Agressive physical therapy for my 85 year old knee two months after surgery seems to be making it worse. Anyone else with this experience? - AgingCare.com
Thx Veronica. Strengthening core muscles is so important. I have benefitted from the exercises my dd gave me and keep working on them as I am able. Glad you are having good sessions. I agree that being sore is not bad, but pain is not good, For me it is the fatigue that limits me more than anything. There are a lot of deficiencies in people with CFS/FM and ATP is one of them. Building muscle builds ATP and I have experienced that but still have more limitations than I would like. I have to agree that persistence and attitude are key.
Golden attitude is more than 50% of the success in rehabing a replacement joint so I am sure you will do fine if you ever need one. Consistency at your own level is the key to success.
Ten years ago I rehabbed my hip and knee quickly. This year at 78 iIhave been much slower and in addition have other health problems. I am finally getting good sessions of PT because I have now exceeded the limit of my co-pays and my sessions are free till the end of the year. i have had generalized weakness for many years so am somewhat limited. My newest hip functions very with good range of movement but I am limited with core strength which is what we are woorking on plus balance which is why I have had so many falls. I think they do follow the same types of exercises for all ages it is just the intensity that is different. Overtime the PT increases my exercises if it causes distress he stays at the same level. Likewise if I find something easy he increases the intensity the next time.
I think it is OK to feel sore after a session but increased pain is different and should be discussed with your surgeon. The patient has to be part of the team or they won't advance and become crippled. I have seen many overweight patients putting little into their therapy and asked a PT how they got on and his reply was "They don't" The mother of someone I know had both knees replaced and just sat around and consequently now hardly walks and it is then with bent knees. Think about John McCain. he came out of POW camp and could not walk. Well he put a lot of painful effort into PT and seeing him now you would never know he was so disabled. Unfortunately he is now approaching the end of life but it is not because he put no effort into his PT. He probably only has weeks to live but is still fullfilling his political duties which says a lot for his persistence.
The quality of PT treatment varies greatly so it is important not to stay with a PT who is not pushing you in the right direction. I found those in hospital and rehab were only interested in getting me walking but now all kinds of strengthening exerc9ises have been included.
Sometimes I wonder if they apply the same program to all people with knee (or hip) replacements. My mother had a hip replacement at 99. She was always very active and is a physiotherapist herself. She left rehab early as she said they were telling her to do things she could not do. Mother was never a wimp when it came to exercise, so it made me wonder how well programs are tailored to individuals especially when it comes to seniors. If I ever need a joint replacement I will be in trouble as I have CFS/FM and cannot exercise as I once did. I simply can't do it.
There's another possibility, that the therapist overestimated your progress and now is pushing you to reach goals that he or she set, on his or her own, w/o discussing the progress issue with you.
Talking to a physical therapist, they want know what your life was like before you had your knee replacement. Where you living at home independantly and are you successful with it. They want to you to work as hard as you can so you can go back home and live independantly. It can take up to a year before the replacement fully settles in your body.
Well good for you both for getting it done and for being so internet savvy! - if I may say so as a compliment.
Yes do talk it through with your surgeon. Quite apart from anything else, if it was all going well to begin with then it's not impossible something has gone "ping" and needs correcting. Hope this is just a glitch and you'll soon be getting the full benefits.
Appreciate all the reply's. For answer to the question about who belonged to the 85 old knee. That was me . I am pretty active and have cooperated fully with the therapist and made good initial progress but over the past couple of weeks the therapuetic demands have increased and my knee has been getting worse. Good suggestion, That I talk with my surgeon about it,
Define “aggressive “. Post op PT after Total Knee Replacement is necessary as the person needs to get up to walk, etc. A physical therapist should, of course, taylor the therapy according to the person’s need and stamina & age, but with post op TKR PT is expected and should have been explained to the person prior to the surgery, and usually is. Might be termed “aggressive” due to the person’s stamina, but a new knee needs exercise as in the long run it is detrimental if you don’t exercise it. Try an ice machine compress or ice packs to the surgical knee after PT for swelling and discomfort. Usually post op knees are on warfarin for a month after surgery to prevent blood clots. Prevention of blood clots is another reason the person needs to get up and walk. I have seen many 80+ year old do quite well after knee replacement. Those patients were pretty active before the surgery which probably contributed to their success. Good luck!
