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No pain no gain is an outdated notion that some physical therapists unfortunately still believe in.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.
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.
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?
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.
What has your therapist said when you've raised the issue with him or her? Have you also discussed it with the prescribing doctor?
These would be the first options. Perhaps you need a different therapist.
Is this in home therapy, or are you going to a commercial therapy company, or a therapy unit of a hospital? I've found (a) the hospital affiliated therapy providers are usually better than in home care but (b) therapists with a lot of experience with older people are often better than younger ones. No offense to the young folks, but it does take a while to assess what an older patient is capable of handing.
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!
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.
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,
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.
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.
By proceeding, I agree that I understand the following disclosures:
I. How We Work in Washington.
Based on your preferences, we provide you with information about one or more of our contracted senior living providers ("Participating Communities") and provide your Senior Living Care Information to Participating Communities. The Participating Communities may contact you directly regarding their services.
APFM does not endorse or recommend any provider. It is your sole responsibility to select the appropriate care for yourself or your loved one. We work with both you and the Participating Communities in your search. We do not permit our Advisors to have an ownership interest in Participating Communities.
II. How We Are Paid.
We do not charge you any fee – we are paid by the Participating Communities. Some Participating Communities pay us a percentage of the first month's standard rate for the rent and care services you select. We invoice these fees after the senior moves in.
III. When We Tour.
APFM tours certain Participating Communities in Washington (typically more in metropolitan areas than in rural areas.) During the 12 month period prior to December 31, 2017, we toured 86.2% of Participating Communities with capacity for 20 or more residents.
IV. No Obligation or Commitment.
You have no obligation to use or to continue to use our services. Because you pay no fee to us, you will never need to ask for a refund.
V. Complaints.
Please contact our Family Feedback Line at (866) 584-7340 or ConsumerFeedback@aplaceformom.com to report any complaint. Consumers have many avenues to address a dispute with any referral service company, including the right to file a complaint with the Attorney General's office at: Consumer Protection Division, 800 5th Avenue, Ste. 2000, Seattle, 98104 or 800-551-4636.
VI. No Waiver of Your Rights.
APFM does not (and may not) require or even ask consumers seeking senior housing or care services in Washington State to sign waivers of liability for losses of personal property or injury or to sign waivers of any rights established under law.
I agree that:
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I authorize A Place For Mom ("APFM") to collect certain personal and contact detail information, as well as relevant health care information about me or from me about the senior family member or relative I am assisting ("Senior Living Care Information").
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F.
You consent to APFM's reaching out to you using a phone system than can auto-dial numbers (we miss rotary phones, too!), but this consent is not required to use our service.
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.
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?
These would be the first options. Perhaps you need a different therapist.
Is this in home therapy, or are you going to a commercial therapy company, or a therapy unit of a hospital? I've found (a) the hospital affiliated therapy providers are usually better than in home care but (b) therapists with a lot of experience with older people are often better than younger ones. No offense to the young folks, but it does take a while to assess what an older patient is capable of handing.
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!
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.
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