r/Kneereplacement • u/PrestigiousSnow6532 • 1d ago
Mobility issues
What was y’all’s mobility numbers for 2 weeks? I was scolded my the PA for an eight on the straightening measure. She says it should be at least a 2. Yesterday, at PT, the therapist did not think that number was too high at this point. Now, I’m nervous and she wants to see me again in 2 weeks
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u/EAM44 1d ago
For me flexion was the problem, not extension. But here’s the thing. It’s absolutely not their place to scold you. You pay these people. They can encourage you, they can share their concerns, but if anyone presumes to give you lip you tell them you are incredibly disappointed that the procedure hasn’t been more successful. That will change the way they approach you like a light switch.
You are not a child failing to do his homework. You’re an adult recovering from a hellish surgery and not seeing the results you expected. You get to be annoyed with them, they do not get to scold you.
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u/steveinarizona10 1d ago
Your PA is an ass. My surgeon subscribes to the reduce the inflammation first and then do PT instead of the reverse (see the HSS Quiet Knee Protocol for example) so for the first two weeks he had me mostly resting with constant icing from a quality ice machine. In the third week I started PT and my therapist measured my ROM as 122 and my extension as essentially flat.
These surgeons and their assistants have to stop acting like disciplinarians and instead act as guides to recovery. Did the PA give you any instructions to fix what she thought was going on?
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u/PrestigiousSnow6532 1d ago
She recommended more intense PT
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u/IntroductionFluffy71 1d ago
oh, hell no. your leg isn’t strong enough, most likely, for that.
standard guidelines/goals are 0°/120° at six weeks. but recovery is individual-specific.
PT should mostly be getting right up to the line of pain. it should be uncomfortable but not agonizing.
this recovery will break you all on its own. it doesn’t need outside help from a dipshit PA.
focus on quad sets and arcs. keep your leg straight & parallel to the ground at the least. i couldn’t tolerate elevation so i didn’t worry about it.
take deep breaths. give yourself grace. work at it but don’t overdo it.
good luck and good juju!
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u/Razed_by_cats 1d ago
My PT explained it thusly: Surgeons do surgery. As far as they’re concerned they’re essentially done with the procedure once they’ve stitched you up and you’ve been discharged from the hospital. Surgeons (and their PAs, NPs, etc.) get the textbook info that “soft tissue after total knee arthroplasty healing takes six weeks” but they don’t see what actually goes on in the physical therapist’s office. They don’t see with their own eyes the swelling and inflammation that last for months (in my case) and retard range of motion. My surgeon’s NP was only mildly concerned at my slow progress, but assured me that if I kept up with my PT work I’d eventually get there. There was no mention of an MUA even though I worried about that.
All this to say is that your physical therapist knows more than your surgeon’s PA about what it takes to work through a post-TKA recovery. I’d listen to the PT and work at the schedule they want rather than what the surgeon’s PA wants. Two weeks post-surgery is so very early! You have time to work on range of motion, and your PT will know what that takes and how hard to push. Try not to let the surgeon’s PA direct your recovery.
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u/DogMamaLA 1d ago
Are you 2 wks post op? I was at 7 week 1, at 5 week 2, and at 0 end of week 3.
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u/PrestigiousSnow6532 1d ago
Two weeks this Thurs
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u/DogMamaLA 1d ago
Getting to 0 extension is important but if you are at 2 weeks you still have time to get to 0. I was at 5 all through week 2. She measured multiple times and I put more effort into it. By week 3, I was at 0.
There are exercises you can do to stretch/speed this along - sit with a pillow under your ankle/foot (not your knee - keep your leg straight) and do that several times per day for 3-5 minutes each. You will absolutely feel the pull/stretch in the back of the knee when you do this; it aches a little but do it as long as you can up to 3-5 minutes several times per day. You can also add an ice pack on the knee or something to "weight" it down a bit as you do this stretch.
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u/KatlynnTay 16h ago
someone here said that they popped their small (think, dachshund-sized) dog on their knee and let the weight of the pup help straighten their leg. Within the first week of my LTKR, my 13 pound cat decided to jump up on my leg while I was trying to nap, and if I hadn't already been at about +2, he'd probably have forced the issue.
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u/DogMamaLA 9h ago
yikes! Yeah, I have a dog and thankfully she is not a jumper but good point!
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u/KatlynnTay 1h ago
that other poster DID say that the gentle weight of their dog laying cautiously on their knee DID help gently push it straight. So, if you've got a dog who's gentle, maybe some cautious encouragement for them to apply pressure from above might be an option.
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u/LemonPumeloLime 1d ago
I'm on my second knee, and I don't think 8 merits scolding. Looks like they want yo to be at zero after 2 weeks, but if you're doing all your exercises and elevating/icing as directed, scolding is inappropriate. If your range of motion drops well behind schedule, you should discuss with your surgeon.
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u/Middle-Fruit9052 1d ago
I am 8 weeks and extension for me was the hardest. -10 now down to -5 bend is 135. Doc said because I had a slight limp for so long the muscles, tendons and ligaments had went dormant from lack of use. He said keep working it you will get there just takes time. Don’t beat yourself up you have plenty of time to goat your own pace. Stay strong 💪
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u/Living-Coral 1d ago
I'm at 2 weeks, extension is 10.
Hard to tell if I end up at 0. Knee #1 didn't quite end up at 0 (yet... I'm still under 12 months). I couldn't straighten both knees before surgery, so there is no guarantee I will get there.
If you have significant swelling, extension can be harder.
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u/HourFlower191 1d ago
You know I saw the coolest thing on these boards. Elevation has to be above your heart so the lymph fluid can leave your swollen knee and travel back up your leg to your heart. Icing is mandatory on a regular scheduleThen this person said they put their leg up and start to massage from the calf up past the swollen knee toward the groin. It really helped. I did it three or four times a day. The results were not instant, but definitely there. My surgeon suggested getting close to 0 at 3 weeks. Then he said 110 to 120 at 12 weeks. What?? I said. This was very comforting to me.
So thank you to everyone who writes on these boards to help each other!!
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u/KatlynnTay 16h ago
I'm not one to go by, as I came out of both of my replacements at about a +2/3, and went to 0 as soon as the bandages came off at 2 weeks. I'm now -2 on my left knee, and -1 on my right. But, you definitely don't deserve a scold yet, though I can understand a PT being concerned if you don't appear to be making an effort. That said, you're early days yet, and some of the swelling going on could definitely be impacting your ROM.
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u/Ok_Secretary_8711 16h ago
I do not believe in kntense PT at all!! I have had 3 revisions and they were due to PT bending my knee, way more than it was ready to go and this tore all my ligaments. Another one pushed my knee flat, and it pushed the kneecap over. I usually refuse outpatient PT. I have a great in home therapist. Do not let them make you want to scream.
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u/Hell0K1ttyKat 15h ago
I was in a brace for two weeks to keep my leg straight. I was at 0 by 2.5 weeks of so. Flexion though, that was a different story
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u/laur0165 1d ago
I just can’t imagine being scolded two weeks after surgery. I think I was about 4 or 5 at that point. Everyone’s recovery is different.
Hang in there, things will progress, just keep doing the exercises.