No pain no gain is an outdated notion that some physical therapists unfortunately still believe in. You might ask about a different therapist or trying some alternative therapy.
Is that, your 85 year old's knee? As opposed to your knee and you're 85?
Either way, the outcome you're after is that the joint should be more comfortable and more reliable than it was before surgery. There is nothing wrong with asking your PTs to explain their treatment and how it will achieve that outcome, and what they need from their patient in terms of co-operation and diligence and stoicism.
But the reason I ask is that if this is someone else's knee, it's harder for you to judge how much they can reasonably be expected to cope with. Can you describe the person's usual attitude when it comes to 'no pain no gain' situations? And when you say 'worse' - worse than before the operation, or worse than it was, say, a month after it?
Ten years ago I rehabbed my hip and knee quickly. This year at 78 iIhave been much slower and in addition have other health problems. I am finally getting good sessions of PT because I have now exceeded the limit of my co-pays and my sessions are free till the end of the year. i have had generalized weakness for many years so am somewhat limited. My newest hip functions very with good range of movement but I am limited with core strength which is what we are woorking on plus balance which is why I have had so many falls.
I think they do follow the same types of exercises for all ages it is just the intensity that is different. Overtime the PT increases my exercises if it causes distress he stays at the same level. Likewise if I find something easy he increases the intensity the next time.
I think it is OK to feel sore after a session but increased pain is different and should be discussed with your surgeon. The patient has to be part of the team or they won't advance and become crippled. I have seen many overweight patients putting little into their therapy and asked a PT how they got on and his reply was "They don't" The mother of someone I know had both knees replaced and just sat around and consequently now hardly walks and it is then with bent knees.
Think about John McCain. he came out of POW camp and could not walk. Well he put a lot of painful effort into PT and seeing him now you would never know he was so disabled. Unfortunately he is now approaching the end of life but it is not because he put no effort into his PT. He probably only has weeks to live but is still fullfilling his political duties which says a lot for his persistence.
The quality of PT treatment varies greatly so it is important not to stay with a PT who is not pushing you in the right direction. I found those in hospital and rehab were only interested in getting me walking but now all kinds of strengthening exerc9ises have been included.
Yes do talk it through with your surgeon. Quite apart from anything else, if it was all going well to begin with then it's not impossible something has gone "ping" and needs correcting. Hope this is just a glitch and you'll soon be getting the full benefits.
Post op PT after Total Knee Replacement is necessary as the person needs to get up to walk, etc.
A physical therapist should, of course, taylor the therapy according to the person’s need and stamina & age, but with post op TKR PT is expected and should have been explained to the person prior to the surgery, and usually is.
Might be termed “aggressive” due to the person’s stamina, but a new knee needs exercise as in the long run it is detrimental if you don’t exercise it.
Try an ice machine compress or ice packs to the surgical knee after PT for swelling and discomfort.
Usually post op knees are on warfarin for a month after surgery to prevent blood clots. Prevention of blood clots is another reason the person needs to get up and walk.
I have seen many 80+ year old do quite well after knee replacement. Those patients were pretty active before the surgery which probably contributed to their success.
Good luck!
Either way, the outcome you're after is that the joint should be more comfortable and more reliable than it was before surgery. There is nothing wrong with asking your PTs to explain their treatment and how it will achieve that outcome, and what they need from their patient in terms of co-operation and diligence and stoicism.
But the reason I ask is that if this is someone else's knee, it's harder for you to judge how much they can reasonably be expected to cope with. Can you describe the person's usual attitude when it comes to 'no pain no gain' situations? And when you say 'worse' - worse than before the operation, or worse than it was, say, a month after it?