TKR 2nd TKR - 6/26/2025 - repeating same good BS post op protocols!

[Layla]

this PT puts me in the wringer/pain the last 2x times I’ve seen him.

Yeah...NO.
I guess the PT's approach is more pain is needed in order to heal. Makes no sense.
The sad part is, many go along with this because they view the PT as the professional and so they must know what's best, right? They may be trained, but they're not infallible. Also, some are better than others. They follow general guidelines that do not apply to everyone. They should consider your pain as feedback and we should know upfront if they're in the "no pain, no gain" camp because as we often see, those aggressive approaches are usually counterproductive. I am sorry you had to endure that pain and hopefully you're feeling better today.

 

[sistersinhim]

The PT is a nice guy, but I feel like someone (maybe me) needs to tell him the BS approach. He could injure or certainly delay people’s recoveries.

Most definitely, he could and probably does. There seems to be very few therapists that know how to rehab a joint replacement correctly. We need to be a strong and protecting participant in our recoveries. After all, we are the ones that have to deal with the after-effects of an incorrect PT session. Gentle, non-forcing movements go much farther in recovering a joint replacement than the aggressive ways.

 

[EalingGran]

I didn't do any strength work with bands or weights until 5- 6 months. I used a gentle pilates based approach ( have a look at my pilates teacher's free YouTube videos- Google Katja pilates for a knee friendly class with no squats).
Strength training is important later on but counterproductive in the early months as it can cause inflammation and risk injury.
Some PTs push ridiculous amounts early on and put people off completely. This really is a marathon not a sprint.
I still do a regular pilates regime 3-4/week at approaching 3 years. Finding something you enjoy enough to keep
doing longer term is more important and useful than hurting yourself early on.
There is research that shows TKR knees are weaker at 1-2 years than the unoperated leg- so work is necessary longer term.

 

[ferddword]

Feeling better today. Still have the tightness of course. And the numbness on lower shin. I’ll continue to do stretching and light exercises with a bit of quad strength workouts. Trial and error and look to keep improving day by day! Thanks everyone for your guidance.

 

[ferddword]

When walking and moving around for a longer duration, my knee starts to feel blocky and starts clicking and also feels clunky. Does that mean it’s swelling a bit and probably overdoing the activity?

 

[mendogal]

Not sure what blocky means so I can't speak to that.

Clicking and clunking is normal with implants, not usually related to overdoing it.

My left clicked audibly with every step, like a metronome when out taking a good walk. I told my surgeon if it could do that he should have just installed a pedometer

 

[ferddword]

Does the clicking and clunking come about because it’s swelling a bit? Because it doesn’t do that when I 1st start walking. And I guess the blocky feeling I mean is my knee feels like it’s small and acts like a hinge but when I walk or I’m active for some time it starts to feel larger and monolithic. Lol. Idk. Does that make sense? Maybe not.

 

[Jockette]

Here’s an article about the clicking and clunking.

 

[benne68]

when I walk or I’m active for some time it starts to feel larger and monolithic.

I think I understand what you are saying because I had something similar. My guess is that it is internal swelling -- remember, there can be inflammation inside the joint even if you don't see any swelling on the outside.

I know 5 weeks seems like a long time but you are still very early days in this recovery. Tightness, numbness, swelling, etc. are all common at this point. Soft tissues need 10-12 weeks to recover from surgical trauma. Try to give your body a little more time to heal.

 

[ferddword]

Thanks @Jockette. @benne68 - yep I think it is a bit of internal swelling. That’s right today is my 5 week mark. . Have the numbness and pins and needles feelings which will probably last awhile. Otherwise, feeling pretty good and positive about things.

Thanks everyone!

 

[Layla]

Many people who have joints replaced ask about noises that come from their new joint, so you're in good company, ferddword. They describe a clicking or popping sound or they may have a definite clunk in a knee or hip when walking. While these unexpected noises can be puzzling, they are usually not a problem. The soft tissues around your new implant must settle in with each other and adjust themselves to work smoothly together with the hard metal, ceramic, or plastic parts of your prosthesis. If the noises or sensations are accompanied by pain or swelling, or if a new noise develops all of a sudden, let your surgeon know. Over time the clicking and clunking should subside. You seem to be doing really well and I like your positive attitude.
I hope you have a nice weekend!
@ferddword

 

[ferddword]

Thanks @Layla!

 

[ferddword]

Hi folks. 6 week anniversary today. Saw the OS yesterday for 1st visit since surgery. She said everything looks good. I’m at 123/0. I have to say pain is minimal. Just have the tightness but not too tight. Still have some numbness from Iovera shots but slowly dissipating. Knee does feel solid. OS said I’m in a pivotal point because she knows I feel like I can work out but if I work out too hard/much it will swell. So she said don’t work out everyday so we can continue to get the swelling down. I told her I went to PT 3x. She was surprised I’m where I’m at by doing it on my own with the BS team behind me!

She cleared me for swimming, golf and light strengthening exercises.

Will continue to update. Thanks everyone for the help!

 

[mendogal]

Great news!
Yep, the key moving forward is to increase time or distance of any activity by no more than 15% increments. Slow and steady.

 

[ferddword]

Would you say 15% per week?

 

[Jamie]

Thank you for sharing BoneSmart with your surgeon. Maybe she should check us out for her patients….just sayin’…..

 

[ferddword]

True!

 

[mendogal]

Would you say 15% per week?

When I was increasing my walking in the community I would only walk whatever my current maximum time or distance was every 2 to 3 days, walking considerably less on "off days"
So I was testing a new "maximum" a few times a week.
Yep that sounds good!

 

[sistersinhim]

She was surprised I’m where I’m at by doing it on my own with the BS team behind me!

The Bonesmart way really works for most members. You are one of them!

She cleared me for swimming, golf and light strengthening exercises.

This is great! I must warn you about swimming, though. Water adds resistance and it is very easy to overdo while not knowing it. Just walking in a pool is a lot of stress on that new knee of yours. Start out very slowly and see how your knee reacts that night and the next few days.

 

[Jockette]

I second being careful in a pool. My PT put me in a pool at 4 weeks post op, the session was 50 minutes, and they had me doing countless bending exercises. It took me 3 days to recover from it. That many exercises, that early in recovery, was ridiculous. That is when I started googling and found Bonesmart and a much more sensible approach to this recovery.