TKR Getting back to hiking and climbing.

@rustic Great to read your recovery updates.... gives me on my 21 day post-op status a lot to look forward to... thanks for the continued updates!:thumb:
 
Seventh month just finished, and I'm doing fine. Slow going, but still improving. I'm getting closer to full extension (tough going there), my quad is finally gaining some strength, and the deep "mystery pain" is a bit reduced this month.
The mountain bike riding is getting better each week. I do an out and back up a big hill near my home. 3.3 miles each way, with a 750 foot elevation gain going out. Mostly coasting coming back home.
Rock climbing hurts less each week, and I'm getting stronger. I'm still keeping my hikes short, because they cause swelling, and limit my gains towards extension.
 
Excellent progress! It will be 2 years for me in July and like you, I was quick to get active again but it seemed much longer until I was completely pain free. Honestly it was well over a year. Not bad enough pain to stop me from doing what i wanted but it was there now and then like when i would do a quick sharp turn or raise my activity level. For me eventually it did became completely pain free. I've met people who aren't completely pain free just greatly improved and I'd almost resigned myself to that when it finally gradually happened. Hopefully in time you will be completely pain free too. Im struggling with other body parts at times but knee is good. Solid with slightly more flex than my natural knee. I suspect you will do much better than I have. You are certainly more of an athlete. Just keep working on the balance between pushing your limits and not overdoing to the point of setback.
 
@Jajakio, it is so encouraging to get feedback from someone like yourself! I’m just past one year and what you described about residual pain is exactly what I currently experience. I attribute most of mine to muscles that are still gaining strength and ligaments and tendons that are still stretching and loosening. Can’t wait for the day when nothing seems to bother my knee.
 
My experience is that the tissues of the operative leg are cranky for months. They rebel even with moderate activity. I am careful not to push things – I have serious pain issues with neuropathy so I don't need the knee to hurt as well – and luckily my knee is already pain free. Aggressive activity (e.g. mountain biking) in the first few months may result in chronic irritation (inflammation). I have fitness oriented friends and am in awe of their passion. What I'm trying to say is it's possible that backing off that level of activity for a while may give your body the chance to finish mending the knee and stop hurting.
 
Wow, another month went by quickly. I just finished my eighth post op month. I also just finished a two month long segment of once a week PT (working on extension, hip pain, and quad strengthening).
A couple things I did differently this month were relying more on compression than icing, and doing longer duration holds when working towards getting better extension. The longer duration stretches worked and the back of my knee almost touches the floor when I sit on the floor with my legs straight out. Man, achieving that was tough and painful, because that knee hadn't been straight for at least 20 years. In this recent month, I spent at least an hour a day on it every day, and sometimes two hours or more (30 minute periods, spread throughout the day).

Biking seems to cause more swelling than climbing or hiking, so I cut back on that some lately. Indoor rock climbing has been going great (six sessions in May). I think that I'm ready to do a careful/easy day of climbing outdoors, but the weekend weather hasn't cooperated yet. My wife will be doing the leading.
I did a 4.7 mile hike this morning, and that felt good. At 16 minutes per mile, I'm finally going fast enough to tax something other than my knee (like my breathing and endurance). It was fun to dust off the old heart rate monitor, and charge up my IPOD that has songs based on their cadence for fast walking.
An important trend this month is that I am now joining my wife on hikes, without holding her back (much). This was what I gave the surgeon as my "most important reason to have the surgery." I was worried about this for many months, but it looks like that is becoming a reality.

Stay strong, fellow bonesmarties! I hope to hear from some of you.
 
@rustic great update ...glad to hear you out there again with your wife. I am with you on extension, its been my thorn in the side but like you almost there. Pulled calf muscle on tkr leg couple weeks ago, not stretching enough in between walks. Had to pull back for 10 days. Needless to say a good reminder to never stop stretching. Got complacent with it as life seemed to get in the way. But must be regular or progress slips back.
 
