BoneSmart® Hip / Knee Replacement Forum
The world's leading knee and hip replacement
patient advocacy organzation & online community


[TKR] Worried Knee

Discussion in 'Knee Replacement Recovery Area' started by Sasysusie, Mar 18, 2013.

  1. Sasysusie

    Sasysusie Junior Member

    Offline
    Member Since:
    Mar 9, 2013
    Age:
    60
    Messages:
    73
    Gender:
    Female
    Lets see if I am doing this right... I had my surgery on Jan 12, 2013. Reading this forum I'm not sure if I feel better now or just want to go sit in a corner and cry.

    I am an active person and determined and always follow Dr's and therapist's directions and never thought I'd have any trouble recovering from this. I had hip replacement surgery 2 years ago and it was pretty much text book but this knee - ugh!

    I used the CPM machine for 3 weeks after the surgery and I did in home physical therapy as well. I did all of the exercises I was given never missed. I started Out Patient therapy and after just 2 sessions with outpatient I had an appointment with my Dr. he took one look at my knee, saw the inflammation and stopped out patient therapy. He wanted me to just continue with all my exercises I had been given. I am and I do each and everyday.... several of them. I also go for walks.

    My problem and my worries are my bending. On the CPM machine I could bend 110 degrees. but..............on my own ugh the bend is soooo bad. It feels so tight and as if it just wont bend ... I do a bending exercise where you lay on your back and pull it into a bend as far as you can but ohhh that is hard.

    The Dr has told me to do that bend just to where its uncomfortable and hold it, before I was pulling it with a strap to make it bend to the point I'd have tears. He told me to absolutely stop that, that I was causing the inflammation in the knee and the fever. He feels I need to relax a bit and he says the bend will come. I still have a lot of swelling too so that does not make it any easier. I feel so frustrated at times.

    I can do a full rotation on a recumbent bike as long as the seat is not too close. But move the seat forward and ohhh it's not going to go full rotation. Will the bend really come in time as long as I stay active and do all my exercises and walking?? I just don't know what to think or do.

    Reading this forum sounds like some are doing so good and some are about where I am. I'm getting so frustrated and yes I'm still taking Norco pain meds when they are needed, not on a daily basis now, and yes still lots of ice. It does not take very much activity and the swelling really comes on fast. I worry is that normal at 2 months out?

    Sorry I've rambled I just am worried a lot. thank you for reading and thank you all for sharing.
  2. Campervan

    Campervan Sr Bonesmartie

    Offline
    Member Since:
    Jan 17, 2012
    Messages:
    1,397
    Gender:
    Female
    Country:
    New Zealand New Zealand
    Location:
    New Zealand
    Hi, all you have written could have been written by a whole bunch of us on the forum. A few of us have a slow recovery, most average recovery and some fly through. I was one of the slow ones with ROM stuck at 107 for months and month. Every few months it improves in one big jump, not just slowly each week. I had a review with my OS 10 days ago at 15 months post op and he measured 120. Three months ago it was only around 115.

    Your OS has told you to back off on the exercises and that's spot on in line with with Bonesmart way. Gentle exercises all the way and never never let any therapist push you to the point of pain, discomfort only.

    Keep up your pain meds, icing, elevating, gentle stretching. And ride the recumbant bike with the seat as far way as you can. You'll get there in the end. Remember the hare and the tortoise!
  3. Roy Gardiner

    Roy Gardiner Forum Advisor

    Offline
    Member Since:
    Jul 23, 2011
    Age:
    62
    Messages:
    3,176
    Gender:
    Male
    Country:
    United Kingdom United Kingdom
    Location:
    Essex and London
    Susie, DON'T PANIC.

    You are only just over 2 months out, and you (I am sorry to be blunt) are overdoing things and setting back your recovery. You say so yourself "I was pulling it with a strap to make it bend to the point id have tears".

