TKR 3 months post op tomorrow

RBG

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I’m so worried. I’m three months post op tomorrow. I was ahead of schedule as far as ROM at my 6 weeks mark and was told by my Dr I could stop going to PT. I was at 120 degrees bend and 0 degree straight.
I have to admit I lessened my in home PT.
My knee seems to have stiffened more and is more painful at the bend position plus the back of my knee hurts so much when I walk that my gate is off now because of that. I have to limp to the couch to straighten my leg after cooking or cleaning.
I have no idea what is happening but I feel like I should be improving each month by now but I think I’m getting worse. It’s really messing with my mind because I’m in worse pain now than before my surgery.
Am I too impatient? What’s going on with me?
I go for my 12 week post op one week from today but I’m so apprehensive now.
Is pain behind the knee when walking normal?
 
Hello and Welcome to BoneSmart. Thanks for joining us!
Was your TKR on September 28th? Wondering which knee you had replaced also? We'd like this information to create a signature for you.

Please take a deep breath and relax. Your knee is stiff due to inflammation and swelling is considered normal for several months post op as is pain behind the knee at this point.

I am wondering what your daily physical activity looks like and whether you're doing something new or different that is aggravating your knee. Consider your activity and whether you may be overdoing it at this point. Make use of an assistive device while you're limping, it's only temporary.

Three months post op is still pretty early in the entire scheme of things, so you may have to be more patient. Try not to worry about your ROM, it will come. While it is currently limited, it will naturally increase as the swelling subsides and the pain eases. Give it time.

I will leave our Recovery Guidelines as some info will still apply. I wish you all the best at your 12 week post op next week. Let us know how it goes.
 
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KNEE RECOVERY GUIDELINES

As you begin healing, please keep in mind that each recovery is unique. While the BoneSmart philosophy successfully works for many, there will be exceptions. Between the recommendations found here, your surgeon's recovery protocol and any physical therapy you may engage in, the key is to find what works best for you.

1. Don’t worry: Your body will heal all by itself. Relax, let it, don't try and hurry it, don’t worry about any symptoms now, they are almost certainly temporary.

2. Control discomfort:
rest
ice
take your pain meds by prescription schedule (not when pain starts!)​

3. Do what you want to do BUT
a. If it hurts, don't do it and don't allow anyone - especially a physical therapist - to do it to you​
b. If your leg swells more or gets stiffer in the 24 hours after doing it, don't do it again.​

4. PT or exercise can be useful BUT take note of these

5. At week 4 and after you should follow this

The Recovery articles:
The importance of managing pain after a TKR and the pain chart
Swollen and stiff knee: what causes it?
Energy drain for TKRs
Elevation is the key
Ice to control pain and swelling
Heel slides and how to do them properly
Chart representation of TKR recovery
Healing: how long does it take?

Post op blues is a reality - be prepared for it
Sleep deprivation is pretty much inevitable - but what causes it?

There are also some cautionary articles here
Myth busting: no pain, no gain
Myth busting: the "window of opportunity" in TKR
Myth busting: on getting addicted to pain meds

We try to keep the forum a positive and safe place for our members to talk about their questions or concerns and to report successes with their joint replacement surgery. While members may create as many threads as they like in a majority of BoneSmart's forums, we ask that each member have only one recovery thread. This policy makes it easier to go back and review history before providing advice.
 
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Here is a little scribble on the reality of recovery.
rps20171117_054543-jpg.71434
 
Yes my surgery was Sept 28th. I was my right knee.
My kneecap is also numb and has been since surgery.
I’ve read that I may never get the feeling back.

I’m not really doing any more or any less than always.
I have a freestanding petal machine. Not a stationary bike but just petals that sit on the floor I can use while sitting in a chair.
I’m also doing heel slides but those are becoming so painful, it difficult to make myself do them. My knee is definitely more sore in the last two and a half weeks than it has been, ever.

Thank you so much for answering me.
 
@RBG Knees can be unpredictable sometimes. You think you're going along just fine in recovery, and....BOOM!....you change your activity schedule just a bit and you get swelling. This is what it sounds like is happening to you. The solution is to scale your exercise and activity way, way back. That means lots of resting time with your leg iced and elevated.

