Once you have undergone total knee replacement surgery and you are bending your knee maybe 80-90 degrees three to six weeks after surgery, you more than likely will find yourself being scheduled by your orthopedic surgeon for a knee manipulation.
I have mentioned in previous posts that once someone has a knee manipulation, they need to take a personal vow that they are going to become more disciplined or aggressive in getting their knee to become more mobile.
Getting the manipulation then coming home to repeat the same behaviors that lead to an under performing knee in the first place will be a waste of time for everyone involved but more importantly yourself!
I have seen too many of these types of outcomes in the past. It seems that if someone has to go back to the hospital for a knee manipulation in the first place, they are more than likely to come back home and continue to under achieve again. Unless there is some sort of mechanical failure with the prosthesis itself, it is then all mental!
When I say mental I mean the fact that some patients will get very anxious when it comes to working on their knee mobility, in other words, the flexing or bending and straightening of the knee. Instead of trying to relax their bodies and go with the flow for a short time, they tense up and fight the process leading eventually to the accumulation of scar tissue which the more that builds, the more painful your knee becomes and of course the less mobility you get.
As a physical therapist, we can only guide the patient and help them in obtaining more mobility with the knee that has been replaced or surgically repaired. The best physical therapist in the world will not be able to do the work for you. Ultimately the responsibility lies with you the patient in getting the most mobility out of their knee quickly as possible.
The bottom line here is that you are in a race against time after surgery to get full mobility out of your knee before the scar tissue which is a natural process the bodies uses to repair and heal itself becomes too big to surmount.
Waiting until things get better or for the pain to subside is a dead end street. While you are busy waiting around for a better day, your body is rapidly trying to lay down scar tissue to help in the repair process and in the meantime locking your knee down.
Adequate pain control is a must during knee rehabilitation to effectively mobilize your knee in the first place, Too many people try and get off the pain medication too fast and cannot understand why they are in such pain.
Reasons, why patients do not get more assertive in the knee flexion and extension exercises, are many however pain and discomfort is the really the biggest issue, everyone handles this differently. People become anxious when bending the knee none of us like to inflict pain on ourselves, well at least most of us.
Get yourself mentally prepared before surgery that rehabilitation will not be easy but it is something you can conquer with a little mental toughness added to the rehab program. Remember, the pain of discipline is temporary but the pain of regret lasts a lifetime.
Richard Haynes PTA, CPT
Total Joint Fitness LLC