    Stop all that at once, please. Listen to the doctor "he told me to absolutely stop that , that I was causing the inflammation in the knee and the fever. He feels I need to relax a bit and he says the bend will come, I still have a lot of swelling too so that does not make it any easier." 100% spot on.

    Your knee is injured needing healing, not unfit needing training. You don't heal a broken leg by walking on it, you don't have a cut heal by picking the scab, you don't even run a car engine in by revving it to the max.

    Training: no pain, no gain. But you are not doing training.
    Healing: no pain, more gain. This is what you are doing.


    This is the way forward:

    - rest, elevate, ice and take your pain meds by the clock
    - If it hurts, don't do it and don't allow anyone - especially a physiotherapist - to do it to you
    - If your leg swells more or gets stiffer in the 24 hours after doing it, don't do it.
    - If you won't die if it's not done, don't do it.
    - Don't stand if you can sit; don't sit if you can lie down, don't stay awake when you can go to sleep

    --------------------------------------

    OK. You can help ROM by doing gentle stretching exercises to the point of discomfort only, no pain. See my exercises link (below) for some examples.

    Don't move the seat forward on the recumbent. Set it at the point where you can do a full rotation, set the thing on zero resistance and turn those pedals slowly, gently for a couple of minutes max. If your knee swells after doing it, move the seat further away until there's no swelling reaction. Then repeat the exercise several times a day.

    You will find that the first few seconds are tough and uncomfortable, then the leg will loosen and it will be easy. That's good. When it's pretty easy right from the start, move the saddle just 1/4" or so nearer the pedals.


    You're icing, good that'll help. Now, lots of daytime TV and sitting. Tough work, has to be done.
    • Like Like x 1
  4. tashia

    tashia Sr Bonesmartie

    Offline
    Member Since:
    Nov 4, 2011
    Messages:
    5,314
    Gender:
    Female
    Location:
    United States
    Welcome to the site. Yes recover does take time. At least it did for me and many others here. So Ice. elivate, rest and do pain control whenever you are hurting. I have found my leg which is now three years old every once in a while decided that it needs some TLC (Tender loving care). I give it some and then everything is fine. Keep up the good work and the next thing you know it you will be in recovery. Do take care. Tashia.
  5. Dhare63

    Dhare63 Sr Bonesmartie

    Offline
    Member Since:
    Oct 30, 2011
    Messages:
    1,075
    Gender:
    Female
    Country:
    United States United States
    Location:
    New England
    Hi Susie,

    Welcome to Bonesmart, where you will find lots of sage advice and first person guidance.

    First, as other have said including your OS, you are overdoing it. You should never do anything to the point of tears. That is completely counterproductive and will not produce the results you seek. In fact the opposite will happen as you have seen. You said you have followed the protocol for exercise and pt, so do as your OS suggests and slow down some.

    As for the CPM, the measurements you get on it are not very accurate. The position of your leg in the machine, whether you are strapped in, etc are all variables that make the numbers unreliable at best. While I like the cpm, it's really best to provide gentle motion, that's it.

    Two months is early days in this process. Your recovery from hip surgery is not to be compared to the knee, as the physiology and condition of your body may have made the hip surgery easier to recover from. You may need to reconsider your expectations and accept that it will take some time.

    Slow down, ice, elevate and control pain. Here's an analogy that we use often here; think of a hose full of water and think about trying to bend it....it's very difficult to do. Your knee is no different. With the swelling being so present, of course it will be hard to bend. I would suggest you try to find either a pt or massage therapist that does lymphatic massage, which can help move the fluid out of your knee joint and to drain away from the body. I used this and it helped me quite a bit. Also, after you ice, or after massage, use your compression stocking. I hated my Ted hose until I cut the feet out of mine, which made it easier to get on, then wear it after icing to keep the fluid out of joint. If you know you will be doing a lot of walking, wear the hose under your pants, it does help.

