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TKR 16 Weeks +, not sure what to think?

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I managed to bypass the dreaded rubber band sensation, it can persist for a long time. Plenty of time to work on strength after you are mostly healed. Like, around the time you realize its been a few days or even longer since you've given The Knee much thought. By that time you will be doing a lot of your normal day to day routine, all of which requires a certain amount of strength. Most people's legs are the strongest muscles they have already. And having knee replacement surgery doesn't make you weak. Just wounded. So heal first, then train if you feel the need.
 
HI @oneilllm

I'd like to add my agreement with all the people who have told you that you have been doing too much!

Simply going to work is all the exercise your knee needs, especially with a physically demanding job like nursing.

When you're not at work, try to rest, ice and elevate your knee as much as possible - yes, even at three to four months post-op.
 
My surgeon and GP both give me Nexium to go along with the Celebrex. Brilliant combination.
 
TY all again for the encouragement.

I'm already on max dose of PPI (Nexium 2x a day + Ranitadine) and the Celebrex still tore me up. Now trying the TYLENOL dosing.


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Did my best with the rest Josephine, but one more note---

1. what are your pain levels right now? In addition to what I mentioned already - Tightness, stiffness, etc, I notice a few areas of tenderness to the touch, about a 3/10 that seem more joint than muscular.....

Thanks again for your help!
 
Interesting about your hamstring.....I think that was the beginning of my knee problems. I have no problem straightening my leg, but it just won't bend past a certain point. I am at 12 weeks and still have swelling and pain. As soon as I stand up in the morning, it swells. Must admit that I haven't been very kind to my knee the past week as I've been walking all over Spain! I know people who were back to their normal lives at two months, but had no swelling.
 
Betsyaz, my experience is more like yours - in fact at my very first postop PT appt they commented on how much more swelling I had, and I continue to swell when I'm on it for any length of time. I continue to feel like there's a band around it, and it aches or pains. I am now on the Tylenol regimen and icing and elevating more.

At least u got to see Spain!!! Good luck to you!


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Jo is away for a day or two, I will tag her for you @Josephine so that she knows you answered her questions in post # 20
 
At the risk of sounding like whining, I had a horrible day today, and the pain and discomfort brought me to tears.

I did walk quite a bit, but the pain I experienced in my knee and leg is clearly worse than it was say a month ago: pain behind the knee just above the crease, aching up into the groin, around to my hip and into my back (I know the Sartorious muscle is very long, follows that path and has shown some inflammation...?), tenderness to the touch above the kneecap in the center of my leg and below the kneecap towards the left side... Then that overall feeling of tightness like a vise grip around my leg. And still fairly swollen.

It scares me that it's worse, let alone not better, and I start believing something is terribly wrong. I want to believe overuse... I am working on taking an anti-inflamm I can tolerate per your guidance here, and icing and resting when I get home. It is just crazy to be I'm at 18 weeks - approaching 5 mo. now and still like this!

@Josephine ...?


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Just reading about IT Band and Pes Anserine inflammation here and wondering if ALL this is muscular. Confused, hurting...Ugh!


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Jo is away for a short while, she will be back soon. I am struck by your posts----I also had pain from overuse and frankly, I had trouble believing that the amount of pain I had was from overuse, but it was.

So, despite swelling, you have continued to shoulder on---walking too much, going back to a strenuous job, doing pt, etc. Now, we tell you that this level of activity can cause swelling, but I am not sure that you believe us.

In fact, I tell people to deal with the swelling early on--to lie in bed 80% of the time during the first 3 weeks with their leg elevated and icing non stop. Just so they do not incur the problem you are dealing with now----chronic swelling!

You are very knowledgeable about the muscles, but you want to "work it out"---it seems that rest is not an option for you----and yet, in my opinion, your body is crying out for rest!! Try an experiment. Take a weekend off----Stay in bed or on the couch the entire weekend---getting up just for bathroom breaks and meals. Have a good supply of books handy. Elevate your leg the entire time and keep ice on it too. Rotate two gel packs.

Elevating your leg to control swelling and pain
Using ice

Do not walk those days, do not work, do not go to PT. Now, how does your knee look? If your swelling is down and your pain is less---you will have your answer. I think you are going to have to limit your activities for a month or so---not the rest of your life!!! you need to take care of the swelling by icing and elevating for hours when you get home from work--not 20 min. Your chronic inflammation is going to need to be treated by RICE--rest, elevation, icing and compression.
 
