Both knees total replacement

[Premier Lady]

I have a client that had total replecement of both knees. One of them almost a year ago and one recently.
Neither knee is extending of flexing fully.
She came in one day unable to extend the knee with the oldest surgery . I worked on the legs and in the end of the session the leg was straight. She came back several days later and said that it felt ok but she was now unable to flex the knee.

Anyone out there has worked with total knee replacements? Any comments or sugestions? This client says another woman with the same surgery at her PT office can move the legs fine, and she is still dealing with so much problems like pain and lack of range.

 

[Maybel T]

I really hate knee replacements.

I recently had an 82 year old client who had it done. She is on a fixed income. Besides her knee problem, she also had low back pain, which may have been examassageplanetated by the bad knee.

I gave her a steep price cut if she came in 2x a week. For a month, she came in twice a week. I was able to stop the back pain, but the knee was still bothering her. It was weak and gave out easily.

In my opinion, she should have had some physical therapy and pain pills to deal with the knee before they resorted to a tkr. She is in fair health and her mind is good. Six months ago, her doctor took her off her pain meds and told her to take advil. HELLOOOO??? This is an 82 year old woman!!! The pain was driving her nuts and she was having a very difficult time sleeping because of it. She would have done anything to stop the pain, so she agreed to the tkr. She is on medicare and has supplimental insurance. I think the doctor just saw dollar signs. The way my client made it sound, she was the one who suggested a knee replacement and he just said, "okay, that might work." HELLOOOOOO????

Another client who comes rgularily to a hairdresser in my building but says she cant afford massage had a double knee replacement. THe first one was about 8 years ago and the second 3 years ago. I dont know what the first one was made of, but she doesnt have any problems with it. The second one is titanium and it bothers her so much. Most of the time it is rather warm to the touch. It feels like a fresh knee raplacement that is still healing, but at the time was in for 2 years. My opinion is she is her body doesnt like that titanium and is rejecting it. Kind of like when people who have sensitive ears wear cheap earings. The difference is it is easy to take the earing out!! Not so with a titanium knee, at least not without surgury!

Anyway, kind of off target.

Knee replacements can be tricky because they limit what we can do. Any stretching which involves the knee is out. Cross friction and skin rolling are great. As far as stretching the hams and quads, you can try pinning them down with one hand while you drag a dry hand in the opposite direction.

I would also recommend your client learn to stretch their hams out as well. That stretch where you slightly bend your knees, stick out your but and try to straighten up your knees works well. Preach self massage too. Anyone with a knee replacement should have had PT, have them refer to the information thier therapists gave them.

 

[amee G]

I worked in a PT office and saw quite a few TKR's. Each person was different.
I was told by the PT the reason some people have problems fully extending is 1. the incision its self 2.Lack of strenghting prior to surgery and 3. lack of it after. 4. the actual Dr. performing the surgery and how he cut into the muscles.

I saw patients 2 months after surgery with almost full extension and others 6 months later could still hardly bend it.
Alot of people feel the pain but don't want to do any exercise because they are hurting which in turn actually prolongs their pain. Or stop exercising because it hurts.

 

[Woody.]

Thank you both for the responses.

So from what you say there is a possibility that the recovery will take a long time, like many more months, right?
I'm doing cross fiber and stretches and this client has some relief but from my point of view the progress is kind of slow.
This client does all exercises from the PT at home and still has sessions there, so I think the effort is there. I hope the return won't take for ever to happen.

 

[SportsInjuryCharley]

I, too, worked in PT for a couple of years and yes, knees generally are a long rehab, right behind shoulders

 

[Niofania F]

If the patient didn't work really hard right away (within the first 6 months I believe) it is a slow process. One thing that my client found really helpful was an exercise going through the entire alphabet with his foot...tracing each letter. Hope things get better for your client!