TKR 10 weeks post op

[Flashlight]

You are doing great! You worked it out and moved forward. We all need a little help now and then. Don't be so hard on yourself. The more you get out and about the more you will regain your confidence.

 

[beachy]

Don't beat yourself up. We all have milestones at different times in recovery. Keep trying and you'll be successful!

 

[Maximoo]

I had another physio session last Thursday and although I can walk/waddle around the house I’m still frightened to go outdoors alone. (Nearly 5 months PO) He said I need to strengthen the quad more & wants me to increase the exercises:
Increase ankle weight from 1kg to 2 kg and leg lifts and bending 10 reps x 3 times per day. Ham string stretches, static bike 10 mins x 2 times per day. Stair lunges, knee hangs on/off all day. Took me a few days to recover from Thursdays session, so do you think this is a good amount of PT to improve my walking ?

 

[EalingGran]

Increase ankle weight from 1kg to 2 kg and leg lifts and bending 10 reps x 3 times per day.

I think we are about the same in terms of timing. My PKR was 25th October.
I can walk well- better than pre-op. Up to 4 miles with a break. Just carry a foldable stick for getting off buses/ trains and now pretty independent. My only problem is some residual medial pain on stairs.
But I am only using 1/2 kg weights on the advice of my pilates teacher- and we only started with weights recently.
I think 2kg weights are a lot and I would worry they would be counterproductive.

 

[Maximoo]

I was wondering about that as well. I have tried the 2kg on 2 sessions today and my leg feels quite stiff now. But how else can I build up the quad muscle?

 

[Jockette]

Increase ankle weight from 1kg to 2 kg and leg lifts and bending 10 reps x 3 times per day. Ham string stretches, static bike 10 mins x 2 times per day. Stair lunges, knee hangs on/off all day. Took me a few days to recover from Thursdays session, so do you think this is a good amount of PT to improve my walking?

That’s a long list and a lot of reps. Personally, I wouldn‘t do them, but I don’t like a list and a bunch of reps.

although I can walk/waddle around the house I’m still frightened to go outdoors alone. (Nearly 5 months PO)

I’m sorry you have this fear. What specifically scares you?

I definitely had less confidence walking around after my replacement. Time is what helped me overcome it.

 

[EalingGran]

But how else can I build up the quad muscle?

I do a 20 minute leg/ glute strengthening pilates session most days ( Google katja pilates on YouTube) plus a few specific exercises for the medial quad ( vastus medialis).
I also have a private pilates lesson once/ week currently. We have only just started adding resistance band work and tiny weights.
I have found pilates best for gradually building strength without risk of overdoing things and causing injury.

 

[sistersinhim]

But how else can I build up the quad muscle?

As you heal and use your leg more those muscles will naturally gain strength. Mine did, and I never did any exercises, just used my knee naturally. Repetitive exercises, especially with weights will only anger your knee causing more pain and swelling. That slows down your healing. I've always believed that the natural way is the best way. Every time you use your knee in any movements, what you did is PT!

 

[Jockette]

I've always believed that the natural way is the best way. Every time you use your knee in any movements, what you did is PT!

This is my view of this “rehab” also.

 

[Maximoo]

Thank you. I think I will leave the weights for a while and see if my knee settles down. Physio said the quad was 3cm smaller on the operated leg and needs building up. Also he wants me to build up to a 5kg weight ☹️ @Jockette i think my fear is being outside and there being nothing to hold onto if I need to stop. And the mini panic attack I had the other week hasn’t helped. I feel better if they’re someone with me, but that’s not practical during the week when everyone is at work.

 

[Jockette]

i think my fear is being outside and there being nothing to hold onto if I need to stop. And the mini panic attack I had the other week hasn’t helped. I feel better if they’re someone with me, but that’s not practical during the week when everyone is at work.

I suggest you continue to use your walker, it will give you the security you need, and help you go places by yourself.

The reason I asked specifically is, I don’t think all those exercises will help the fear you have, as that fear is more the issue than instability.

This is your recovery, no one else’s, and you get to choose how you do it. If a walker will help you have independence, then use it.

You might want to consider stopping formal PT so that you don‘t get expectations from a source that doesn’t really understand you. Strengthening exercises can have their place, but I don’t think they will fix a confidence issue, or a panic attack. Panic attacks are real and I totally understand.

 

[EalingGran]

Are you using a stick outside if you are anxious? I am frightened of falling and I don't mind using a stick indefinitely so long as I can get out and do all the things I want to do. There are even sticks with a little tripod base for extra stability.

 

[Maximoo]

I do a 20 minute leg/ glute strengthening pilates session most days

@EalingGran i tried one of Katyas Pilates yesterday which was good, once I got on the floor. I couldn’t do it all but it was a good start. She is VERY flexible, I don’t think I’ve ever been able to get my legs in those positions, even 40 years ago . This might seem a silly question but which hand do I hold my stick in, I been told different sides by 2 physios. My TKR was right side

 

[EalingGran]

She has loads of different classes- some tricky and some very gentle. You can do the arm strength one seated as well. I find it helpful to build up my arms to help with getting up etc.
I was taught by the hospital physio to use the stick in the opposite hand to my operation site. I think the reason is that it is meant to give a more balanced gait.
Having said that I feel safer using it on the same side as my operated knee. I feel it gives me more support.
I mainly just carry my stick now and only use it for very rough ground or getting on an off trains/ buses. I try to vary the side I carry it on so I keep even.
I think if it gives you confidence to go out then use whichever side you feel safest with- at least to start with. Maybe ask someone else to just check you are walking reasonably straight.

 

[sistersinhim]

I am finding that Tai Chi is helping me and it's very gentle movements. You can find them on youtube. Many are free. The one I'm using is.

 

[beachy]

@sistersinhim
Can you share the YouTube channel please?
I don't have the patience to look at all of them.

 

[sistersinhim]

Sure, here's the one I'm doing: https://usercontent.flodesk.com/441...load/d889eab4-b0b5-47ee-9c50-77530991449e.pdf

You click on the day you want to do and it takes you there. It is led by Dr. Adam Potts, PT. I hope you can do some of it. I was surprised at how much it raised my heartrate, so that proves that my muscles are working!

 

[Ayse]

OMG, 5kg sounds so excessive! I had a physio who wanted me to work up to that after my tibial plateau plate was put in. No way could I have done that even with a healthy knee.

I also have the confidence and anxiety issues due to my problems. Is there a quiet area outside like a car park where you could be driven to and do a few laps with your walker? Then build it up slowly as you gain confidence?