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TKR 19 mos, knee overuse and strain.Worried again.

@Legseleven Oh my goodness! I will. I have only done a few from a high bed. Honestly exercises are so confusing. My surgeon said no squats or lunges. HIS PT group said do sit to stands off a low bench, a PA said a few mos ago all you need to do is straight leg raises and hold til thigh quivers! I said they hurt my hip flexors and low back and he said bend other leg which I would do anyway- but really they have thrown off my low back. OK. At the end of the day I need to slow the heck down and listen to my body even if I think I should be so much better! This is an art and i need to respect it. This group is the BEST.
 
@Readabook … I agree with everyone that is suggesting you take things easier for quite a while until things settle. But I’ll tell you about my daughter’s experience with hyper mobility and maybe it will be something you can explore.

My daughter was having a lot of trouble with her joints being painful from her bouts with hyper mobility. Hers was so bad that her shoulders and hips would routinely slip out of joint and she would adjust her body to put things back in place. The therapist explained to her that our joints are pretty much held in proper position by the soft tissue (muscles and ligaments). All of this soft tissue must be in balance for things to work properly. If a particular muscle is tight or maybe a ligament is a bit stretched, it can throw this delicate balance off.

Following an evaluation of her muscles in the shoulders and lower body, she started my daughter on a series of gentle exercises to strengthen the muscles that were weak and allowing the hyper mobility. It has taken almost 9 months, but my daughter is better. She probably always will need to be conscious of this tendency to be overly “bendy,” but it has been amazing to see her progress. So, you might try to find a therapist who has experience working this type of problem and can analyze how your soft tissues are performing. Be sure any therapist you see has DPT after their name. Having a Doctorate of Physical Therapy means they have had additional medical training that allows them to diagnose problems with the body’s soft tissues.
 
Legseleven said:
I was doing well and trying to get back to work and did too many and next day couldn’t move.
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I think those of us who are a bit competitive or very goal directed can definitely overdo things, and especially if we have an underlying issue like hypermobility.
It is so important as we age to really listen to our bodies and switch to more sympathetic forms of exercise like pilates or Tai Chi.
 
Hi Readabook,
We haven't heard from you for several weeks. How are things going for you...we'd love to know?
Hope to hear from you soon.
@Readabook
 
@Layla - Thank-you. I have been a bit off kilter. busy with life of course as we all are. Taking care of 3.5 year old granddaughter and she is one who figured out to climb up to a counter but then I have to lift her down (None of this is planned of course!) low back, psoas and glute pain- which of course coincides with foot and ankle stuff and then NOW the dreaded shin splint feeling AGAIN. Honestly- I do balancing on one foot and my peroneal tendon still get so angry. And there really is no muscle there. So I am a bit behind in my organized exercises. But also frustrated. I think I am 21 months post op now. I have good bend etc, but the soft tissue, the impact on feet, shin.. as you said it is all connected. But those folks out there who are perfect after a few months bewilder me!
 
Please don’t feel bewildered. It is your body and it is all connected. I’m still dealing with what has now been diagnosed as petellarfemoral syndrome, based on an MSK ultrasound . It’s alittle less painful, but still extremely tender. My OS meeting was useless. The special mri because of the knee metal didn’t really show the soft tissue and was inconclusive.

The best relief I have so far is to get my walker out to offload weight on my trips to the bathroom . I have listened to a lot of YouTube and I have been starting to work on strengthening my gluts. I’ve also found that a lot of the regular exercisers for after the surgery should not really be continued after you get the range of motion to where it needs to be. And other exercises I was given also only increased the muscle imbalance that I think I’ve had for probably a very long time.

I have a pt appt finally next week but am concerned about what type of assistance I might be given. I also have an appt with a physiologist in 2 weeks. My best advise to myself now, is not to do any exercise I’m given without an explanation of what muscles it is supposed to strengthen and then to decide if that is something that will help my knee function without pain.
 
@great button Gosh- this is so supportive and helpful. I keep reading that I should get stronger glutes. I am going to meet a new PT in a month. I agree that any exercise I have been given or done is just like what I did after surgery. But shouldn't balancing be good? I remember being told I had patella femoral syndrome 20 years ago! It feels like a catch all!!! Now if I can get inflammation down.. and how come we are still dealing with this? Thanks so much!
 
Ok glad you are on to what I’m saying. Balance from what I’m hearing is not good if you have patella problems because you are putting all the weight on the one leg/knee. If your overall muscles are stronger then you will have good balance . Especially the glutes, and no more exercises that work the the upper thigh , like almost all the ones I’ve been given over and over again. And no bike either until you can use your glutes properly. Again, just think about what is the root cause of where your pain in your body is. I’ve been through a long time of misdiagnosis and the wrong exercises at the wrong time. I have to take some control and not just blindly trust these guys, because that hasn’t worked for me at all.
 
Wow- thank-you. I must admit that my old yoga brain wants me to balance and this implant surprises me, So relieved to hear an explanation. I am embarrassed to say that i did the bike at my very traditional PT- and promised to continue- by did not as I would have to drive to a gym in the winter.I have dozens of stairs and figured that was good enough. But everyone says bike is good- so I failed that. Maybe not. I used to ride when I was younger and I think it really hurt my knees... Why they don't tell you this. My surgeon said "90 days and you are done." !!!
 
