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TKR 11weeks post tkr

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Roux

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Thanks so much jockette. I will follow your advice
 

Jockette

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You really will be fine with all the normal activities you are doing.


This is what @TortiTabby experienced. (Just so you know, ADL means Activities of Daily Living, which means just go about the normal things you do in the course of your day, and not doing a “list of exercises.”)

Just an update for those who are apprehensive about gaining ROM:
It has now been 26 weeks and all I do is ADL and this is what my ROM has done:
3.5 wks: 75
6 wks: 85
7 wks: 90
10.5 wks: 95
14 wks: 100
17 wks: 105
20 weeks: 110
26 weeks (where I am today): 120!!!
I did it! My goal of 120! No "pushing through pain", no PT after the first 3 visits, and most importantly to me: No MUA! My surgeon who said I would never get beyond 85 ROM without pushing through pain was wrong, wrong, wrong. I'm excited to see if it gets even better. :happydance:
 

Rockgirl4

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My surgeon was very strict in having me ride my stationary bike for ONLY 5 minutes, and ONLY 1 time a day. That's it!! He told me to keep this up even at 6 months post-op, as I continue to have issues with rebound swelling. Anything over 5-6 minutes can keep the knee angry and inflamed. I was doing it 2-3 times a day for 5 minutes and couldn't get the swelling to improve until I took his advice and backed off to ONLY 1 time a day. My PT didn't like it, but the proof was there after I started obeying the "once a day" advice.

There just isn't a one-size-fits-all to this recovery. The scar tissue is not sitting there, waiting to pounce. It's fear-mongering to scare us all into over-exercising, and it slows down recovery. My surgeon is a Knee/Hip Reconstruction and Revision specialist. He has seen it ALL over the last 20 yrs and hates the way PTs scare people into staying chronically inflamed and in pain after TKR. It's one of the reasons he doesn't send everyone to PT either.
 

Lindylee

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My surgeon and physio always said it was ok to work in discomfort but not pain. Last year I had the exercises from the hospital on discharge and started formal physio at 6 weeks. At 4 weeks I added in shoulder bridges and put myself back a week at least. At physio we did circuits of exercises, 2 minutes on each (bike, cross trainer, treadmill and some static exercises) and if anything was painful they tried to adapt it for us or told us to leave it out.

For me, I found my knee stiffened very quickly and the first heel slide was difficult for a long time, so I just did 2 or 3 more frequently instead of 10 in one sitting. You're only a quarter of the way through a minimum recovery so try not to worry. It does take time.

I have issues still with the IT band on my first knee, which is just over a year old. The surgeon said it would probably take 18 months to settle. When I think how long I had a crooked leg, it's not surprising it's going to take time for the surrounding tissues etc to adjust.
 

sistersinhim

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Many of us never took formal PT or did exercises. I am one of them. I had 11 knee surgeries, 2 of them kneecap removals and 1 tkr. Even after those I never took formal PT. But, I didn't just sit around and do nothing. I used my knee as it was intended to be used by walking around to take care of my daily needs. As I healed I was able to do more. Icing and elevation was a huge part of my recovery.

Listen to your knee. It will tell you if you're doing too much by increased pain and swelling. When that happens, I found that resting, icing and elevating helped.
 
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Yes, everyone's recovery and timeframe for the TKR to settle varies. And the Activities of Daily Living (ADL right?) for sure count. (eh, I hope I got that right) - LOL?

Anyway the things we do daily all count as PT as well. Be good to yourself as you heal :kittykiss:
 
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I understand that flexion will return in time on its own, but does extension return to normal with daily activity also.
 

Celle

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Of course it does, but it sometimes takes longer than flexion.

One of the best ways of encouraging extension is to lengthen yous stride slightly when you're walking. That means the knee has to extend further each time you step forward.

This article gives a few tips about extension:
Extension: how to estimate it and ways to improve it
 

Seatides

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@Roux, I'm at a little over 11 weeks, and I have these moments of panic over my extension! I'm always noticing little improvements in my flexion -- things that are suddenly easy to do that had been challenging not that long ago. But how can you tell during your ADL that your extension is improving? When I sat on the floor this morning, I could get my fingers beneath my knee easily. My knee still feels stiff most of the time, although it's bending better all the time. I keep thinking that maybe I'm underdoing it, but maybe in some ways I'm overdoing it. Yesterday I did about 20 minutes (no resistance) on the recumbent bike, which felt good at the time, but maybe that was too much?

