen. He said that at three months post op, I should only be working my lower body every other day at most. He firmly believes that I’m over exercising and that’s why am in so much pain. I made the mistake of joining Facebook groups for knee replacements, and although the people meant well, they were Nazi exercisers! I kept hearing things like “no pain, no gain, and I just thought that more was good. Starting today, I’m only going to do lower body every other day and just stretch and practice walking on the in between. Hopefully, that will help. Thanks for responding to my post

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@dkapustin That sounds good. My ortho said 5 on, 2 off, but the important thing is to give it a rest to recover. I do exercises at my health club and alternate between the gym and the pool so I am not doing the same thing every day, plus the gym is strength training and at my age, they say that's important.
JK

Liked by dkapustin

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@dkapustin

@contentandwell I'll give that a try. I've been to many PT clinics in addition to skilled nursing facilities (in patient rehab) for many members of my family and friends, and in Florida, they all work that way. They work with one person at a time but always have 2-3 people they are working on at the same time. So they set you up for a exercise, tell you how may sets and reps to do, and then move on to the other person. It's very standard. I see my OS tomorrow for my 12 week PO and I need answers as to why I"m in so much pain and am so sore most of the time. I know it takes a year to heal but I feel, for as diligent and I've been with PT, that I should be doing and feeling better than I do We shall see. Thanks for the feedback. Hope you are doing well.

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Hi @dkapustin – I'm curious where you live in FL? I want to put JK's mind at ease @contentandwell – here in Northeast FL (St.Augustine/ JAX) the physical therapists are dedicated to one person during the entire session. Of course, during my in-home PT, the therapist arrived at my house and we worked on my issues for the time he was here. When I graduated to outpatient PT, I went to the facility but I still had the undivided attention of the therapist for my entire session. This was true for my first TKR in 2017 and my most recent one this year. Actually, I've had a number of friends with joint replacements and never heard of any of our local physical therapists attending to several patients at once. For the prices they charge, I would not have been very comfortable sharing! I'm sorry you are still in so much pain and having mobility issues this far out. Hoping your visit with your surgeon today will give you some insight and support on getting rid of it.

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@debbraw

Hi @dkapustin – I'm curious where you live in FL? I want to put JK's mind at ease @contentandwell – here in Northeast FL (St.Augustine/ JAX) the physical therapists are dedicated to one person during the entire session. Of course, during my in-home PT, the therapist arrived at my house and we worked on my issues for the time he was here. When I graduated to outpatient PT, I went to the facility but I still had the undivided attention of the therapist for my entire session. This was true for my first TKR in 2017 and my most recent one this year. Actually, I've had a number of friends with joint replacements and never heard of any of our local physical therapists attending to several patients at once. For the prices they charge, I would not have been very comfortable sharing! I'm sorry you are still in so much pain and having mobility issues this far out. Hoping your visit with your surgeon today will give you some insight and support on getting rid of it.

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@debbraw I live in the Tampa Bay area and have been to at least a half a dozen outpatient PT clinics, in addition to, skilled nursing facilities caring for myself, my mother, and my sister. They all work on several people at one time. Not in a group setting, of course, but they set a person up for an exercise, say something like, "do 2 sets of 15 and hold for 5 seconds" and walk away to their other patient and repeat. Sometimes they just walk away and work on their laptops. But I have never had them actually stand there and watch me or my family member do their sets or the bike warmups. They always go on to do something and then come back and move me to the next exercise.

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@dkapustin

@debbraw I live in the Tampa Bay area and have been to at least a half a dozen outpatient PT clinics, in addition to, skilled nursing facilities caring for myself, my mother, and my sister. They all work on several people at one time. Not in a group setting, of course, but they set a person up for an exercise, say something like, "do 2 sets of 15 and hold for 5 seconds" and walk away to their other patient and repeat. Sometimes they just walk away and work on their laptops. But I have never had them actually stand there and watch me or my family member do their sets or the bike warmups. They always go on to do something and then come back and move me to the next exercise.

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@dkapustin When I am doing something the therapist stays close by to make sure I am doing it correctly. He very occasionally goes into his office for something if I'm on the bike or treadmill for warmup. a long time ago I did have one therapist who kept walking away but I think she was flirting with a guy therapist!
JK

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@dkapustin

@debbraw I live in the Tampa Bay area and have been to at least a half a dozen outpatient PT clinics, in addition to, skilled nursing facilities caring for myself, my mother, and my sister. They all work on several people at one time. Not in a group setting, of course, but they set a person up for an exercise, say something like, "do 2 sets of 15 and hold for 5 seconds" and walk away to their other patient and repeat. Sometimes they just walk away and work on their laptops. But I have never had them actually stand there and watch me or my family member do their sets or the bike warmups. They always go on to do something and then come back and move me to the next exercise.

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@dkapustin – I am sorry for your experience with PT. My therapist stayed with me and sometimes even actually moved my leg, let me push against her, held the rubber bands for me to pull, etc. She was very engaged in the whole process. Even if she wasn't physically helping me, she watched my face and monitored my movement. You have made me realize (again) how luck I was to have both of my excellent physical therapists!

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@dkapustin

@contentandwell Actually that’s exactly what I’ve been doing per my OS. I saw him today and he took new x-rays and reviewed my exercise regimen. He said that at three months post op, I should only be working my lower body every other day at most. He firmly believes that I’m over exercising and that’s why am in so much pain. I made the mistake of joining Facebook groups for knee replacements, and although the people meant well, they were Nazi exercisers! I kept hearing things like “no pain, no gain, and I just thought that more was good. Starting today, I’m only going to do lower body every other day and just stretch and practice walking on the in between. Hopefully, that will help. Thanks for responding to my post

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@dkapustin I haven't seen a posting from you for a while about your knee. How is it doing? I hope that cutting back on exercises a bit has helped you, and you are in less pain than you were, but still doing well with ROM.
JK

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@dkapustin

@contentandwell Actually that’s exactly what I’ve been doing per my OS. I saw him today and he took new x-rays and reviewed my exercise regimen. He said that at three months post op, I should only be working my lower body every other day at most. He firmly believes that I’m over exercising and that’s why am in so much pain. I made the mistake of joining Facebook groups for knee replacements, and although the people meant well, they were Nazi exercisers! I kept hearing things like “no pain, no gain, and I just thought that more was good. Starting today, I’m only going to do lower body every other day and just stretch and practice walking on the in between. Hopefully, that will help. Thanks for responding to my post

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@dkapustin How is your knee doing now? I presume you cut back a bit on exercise. Has that helped?
JK

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