TKR 2active getting her life back!

[2active]

Today is exactly two weeks since my left TKR. I'm still very stiff and swollen and my range of motion is only around 50. I went to outpatient PT last night as the doctor instructed, however today I'm tighter than ever! My biggest problem is my leg has almost no strength. Leg lifts don't happen, as I have no strength to even lift my foot up off the sofa or bed. Sideways is no problem, but straight up isn't happening at all. Kinda scares me.... I'm doing at home exercises, but I feel like I'm getting nowhere. I can walk without a cane around the house but not on stairs just yet. I think I might cancel future PT appointments, and just focus for now on reducing the swelling. This leg isn't going to cooperate until the swelling is down. And as far as my muscle strength... I'm scared!

 

[sistersinhim]

Don't be worried. It takes a while to get the strength to lift your leg. That's why so many of us had a leg lifter until our quads could do it. You can take a couple of belts and hook them together to pull your leg up until it gets strong. Don't fret. It's perfectly normal to not be able to. I wasn't able to lift mine alone for close to a month.

 

[bottomshollow]

@2active, we've moved the above post back into your recovery thread where it properly belongs. Anything pertaining to your recovery should always be in your thread. When posting in other members' threads, the conversation should concern their recovery.

You need to sit back, take a deep breath, and relax. You are VERY early in recovery. What you are experiencing is totally normal. Stop exercising! Normal activity of just getting up and down and around the house is all you need. You need to be elevating toes above nose, icing for at least an hour at a time, taking your meds on a schedule, and getting lots of rest. Yes, focus on getting the swelling down. This is going to be a LOOOOOONG recovery. At about three months, you'll start to feel that you're not sorry you did this. At about six months, you'll begin to feel that "normal" is possible again. By nine months you'll really be seeing light at the end of the tunnel.

Also, not wishing to burst your bubble further, being younger than the average TKRer gives you no advantage at all in the length of time recovery takes. Sometimes youth is a disadvantage because you don't have the patience we older folks have.

Take care, follow the BoneSmart mantra----and remember that WE CARE!

 

[KarriB]

I used a leg lifter to practice leg lifts. I would pull my leg up with arm power, but after a few days I'd use less arm power and more leg power until it was all leg. Are you limping when you walk around the house without a walker or cane? You are very early in recovery and your exercises may be adding to your tightness and swelling.

 

[2active]

Yes. I am limping with a stiff leg. I am definitely impatient... I will admit that. Maybe even a bit blue because I am just not used to being home and resting so much. I understand this is a process. I need to chill out and accept the fact that this is going to take a while. I am going to follow the mantra. I don't take pain medications since I don't really have pain unless I'm exercising. No more of that until the swelling is down. My ice machine and elevation above my heart will be my focus for the next few days. Hopefully I will see some improvement within the next couple of weeks. I will also use my cane more. My husband is helping with some leg lifts to strengthen my leg muscle.

 

[KarriB]

At not a month post op and limping you need to be using a cane or walker (which ever you feel comfortable with) until you aren't limping. It's more important to begin using a correct gait than it is to go without a walking aid. Plus, if you're limping you're putting undue pressure on your knee. No one wants to be laid up like this, but in the end taking it easy will help you recovery quicker than if you over do it. I know you said you aren't taking pain meds, but it's not a good idea to medicate before therapy as then you can't feel if you're hurting and if something hurts you shouldn't do it.

 

[2active]

Thank you... It's so crazy how the opinions on PT are so opposite. Pt says take medicine before therapy so you can push through pain, and the BS Mantra says just the opposite about pretty much everything. So confusing.... I'm following the mantra as of now. Ill keep you posted. Thanks so much!

 

[2active]

I stopped physical therapy last Monday and began to follow Josephine's advise and follow the BS Mantra. The swelling has definitely gone down, though not completely of course. I just need to know if it's normal to still have little ROM. Mine is around 50 and PT wanted me at 90 after only a week or so after surgery. I'm still really tight, and there's no way my knee will bend that far. I do heel slides and ankle pumps, and all the other small exercises without torturing my knee and I'm very active in the house, so I guess I just need some reassurance that I'm not going backwards by stopping PT. Also, when does scar tissue start to form, and am I at risk for this with my ROM being so low. Can you please tell me your thoughts and professional advise? Thanks so much... Also, this Tuesday I'm suppose to take of the black mesh tape covering my incision. What's the safest way to do this without bothering my incision? Thanks!!!!

 

[zzevi]

It's just a time thing when it comes to gaining ROM, you need to heal, anytime it's irritated it becomes more difficult to get it to bend. It's a very, very slow recovery process, which I believe because where not informed properly leads to being depressed about our situations.
In the beginning the improvements seem to happen more often, seen on the weekly basis or so. Later on recovery is still taking place, you just come to realize hey I can final do this or that again and I haven't been able to do that for some time.
It does seem to take patience that I haven't been the best at either, which looking back can hold you back, don't over do things. All I can say again is it takes time, just allow it to happen don't push yourself for a faster recovery as it just won't happen and you will be more disappointed.

 

[RMasano]

My PT is very gentle and does not push. I only have a week left with her because she comes to my house. I have to start going to outpatient after that. My ROM is around 75 but my extension is negative 22, which is worrisome. I am also very tight. I can't answer your other questions because I don't have the answers, but would also like to hear others responses.

