Originally Posted by
Jtmav
A little over 3 and a 1/2 weeks since surgery. Walking without any crutch or cane and been going to PT twice a week. My ROM is at 100 and got on the stationary bike at PT yesterday and rode for 10 mins, no resistance. While it started out uncomfortable after awhile things seem to loosen up a bit. She cleared me for 10-20 mins on the stationary bike starting tomorrow. Probably the worse part of this is forcing the knee to bend by the PT. It seems there are 2 schools of thought in this, traditional is you have a 6 week window to get as much ROM as you can before the scar tissue starts to really harden. The other is that forcing the knee will cause more damage and set back the ROM. To be honest I am a bit confused by some of this. I can see the need to work the knee and surrounding muscles but only after the soft tissue damage can heal. I am going to accept the more traditional model as I am seeing early results and will just accept the pain of forcing the knee seems to be necessary. I have learned that there is a difference between rehabbing surgical trauma and muscle rebuild. Anyone else here have thoughts about this?
Jtmav,
I also have noticed the 2 schools of thought on how to rehab from TKR. It seems to me in the US, at least everyone I've talked to, that "No pain no gain" seems to be prevalent here. In others countries, UK for one, they lean towards "push until discomfort but not pain" and so not worry about muscle rebuild early on, just ROM. I am 4 weeks past a revision of a TJR done last November and have gone to 2 different PT clinics. Both clinics and all the staff are off the "No pain no gain" school. I am not sure it is important to rebuild muscle aggressively while regarding trauma.
Tailwinds,
Charlie