How much are you using that pedal machine? Have you resumed some of your normal household chores like cooking or cleaning? Are you running errands?

I suggest you stop using the pedal machine for a while until you can do heel slides once again with little or no pain. You will need to get up and walk around the house for about 5 minutes every couple of hours using whatever walking aid you need so as not to limp. I suggest your walker as you get the most stability from it.

Please read the linked articles provided for you in the post above. It will give you an idea of activity levels for various stages of recovery. Even that is not cast in stone. Everyone's recovery is unique, so it's important to listen to the signals (pain, swelling) that your body sends you and respond accordingly. That means when something causes you pain or swelling in the 24-48 hours after doing it, you're not ready for that level of activity just yet. You must slow way down and let your body regroup. Then try to increase activity on a slower schedule. Most people aren't really getting back to normal until 6 months or so out from surgery. And, for some....it can be even longer. Your body is in complete control of your recovery and it will heal at its own pace.
 
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Thank you, Jamie. I am resting. I’ve been feeling that the reason for my problems are my own fault. That it’s because I’m NOT as active as I should be. For the last probably, 2 weeks I have scaled my activity way down. I’m only using the petal machine twice a day for 15 minutes at a time. It doesn’t hurt me to use it.

I’m not sleeping much and when I do it’s at odd times. I never sleep more than 3 hours at a time.
Lately I have my days and nights mixed up. I might be awake until 6 in the morning and finally drift off then and sleep until around 9 am. I dread the night time.? I must mention that I’m am normally a night person though. I figure sleep is sleep and I should sleep whenever I can. I’m probably getting around 5 hours of sporadic sleep a day.

My fear has been what the Dr is going to say about my lack of progress. Is he going to blame me because I’m not as active as I was because of the pain? I’m afraid he’s going to sedate me and manipulate my leg to loosen it up. I’m afraid he’s going to want to do surgery again.

My plan was to have my replacement on the right knee. Heal for 3 months and have a replacement on my left knee and heal for 3 months and go back to my gardening by April.
Well it’s been 3 months and I can’t imagine getting the second knee done yet.

Right now I’m doing a little housework when I feel like it and I’m cooking. I bake our own bread. We haven’t bought bread any bread at all in years. So every few days I bake bread. Lately my husband has been in the kitchen with me fetching and handing me what I need. I’ve been wondering if that’s a mistake because it’s keeping me from moving like maybe I should be. We are retired restaurant owners and we just normally work well in the kitchen together.
We don’t even have to speak. Actually my husband could bake our bread if I want but I’m feeling like I do need to keep that activity going. Besides bread making allows for rest between rising of the dough. But usually by the time I’ve finished the cooking and cleaned up I’m can’t wait to limp back to the couch.! I say limp because I’m limping again at that point. My husband cleaned the kitchen last night for me.

I’ll get my walker back out of the closet and start using it again, I guess but that makes me feel like a failure.
 
Hello RBG, I'd like to add some thoughts..
I’m not sleeping much and when I do it’s at odd times
I figure sleep is sleep and I should sleep whenever I can. I’m probably getting around 5 hours of sporadic sleep a day.
If you're able to, try to work toward a more consistent sleep pattern, by going to bed at the same time each evening and waking around the same time each morning. This will reinforce your circadian rhythm and benefit you physically as well as positively affect your productivity and overall wellbeing in regard to your mental and emotional health.

Keep in mind also that your body is in repair as you sleep, so try to target 7-8 hrs nightly.
My fear has been what the Dr is going to say about my lack of progress. Is he going to blame me because I’m not as active as I was because of the pain? I’m afraid he’s going to sedate me and manipulate my leg to loosen it up. I’m afraid he’s going to want to do surgery again.
Please, don't "fear" your surgeon. You don't have to accept blame from anyone. He can not sedate you, manipulate your leg, or force you to have surgery without your consent. So there is no reason to fear him. It is your body, you're choice. Cliche', I know...but it's true.
My plan was to have my replacement on the right knee. Heal for 3 months and have a replacement on my left knee and heal for 3 months and go back to my gardening by April.
Well it’s been 3 months and I can’t imagine getting the second knee done yet.
You don't have to face another surgery until you're ready. Now may not be the time and that is okay. Again, it's your choice. Only "you" live with the pain now and the healing pain post op. Try putting it out of your mind and wait until you're ready.

