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babette
@babette

Posts: 40
Joined: Aug 22, 2018

Scared of pain in PT

Posted by @babette, Wed, Aug 22 7:16pm

I’m starting outpatient PT next week … I’ll be 5 weeks out from a R TKR. Until now I’ve had gentle PT at home and I’m concerned about more aggressive PT being painful. I’m also concerned about it creating more inflammation and, in my case, scar tissue. Reasonable fear? Words of wisdom/encouragement most welcome!

REPLY

Hello @babette, I see you recently joined Connect and I would like to welcome you. I'm not quite to the point for the TKR but have the bone on bone and advanced degerative arthritis in the knee. I have been doing the pre-surgery PT for about 6 weeks just in case I have the surgery in the near future. It's not likely for me now but I continue to do the PT because if nothing else it helps strengthen the supporting muscles and tendons to keep the joint mobile. I'm sure the outpatient PT will help with your overall recovery even though it may be a little more difficult than the PT at home. I think there is always some reasonable fear, it's part of our nature ☺.

I'm tagging a @JustinMcClanahan who I'm pretty sure has some knowledge that will be helpful for you.

@babette do you have pain and inflammation now from doing the home PT?

John

@johnbishop

Hello @babette, I see you recently joined Connect and I would like to welcome you. I'm not quite to the point for the TKR but have the bone on bone and advanced degerative arthritis in the knee. I have been doing the pre-surgery PT for about 6 weeks just in case I have the surgery in the near future. It's not likely for me now but I continue to do the PT because if nothing else it helps strengthen the supporting muscles and tendons to keep the joint mobile. I'm sure the outpatient PT will help with your overall recovery even though it may be a little more difficult than the PT at home. I think there is always some reasonable fear, it's part of our nature ☺.

I'm tagging a @JustinMcClanahan who I'm pretty sure has some knowledge that will be helpful for you.

@babette do you have pain and inflammation now from doing the home PT?

John

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I did PT instead of shots or surgery for two torn meniscus and osteoarthritis. Had exceptional results.

Hi @babette! I had a right TKR on May 14. I did not get 5 weeks of home therapy. I was at the PT on May 16. I went in prepared for agonizing pain, but I found out that it was not as bad as I had expected. Some things that I felt were helpful is to find a PT that you know and that will listen to you. I have known my PT for some time now and I trust him. When I started PT I noticed that he was working with my knee, but was also watching my facial expressions. Because of that he knew when to stop or give me a break. I did deep breathing while he worked on my knee, which helped me to relax and helped to keep my leg relaxed as well. I started out with my PT working on my range of motion and then went to exercises. If you have pain medication, take it about an hour before therapy, if not take an Alieve or Tylenol if the doctor approves. Before going to PT I would use heat on my knee to loosen it up. I also did aqua therapy. If you are able to do that I highly recommend it. Where I go for aqua therapy, the pool is 92 degrees. The water takes a lot of pressure off my joints. You are working the same muscles as you do in land therapy, but it is much easier and the warm water felt great on my knee! Also do your exercises on the days you don't have PT. Recovery takes a while and is a full time job. But don't be afraid, it won't be easy and completely pain free, but it is tolerable and you can do it. Talk to your PT and let him know how you are feeling. You've got this!

@ssbionicknee: Thanks for your advice the the benefit of your experience. Taking meds prior to sessions is a good idea, as is aquatic therapy. I've taken lots of water exercise classes over the years and I love them! I think the most important thing, though, is open communication with my PT as you suggest. I have a (short – lol) list of talking points to share with her. My first session is on Tuesday; I'll post here afterwards!

@babette

@ssbionicknee: Thanks for your advice the the benefit of your experience. Taking meds prior to sessions is a good idea, as is aquatic therapy. I've taken lots of water exercise classes over the years and I love them! I think the most important thing, though, is open communication with my PT as you suggest. I have a (short – lol) list of talking points to share with her. My first session is on Tuesday; I'll post here afterwards!

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I wish you the best on Tuesday! I will be waiting to see how it goes. 🙂

Hi @babette! My mother (now in her 80s) has had 2 TKRs. She is not one for doing PT on her own, and for the first TKR skimped on the exercises unless actually done with a therapist in person. She made an excellent recovery eventually but it took longer than expected due to her recalcitrance with the exercises. For the second TKR, she was much more diligent with the home exercises and made excellent progress, especially for a person in her late 70s. She added aqua therapy for the second TKR, which she could do in her home jacuzzi, and that did wonders to keep her incentivized to keep up with her therapy.