    Please don't worry that you are behind schedule or that something is wrong. Your knee is trying to tell you to slow down. Please listen to it. You are at the intersection of frustration and depression, and that is completely normal. It will get better, truly it will. Try journaling on a daily basis on how you feel, what your activities were and how the knee feels. After a while you will see that you are making progress, it simply takes time.

    This is all very easy to write, but difficult to do. I know from personal experience. Be kind to yourself. In the words of the great coach John Wooden, "hurry but don't rush".

    Keep us posted and the support system is in place to help!

    Be well,

    Dawn
  6. bottomshollow

    bottomshollow Moderator

    Online
    Member Since:
    Sep 17, 2011
    Age:
    71
    Messages:
    9,647
    Gender:
    Female
    Country:
    United States United States
    Location:
    Eastern NC
    easter welcome 1.jpg Sasysusie, so pleased you have joined us here on the forum and started your own thread. As you can see, we are a friendly bunch ready to jump in with answers and advice.
    I have some reading for you! The first set is essential reading, the second and third are useful and the fourth is just good information, but you will need it all.

    Group A
    The importance of managing pain after a TKR and the pain chart
    Myth busting: no pain, no gain
    Swollen and stiff knee: what causes it?
    Progression of activity for TKRs

    Group B
    How Long Does Healing Take ......
    Chart representation of TKR recovery
    Energy drain for TKRs
    Elevating your leg to control swelling and pain
    Using ice
    Constipation and stool softeners
    Sleep deprivation is pretty much inevitable - but what causes it?

    Group C
    Knee Replacement - Where Am I in Recovery?
    So What Is It Going to Take? The Five “P’s” of Knee Recovery
    Work “Smarter” and not “Harder”
    About recovering a knee - from one who knows!
    Some suggestions for home physio (PT) and activity progress
    Myth busting: The "window of opportunity"

    Group D
    MUA (manipulation under anaesthetic) and adhesions
    It's never too late to get more ROM!
    It's Worth the Wait for ROM
    Myth busting: on getting addicted to pain meds
    Post op blues is a reality - be prepared for it

    Please don't be overwhelmed by the list. The articles are not lengthy and contain information that will answer many questions and help you make your recovery much easier on your knee and on you.

    We are here to help in any way we can: answering questions and concerns; supporting and encouraging you from start to finish; giving you a place to vent, whine, complain if you need to; sharing experiences with one another; and having fun and some laughs along the way.

    Take care and keep us posted. We care. easter hugs 11.jpg
  7. Sasysusie

    Sasysusie Junior Member

    Offline
    Member Since:
    Mar 9, 2013
    Age:
    60
    Messages:
    73
    Gender:
    Female
    Just to clarify.. the only reason I was doing the exercise with the strap is because my therapist told me to do that. I might have worded that wrong. Both my home therapist and outpatient therapist pushed hard. Out Patient pushed the hardest and told me to use the strap to pull the knee in more. Once I saw the Dr. (after just 2 outpatient sessions) he put an end to that.

    I followed his orders and I stopped immediately doing the strap pulling exercise. Since that moment I have been doing all the exercises I was given but not to the point of pain, just to the point of discomfort. I must have worded that wrong the fist time, maybe I did a better job this time. Things seem to come out on paper differently than my brain was planning on it coming out!

    I have not been measured in a few weeks now since I'm not going to Out Patient therapy. But I'm pretty sure the most bend I have to this point is 90. I'm trying to just keep looking forward. I rest and elevate as much as I can. I go do light shopping because the OS said walking is a good thing..so why not shop while I walk. But I do know after just a bit of walking the swelling comes fast... so I get myself home back on the bed and put the ice machine back on! and say awwwwwwwwwwww!!

    I'm taking everything I'm reading to heart, and I have been telling myself slow and steady wins the race - it's just easier said than done. I have backed off trust me, I do listen to my doctor and trust him. Once sad lay off I did... but then I had that lingering nagging in my brain saying if I back off too much will I ever get bend... So reading your comments does help give me confidence I'm doing the right thing and to just keep going.

