TKR What did I get myself into?

My knee is still swollen and tight. Is it easier to get to full extension than to boost flexion number?
It is normal for the extension to take longer to come all the way in than flexion does. Those muscles and tendons in the back of the knee are huge and take longer to stretch out. But, your extension is amazing at only 3 weeks out. I can't imagine why your doctor even mentioned that. Most all of us wished we had had that at 3 months, must less 3 weeks! Celebrate your great extension!
I just want my knee to really settle down and do not want an aggressive PT appt.
Aggressive PT will just cause more swelling and pain, making your ROM worse. Swelling is the main thing that affects ROM, not an unfit knee.
 
Thank you one and all for the encouragement. I’m walking around pretty well with limited discomfort. My incision looks great and my first outside PT session is tomorrow morning. Hoping maybe some massage as my calf is still a bit swollen as is my lower thigh. I WILL NOT let anyone press down on my knee with any force. It really feels better as my swelling goes down. And now at day 22 finally feeling better, though perfect restful sleep is still fleeting!
 
I was at 8 yesterday for my first PT appt. Therapist was not concerned in the least and neither am I. It will happen naturally as your swelling decreases. And your swelling increases with PT. Catch 22.
 
Well I had my first PT session outside my home. Looks like insurance covers 15 sessions. My therapist is concerned that I’m not fully extended at 24 days and mentioned the “window” which seems to be every therapists concern as if you don’t hit full extention within a month of surgery you are doomed to a permanent limp. So confused as my knee is still swollen and subsequently feeling a little stiff. But then I was told that the exercises will help reduce swelling. I almost wish I could just do my daily activities, a little walking and a few easy exercises and let my knee continue to heal. Sleep still difficult because of nerves firing at odd times jokting me awake. 2nd PT appt is Monday afternoon and then again on Wednesday. Personally, I haven’t felt that elevation and icing are doing much and was advised to out my compression sock back on as its supposed to help with inflamation. Was walking today without asssistance, which I thought was positive. Appears to be a fine line between over working and under working. Where is that light at the end of the tunnel???
 
Unfortunately, at 24 days in a recovery that lasts an average of a year, that light at the end of the tunnel is still a ways off.

My therapist is concerned that I’m not fully extended at 24 days and mentioned the “window” which seems to be every therapists concern as if you don’t hit full extention within a month of surgery you are doomed to a permanent limp.

Reread this:
Personally, I haven’t felt that elevation and icing are doing much
It’s going to take more than 24 days to see a difference. A lot of it has to do with your body’s healing rate.
But then I was told that the exercises will help reduce swelling.
A list of exercises probably won’t do this and can actually increase your swelling. Moderate activity and balance with rest is what will help.
I almost wish I could just do my daily activities, a little walking and a few easy exercises and let my knee continue to heal.
You don’t have to wish this, you can do this type of rehab if you choose. It’s your decision how you rehab your recovery. Doing “just” this has been successful for many, along with lots of patience.
Was walking today without asssistance, which I thought was positive.
Yes, this is very positive! ROM numbers are not the only sign of improvement. There are lots of “milestones” that indicate that you are coming along well, and you are!
 
But then I was told that the exercises will help reduce swelling. I almost wish I could just do my daily activities, a little walking and a few easy exercises and let my knee continue to heal.
Not true. Exercising a swollen and inflamed knee will actually cause more swelling. All you need to do are your daily activities. We have had tens of thousands of knee replacement members through the years and their personal experience has taught us that overworking a joint replacement is counterproductive.
Personally, I haven’t felt that elevation and icing are doing much and was advised to out my compression sock back on as its supposed to help with inflamation.
Are you elevating correctly and icing for at least 45-60 minutes at a time? I iced and elevated my toes above my nose the whole time I was sitting or laying down for the first 2-3 months. You can not over ice if you have a cloth between your knee and the ice source. Ice reduces inflammation, pain, and swelling. Compression socks will help push that fluid, (swelling), up to your kidneys to get flushed out. They do not reduce inflammation, only ice, healing, and reducing your exercises will reduce your inflammation.
 
There is no window. I will never understand the scare tactics that PTs use. You can't straighten a swollen joint. Nor bend it to the degree the PT wants.
sistersinhim is absolutely correct about I &E. It takes a lot of patience to elevate and ice for long periods of time.
Jockette is absolutely correct, too.
We are a day apart in surgery dates and your recovery sounds similar to mine. Only difference is I did this before and know what to expect. For the most part. It is a long recovery.
 