Lately my husband has been in the kitchen with me fetching and handing me what I need. I’ve been wondering if that’s a mistake because it’s keeping me from moving like maybe I should be.
Personally, I think it is a mistake. For now, consider getting most of your exercise through the activities of daily living and make an effort to do what you are able to comfortably on your own, without assistance from someone else (hubby). Aim for regular walks around the house so you're not sedentary.

You're only three months post op. This recovery can last a full year and longer for some. You may be one that notices improvement into the second and even third year post op.
Get out the assistive device if you need it, there's no shame in that so please try not to view yourself as a failure for doing so.
Think positive, brighter days are ahead. :SUNsmile:
 
1. Like I said, I am a night person. I’ve always been a night person. I’ve researched what to do about this and tried everything you suggested to get my rhythm adjusted. It’s not happening. I’m 72 years old and I’ve also been though sleep studies without any change. It’s difficult for anyone who is not a night person to understand this but trust me. It is what it is.

2. For the last 2 weeks doing my regular chores have gotten uncomfortable for me. That’s why my husband started to help me. He only started last week but I think you are right. Maybe I should do these thinks alone.

Question: what is a good exercise or something I can do for the tightening and pain I feel behind my knee when I walk? It’s causing my gait to be off. I avoid bending my knee when I walk because it’s so tight and painful in the soft tissue back there when I do.
 
As long as the sleep schedule is working for you, you've exhausted all options to regulate it and you're feeling well rested, it will have to suffice. Hopefully one day it will improve. I am sorry you have to deal with this and it's obviously caused you some stress since you sought help through sleep studies.

If the activities of daily living and some light housekeeping and cooking is not causing you pain, try to engage to remain limber and comfortably mobile.

If you haven't tried using a plastic bag, under your heel for the heel slides, removing the friction and making it easier, try that and see if it helps you achieve the benefits of that movement.
The tightness behind your knee is from inflammation and regular icing ICE and elevation ELEVATE should help with that. Give both a dedicated try several times per day and see if you notice a difference. Wishing you lots of comfort and relief. :console2:
 
Hi RBG! I’m sorry you are struggling…I know how hard this recovery can be, both physically and mentally. One thing I wanted to share re heel slides: Heel slides have never worked very well for me. I know they are the standard exercise for improving knee flexion, and I don’t know why they don’t work well for my knee, but I didn’t see much progress until I started the ‘leg hang’ type flexion stretches. Several times a day I sit on my bed, table, etc and hang my legs off. At first just letting them hang was enough stretch. Gradually I’ve started pulling my heel back more and more to get more flexion. I don’t try to force it by hooking my other foot over my foot and pulling (passive flexion), I just use my leg muscles to pull it back (active flexion). For whatever reason, this just works better for me. I’ve seen a lot of improvement with no pain. Maybe it would benefit you too! If nothing else it might be something you could add to your arsenal. Best of luck to you on your journey!
 
Hi RBG! I’m sorry you are struggling…I know how hard this recovery can be, both physically and mentally. One thing I wanted to share re heel slides: Heel slides have never worked very well for me. I know they are the standard exercise for improving knee flexion, and I don’t know why they don’t work well for my knee, but I didn’t see much progress until I started the ‘leg hang’ type flexion stretches. Several times a day I sit on my bed, table, etc and hang my legs off. At first just letting them hang was enough stretch. Gradually I’ve started pulling my heel back more and more to get more flexion. I don’t try to force it by hooking my other foot over my foot and pulling (passive flexion), I just use my leg muscles to pull it back (active flexion). For whatever reason, this just works better for me. I’ve seen a lot of improvement with no pain. Maybe it would benefit you too! If nothing else it might be something you could add to your arsenal. Best of luck to you on your journey!
Thank you! I’ll try that!
 
Hello
New here and post op 2months 2 weeks. I'm finding the same problem as you. Was at 135 then dropped to 130 and now don't want to do heel slide at all! It hurts! I appreciate you question as I think I will back track to hanging and bringing foot in as well. Good luck to you and hope to hear if it helps you.
 