 

[mwetzel394]

Ice and elevate as much as you can , especially after the PT, they preach patience here my ROM was 97 after the in-house PT was done, after about 3 1/2 weeks, and they were not satisfied, Doctor was fine, at my 4 week visit, i chose Op PT he did not really care, I found to get out and walk on your crutches' is what worked for me, we had a rainy December after my surgery, so going outside was tough, go to the supermarket or offic max thats what i did , made a big difference , just walk forcefully for 10 -15 minutes , until your'e tired.
Good luck !!


R Partial Knee Replacement 11/28/16

 

[2active]

Thanks so much! I just worry about scar tissue building up. I'm moving around as much as possible. My ROM seems to be way behind everyone else's.

 

[newlybionic]

Don't worry about scar tissue building up now. What's stopping you is the swelling. You can try sitting at the end of your bed and just letting your knee bend naturally. Extension is usually slower than bending to achieve. When you are icing try icing the back of your knee too if you haven't been doing that. Taking pain medications also help to diminish swelling. Swelling is your body's response to pain. It acts like protection to not allow your knee to bend. If you don't want to take narcotics you can try a step down medication called tramadol combine drugs with Tylenol which can be very effective. If not then take Tylenol 1,000 mg 4 times a day so that you keep a level amount in your system over 24 hours. It will get better!

 

[sistersinhim]

I bet you are doing too much around the house and your inflammation is up causing more swelling. You can't bend when you're swollen. It swells inside the knee also, which you can't really see, just seeing it around your knee on the outside. Try doing as little as possible and ice and elevate as much possible.

 

[2active]

okay. Thanks so much for all the advise. I probably am doing too much, but I know that movement is also important so I get so conflicted. I hear do as little as possible to walk forcefully through a supermarket so I get nervous as to what I really should be doing. My extension was a 2 last Monday, and my husband says it feels and looks totally straight now, so I'm thankful for that. I will take it easy and ice/elevate more. I can't take narcotic meds. I just take extra strength Tylenol when needed. Thanks for all your help.

 

[2active]

I'm three weeks and 2 days post op. I took my last strip of Dermabond mesh off two days ago as instructed. When I did, I had a 3/4 inch opening in my incision at the very bottom under my knee. It looked like I had cut myself. The opening wasn't red around, just open. I was very concerned so I called my doctor, and he said that small openings in this area are seen a lot due to it being along the bone, and to not be concerned unless it was red around the opening and draining/bleeding. He said to wash with antibacterial soap, and apply a sterile covering until it scabbed over. No antibiotic ointment. The rest of my incision looked tight and completely closed at the top and all the way down to where it was open. Today, I got up and noticed during my shower that the very top of the incision looked pink, so I got out to inspect, and it appeared that it might be coming unglued a tad. Not red, just pink, but the day before was completely closed and the color of my skin. I called the doctor again, and the nurse instructed me to do the same for the top, as I was doing for the bottom. Has this happened to any of you? My doctor used internal stitches and glue to close the incision, which I love. Could the stretching of my knee during my exercises ( heel slides) be causing this to happen? I didn't ask the nurse this. I spaced it when I was talking to her this morning. My ROM is now around 45. Not the greatest, but the swelling keeps me from bending it at further without pain and further aggravation. I still don't have strength in my leg to lift straight up either. I'm working on this within reason. I do have full extension which I'm happy about. I'm sleeping on my side which allows me to rest well at night. I have been driving my car short distances since my right leg is fully functional. I stretch my left leg out on the floor board, and just cruise. It's not too bad. I get a little stretch during the drive since it's bent slightly, so I consider this one of my exercises. I get into my car by swinging my left leg in hip side up, since those muscles haven't been disturbed. People driving by probably think, what in the world is that lady doing??? lol Anyway, can some of you please let me know your experience, if any with incision openings, and your ROM progress? Thanks so much. I look forward to hearing from you.

 

[Celle]

I'm glad you contacted your surgeon about the small openings in your incision. Follow his advice and they should soon heal over. Keep them clean and dry.

Don't worry about doing exercises - just concentrate on doing as much resting, icing and elevation as you can, to help get rid of the swelling that is preventing your knee from bending.

Don't worry about scar tissue forming - that's a scare story the PT therapists tell you, to encourage you to work harder at exercises - which is the wrong approach.
Scar tissue (by which they mean adhesions) isn't just waiting to pounce if you don't exercise enough. That's an old myth that should have died long ago.

It's not exercising that gets you your ROM, it's time. Time to recover, time for swelling and pain to settle and time to heal. Your ROM is there right from the start, just waiting for all that to happen so it can show itself.

There's no need to rush to get ROM, because it can continue to improve for a year, or even longer, after a knee replacement.
Myth busting: the "window of opportunity" in TKR

 

[sistersinhim]

I agree with Celle. Since you do have openings, why chance it opening more when trying to bend your knee? Let those places heal first, then worry about exercising. ROM will come naturally after you heal more and swell less.

 

[2active]

Okay thanks ladies. That's exactly what I have done today. Rest, ice and elevation. No stretching today except for walking through the house to get from point A to B. I will keep you updated on my progress and healing.

 

[RMasano]

I had drainage and my OS said very little PT until it was healed. I am a little behind because of it, but my OS first priority was making sure that incision was completely healed. Take care and rest!