TKR 10 weeks am I going backwards

[Eljina52]

Hi Everyone
New here but so pleased to find BoneSmart
As I said I’m 10 weeks yesterday from left TKR. All has gone well and i have zero degree flexion less if leg muscle not warmed up. My retraction at last physio appt on 5th September was 113. My lovely physio said now fine with cane and we upped my exercises. I’ve been doing the lying on the stomach with knee joint having gravity to pull down plus my other leg across and I manage ok but a big painful. The straighten the knee fully using the rubber band round my thigh again much same as other exercise. However I now do standing at stairs and placing my bad knee on second step and leaning into a stretch. For 5/10 secs 5 times. Now that I limp feel very uncomfortable and to be honest from starting that I feel my knee heavier more restricted etc. My scar has healed well but I’ve noticed it seems more engorged and red after physio which doesn’t go down as it used to. Still using elevation and ice. I have come down in the painkilling meds as it’s not exactly pain as such. Also as my husband had had bad sciatica I have been ironing ( standing as sitting is worse) cleaning bathroom and shower changing beds. I do feel like crying as I feel I’m gong backwards. Have Consultant appt 26th and he wants me to have very good results.
As I’ve no one that’s been through this around me I’d love to hear from the “experts”

 

[Jockette]

Hi and Welcome!

I know 10 weeks seems like a long time in recovery, but actually for a joint replacement, it’s not. Joint replacement takes an average of a full year.

It is not necessary to do any exercise that causes pain, so stop doing those that do. Many of our members didn’t do any specific physio, and they recovered just fine. Any movement you do throughout the day is technically “exercise.”

I’m sorry that your husband is not able to help you with your daily activities. Try to space them out and still take rest times to ice and elevate, or at least sit with your feet up on an ottoman, throughout the day.

I will leave you our Recovery Guidelines. Each article is short but very informative. Following these guidelines will help you have a less painful recovery.

Just keep in mind all people are different, as are the approaches to this recovery and rehab. The key is, “Find what works for you.“ Your doctors, PTs and BoneSmart are available to help, but you are the final judge as to the recovery approach you choose.

Knee Recovery: The Guidelines

1. Don’t worry: Your body will heal all by itself. Relax, let it, don't try and hurry it, don’t worry about any symptoms now, they are almost certainly temporary

2. Control discomfort:

rest​

elevate​

ice​

take your pain meds by prescription schedule (not when pain starts!)​

don't overwork.​

​

If you want to use something to help heal the incision, ​

BoneSmart recommends hypochlorous solution. Members in the US can purchase ACTIVE Antimicrobial Hydrogel through BoneSmart at a discount. Similar products should be available in the UK and other countries.​

3. Do what you want to do BUT

​

a. If it hurts, don't do it and don't allow anyone - especially a physical therapist - to do it to you​

b. If your leg swells more or gets stiffer in the 24 hours after doing it, don't do it again.​

​

​

4. PT or exercise can be useful BUT take note of these

​

the BoneSmart view on exercise​

BoneSmart philosophy for sensible post op therapy​

5. At week 4 and after you should follow this

Activity Progression for TKRs​

6. Access to these pages on the website

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Oral And Intravenous Pain Medications​

Wound Closure​

The Recovery articles:
The importance of managing pain after a TKR and the pain chart
Swollen and stiff knee: what causes it?
Energy drain for TKRs
Elevation is the key
Ice to control pain and swelling
Heel slides and how to do them properly
Chart representation of TKR recovery
Healing: how long does it take?

Post op blues is a reality - be prepared for it
Sleep deprivation is pretty much inevitable - but what causes it?

There are also some cautionary articles here
Myth busting: no pain, no gain
Myth busting: the "window of opportunity" in TKR
Myth busting: on getting addicted to pain meds

We try to keep the forum a positive and safe place for our members to talk about their questions or concerns and to report successes with their joint replacement surgery.

While members may create as many threads as they like in the majority of BoneSmart’s forums, we ask that each member have only One Recovery Thread. This policy makes it easier to go back and review the member’s history before providing advice, so please post any updates or questions you have right here in this thread.

 

[Jockette]

And, you are not going backwards. This recovery has a lot of ups and downs, and what you are experiencing is the effects of doing more than your healing body is ready for, which is causing you additional pain. Slow things down, which will give your body a better opportunity in which to heal.

 

[Jockette]

Please give us your surgery date and we’ll make a signature for you.

 

[Eljina52]

Please give us your surgery date and we’ll make a signature for you.

17th July 2023

 

[WFD]

I feel I’m gong backwards. Have Consultant appt 26th and he wants me to have very good results.

Your consultant's goals are his and not yours, and it is not your responsibility to meet them. The exercises you describe, especially the one using the stairs, would put me flat on my back in bed.

