Physio appointments post total knee replacement

Moomin

Hello all,

Just coming back on this message board to get thoughts about physio post total knee replacement surgery. My mum had her op about 2 months ago. Her consultant said it went very well and since then she's had a few physio sessions which she found very helpful. She's also made a big effort to do the physio exercises at home, but never feels that this goes as well as the sessions with the physiotherapist. However, at her recent orthop consultant appointment mum was told that she would benefit from more physio in order to get the best from the TKR. In particular,she needs to increase the bend in her knee and also get the strength back in her thighs. She also feels that she's constantly dragging her bad leg. We are looking at going private for the extra physio as more is not available on the NHS.

Does anyone have any idea how frequently these appointments should be? We did ask the orthopaedic consultant and he didn't really give a clear answer, other than "well if you are a professional sportsperson who'd had this op, you'd have a physio apptmt every day, but for everyone else, it's different...". The consultant also said that if *he* was in this position, he'd definitely invest in the physio.

We are on a tight budget, so can't splash out on endless physio. But at the same time, want to do what's in my mum's best interests. We are also wary that some physio businesses have very pushy marketing...

So, just wondered if anyone else has had any thoughts on the above ie how frequent the sessions should be, for how long (eg once a week for a couple of months? I understand there's a window of about 6 months post op in order to do all the physio to make sure the knee really recovers). Also, how come my mum still needs more physio even tho she is doing the exercises at home?
Plus would it be useful to separately go for some gym sessions eg on a cycling machine?

Many thanks!

stickywicket

It's both good and wise of you to look out for your Mum, Moomin, because you're right – there is a golden window of opportunity and it's best to grasp it. The physio exercises are so important in helping us achieve this.

You ask “Does anyone have any idea how frequently these appointments should be? “. Frankly, no. I don't think I recall many people on here getting extra physio post-TKR. I never had it and I've had two TKRs and a revision. My plan of action was always just to concentrate hard on the quad exercises from the start, doing them about 4-6 times each (10 repetitions per time) daily. It always worked.

You say your Mum feels the exercise sessions at home never go as well as those with a physio. There could be several reasons for this. She could be afraid of pushing herself unless the physio is there to say it's OK. She might simply not be doing them as often as she should. They are incredibly boring and time-consuming and, because one has to count all the time, it's impossible to combine them with anything else other than the radio.

Maybe your Mum just needs regular assurance that she's doing them right and making progress. I'm sure there are grasping physios as with any other profession but both of those my husband has occasionally used have been great. Word of mouth is always the best recommendation but, if you're relying on adverts, go for one who specialises in musculo-skeletal problems.

As for gym sessions on a cycling machine. I'm sure these would help at some point but, as we neither know your Mum, nor have any medical qualifications, we really can't be the ones to say yes or no. The physio could t hough.

Moomin

Thanks a lot for the reply. It was definitely worthwhile going to see the physio. Apparently my mum had been doing some of the original exercises incorrectly, so she was given guidance on how to change this. The physio took time to assess what my mum needed to focus on (knee bend and building up her strength), and the exercises were tailored to this. It has helped re-motivate my mum as well and she's doing the exercises several times a day (unlike before). Fingers crossed, she'll continue to progress.

Thanks again for the advice and tips - really appreciate getting this personalised response...

stickywicket

I'm so glad it's working out well for her. It's so easy to get things slightly wrong and so invalidate the entire exercise.. Your Mum now has the guidance and assurance which was what she clearly needed and I hope she will go from strength to strength.

lindalegs

Hi Moomin,

When I had both my knees replaced in 2000 the NHS supplied intensive physio and hydrotherapy twice a week for six weeks :shock: Times have changed so much now with all the cuts within the NHS. When I had a revision of my right knee 3+ years ago the physios came to see you in hospital then booked you in for physiotherapy six weeks after the op. (I wasn't offered this because I was doing alright anyway being a veteran of knee replacements and all.) I did remember all my exercises from the 1st time round and did them twice a day at home, three times if I was well enough.

I think it's easier to be disciplined if someone is checking up on you, be it a physio or a member of the family, in my case Mr Legs. We made a tick chart listing the exercises and because I knew someone else would be around to look at my progress and even measure my 'knee bend' it made me try harder. Why 'shell out' for private physio when you already know the exercises your mum will be given? You could put the money you would have spent on this into a pot and have a treat as a further incentive .....just a thought.

Hope this helps.

Luv,

barbara12

Hi Moomin
Im so glad to hear your mums op went well.now I suppose for the hard work..they do say you have to work much harder with knees than hips..I do wish your mum well and please keep us updated..