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Avoid Manipulation Under Anesthesia (12-weeks after knee replacement)
An Interview with PTA, Kim Sajewski
“The Dianne Story” – Part I
We are pleased to share this interview from The Bee’s Knees Podcast and KNEE RADIO 1. We share the account of Dianne Smith’s recovery after total knee replacement. Dianne was able to avoid manipulation under anesthesia after 12 weeks of struggling in outpatient PT.
Dianne faced an additional challenge in that she had three blood clots in her calf when she started on X10. At the end, the blood clots were gone.
Details in the article below and on the podcast. This is part one of a two-part series.
Hello, my name is Kim Sajewski, and I was fortunate enough to be the recovery coach for Dianne Smith. When I first spoke with her, she was about 83 days post-surgery. Typical patient that I talk to are frustrated, struggling, dodn’t know where to go. Dianne found us at at x10therapy.com: and she did her research. She was a great patient. She wanted to know what else she could do. And I was upfront and honest with her. We talked about where she was in her recovery, what she had been doing.
She was in outpatient therapy. She was zero degrees extension, which she had full, and she had about 103 degrees flexion. The unique thing about Diane and I have not seen before with X10 is Diane had three blood clots in her calf. She still had them when she came to us, and I told her I was concerned. I had never seen it before, but she had been in outpatient therapy. The surgeon told her there’s nothing that they can do about them. She, she was on blood thinners; they didn’t give her any restrictions.

Kim Sajewski
In going through what she was doing in outpatient therapy, I knew the X10 would be way more gentle than the outpatient therapy was for her. She was being forced into manual stretching to the point that she was like, “Kim, I was smacking my hand on the matt / table, tapping out. I’m tapping out like in a wrestling match.” And I said I understood, and it’s not the way to go, but it is what it is. We both said the same thing. As soon as I started saying it, she started finishing it for me. I said, “You know, when patients continue, you have your trust with your therapist and things are going okay, but then things don’t go so well. But then they keep doing the same thing over and over again and expecting a different outcome.” And she said it right with me.
She said, “That’s a definition of insanity, to keep doing the thing, the same things over and over again, and expecting something different, an outcome, something different.” And we laughed.
She’s like, “I knew I couldn’t keep doing this anymore. I was a young 60-year-old grandmother who wanted to play with the grandkids. I had places to go. I wanted to travel. I did this for a reason. You know, my knee was so painful before surgery, and I did this because I wanna get back to life.” Unfortunately, this happened.
From the blood clots, her leg had swelled up. She was suffering from swelling from quite a long time, her leg was very tender, and wasn’t getting anywhere with range of motion. PJ on our team first talked to her just said, “Listen, whether you get the machine or not, you just have to stop doing what you’re doing. Ride the bike three times a day. Just stop this forceful stretching. This pain mechanism is not going to stop.” So she decided to get the X10.
Before she got the X10, she already had gained nine degrees from doing what PJ had told her to do. So I was, I was so happy. We’re all a team here, so we want the best for the patient. And I was happy that she was able to gain that much range.
Now she’s excited, right? She is gaining this range, and now she’s getting a little bit ahead of herself. So that’s where the coaching with my patients, what all the coaches do: ometimes we have to pull the reigns back. It’s a slow process. It’s the slow not forceful process that works. And the knee takes some time to slow down. It takes some time to get used to that, and it’s not going to happen overnight. And I told her that, I said, “It’s not a miracle machine. You have to give the knee some time to calm down. It has to reset itself again. And it has to realize that you are not doing something that is going to make it hurt and is not going to be painful. So once it starts to calm down and realize that it’s okay, what it’s doing, and it’s okay to go one degree at a time, everything starts to follow through.”
And so she did that. She was re respectful of that. She trusted the process. She trusted that this was the road for her. She knew she couldn’t get any worse than what she was. Maybe she could, I don’t know if they caught forcing her, but she knew she wasn’t going to go back to that. I had spoken to her about her outpatient therapy as well. And I said, you know, if you have a good relationship with your therapist, just tell ’em that you have this machine. You can or cannot, you know, but just say, you know, let’s just try not forcing my knee into, into a bend. Let’s just try doing other things. Let’s, let’s focus on the strength. Let’s focus on hamstring flexibility, but not, not the bend. Let’s not do that. And her therapist was very respectful of that. He listened and he said, okay.
And soon all of these things started taking place, and her knee was calming down.,she started to notice that she was walking better. Then when she went into her outpatient PT clinic, everybody’s like, “Wow, you’re walking so much better. You’re more fluent. You know, you’re not stumbling. You’re getting that full stride.” And so, that really made her happy, and she wanted to do more. But I, once again I reminded her, “Diane, let’s pull the reins back. We talked about it going slow and steady.
Dianne continued that progress as the days went on. The numbers were going up, she was gaining. She was progressing well. She was progressing as she should. One degree at a time. And the knee was accepting it.
However. To me the numbers, yes, they mean a lot. But… functionality meant even more. She was now able to get in and out of her car. Her husband said, “You bounced out. You bounced out of the car. Like it was nothing.” She was walking. She got to go down on the floor and play with her grandkids.
And on the phone I could hear the tears in her voice. She was just so happy that she was able to be down on the floor playing with her grandkids.
I think 19 days after she had the machine, she got to zero degrees extension and 130 degrees flexion (that is traditionally full flexion for most of us). She literally texted me that night, a picture of her screen, and she’s said, You have to celebrate this with me!” I, of course, called her and I said, “Oh my gosh, who would’ve thought this happened ?? !!”
And then 23 days after her blood clots were gone, she called me once again.
Dianne said, “I don’t know. I don’t know what happened. I don’t care how it happened, but they’re gone. My leg is no longer swollen. It’s not painful. I can touch it. You know, anybody, you know, my grandkids touch my leg. I don’t jump. It’s l like, it’s a miracle, you know? And she was so thankful of finding X10.
And we had our doubts. We had our honest talks about, “Hey, you know, I can’t promise you that this is going to get you to where you think you want to go, where want to be. But I can guarantee you it’s going to get you better than what you were.” I told Dianne, “You trusted that process and you did it!”
So it was amazing!
Now we’re just friends. I told Dianne, you’re not only my patient, but you’re my friend. So she’s sending me pictures of her grandkids and everything. And it was, it was pretty. It’s an amazing story. I’m so happy for her.
KNEE RADIO 1 (powered by The Bee’s Knees Podcast)
This interview “Avoid Manipulation Under Anesthesia” is available exclusively on The Bee’s Knees Podcast and on KNEE Radio 1, a new radio station engineered to help millions of knee surgery patients each year. You can listen to KNEE RADIO 1 right here: KNEE RADIO 1

The X10 Meta-Blog “Avoid Manipulation Under Anesthesia”
We call it a “Meta-Blog.” We step back and give you a broad perspective on all aspects of knee health as with this article on ‘Avoid Manipulation After Anesthesia (12-weeks after knee replacement)’.
In this one-of-a-kind blog we gather together great thinkers, doers, and writers. All our work is related to Knee Surgery, Recovery, Preparation, Care, Success and Failure. Meet physical therapists, coaches, surgeons, patients, and as many smart people as we can gather to create useful articles for you. This is for you if you have a surgery upcoming, or in the rear-view mirror. Or maybe you just want to take care of your knees to avoid surgery. Executive Editor: PJ Ewing
To subscribe to the blog click here.
GET HELP NOW – TWO FREE EMAIL SERIES BELOW
Two resources for you below to help with knee replacement pain management. Both are email series that we created to help those who need some additional thinking for pre-surgery and post-surgery.