So I found what I think are really clear logical and very detailed YouTube videos from a Dr of PT from El Paso. I don’t know if I’m allowed to post that. It would be good if you could see them for yourself and see what you think. I’m working on glutes just beginning and I can feel the different when I walk to the bathroom, even though I’m not very good at it. But that and all of the information I’ve heard makes me feel that this Dr Dave has got this figured out better than everyone I’ve trusted with my body so far. And it’s free. Just take some time and look at some that’s what I’m doing.
 
I'm sorry you're feeling behind in your exercise program and still dealing with pain. Keep working on it all to the best of your ability. Try to prioritize time dedicated to what you need to do to feel better. The member's who seem perfect after only a short time, likely have a less physically demanding life than you. I hope you find a good match in a PT next month. Enjoy the weekend and stay in touch!
@Readabook
 
Readabook said:
Taking care of 3.5 year old granddaughter and she is one who figured out to climb up to a counter but then I have to lift her down
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Readabook said:
I am a bit behind in my organized exercises.
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Just chasing after and taking care of your granddaugther is all the exercise you need to be doing. This is all natural PT, just what the knees prefer!
 
@sistersinhim I find it all confusing depending on who I am talking with. Some folks will say that the daily living is enough- but many will say that I need to do specific exercises to prepare for activities of daily living and I get "hurt" because I am not strong enough. I passed the stair test at PT cause I have to do stairs to get around my home. I passed the range of motion cause I am pretty flexible. But i do all the things that I think we all do and I get irritated and need to take time off- they aren't big things in my brain... but I had hoped that I could handle big hikes etc by now. I am def listening to everyones great advice. I need to find more subtle ways to strengthen the muscle to protect the tendons and ligaments. Correct?
 
Yes, I had lots of setbacks, when I thought I should be able to do stuff by that time. But clearly after TKR there is still a root cause issue of how the hold thing happened in the first place. And even with the new knee those issues are still there. I’ve completely backed off and am getting a little relief from the pain and swelling but and not active at all yet. I was, and I think it kind of becomes a build up of wear and tear on your knee when the rest of your muscles aren’t working to properly support that knee. I’m also now worried about my other knee. So I’m suggesting again to look at those videos I mentioned to see if they might be helpful.
 
Hi greatbutton,
I've been reading through the helpful updates and insights you've shared here with, Readabook, and see she has appreciated your posts. Please consider doing a thorough update on your thread as well. I believe you'd appreciate having some of this information on your own thread to reflect back upon at a later date.

Thanks for supporting BoneSmart as an Insider and for your care and encouragement of fellow members. :)
A great weekend to you!
@great button
 
Readabook said:
have been a bit off kilter. busy with life of course as we all are. Taking care of 3.5 year old granddaughter and she is one who figured out to climb up to a counter but then I have to lift her down (
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This is heavy duty work for anyone with joint and tendon issues.
Readabook said:
find it all confusing depending on who I am talking with. Some folks will say that the daily living is enough- but many will say that I need to do specific exercises to prepare for activities of daily living and I get "hurt" because I am not strong enough
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It is hard to balance stuff like caring for others with some self care and building up strength. I do try to do 15- 20 minutes of glute strengthening exercises 3-4/ week plus a bit of core work and back exercises when I have time. But like you I can overdo things and my various joint issues can interact negatively if I do too much.
I found it helpful to journal my progress.Logging what I am doing, any progress or set backs plus what specific triggers cause flare ups and what exercises help.
For some people here just everyday activity is enough. But I have specific issues with an overstretched MCL causing some ongoing tendinitis. Plus hip osteoarthritis and lumbar arthritis/ spinal stenosis. I do need some more systematic ongoing exercises to support my daily activities.
The real key here is that we are all different. We came to surgery from different starting points, different injuries and deformities. For some of us the surgery is sufficient to rectify all our joint issues and we will rehab naturally and easily. Others will need a bit more specific rehab, although it definitely should never be painful. It is important to find something that you enjoy and don't find boring. For me that is pilates. I used to love yoga but that is now too dangerous as I can definitely overtwist and cause injury. Also I can't to water exercises as my swimming technique isn't good enough and I can hurt myself.
I do need to be careful and some things like prolonged standing or long car journeys can still be painful. However at nearly 4 years I can walk miles and have done some fairly tricky hikes and climbs. It is really about learning to understand and accept your body and work within your limitations but trying to gradually improve at the same time. Good luck!
 
@EalingGran Thank-you!! And we have those loose joints!!! I have much the same msk system issues as you. I came to surgery cause my femoral condyle broke and no surgeon noticed on xray til the last one who said "you have NO choice!". And osteoporosis. Between set backs, caregiving and life I have not had a chance to look into your pilates person. But I do remember. I actually have an appt in September with a private PT and body worker who is supposed to be very gentle, educational and wise. I just read that my balancing could have been a bit much and shin and foot all suffering. I am not an athlete. But I always push myself because the situation calls for it. I am that person in my family and I hate to say 'I can't". My parents and daughter were inconvienced (sp) by my TKR and I am just trying to keep up. Oh well. We each are unique.
 
Readabook said:
We each are unique
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Oh yes! And what works for one, might not work for another. The key is finding what works best for you. Another key is to find what is causing you more discomfort, and then stopping it until your knee is ready for you to do it again.
 
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