Thank you @skigirl --- I do believe you and believe me, am following your directions. I have stopped PT, am off today and thru the weekend and am doing just as you say - resting, elevating, icing, medicating. Yesterday I had meetings to attend to wrap up before I left and at the day's end felt completely trashed, so fear sets in.... What Ifs...? Thank you for the reassurance, I do appreciate it!


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Kelly is right. You're going to need some serious down time to allow your knee to settle. Any effort to continue working when it is still swollen and hurting will just compound your problems. Also, if you are still not sleeping well, that can contribute to how you're feeling. Is it possible to take a week or so off from work. Two weeks would be even better.

I know you feel that you've been taking things easy these past couple of months, but your knee is telling you otherwise. I do think this is strictly a muscle and soft tissue inflammation from too much activity and not a problem with the implant itself.

When you are off your feet this weekend, elevate your knee (toes above the nose) and keep ice on it both front and back. You cannot over ice as long as you keep a kitchen towel around the ice source to keep from getting skin damage. Even ice at night when you're sleeping.

If you improve over the weekend (and I believe you will)....that is not a signal that you can head on back to work and everything is good again. It just will mean tissue inflammation is the problem and you will need to readjust your schedule to allow at least a month of reduced activity for your knee to completely heal from this.

Please let us know how things go!!
 
TY @Jamie!
Thank you. Icing & toes above nose now, and I understanding will have to continue until it's resolved.

Do you feel there would be a benefit to seeing a chiropractor for soft tissue work at some point?


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It seems like some people heal quickly and can get back to "normal" within a few months and then there are the rest of us! I'm at 7 months BTKR, was doing good early on and finished PT and was simply walking around in the pool with slight bouncing when one of my knees started hurting in a different way. I thought simply resting a while would make it better but 3 months later I'm still waiting for the pain to ease. The OS first said it was pes anserine tendenitis which can take quite some time to heal, 2 months later he wasn't so sure what's causing it. The implant looks great, there's no infection, just this pain on weight bearing below the knee on the inside. OS said it will get better or it will get worse or maybe it will stay the same . . . so helpful! I'm now trying some laser treatment and am hoping that may help. This is all to tell you to please take it easy and don't push so hard or you may get into one of these situations where the pain of unknown origin continues.

Just anecdotal from the small group I know who've had TKR's, but it seems like the people who had them done before their knees got very bad have had much better success. Wish I could have had mine done 10 years ago. Right now I have more pain in one knee than before surgery and I wouldn't wish that outcome on anyone.
 
Hi @VancouverUSAgal, I am so sorry for your difficulty. I completely agree about waiting so long for the replacement! The MDs always said, "You'll tell me when you're ready for your new knee", based on pain level. And even as an RN, I was not fully prepared for the magnitude of the surgery and thought I was supposed to jump right back on my feet and into my life, which I really tried to do, even if I was dragging my leg behind me. My waiting to have the TKR resulted in muscle contractures and a huge valgus deformity. So I already had all these muscle issues, then after the replacement tried to jump back into everything. Crazy now that I'm here on this website hearing all the stories and reading all the resources. I should have done that before, and now tell every everyone considering TKR about this site. I think MDs should have to send all their prospective patients to "joint school" -- some surgeons, like mine, approach it so casually! You will be in my thoughts and prayers and I do hope in the end this "new pain" disappears.
 
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@oneilllm it sounds like we've had a very similar post op experience. I pushed myself like the PT said to do. Being a nurse and a gym rat, I am used to pushing thru the pain. I felt like the OS and PT were disappointed in me. I kept asking since week 4 about the terrible pain on the side of my knee. They never once gave me any indication that it was anything but normal and I wasn't stretching and doing my exercises enough. I knew I was doing all the things they told me to do. I finally pulled back on all the stairs, elliptical and quad/hamstring machines they were having me do. Then I found Bone Smart. Would have, could have, should have. I haven't decided about going back to the OS at this point. I am pretty unhappy with them right now. I am lucky I live I Atlanta and have a plethora of OS to seek guidance from. Hang in there and we will recover with the help of these Bone Smart family!


July 14th, 2014 Left Total Knee Replacement
 
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@MoPeaches, wow, I would say! I will say that my PT did acknowledge and treat the my muscle issues, but we never did stop pushing forward. And the surgeon, he never really read or acknowledged the PTs input, like he'd done his part.
I pray things are going better for you...TY for your encouragement - it means a lot to know I'm not crazy, and not just a whiner! The very best to you!


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My tkr was close in time to yours. I know it's hard to believe we are still in recovery time, but we are. I was able to ease into activities a lot more than you have been and I still get a bit achy if I try to do too much. hang in there and give that knee a break whenever you can.
 
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