At the end of June (nine months post op), I had a visit with my OS. It was an extra visit, because I had some problems at my six month's checkup (lack of extension, a centralized "mystery pain", and more than normal atrophy of the surgical leg).
The most important thing was that, in the intervening three months, I achieved full extension. OS liked my joke about me doing MWA (manipulation without anesthesia), and he was pleasantly surprised that it worked. I had also been working on pure strength, and starting the long process of getting that leg back to its normal size. Unfortunately, the mystery pain was still present. It feels like it is right where they chop off that piece of bone that the ACL and PCL were attached to. There is a hole in the spacer right there as well, and the OS thought there might be a blob of scar tissue right in the center of everything. We decide on "watchful waiting" and my next scheduled checkup (with x-rays) is in November.
So, just a week later, I did my first outdoor rock climbing since surgery. Much different than the controlled environs of a climbing gym. There is much more twisting involved, and more chances of bumps and bruises. I wore some good knee armor (mountain biker sleeve, with a hard cap), and bumps weren't a problem. I had two or three pretty serious "twinges," that didn't have lasting effects or ruin my day. It turns out that those pangs of pain might have done some good. Broke up that central blob? I don't know. But I had less swelling and pain all the following week, and the "mystery pain" is suddenly reduced. Time will tell how this will all work out.
 
I'm in my 12th post op month. As always, "some good, some bad." Mostly good, but I really hoped I'd be through with dealing with specific "problems" at the one year mark. I'd rather just be trying to get my body back into shape, and not be worrying about inflaming various parts of my knee.

The rock climbing has been going great, and doesn't cause problems. I wear heavy (hard cap) protection when climbing outdoors. A light elastic sleeve when climbing indoors.

The walking and hiking feels great most times, but my mileage that I can do in comfort has been slow to increase. I go about five miles before I notice knee "achiness" building up. I've done several 7 mile hikes, and will try a ten miler this month. I have to start carrying some weight at some point, if I'm ever going to go backpacking again.

I believe that my deep/centralized "mystery pain" is probably a bit of flesh impinged in part of the prosthesis. The OS says they can "scope" the knee to trim some junk out, but I think it isn't bad enough to risk another surgery. I'm hoping the nerves in that bit of flesh will die off eventually, and it will stop hurting. It hurts less each month, but and is mostly a bother at night.

I had some problems with that hard/tender bump just above the kneecap that most people end up with. I bought a pulsating jigsaw type massager that really relaxes that area. This is rapidly becoming a non-problem. This is important, because I need to reverse the atrophy that this leg has. Only way to do that is exercises that stress the quads.

I seem to lose range of motion if I don't stretch (quite a bit) every day. Especially for extension. I wonder if this is common for others a year or longer out from surgery? Note: my leg didn't go straight for years before surgery, and I only got full extension in the 8th month post op. I'd appreciate any opinions on this.
IMG_20190723_140444.jpg
 
Great climbing pic. Thanks for sharing.

I’m about 16 months past my first PKR and still do stretches/exercises for bending. I think I backslid a bit because I sprained the medial ligament in that leg while recovering from PKR in the other leg done 5 1/2 months ago. Extension seems fine. But I was told “at least a year” for true recovery of nerves and soft tissue and 2+ years for sensitivity in the bones to go away when the barometric pressure drops.
 
I seem to lose range of motion if I don't stretch (quite a bit) every day. Especially for extension. I wonder if this is common for others a year or longer out from surgery? Note: my leg didn't go straight for years before surgery, and I only got full extension in the 8th month post op.
I think your knee's pre-op history is relevant here. If it was partly bent for years pre-op, then the muscles and tendons had probably shortened. That's why it took you 8 months before you achieved full extension, and it may be that your leg still has muscle memory of being bent a bit.

Achieving full extension, even if it did take 8 months, it quite an achievement.