Hi, I think not sleeping is working against you. I know I struggled with this as well and still do at times. It doesn't matter if your routine is you are a night person. You need your rest. When I talked to my OS about the lack of sleep, he just said that was a side effect of the knee replacement and it will improve. At 4-months or so I am sleeping better. I found stretching exercises helped loosen up the tightness. You can find some gentle exercises on YouTube. Do a search for total knee replacement. It sounds like you have a very supportive husband. Best wishes to you.
 
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I’m so worried. I’m three months post op tomorrow. I was ahead of schedule as far as ROM at my 6 weeks mark and was told by my Dr I could stop going to PT. I was at 120 degrees bend and 0 degree straight.
I have to admit I lessened my in home PT.
At only 3 months you are 1/4 of the way through this recovery. Not doing PT is not what is causing your knee to lose some ROM, it's swelling. Since your knee has already bent to 120, that means it doesn't have adhesions and a MUA would do nothing but inflame it even more, causing a large setback. That bend is right there, plus an even better one as you heal! You do need to ice and elevate more than you are doing. This includes doing less to allow the time for the inflammation to leave your knee.
I figure sleep is sleep and I should sleep whenever I can.
You are exactly right. Getting sleep is an important part of healing. Sleep when and where you can. In my early days, which you are in, I took numerous naps; sometimes in the morning, sometimes in the afternoon, and even sometimes in the night before a normal bedtime for me. It was about 6 months before my normal sleeping habit came back. Even then, it was far from perfect.
Right now I’m doing a little housework when I feel like it and I’m cooking. I bake our own bread. We haven’t bought bread any bread at all in years. So every few days I bake bread. Lately my husband has been in the kitchen with me fetching and handing me what I need. I’ve been wondering if that’s a mistake because it’s keeping me from moving like maybe I should be.
No, you are not making a mistake. You are very early in your healing and your knee has told you that you are doing too much, which includes being on your feet more than you should be doing at your level of healing. It's too early for you to try to go back to all your normal activities. Your knee rebelled against that extra 'workload' on it. The best thing for you to do is to listen and react to your knee's reaction. If the pain and/or swelling increases, back off your activities and let your knee calm down. Then, slowly add one thing back in and see how your knee does. If OK, do it for a few days, then try adding something else. If your knee is unhappy with that added activity, then don't do it again for a few weeks, then try it again. I tried adding the swimming pool at the Y at 4 months. All I did was walk to the lap swim, swim one lap and walk back out to the showers. This angered my knee really badly. It was another 2 months before I tried it again and it did fine.

You can not speed up your healing by doing more, but you can sure slow it down. The knee is in control for the next 3-6 months for you. It is a learning process. I realize that everyone has things that they have to do, and the knee will suffer. But, if you continue to do something that inflames your knee, it slows down your healing, extending that pain and swelling.

Since you already hit 120 degrees, your knee is in good shape. Your soft tissues and bones are still in the healing mode, and that ROM will fluctuate for a long time. Try not to worry. If cutting back activities, along with icing and elevating more for a few weeks, don't bring your pain and swelling down, then it might be time to call your doctor. Remember, you don't need a MUA because it has already bent very well! You just have angry soft tissues! :flwrysmile:
 
I’m not sleeping much and when I do it’s at odd times. I never sleep more than 3 hours at a time.
There is an article about this in the Recovery Guidelines:

I have a different sleep pattern, also, but it doesn’t bother me. It helps if you don’t worry about it and just go with whatever works for you. I am retired, and I try to avoid morning appointments, so that I can relax and sleep when I can. Sometimes I am up all night. I find no point in staying in bed if sleep doesn’t happen, or going to bed when I’m not tired, no matter what time it is. My husband was the same way. We slept great when we were younger, but as we got older things changed.

Best wishes on your continued recovery! And, just so you know, I continued to have even more improvement all through my second year. This recovery really does take Time.
 
Hello and Happy Thursday!
As you're noticing here on the forum, RBG, as staff, we have differing opinions due to our own personal experience with joint replacement and recovery and also our varying lifestyles. Also, we are not medical professionals. I certainly hope this isn't confusing you because I don't believe any of us would want you to feel that way. Obviously, no single persons advice is more credible than another's.

