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TKR 2 weeks post op pain and stiffness^

Hi All,

After another physio session yesterday and increased pain on the medial aspect of my patella, the physio think I may have a quadricep tear. He also noted that I my leg is buckling inward to a valgus position.

Meeting with my Consultant again tomorrow, has anyone else experienced anything like? I do have a of pain from the inner aspect of my knee and there is a visible dip.

Thanks guys [emoji4][emoji106]


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You might also have increased pain simply because you are doing more in PT than your fairly new knee is ready for.

You are recovering from a major surgery that caused a huge amount of trauma to your leg. Many PTs forget this and expect us to be able to do too much.
 
pepsicola said:
I’m just 3 weeks post op and finding after physio I’m getting a lot of pain. Physio has me doing 10 exercise sets 3 x day.
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Even though you are 4 weeks out now, the is still way too much exercise to be doing on a knee that's still only 1/12 of the way healed. Please slow down. You are not helping your knee one bit, just slowing down your recovery.
 
Thanks @sistersinhim. I am really following the guidance of my physio and consultant. I understand that we need to give time to heal which I also R.I.C.E. on a regular basis. I have, however, been slowing down all PT this week and taking more time to rest.


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sistersinhim said:
Have you seen any improvement in your pain since slowing down?
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No not really, the pain is still present on the inner side of my kneecap and can see a significant lag of me knee falling inwards.

Met with my consultant yesterday who said he is not overly concerned, wants to see me again 5 weeks and to continue with strengthening programme of PT?



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It seems to me that the exercises are keeping you inflamed and sore. We suggest that no strengthening exercises be done until you knee is at least 3-4 months old. Yours is just 1 month. Doing too much will slow your healing and recovery done.

You and your body's first order of business is to heal. During this critical period of several months it is important to never do anything that causes you pain or pushes your knee to excess. This disrupts the healing process. I also recommend that you click on the Wound Care tab at the top of the page and read all three sections about how both your wound and the surrounding tissues heal. This will also reinforce the idea that your soft tissues need time to mend without being ripped apart by exercise meant for later in the recovery process. There is plenty of time to strengthen your muscles once the healing is concluded. You definitely want to wait at least 3 months for any strength exercises and possibly even 6 months to a year. There is no set time....it depends on your body.
 
"Strengthening" can simply involve doing more activities of your daily life (as the knee permits). What kind of exercises are they giving you?
As fellow advisor Roy says, you're not in training, you're healing.
 
kneeper said:
"Strengthening" can simply involve doing more activities of your daily life (as the knee permits). What kind of exercises are they giving you?
As fellow advisor Roy says, you're not in training, you're healing.
Click to expand...

I have 5 sets of strengthening from sitting to stand with a 2kg weight, leg extension tightening quads, leg raises, cycling (no resistance @ 60mph. I do understand what you guys are saying about not training but healing. I was so immobile for 2 years prior to my surgery I think I also want to get moving and the pain is different to pre surgery if that makes sense.
 
It is far too early in your recovery to be doing any strengthening exercises, particularly with weights.
Your knee isn't lazy or unfit - it's wounded from major surgery and it needs time to start healing before you stress it with strengthening exercises.
While it's healing, your muscles will gradually be regaining some of their lost strength anyway, just with your activities of daily living.

I know strengthening is what your surgeon advises, but I want you to know that not all surgeons advise that - and they also get good results.

My surgeon doesn't allow any PT at all for the first month after a knee replacement. He says your knee needs that time, to start on its journey of healing. For that month, we rest, ice and elevate our leg, and walk around the house.
After that month, we just go to PT once every 2 weeks, where we are shown a few new exercises to do at home.
His patients all do well and achieve good ROM and function, as I did, and he hasn't had to do a manipulation to help with ROM for the past 4 years. I think that speaks for itself.

PT should not hurt - at the time, or later. If it hurts, it's bad PT - and no PT at all is better than bad PT.
 
@pepsicola
You are a bit ahead of me on your recovery but not much. My op was 1st March.
My knee is stiff and there isn't a lot of movement at the moment. I saw physio 2 weeks ago and exercises given were very minimal, just heel slides, flexing my muscles to get the knee flat. I go again tomorrow. They did tell me last time that we would be doing strengthening exercises next but I very much doubt it will include weights. I don't think I am ready for that but then perhaps I have been taking things too easy.
I will give an update on what they say.
 
Bionic said:
@pepsicola
You are a bit ahead of me on your recovery but not much. My op was 1st March.
My knee is stiff and there isn't a lot of movement at the moment. I saw physio 2 weeks ago and exercises given were very minimal, just heel slides, flexing my muscles to get the knee flat. I go again tomorrow. They did tell me last time that we would be doing strengthening exercises next but I very much doubt it will include weights. I don't think I am ready for that but then perhaps I have been taking things too easy.
I will give an update on what they say.
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Hi there, it was only 2kg hand weight which I helped when practising sit to stand position. My knee is almost falling inward so my PT was keen to strengthen this muscle. Consultant confirmed there is a lag and suggested swimming which I have done today and must say I do feel a lot less stiff and really comfortable.


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Bionic said:
Glad you feel more comfortable today.
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I am thank you, I know it’s early days but I spent 3 years of my 40s not being able to walk, so happy to be able to move again



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You can probably do those sit to stands without weights until they get too easy--which I'd think won't be for a while. My guess also is that you're "sitting to stand" in your daily life a few times a day anyway.

Tightening the quads (what they called "quad sets" for me) shouldn't be bad at this point--at least it wasn't for me. You're only month out at this point. I'm not saying you won't want to strengthen your muscles, just that you need to pay attention to what your body is telling you and not let yourself be pushed too hard.

I thought I had to "suck it up" and do some of the exercises my first PT had me do with my first tkr and I got tendonitis for my trouble. Taking it slow but steady (and saying no to things like squats) got me there without unnecessary suffering with my 2nd tkr.
 
Thanks guys and hope your all well.

I have been a little more mobile again this week and really starting to notice my leg doesn’t look straight??? I’ve still got a real limp and sure this will go over time, be good to hear your experiences too [emoji4]


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@pepsicola
My leg looks far from straight as well :-(
To be honest it has looked that way for some years so I am thinking it won't correct itself overnight. I am hoping that by walking and trying to use the knee as normally as I can it will all come right eventually.
I have also got a limp, although am still using one crutch. From past experience with my hips i am sure that as the knee gets stronger and I get more confident the limp will go.
 
Bionic said:
@pepsicola
My leg looks far from straight as well :-(
To be honest it has looked that way for some years so I am thinking it won't correct itself overnight. I am hoping that by walking and trying to use the knee as normally as I can it will all come right eventually.
I have also got a limp, although am still using one crutch. From past experience with my hips i am sure that as the knee gets stronger and I get more confident the limp will go.
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Thanks Bionic, it’s reassuring to know that you have similar symptoms. Really feel this forum is a huge support and thanks for taking the time to reply. I have been swimming this week and been feeling like I have a lot less pain so tried a walk yesterday but today my knee feels really stiff and sore. It’s difficult to know what / when to do things when you have a good days


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I would live to go swimming or even just walking in the pool but my scabs haven't quite healed yet so need to wait for a bit.
 
Bionic said:
I would live to go swimming or even just walking in the pool but my scabs haven't quite healed yet so need to wait for a bit.
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Yeh I was around 4 weeks but got the green light last week. Feels great in the water and no pain


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