From your rock-climbing photo, I see you also have a pretty good bend in that knee. :thumb:
 
Time for a one year update. I wouldn't say all is well, but rather "most is well," lol. All along, I've been above average as far as function, but worse than average as far as lingering pains. One, by one, most of them went away, but I always had one "mystery pain," that felt deep. I had extra followup appts. due to this specific pain (no real suggestions from the OS), and spent a heck of a lot of time with my PT trying to figure out what it might be.
I can walk pretty far, ride my mountain bike without getting this pain and rock climbing only causes occasional twinges. Stairs and steep trails are no problem. But, a specific movement really hurts. I'll try to attach a picture. If I'm laying on my side in bed, operated knee up, and try to adjust the covers by raising that leg a few inches and moving my foot, it hurts. I also notice it if I (while standing) try to do a slow motion Karate kick to the side. Just the weight of my shoe makes a big difference in pain.
I have another followup with my OS in a month, and I've been trying to figure out what to do about this one remaining pain.
I've got just one article so far (where this picture came from) and am open to suggestions, medical opinions, anecdotes if you've had this pain, etc.
side abduction.jpg
 
On the good side of things, I'm back to a full work load as far as my "country living" goes. Maybe this picture will give some hope to those people that do various physical jobs.
 

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I'm a climber too, 12 weeks out from TKR. I have that same wierd pain when I lift my leg to move covers around at night. Yikes, you still have it at 12 months? That scares me!

I'm going back to the climbing gym tomorrow for the first time just to belay my friends. Hoping to get on something easy in the near future, not quite yet though, I'm petrified that I won't be able to return to the sports I love. My recovery is going so very slowly, it's basically torture to have these beautiful fall days and not be able to be active.

Could you give a sense of how your range progressed? I know that drop knee moves won't be happening, but can you put pressure on your leg when it's high and out to the side? Can you high step at all, and about how high? Have you tried any crack climbing? Those things seem so far away for me at this point, but I'm crossing fingers I'll get back to them eventually.
 
I'm a climber too, 12 weeks out from TKR. I have that same wierd pain when I lift my leg to move covers around at night. Yikes, you still have it at 12 months? That scares me!

I'm going back to the climbing gym tomorrow for the first time just to belay my friends. Hoping to get on something easy in the near future, not quite yet though, I'm petrified that I won't be able to return to the sports I love. My recovery is going so very slowly, it's basically torture to have these beautiful fall days and not be able to be active.

Could you give a sense of how your range progressed? I know that drop knee moves won't be happening, but can you put pressure on your leg when it's high and out to the side? Can you high step at all, and about how high? Have you tried any crack climbing? Those things seem so far away for me at this point, but I'm crossing fingers I'll get back to them eventually.
Glad you found me here, Wendy. Lots of hikers and backpackers on here, but I think your the first rock climber I've met here.
To answer your question about high stepping while climbing: Did you see the fairly recent picture I posted of me climbing indoors? It is just a few posts ago (Sept 4). The thumbnail enlarges if you click on it. It doesn't hurt to weight my leg with the knee bent that much. My knee actually goes about ten degrees past that when it is relaxed, but it would hurt if I weighted it near full flex. Interestingly, steeper climbing is affected less by the tkr. When it is overhanging, less weight is on your legs, and the holds tend to be closer together so there aren't many high steps. Low angle climbing (especially granite slabs etc.) is much more affected. There are more high steps, and often you need to do a move that approximates a one legged squat. I'm getting pretty good at switching feet, and coming up with alternative sequences.
First time I went to the climbing gym was 10 weeks post op. I wrote some about that in my Dec 5, 2018 post (first page or two of my thread). Climbing was the one of the first things I could enjoy after surger, actually. I couldn't ride my bike, ski, or hike more than about a mile at that point. Everything but climbing hurt pretty bad, and made me swell up.
I stuck to indoor climbing for many months before venturing outdoors. I've gone to the gym almost 50 times since surgery. I've been climbing outdoors about three times this year. Basalt, trad, crack climbing. I can climb cracks about as good as I did before. Outdoors, I wear some serious knee protection. Indoors, I wear an elastic sleeve, with some strips of thin foam added inside.
Have fun with your friends tomorrow! You'll be back to it soon. And feel free to ask me more questions in the future.
 
@sistersinhim @rustic @76Dawg

hmmm... more inner knee bursitis talk.... FC2613FB-8115-483E-9750-C7CB026B93D1.jpeg

I was using this diagram (from knee.pain-explained online) to id just where that medial bursa is. Applying warm, moist heat to that area has helped.
 
I hope it works for you as well as it did for me.
 

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