PKR Working on improving ROM

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Pjays

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Hi all... Great forum.

Had a partial knee replacement a week ago and so far, all going well. Pleased with progress... Getting around fine and getting close to dispensing with the crutch. Still stiff and sore at times..but hey.. Only one week and I feel it's improving slowly.
I have been following a modest regime of exercises sets for me by my physio and pleased that I can do them without any real issues.

The ones I struggle with a little are the heels slides to improve ROM. I do a set of 5 three times a day which does seem fairly realistic. I am trying to get the balance of how much pain to get to... I don't find them easy at all... And go to a point where its pretty sore but not unbearable. After I have done my set I am okay... It doesn't impact me or set me back at all. I assume that this pain is standard for the heel slides and my approach is okay as long as I don't push it too hard?

Thanks
 
@Pjays Welcome to BoneSmart!

You should not be exercising to the point of any pain. At only one week out - baby that knee. It has been traumatised. Are you icing and elevating regularly?

I'll leave you with some reading. I know you had PKR but it's still major surgery and most of this content will apply.
First are the BoneSmart mantras ....
- 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 again
- if you won't die if it's not done, don't do it
- never stand when you can sit, never sit when you can lie down, never stay awake when you can go to sleep!
- be active as much as you need to be but not more than is necessary, meaning so much that you end up being in pain, exhausted or desperate to sit down or lay down!

Next is a FAQ (Frequently Asked Questions) thread.

And here are some very crucial articles
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?
Activity progression for TKRs

Healing: how long does it take?
Chart representation of TKR recovery
Energy drain for TKRs
Elevation is the key
Ice to control pain and swelling

Home physio (PT) and activity progress: suggestions
Myth busting: the "window of opportunity" in TKR
Myth busting: on getting addicted to pain meds
Post op blues is a reality - be prepared for it
Sleep deprivation is pretty much inevitable - but what causes it?
 
Yes I am elevating... Not icing as much as I should.. But will do more
 
Pjays,
At one week out you need to let your knee heal, as the swelling goes down your ROM will increase naturally. Pushing against the swelling right now will only irritate your soft tissues cause more swelling and make it harder to bend your knee. Gentle pain free heel slides will benefit you most.
Heel slides and how to do them
@Celle is a fellow Kiwi, she had a partial about 10 years ago, revised last year to a total.
Take care of your knee, your soft tissues were cut into, pulled apart, bones sawed off, then pounded, screws put in and glued, then tissues pulled back together, stitched, glued, or staples in place.

Follow the Bonesmart Manta, Rest, Ice, Elevate, and Medicate on schedule as prescribed.

Here are a few more articles for you to read:
And then some wise words from members who have shared their experiences ...
Where are you in recovery?? (TKR)
Five “P’s” of knee recovery
TKR: work “smarter” and not “harder”
Recovering a knee - from one who knows!
It's never too late to get more ROM!
It's worth the wait for ROM
 
I never did any exercises outside of formal PT---they laugh about me and never bother showing me anything to do at home. I did go to PT three times a week, which is plenty of exercise for a new PKR.

You can rock in a chair and gently bend your knee---but mostly I found that I had some time to do some of the stuff that I had never done because i "did not have enough time". So, I learned to knit, watched three seasons of Downton Abbey and had lunch with friends. I was free of work and it was great fun to relax and take short walk through the woods. Enjoy this small amount of time you have to heal and relax yourself.
 
Not sure if the PKR recovery is significantly different from the TKR recovery but the heel slides were the hardest for me. Early in my recovery I found that the lying down hell slides really hurt beyond the point of discomfort, but I could do the sitting heel slides. At about 3 weeks, as my physio program expanded, I just removed the lying down heel slides because they never felt good. The rest of my program was sufficient to gain strength and mobility. Now at 15 weeks, I find I can do the lying down heel slides with no pain at all. They can still be uncomfortable depending on how long I've been in one position but that discomfort wanes pretty quickly.

Moral is what everyone else has already said, give it time.
 
Hi @Pjays
I'm glad to see another Kiwi here. I live in the North Island, but my husband was born in Christchurch.

I had a PKR, back in 2000. Since then, I've had the PKR revised to TKR in 2011, and a TKR in the other knee last year.

From my experience, recovering from a PKR is just as hard and just as lengthy as recovering from a TKR.

You're doing very well indeed. Just don't try to rush things. This recovery takes a full year, although you will feel heaps better long before that.

Pumpkln is right. It's no use trying to get your knee to bend yet, because of the swelling, so your most important job right now is to rest, elevate, and ice .

Heel slides shouldn't hurt, so if they're hurting you, stop doing them that way. I had no formal PT at all after my last TKR and I did very few exercises at home, and my knee bends just fine, Both my knees do, in fact. My surgeon doesn't allow any PT at all for the first month after surgery, and then only gently. All he allows is just a little walking around the house - and all his patients do well.

Doing heel slides in bed can be very difficult (so don't do them that way) but there are other ways to do them. This article suggests a few variations: Heel slides and how to do them Try a few of these variations, and if you find one you like, just do that - but not three times a day. just do a couple now and then.
I used to sit on a chair and see how far I could bend my knee. i didn't do that to a set routine, just if I happened to be sitting down and I thought of it.

Be kind to yourself and kind to your knee.

Looking forward to hearing from you again. Best wishes. :flwrysmile:

.
 
Thanks for the input.... I have probably been pushing the heel slides a little too much and will back off a bit. Appreciate its going to take some time.
Unfortunately there is plenty of material out there implying that a PKR recovery is really quick and,as wellas I seem to be going at the moment... I can see it's going to take time.
Thanks again
 
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The ones I struggle with a little are the heels slides to improve ROM. I do a set of 5 three times a day which does seem fairly realistic
Actually it's not. Read this to see what I mean Heel slides and how to do them. However, I did no exercising whatsoever after either of my TKRs and was (and still am!) just fine! My recovery articles are in my signature - they're only short, do read them.
I am trying to get the balance of how much pain to get to
You aim should be none whatsoever! Read the articles Jaycey left you.
 
Unfortunately there is plenty of material out there implying that a PKR recovery is really quick and,as well as I seem to be going at the moment... I can see it's going to take time.
I think the much-touted line about recovery fro a PKR being faster is just advertising hype. What we see on BoneSmart is that the occasional PKR patient may have a slightly faster recovery, but most people take just as long to recover as those who had a TKR. After all, your knee is still cut open, had soft tissues pulled aside, had two bones cut, had large foreign bodies hammered and cemented into the bones, then all been put back together again. That's major surgery.

I know that my recovery from a PKR was just as lengthy and difficult as my later recoveries from TKRs.
 
Most stuff has been quite easy for me but heel slides were hard for me too. Its early days - get some good healing in before you push harder and don't believe the 'no pain no gain' rubbish.
 
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