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TKR 12 weeks and Knee-Cation

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cycling67 said:
When in PT or doing my stretches at home I get to a point where my hamstring (I think bicep femoris) "grabs me". I have tried heat, ice, stretching, time, stim at the PT, ultrasound at the PT, ibuprofen and herbal muscle relaxers.
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But you're still doing the exercises, yes? How about NOT doing the exercises? I thought I went through all this with you a page or two back. Less is more, you can't exercise pain away, all that stuff.

And what pain meds are you taking? How much and how often?
 
Thank you Jo for the reply: I am still doing some exercises but VERY limited including stanionary bike for motion, leg raises every other day and less, leg extensions every other day and also less. Exercises at PT (which I will cut back to twice a week) is obviously much more but none cause pain. After re-reading this entire thread I cut back 2 1/2 weeks ago from what I was doing, which admittedly was too much. My leg feels much stronger and extension is really coming, I just battle specific hamstring issues which is hampering some flexion.

So you feel that what I am doing, even now, is too much which is causing hamstring issues? Although I find this difficult to hear I will back off even more. I currently go to PT three times a week and will cut back to twice a week which lots of rest/ice/elevation which seems tough since I do this what feels like all day. :sigh:

In regards to pain meds I am taking the following, one narcotic and one over the counter.
Percuset: 5 Mg every 6 hours which makes a total of 20 Mg in a 24 hour period
Ibuprofin: 400 - 600 Mg typically three times a day (I am cautious of this to take during my meals since I have some tummy trouble)
 
Jo: thank you for the reply. Ok on the ibuprofen vs Tylenol. I will switch to Tylenol but be cautious as there is acetaminophen on Percoset and there is a limit.

I talked to me PT today who i love. He suggested that with the pain and 'stuckness' at around 103 I stop all exercises for the next 2½ days till I see him again. I am to do 3-5min spin on bike 3 times a day plus short walks 3-5 times a day. Hot tub with gentle stretches. Otherwise nothing else. Hopefully this helps.
 
Hi cycling67

Glad you are seeing progress, sorry you continue to have some frustrations. I cannot even imagine doing PT 3x per week - I have not done that ever in my recover. Most weeks are 2x per week but since I can't keep myself from doing too much, I have been going only 1x per week for PT and some exercises at home. Mostly I am letting life be my recovery. I have been lacks with icing and elevating these past two weeks and I can feel and see the difference, definitely more swelling.

My hamstring issues come and go - some days good, some days very sore. I did a lot of walking on uneven ground this Saturday and today at therapy it was my hamstrings that were bothering me. For me I think it all ties into finally being able to use muscles that have been underused for way too many years. I actually walked on a tread mill today for the first time and even tried a couple "squats" with goal of getting in and out of chairs easier. Last week we added a little work on a foam balance pad.

Hoping your "knee-cation" gives you big rewards,
Stacie
 
Jo: yup i saw the limit of acetaminiphen in the article and will adhere to that limit. You are right Jo and in fact i suggested to my PT based on your suggestion and he agreed. He is very open to trying things and listening to his patients for which i am grateful! Thank you for the suggestion and for the next 2+ days i will rest/ice/elevate, spin gently on my bike (3-5 min 3 times a day), and walk short distances 3-5 times per day. I will ice via iceman tonight to start off which will help also. Thank you and i hope this will help me, thank you for your patience with me.

Stacie: thank you so much for your thoughts! I love your saying that life is your recovery. After this "knee-cation" i will only do 2 times a wk for PT. Also congratulations to you for your progress you are doing SO well!!!

Many thanks to ALL who have read and helped me. I still have a long ways to go but still have hope and appreciate your patience with me and my all over the place emotions.

Hugs to all!!!
Brenda
 
Brenda, it seems like the hot tub would be good for loosening up the muscles and massaging while you are in there.