    Thank you all for taking your time
    Susie
    • Like Like x 1
  8. Roy Gardiner

    Roy Gardiner Forum Advisor

    Offline
    Member Since:
    Jul 23, 2011
    Age:
    62
    Messages:
    3,176
    Gender:
    Male
    Country:
    United Kingdom United Kingdom
    Location:
    Essex and London
    The lingering nagging is wrong, trust us.

    Sounds like you're doing it right, don't see those two 'therapists' again; as the old joke goes, the name has been misspelled, there should be a blank after the 'e' for those people.
  9. Josephine

    Josephine Administrator

    Online
    Member Since:
    Jun 8, 2007
    Age:
    72
    Messages:
    50,653
    Gender:
    Female
    Country:
    United Kingdom United Kingdom
    I expect you know this by now but hips and knees are chalk and cheese! (hey, that rhymes!!) :snork:
    Well, praise God for a surgeon who believes in the "BoneSmart way"! There aren't too many of them around and you are lucky to have one! That isn't an exercise it's the original PT - pain and torture! And he is dead right that your problems are mostly of your own creation - but more on that later.
    Let me guess - those nice kind therapists told you that if you don't get to 100 degrees bend by six weeks your knee will set like concrete and never move again, yes?

    WRONG!!

    No bigger myth was ever imposed upon a hapless group victims - called knee replacement patients - than that one. I'm going to repeat articles Judy has already left you earlier but I need to emphasise my message
    Myth busting: The "window of opportunity"
    It's never too late to get more ROM!
    It's Worth the Wait for ROM.
    Let me put this into another context for you - just suppose you walked up to a person in the street and did something like that. What do you think would happen? I would expect you'd be in the custody of the law in no time flat! Just because these people have a 'professional' standing does not give them carte blanche to abuse you in any way they deem fit. It's not on, not at all.
    Because it turns a small exercise into something else. You're only 10 weeks out but because of all the overdoing it of PT and stuff, you're probably more at 6 weeks. You need to read this Progression of activity for TKRs to see what you should be doing just now. Which is NOT shopping! Nor doing full rotations on the bike, nor housework, laundry, meal prep for the family or anything else. Then you will have all the time in the world to rest and elevate and all the time you are doing that you can ice as well!

    Go and read the articles Judy left for you and apply them as if you were at 6 weeks.

    Incidentally, you haven't said what pain meds you are taking, how much and how often. Inquiring minds want to know!
    • Like Like x 2
  10. Dhare63

    Dhare63 Sr Bonesmartie

    Offline
    Member Since:
    Oct 30, 2011
    Messages:
    1,075
    Gender:
    Female
    Country:
    United States United States
    Location:
    New England
    It's all good Susie, glad you clarified a bit. It's very difficult to recover from a surgery of this nature and even harder to find your way to advice that works for you. Your OS sounds like a wise one indeed. I have a feeling you will start to see results as your body adjusts to the slower pace.

    Some of this recovery is simple trial and error. You may need to test the fences a bit to see what you and can't do just yet. I went that direction and it helped me.

    Do stay in touch and bring your questions here, we care and will support you best we can!

    Be well,

    Dawn
  11. pdx

    pdx Senior

    Offline
    Member Since:
    Nov 17, 2012
    Age:
    64
    Messages:
    371
    Gender:
    Female
    Country:
    United States United States
    Location:
    West Coast
    One trick that helped me: Use our old pal gravity. Lie on your bed with your feet flat against the wall or headboard (if it's a high headboard). Gradually slide your right foot down the wall/headboard. Hold for 20 seconds when it starts to feel a bit uncomfortable. Relax while you're holding; just let gravity do its job. If you want to take it a bit further after the initial holding, go right ahead and slide your foot down farther & hold for a bit -- 10-20 seconds.
    Another trick: Sit on a chair. Move your feet back almost as much as you can. Then slowly move your tush forward in the chair, keeping your feet flat.
    Little by little, you'll see improvement.
    If you like water exercise and are able to get to a pool, preferably warm water, that helped me tremendously. I did water "biking" and walking and strengthening exercises. I still go to arthritis-geared classes 2 or more times a week, as they emphasize range of motion -- and it's great to have company.
    Good healing. It's worth it!
  12. Sasysusie