I think I'm nervous because I plan to go back to work in 9 days, so maybe I expect that my knee should be PERFECT (LOL) by then!
 
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I am now entering my 14 th post op week. I seemed To be progressing well. Did yoga on Friday and since that time have developed swelling pain and stiffness. Have been icing and elevating ..it helps temporarily but then returns. Is this unusual or is it just because maybe I overdid it and need to rest it. I still have been doing my adls without difficulty. How long does this pain and swelling last. So frustrating. I felt like I was finally on the mend and progressing and now have this set back. Any suggestions. The only thing concerning to me is that when exercising I usually have swelling and pain for a day. And then resolves but this has been persistent for 3 days
 
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Roy Gardiner

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With any exercise I develop swelling and stiffness which impairs my rom.
A sign to cut back, pain and swelling is bad
I have recumbent bike which I use twice a day
Using a bike to gain ROM is pretty simple:
  • Set the bike to zero resistance
  • Set the saddle low enough so that a single rotation is a challenge; difficult but not painful. When a rotation becomes easy right from the start, lower the saddle a max of 1cm.
  • Gently turn the pedals, through discomfort but without pain.
  • Continue until the knee is 'warmed up' and the rotation is now easy, or for 2 minutes, whichever is the shorter time.
  • Repeat several/many times a day, but don't go mad. Diminishing returns will apply; my guess is that half a dozen reps would be enough
  • Do not pedal fast or for more than 2 minutes, this is a stretching exercise, not training.
  • And if you get any pain or swelling in the 24 hours after doing this, cut it down until you don't
Here is a bit more chat and some pix and how 'healing' and 'training' are different
My pt says no pain no gain. Same as my ortho
The BoneSmart view is that this is simply wrong. Imagine working hard to recover a broken leg or a sprained muscle; you can't, and walking on a broken leg or exercising a sprained muscle are counter-productive, obviously. It's much the same with TKR, you have damage needing healing, not unfitness needing training.

All you need is to help retain mobility (not fitness or strength) until healing is complete. This is done with gentle stretching exercises, without pain.
 

Tykey

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There are different types of yoga, the one I did prior to my TKR involved lots of stretching, twisting and balancing.
I can't think of anything more likely to cause lots of swelling and pain during recovery.
I'd leave well alone, in a few months try again, gently
 
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I am 14 -15 weeks post op from total knee replacement and currently I am experiencing a clicking sensation at the lateral aspect of my knee with some pain with medial and lateral movement of the knee . Still experiencing stiffness intermittent pain and swelling of the knee With exercise. But flexion has improved to 105- 110. Have been doing stretching exercises for my it band. Had xrays at ortho. No abnormality with replacement joint. knee cap very mobile. Still have pain with moderate flexion. Should I be concerned.
 

Roy Gardiner

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Still experiencing stiffness intermittent pain and swelling of the knee With exercise
Pardon the obvious, but do less until you don't have pain or swelling.
Should I be concerned.
By my experience, no. The body 'grows around', for want of a better term, the new implant over many months.
 

Julia1911

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Having similar issues with ROM. 1st week out was at 92-94, then swelling set in at day 5, lost my ankles for a week.

Then lost lots of ROM. Suddenly, could lift teg on my own, do lots of extensions that had been almost impossible before, but now nearing end of 3rd week, ROM still very lacking.

Still lots of post PT swelling -- just rest/walk around house on off days to recover.
 

kneeper

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I was back at work at 12 weeks but that doesn't mean I was recovered. My suspicion is you have overdone. It's so easy to do in the first 4-5 months.
 
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currently entering my 15 th post op week. I am experiencing a pinching pain in the lateral aspect of the knee which is worse with flexion of my knee. Does not interfere with my adls. Can walk up and down the stairs with out issue. Any ideas as to what causes this and should I be worried. I have an appointment with ortho on Wednesday. Thank you
 

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