I am so grateful I found this site..I'm 6 months post TKR of left knee. I can only tell you that my experience aligns with so many others on this site. The saving grace for my physical and mental health? Standing up for my poor, pain-filled knee when PT talked about my "push" for range of motion, window of time, blah, blah, blah. I had known him for over 10 years, trusted his expertise (had helped my with my back after lung cancer, etc), BUT, when it came to the "forcing" my knee the first week, I was in so much pain for days!!! Long story short-know that, in the days, weeks and months after knee surgery, TIME/PATIENCE is key. Small victories are to be celebrated and DON'T listen to anyone that hasn't been through this! Sending you peace for your day!
 
Good sunday morning! Slept pretty well last night for really the first time. Still experiencing a burning sensation on the inside of my knee. Walked quite a bit yesterday but possibly too much as my knee felt a bit worse during the evening. I love getting out but wondering if I need to spend more time doing nothing to help with swelling. Still not close to ROM numbers my therapist wants, oh well! Zingers are subsiding. Still trying to get my head around how LONG this recovery will likely be. But at least I’m liking how my battle wound is looking at 3 1/2 weeks!
 

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Still not close to ROM numbers my therapist wants, oh well!
There is no timeline for this recovery. And at only just over 3 weeks out you should not be focusing on ROM. Ice and elevate to get that swelling down. Your ROM will increase when the swelling is controlled.
 
Happy Sunday, Will!
While your range of motion is currently limited, it will naturally increase as the swelling subsides and the pain eases. Give it time.

Yay for sleep! Restorative rest certainly helps in recovery. I do think since you mentioned you walked "quite a bit' yesterday and your knee "felt a bit worse during the evening" you should scale it back. Hopefully icing and elevation are helping. Your scar looks good!
Still trying to get my head around how LONG this recovery will likely be.
I want to share something a member from the hip side, Klassy, just posted on another member's hip thread this morning -

"While you are sitting there, your cells are flat out at work rebuilding you better. Downtime in recovery is never time wasted, it is time invested in a wonderful future."

A couple more good ones -
"Your current situation is not your permanent destination."

"You're not going to heal 10 times as fast by doing 10 times as much exercise as prescribed."


So enjoy a chill day, WillB :ice: and have a great week!
 
Sleep is a good thing. During the day there is absolutely nothing wrong with a nap or two. While icing and elevating its time for relaxation and rest. Your entire body is tired, not just your knee.

You've said previously you’re somewhat inpatient and many of us fall into that category. But the healing takes time, period. If you overwork the knee with PT its a step back, as you know. This recovery is long and you have a baby knee, that can't be changed. If you feel going to formal PT is too much you can stop going. (Personally I had a hard time wrapping my head around that concept, at first. Once I did it I totally understood.) Maybe skip a week of formal PT and do your own thing - see if you have less pain & swelling. At this time you really should be walking around a little. Formal PT can't make your knee heal faster.

Personally it seems as if you’re right where you should be in your recovery. Your battle wound does look good. This recovery takes time and you've just begun that process.
 
It is definitely a marathon not a sprint.
I am 14 weeks post PKR and still have ups and downs. Enjoy the good things/ progress and try to learn from any backward steps ( like did you overdo it?).
 
If orthopedic surgeons stressed to patients how long tkr recovery really takes, the degrees of post op pain and all the other stuff that happens.....they wouldn't have any patients.
Thank goodness for Bonesmart.
Would be really funny except it is so true!
My surgeon is a lovely chap and does explain things well if you ask him the right questions but definitely one of nature's optimists!
 
Amen to the "no therapist pushing hard on the knee" in either direction!" My TKR was 11-30 and I had an extremely aggressive PT. She would call over another PT to help her push my knee and would not stop even when I said STOP. It was traumatic and caused me much more pain and swelling! I am currently seeing a different PT practice and have made much more progress there since switching. Currently at 129 bend and 1 degree to 0 (varies) at straight. I am sure that it will hit 0 degrees and stay that way soon. Most of these gains were made alternating ice 15 min/rest 15 min/ then heat 15 min. Then stretching and gentle exercises. Most of the swelling finally is gone although it still has episodes when it presents with a vice-like tightness/swelling, however I am able to get rid of most of it using the alternating ice/heat/stretching. Careful with the heat though, I could not even tolerate it for the first 4 weeks or so. Good Luck!
 
Just finished a session with my Kenetic machine and was able to work to 100 on flexion and 0 on extension. Now icing for a spell. Only have the macine for another week or so. It does make it easier to get numbers this early (3 1/2 wks). Upcoming Pt this Mon and Wed. I keep saying “Patience, Patience”!!
 

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