    Sasysusie Junior Member

    Offline
    Member Since:
    Mar 9, 2013
    Age:
    60
    Messages:
    73
    Gender:
    Female
    Sorry ive been missing for a few days. I flew to my folks on monday only a short 1 hour flight, but my mom has been keeping me so busy ive barely had time for here. If walking is good for my knee it should be healed after a few days with my mom! Ive been keeping up with all y stretches and exrcises and icing when I can. Overall i am getting stronger and stronger, I see lots of progress, but still my over all worry is the bend and well my leg does not go completely flat yet. I do have a question, when bend my knee and then straighten i have a click in the back of my knee.. is that normal?? with each bend and straightening i feel it... so just wondering about that now too.
    I love reading all that everyone responds to me here its been so helpful, I am taking it all in.
    Thank you
    Susie
    • Creative Creative x 1
  13. Sasysusie

    Sasysusie Junior Member

    Offline
    Member Since:
    Mar 9, 2013
    Age:
    60
    Messages:
    73
    Gender:
    Female
    My pain has not been as bad lately. Im taking Norco, and usually just one at night when i go to bed.
  14. bottomshollow

    bottomshollow Moderator

    Online
    Member Since:
    Sep 17, 2011
    Age:
    71
    Messages:
    9,647
    Gender:
    Female
    Country:
    United States United States
    Location:
    Eastern NC
    easter bunny 10.jpg Susie, relax, sweetie, knee clicking is very, very common. Happens to most of us. May stay around for several months, but will eventually resolve itself and disappear. My knees clicked starting about the end of month 3 and then continued for the next 4 months. It wasn't something I could hear--it was something I could feel. It didn't hurt--and as long as it isn't painful, then don't worry about it.

    Please remember that this is a 12 month recovery---you still have a long way to go. And flex and extension continue to improve for months. Keep working slowly---each day--and don't over do.

    Take care and keep us posted. We care. bunny hugs 18.jpg
  15. Sasysusie

    Sasysusie Junior Member

    Offline
    Member Since:
    Mar 9, 2013
    Age:
    60
    Messages:
    73
    Gender:
    Female
    2months 3 weeks I saw the OS today. He was not as pleased with my progress as I wish he had been. I am still only at about 90 rom. It just seems to meet with resistance if I try to go more. I think I do get more bend when I just let it fall with gravity and the OS noted that too. I feel like I am walking so much better but OS was not really totally happy with that either, one leg is a bit longer than the other and I think that automatically makes me look different when I walk. I continue to do all my exercises but really how will my ROM ever improve, can it really even at this point. I feel like ive done something wrong. Don't get me wrong my OS did not get after me he is positive and very supportive... he said your doing ok... but ok I not good for me... and the ROM is not good and I know that...im feeling depressed and as if ill never improve now
    just feeling blue I guess its cry day again
  16. Josephine

    Josephine Administrator

    Online
    Member Since:
    Jun 8, 2007
    Age:
    72
    Messages:
    50,653
    Gender:
    Female
    Country:
    United Kingdom United Kingdom
    Oh, so now you know more than your surgeon does, eh? Tell me, did you actually read those articles I left for you in post #9? I think you can't have because if you had, you would know that he is right and you are so, so wrong! You're not even 12 weeks out yet - still heaps of time to keep improving, like 10-12 months!
    So when you say your pain is 'not as bad' now, that leaves me of suppose that you do actually still have pain, yes? So tell me, on the usual score of 1-10 (1 being no pain and 10 being the worst you can imagine) what your pain levels are like at 8am, 12md, 4pm, 8pm, 12mn and 4am (or thereabouts).
  17. robynhood