I have been sleeping a little bit more, but now the neighbor upstairs is waking us up! Arg... I have been going easier on the home exercises, though I realize I have to do enough pt to keep the new knee loose and flowing the best that I can. Thank you all for your support. I am still hanging in there.
 
Hello Brenda, hope you are finding the pain a little easier today and also hope you enjoy your 'kneecation'. I will definitely be interested in knowing the outcome. You sound as if you have a wonderful PT. He sounds as if he really cares and wants the best for you. Cant say that has been my experience unfortunately here in the UK.

Stacie, it's interesting what you say about the ice and elevation, especially as you have progressed so well but obviously this is going to be part of our life for sometime...

Glad to hear that you have been sleeping a bit more rainbird - shame about your neighbour! I had a few days where I was sleeping much better but back to square one again now and counting those blessed sheep...

Have a great day Brenda - you so deserve it:flwrysmile:
 
Rainbird: You are right, the hot tub totally helps at least while I am in it and shortly after. Sadly my muscles tighten up pretty quickly but hopefully with enough persistence they will eventually settle down. We are all interested in your recovery and are here to listen. Keep us posted and thank you so much for your support!
 
Speedy2: I really am enjoying my "Knee-Cation" so far. Today the plan is to have a massage, then do only 3 small spins on the bike and 3 - 5 short walks. I will post to everyone the results, as I am really, really, really hoping that this helps. I need my muscles to CALM DOWN! :)

Question for everyone: We noticed in PT yesterday that I have some pretty severe pain on my shin bone when pressed, like a really horrible bruise. The Physical Therapist is a bit concerned about this. Possibly a stress fracture? This seems unlikely to me given that i don't have pain in that location when i walk. Any thoughts? Anyone have this pain in the shin bone area when rubbed or pressed on?

Thank you, thank you ALL for your amazing support and patience. It is SO nice to go through this difficult time 'together'. I wish you all the best, speedy recovery and patience! :SUNsmile: :flwrysmile:
 
Stress fractures don't occur on the tibia! Apart from the femur, it's the toughest and strongest bone in the body. Much more likely to be soft tissue and probably a bit of fasciitis (soft tissue inflammation). Try some massage on the area.
 
cycling67, hi. I have a tibial stress fracture, diagnosed several weeks after my replacement. I have long tibial stem implants and some osteoporosis, but was clearly seen on film. But..... I had terrible pain when walking, starting 2 weeks after surgery. The area was extremely tender to the touch, but the pain was so bad while up walking that I had to get off my leg for a while. It kept recurring in intensity, so went back to my OS for x-rays. Back to the cane, and off it as much as possible for it to heal. Was told 6-8 weeks of this before the bone would heal. Hope this helps.
 
DebR: Thank you so very much for your reply! I am so sorry that you have this! It sounds like IF I had a stress fracture I would most certainly feel pain when i walk which I don't, only when pressing on it. Please take care of yourself and hang in there!

Jo: Thank you. Agreed, I don't think I have any stress fractures. I will try massage but it is so painful to the touch not sure I could massage it. However I have had massage all around it which is maybe your point.

I guess time will tell, as always. I am into Day 2 of my "knee cation". Only doing small spins (less than 5 minutes) and short walks (less than a block), no stretches except for light extension ones. After this will start back with the gentle stretches but stay very light on the exercise part of the PT.

Have a great day everyone!
 
Hope your feeling better today Brenda and enjoying your knee vacation?
Also good to know it's unlikely you have a fracture - phew. It probably is your tissues and knee recovering from the onslaught it's been through. It could feel more painful also as you regain more feeling into that area again. I know the right side of my knee has become very tender and painful to touch -this being the key -I couldn't feel anything there before.