You are at 113°, and if you backed off and rested, and let the swelling go down, you would gain some range and maybe approach 120°. which surgeons consider normal. I would kill to have your numbers (I'm at 90°).

Back off and rest, and I think you will find you are pretty much already there.

 

[Tentcamper]

Yuck, that red scar. Mine is fine when I get up but then the blood rushes to my leg and the whole leg turns red. By the end of the day I'm all the same color. That's a long story to tell you that silicone wound tape has helped a lot with my scar. At 3 months I have a narrow whit line and it doesn't turn red anymore. You can get it at a drug store (in US) or off Amazon. You'll feel like you are going forward again but it takes patience.

 

[benne68]

Welcome @Eljina52! It sounds like your ROM is very good for 10 weeks post op.

However, it also sounds like your physio is pushing you to do more than that poor knee is ready for. Anything with bands or weight is counterproductive this early in your recovery. I would encourage you to cut back on any exercise causes pain or makes your knee swell up and hurt the next day. Pain is your knee telling you it needs more time to heal.

Please read through the articles Jockette shared above. I think you will find some new insights!

Wishing you a less painful recovery.

 

[Anniemof]

@Eljina52 10 weeks is a very early point following this brutal op. I've never felt depressed in my life until I went through my RTKR in Feb23. Your bend is very good at 10 weeks, I was 90 at 10 days and I'm still 90 at 7 months. The Physio did get me to 100 a few times but that wasn't natural. I am functioning though but far from healed, Breaking my wrist hasn't helped much either. Please don't be too hard on yourself at such an early stage, maybe as you're doing so much in your daily life, you could reduce the physio a bit. I'm not sure my physio made much of a differnece to my knee but the massage and Myofacsial release. ( private physio in UK) has. I'm sure your consultant will be pleased with your progress. Hope you feel better soon x

 

[Layla]

A belated Happy Two Month Anniversary to you!
Congrats on your new knee!

I am sorry to read of your husbands sciatica and his inability to currently lend a hand. Do you have family or friends close by that can maybe lend a hand temporarily, even if only once a week for a few hours until you're feeling stronger and have more stamina...it is an idea to consider. It is easy to feel down when we're tired with limited mobility. Post Op Blues is common and you many be struggling with this a bit Post op blues is a reality - be prepared for it Thankfully it's only temporary.

Try not to feel like you're going backwards, instead look at it as good days vs better days. This little scribble reflects the reality of recovery.

As far as any limp goes, here’s a tip -
Try heel-toe walking when you're limping.
This involves striking the ground with your heel first, then rolling through your heel to your toe, and pushing out of the step with your toe. It takes a concentrated effort, but I believe you'll notice a difference. Give it a try.

Thanks for joining us, I look forward to following your journey!
@Eljina52

 

[Eljina52]

Thank you so much everyone. I’m finding so much help and advice and more importantly support here. Just been looking at the exercise/pt advice and the stair quads is the one that i thought was causing problems and another which I will need to pop back and check on. Read so much this afternoon and evening !

 

[mendogal]

Welcome! I'm popping in to say hi and to add a way to reframe your quite excellent progress: simply stop measuring flexion and extension and let incremental progress in your actual lived activity tolerance be your milestones markers.
Full disclosure: at 14 weeks post op on the R, I haven't been meaured since I quit PT 6 weeks ago. I know my flexion and extension are ok, not great. I CAN walk up and down a flight of stairs sequentially. I CAN'T yet get into or out of the left side driver's seat (USA) without saying "ouch"! That will be my next ROM milestone

 

[Jockette]

Also, there is no Window of Opportunity, my ROM continued to improve well into my third year post op!

 

[Axx72]

Three steps forward then 2 steps backwards has been the norm for many of us. What counts is that it is a little bit better than before. There will be some regressions and many small improvements on the way to your ultimate recovery goal.

 

[skiforever]

I found PT to be overload and quit it. I have a few exercises that I do sometimes to try to gain more ROM, but daily activity should increase the range with no further effort. Recovery is quite a roller coaster, so many ups and downs. It seems to me that you are doing great!

 

[Eljina52]

@Layla I’ve been asked to practice toe to heel walking but on a folded blanket to start making my balance better. I think I’m carrying a tray with mugs of tea. So far my imaginary tea and mugs are just landing in the floor and breaking but will keep trying.
@Tentcamper bought a silicone gel from Amazon it feels lovely. Started to use thanks for the tip. Also using bio oil

 

[sistersinhim]

I’ve been asked to practice toe to heel walking

This should actually be heel-to-toe walking not the other way around.

 

[Eljina52]

Oops re heel to toe that’s what I meant

 

[Layla]

I think I’m carrying a tray with mugs of tea. So far my imaginary tea and mugs are just landing in the floor and breaking but will keep trying.

You're precious...this made me chuckle as I imagine you in action practicing.