    robynhood Sr Bonesmartie

    Offline
    Member Since:
    Oct 19, 2012
    Age:
    62
    Messages:
    1,496
    Gender:
    Female
    Country:
    United Kingdom United Kingdom
    Location:
    United Kingdom
    Susie so sorry you are feeling down. I am at almost six months now and Ive been getting so depressed and fed up about my ROM I seem to be forgetting the good things I have acheived from my TKR. The awful bone to bone pain has GONE, I can go upstairs properly without pain for the first time in years, I can stand still for a long time without my knees screaming at me, I can walk for long distances without sitting down every couple of minutes. All these things are GOOD even if my ROM isnt. It will improve in time Im sure of that. Try to focus more on the good things as youre only 12 weeks out and you have so much more time to increase your ROM. It dosent have to happen in a restricted time scale. Im saying all this when I have done exactly the same as you and got in a right mess thinking about my bend. Its only the knowledgeable people on this forum have convinced me its not worth the upset and at last I understand that. Dont let it take you six months. Everything else seems to be going well for you so concentrate on that. Take Care x x
    • Friendly Friendly x 1
  18. Sasysusie

    Sasysusie Junior Member

    Offline
    Member Since:
    Mar 9, 2013
    Age:
    60
    Messages:
    73
    Gender:
    Female
    I did read them and it makes me feel bad you would think i did not! I read them but i dont memorize them, I read them and then i move on. In the middle of all this healing process and such like changing events as of late, Im sorry if at times i forget every word ive read and let the worry take over. I dont think im the only one after this surgery that has a worried feeling lot of the time. I do read the articles over again a few times and I try to tell my brain see dont worry, but telling yoursef one thing and doing it is another. Like everyone here getting their range of motion is important. How can i just not worry about it. Im just concerned and from time to time i guess i bring my worries here because of all places i feel this is the one place you all can undestand what im going thur. The constan battle of "did I do something wrong" , "am i working hard enough" , "will it ever come". I love the support here, and i do try to believe it will come... so yes i do carry on an do all stretches, but i cant promise ill not have worries and be worried, but to answer your question yes i did read the articles and more than once. I trust my doctor, but the worry never seems to go away.
    Susie
    • Like Like x 1
    • Friendly Friendly x 1
  19. Sasysusie

    Sasysusie Junior Member

    Offline
    Member Since:
    Mar 9, 2013
    Age:
    60
    Messages:
    73
    Gender:
    Female
    Remember too I dnt think im in my normal state of mind just yet.... so if i sounded harsh my apoligies
    susie
  20. maryo52

    maryo52 Sr Bonesmartie

    Offline
    Member Since:
    Dec 5, 2010
    Age:
    62
    Messages:
    2,926
    Gender:
    Female
    Location:
    Maine, United States
    Post TKR legs don't like to bend, certainly not like a normal healthy leg. Those with true bend problems are generally under 90 degrees. You've reached 110 at times. Yes it slips back. It will tend to slip back the more you try to push it forward. That knee of yours, whether to try to gain ROM or not, will gain ROM anyhow. It's a hard concept to grasp, but so many things in life actually don't move faster or better with direct measures. Post-TKR knees can be like that.

    Regarding worry, you know, between the drugs and the unexpected aches and pains and disability and slow healing time frame, worry has a great opportunity to set in. Just step back a few paces and recognize that it's worry and not a real problem. Don't become your worry. And another thing you might try is to fast forward to the six month mark, which is about when things start to look good again. Go to the six month mark when you're bend is 120 or 130 or more (the average is 120 or so but many get more), off pain pills, re-embarking on the activities you've enjoyed in the past. At that point, my dear, you will have a hard time remembering why you worried at all.

    To borrow a concept: Worry is a prayer for what you don't want.
    • Like Like x 2
    • Informative Informative x 1

Share This Page

Open
Close X