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@ginaquilts Thanks for this perspective! One of the reasons I chose the PT facility I did is because they offer aqua therapy. I wish I had Jacuzzi at home!

I actually like the idea of PT and I like exercise, but it's the thought of a therapist doing something *to* me that makes me nuts!

Yes, I understand from my friends who have had post TKR PT that it does get your attention pain wise, but understand that a qualified PT will be trying to help you recover, but not to the point of heaping injury upon surgical injury. I finished seven months of PT after an Achilles’ tendon debridement due to correct a 75% atrophy, and borrowing another tendon to supplement. Not a TKR, but I recovered with those who had that procedure, and they got warming packs, ice packs, rest, and directives to take anti-inflammatory meds. A good DPT will have your best interests their focus. The commercial message “Just do it” is a good mantra. Best regards.

@elwoodsdad Great perspective and counsel! It's nice to know there are some comfort measures involved. I actually watched some YouTube videos (yes, they do exist): "physical therapy after knee replacement."

My goal is to be skiing this season; I think that motivation is crucial in my case!

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@babette
Welcome!
I certainly understand your concerns.
Yes, PT will probably be more difficult than what you had at home.
PT should NOT hurt, but may leave you a little sore.
If the therapist does something with you that HURTS, let the therapist know.
It is important that you advocate for yourself!
A good therapist has a bag full of 'tricks' and should be able to replace the activity that hurts with something that will challenge you without hurting you.
Remember, you will feel sore since you will probably be using muscles and parts of your body that haven't been used in a long time.

I am not a medical person, but I have been through PT many times for many reasons.
I can OFFER you ADVICE for what worked for me.
I took 1 to 2 Extra Strength Tylenol (I cannot take NSAIDS).
After PT, I took a warm shower (or bath) and another 1 or 2 Tylenols.

I wish you the best of luck with PT and stick with it since it will help!
Ronnie (GRANDMAr)

Am I glad to hear someone say that PT SHOULD NOT HURT and a good therapist has other ways of getting the same results…..
I was a movement teacher (,Medau Rhythmic Movement) for many years in England and helped to undo people's bad movement habits by these methods , looking , seeing and listening to what the patient said…..but mostly watching and doing something that finally put that movement right or has worked towards it anyway…..Beryl

@ginaquilts

Hi @babette! My mother (now in her 80s) has had 2 TKRs. She is not one for doing PT on her own, and for the first TKR skimped on the exercises unless actually done with a therapist in person. She made an excellent recovery eventually but it took longer than expected due to her recalcitrance with the exercises. For the second TKR, she was much more diligent with the home exercises and made excellent progress, especially for a person in her late 70s. She added aqua therapy for the second TKR, which she could do in her home jacuzzi, and that did wonders to keep her incentivized to keep up with her therapy.

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I would love to have a jacuzzi to sit in! My knee has been hurting lately and the aquatic center with the therapy pool is closed for 3 weeks for maintenance. It will be back open soon. I have really missed it! It is amazing to me how much better my knee feels getting the pressure off of my knees.

Hey @babette! I was wondering how PT went. Hoping it went well.

PT Report: Overall, it went really well! Today was my initial evaluation. The therapist did all kinds of exercises/tests to get a baseline and was impressed that my knee bend is at 111. On the other hand, my R quadricep is so weak I couldn't push against resistance. We talked a lot about my goals, which was very smart because my objective to be skiing this season is really what's driving this whole thing! I was pretty assertive about pain and he agreed that we could work "to" the pain but not beyond. He was also realistic about being sore after therapy, which is fine with me and to be expected. So, I'll be going 2X per week.

Oh, another milestone! I drove there myself, first drive since surgery and it felt great.

A good day.

I began outpatient rehab 5 days from left tkr. I medicate before going. There is no escaping the pain. The pt is thoughtful of my pain but pushes me more than I would normally go. She somehow got my knee to 90 degrees for a brief moment yesterday. I am more sore today. This is all a big mystery to me. Am I on target or way behind where I should be? Should this new joint be moving more freely 10 days out? I don't mean to scare you. This has been my experience and won't necessarily be yours. Interested in hearing how it goes for you and others.

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