Keep up the gentle stretches and remember every day is a day closer to our freedom...:yay:
 
Speedy2: Yes I am very happy that it is unlikely I have a stress fracture. I feel confident in this. I don't really notice the pain unless it is touched. I am doing OK on my knee-cation. I had a massage yesterday that I feel a bit stiff from today but expect to feel a bit better tomorrow. My PT appointment is tomorrow so i guess we will see. I think, regardless I will for sure be cutting way back on the exercises and only focusing on the gentle stretches, walking and spinning short distances. I think i will move my bike upstairs so that i get on it each hour for just 5 minutes to keep knee loose.

Jo: Thank you for that article on accupressure massage. I have been doing something like this but not with a fist, only with the heel of my hand and not the amount of times suggested. I will add this to the list. Easy to do while sitting, elevating and watching TV. My IT band is certainly part of my issues. Gosh i could be doing this all day with the amount of muscles needing it. I need more hands. :giggle:
 
Jo, @Josephine: Can you, one last time, change my thread title to: "12 weeks and Knee-Cation"

Hi Everyone! I wanted to provide a quick update as to my progress and also specifically from my "Knee-Cation". :) As many of you know I was advised by the great people on this forum along with my PT to take a "knee-cation" meaning stopping home exercises except riding my bike 3 - 4 times a day for only 5 minutes at a time and walking 3 - 4 times a day for short walks. In addition to this I go to outpatient PT twice a week. I was having LOTS of muscle issues (hip to big toe) with cramping, spasms and discomfort. Also struggling with ROM. In addition to the above I use my hot tub most every night and get semi-deep tissue massages each week. There is certainly no doubt that I have all of the tools and resources around me to be successful.

So.......... I have both good news, average news and a question to those smarter and more experienced than I.

Good News --> My muscles are starting to calm down, albeit very slowly. In addition, I think because my muscles are calming down I have less stiffness (unless it is the morning) within the range of motion that I do have. As an example after my first spin session on the bike I can easily bend knee enough to walk up the stairs like a normal person. I also can walk, after warm up, pretty normally with maybe just a minor limp that I think is there simply because of weekness in the leg. I sense progress which is so very, very wonderful! :happydance:

Average News --> I have not achieved any more range of motion. The best I have been able to do at outpatient PT is 108 degrees. I find this very scary and quite unsettling, however I have re-read articles and posts to see that ROM can continue to get better certainly months after surgery but even years. Because of this I just keep on plugging away at the gentle stretching believing that at some point it will happen for me.

Question for the experienced --> Is there any chance that having less stiffness within existing ROM is a indicator of more bend to come???? :beg:

As always, ALL MY BEST to each and every one of you going through this challenge of recovery. Patience is certainly the key, I am getting better but have not mastered it yet.

Brenda (cycling67) who has high hopes for a spring time of cyclingin 2014!!! :bicycle1:
 
Range of motion will come as your knee is ready for it. The key is to listen to what your knee is telling you. I too have taken the knee-caution approach. I had been doing this one stretch exercise where I put my foot on one step and lean fwd bending my knee and trying to touch the next step up with my knee. After several attempts could barely reach it and could not hold it there very long. I stopped trying this for a couple of weeks and when I again tried it the other day, I could touch the next stair with no problem. I had to check to see if I was doing it the same way as the bending was so easy. Bottom line is be good to your knee and time heals all. Be patient and best of luck.


Sent from my iPhone using BoneSmart®
 
What great news Brenda - you sound as if you've been enjoying yourself far too much!! Hot tubs and massage this is just far too indulgent :heehee: sounds much more exciting than my 'little jaunts'. Also great that you're walking upstairs like a 'big girl'. I'm now in that club but i do do a bit of hauling up the banister to help - oh i'm so elegant.

And walking normally...you wonderful woman, you have been busy. What fantastic progress you are making. We're definitely edging towards that 'normal' I was looking for.

Also like you my ROM has not improved (still 90%) so will be very interested to see the responses to your post. Unfortunately, as i'm not experienced I wont even attempt to answer your question but will look forward to' those that know' to see what they advise.
Keep up the wonderful work. I bet next time you post you will have cycled to France:rotfl:
Take care x
 
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