Each recovery is unique. While the BoneSmart philosophy successfully works for many, there will be exceptions. Between the recommendations found here, your surgeon's recovery protocol and any physical therapy you may engage in, the key is to find what works best for you. You know your body best and only, you, can feel your discomfort / pain.

Wishing you comfort as you continue healing, a great weekend and many blessings in the New Year!
@RBG
 
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I’m so worried. I’m three months post op tomorrow. I was ahead of schedule as far as ROM at my 6 weeks mark and was told by my Dr I could stop going to PT. I was at 120 degrees bend and 0 degree straight.
I have to admit I lessened my in home PT.
At only 3 months you are 1/4 of the way through this recovery. Not doing PT is not what is causing your knee to lose some ROM, it's swelling. Since your knee has already bent to 120, that means it doesn't have adhesions and a MUA would do nothing but inflame it even more, causing a large setback. That bend is right there, plus an even better one as you heal! You do need to ice and elevate more than you are doing. This includes doing less to allow the time for the inflammation to leave your knee.
I figure sleep is sleep and I should sleep whenever I can.
You are exactly right. Getting sleep is an important part of healing. Sleep when and where you can. In my early days, which you are in, I took numerous naps; sometimes in the morning, sometimes in the afternoon, and even sometimes in the night before a normal bedtime for me. It was about 6 months before my normal sleeping habit came back. Even then, it was far from perfect.
Right now I’m doing a little housework when I feel like it and I’m cooking. I bake our own bread. We haven’t bought bread any bread at all in years. So every few days I bake bread. Lately my husband has been in the kitchen with me fetching and handing me what I need. I’ve been wondering if that’s a mistake because it’s keeping me from moving like maybe I should be.
No, you are not making a mistake. You are very early in your healing and your knee has told you that you are doing too much, which includes being on your feet more than you should be doing at your level of healing. It's too early for you to try to go back to all your normal activities. Your knee rebelled against that extra 'workload' on it. The best thing for you to do is to listen and react to your knee's reaction. If the pain and/or swelling increases, back off your activities and let your knee calm down. Then, slowly add one thing back in and see how your knee does. If OK, do it for a few days, then try adding something else. If your knee is unhappy with that added activity, then don't do it again for a few weeks, then try it again. I tried adding the swimming pool at the Y at 4 months. All I did was walk to the lap swim, swim one lap and walk back out to the showers. This angered my knee really badly. It was another 2 months before I tried it again and it did fine.

You can not speed up your healing by doing more, but you can sure slow it down. The knee is in control for the next 3-6 months for you. It is a learning process. I realize that everyone has things that they have to do, and the knee will suffer. But, if you continue to do something that inflames your knee, it slows down your healing, extending that pain and swelling.

Since you already hit 120 degrees, your knee is in good shape. Your soft tissues and bones are still in the healing mode, and that ROM will fluctuate for a long time. Try not to worry. If cutting back activities, along with icing and elevating more for a few weeks, don't bring your pain and swelling down, then it might be time to call your doctor. Remember, you don't need a MUA because it has already bent very well! You just have angry soft tissues! :flwrysmile:
Your comments make me feel better. Thank you
 
I'm so glad. We are here to try and make your recovery easier and also be a shoulder for you. Knee replacement is really rough, to me, it was even worse than giving birth. So many people love to tell us that we should be further along than we are, but if they haven't actually had a knee replacement how would they know?
 
I’m not sleeping much and when I do it’s at odd times. I never sleep more than 3 hours at a time.
There is an article about this in the Recovery Guidelines:

I have a different sleep pattern, also, but it doesn’t bother me. It helps if you don’t worry about it and just go with whatever works for you. I am retired, and I try to avoid morning appointments, so that I can relax and sleep when I can. Sometimes I am up all night. I find no point in staying in bed if sleep doesn’t happen, or going to bed when I’m not tired, no matter what time it is. My husband was the same way. We slept great when we were younger, but as we got older things changed.

Best wishes on your continued recovery! And, just so you know, I continued to have even more improvement all through my second year. This recovery really does take Time.
That is my husband and me. We are also retired and schedule appointments for afternoons,
 

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