TKR 3 weeks in with little progress

Deva

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Hi! I’m in the uk & went abroad for my RTKR on May 5 as the waiting lists are so long here. I stayed for 10 days rehab but felt nauseous & dizzy during that period so exercising fell by the wayside.
I’m now 3 weeks post op, my knee is swollen & tight & after any exercise it just seems even tighter & more rigid. I’m certainly not yet at 90°.
I’m using crutches to get around the house, have not ventured outside yet & the knee barely bends at all.
We do not have physio provided on the NHS & reading on here what some people have endured at the hands of their PT, I am loathe to find one privately.
Am I risking permanent disability by having so little progress at this stage?
On the positive side, the wound has healed beautifully!
 

Roy Gardiner

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:welome: to BoneSmart

Am I risking permanent disability by having so little progress at this stage?
The BoneSmart view would be 100% no. It is just soft tissue swelling, which will subside. Please don't do any exercise that hurts, just go for gentle movement.

Knee Recovery: The Guidelines

We are all different, as are the approaches to recovery. The key is, “Find what works for YOU.“ Your doctor(s), physiotherapist(s) and BoneSmart will offer advice and are there to help. The advice may vary, but YOU are the final judge as to the recovery approach you choose.

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

6. Access these pages on the website

The Recovery articles:

There are also some cautionary articles here


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.
 

Jockette

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I’m now 3 weeks post op, my knee is swollen & tight & after any exercise it just seems even tighter & more rigid. I’m certainly not yet at 90°.
Hi and Welcome!

Please don’t worry, this is very normal for 3 weeks post op. The surgery causes a lot of trauma to the whole leg and healing takes time. This recovery actually takes an average of a full year, though you’ll feel much better in several months.
Am I risking permanent disability by having so little progress at this stage?
No, you are definitely not risking permanent damage. Progress in this recovery is very slow.

Gentle bends and short walks are all the exercise you need at this stage.

Regaining our ROM is more about Time than repetitions of a list of exercises.

Time to recover.
Time for pain and swelling to settle.
Time to heal.

Our range of motion is right there all
along just waiting for that to happen so it can show itself.

In the general run of things, it doesn't need to be fought for, worked hard for or worried about. It will happen. Normal activity is the key to success.
 

Samsrf

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I agree with @Jockette ! As someone who has been fighting the ROM monster (I was a forced 70 at 3 weeks) it will come in time. The more I backed off and listened to my body, the better ROM got. It took 7 weeks to peddle a bike a full rotation and I still haven’t lowered the seat all the way my to pre surgery height. Don’t get discouraged! Ice and elevation and the function will come with time. I walked up my stairs yesterday and didn’t even think about it until I was almost all the way up (17 steps) I wasn’t hiking my hip or holding the hand rail- just bent my knee and went up normal… victory!!! I also haven’t attended PT in a week and I actually think them at May have helped. Just focusing on functional ADL movements. Be gentle with yourself & let you body heal. Best wishes
 

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@Deva
I'm 11 months out with first leg, suffered IT Band issues.
No Physio, Hot Tub is Heaven for exercise & sometimes sleep.

Second knee, 8 weeks out.
Replacement joint in the Femur was changed to accommodate IT Band issues.
That does not seem to have worked as IT Band exposing at knee as swelling reduces.

Now Deva, even though I knew better, I went to Physio at 3 weeks thinking it might help IT Band.
After 2 days of following PT Exercises, both my knee were so sore under the knee cap I could not get up out of a chair without something to push up with.

I had to change pain medication and now 5 weeks later. no Physio, only lite exercises in my Hot Tub, walking 40 minutes on flat roads, little stationary biking am I recovered to #2-4 pain.
My ROM is 130.

Good luck with your recovery and listen to advice from Bonesmart. I knew better.
 

sistersinhim

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I'm one of those who never took formal PT. I've had 12 knee surgeries, 2 of them kneecap removals, and 1 tkr. Even after those I never took formal PT. But, I didn't just sit around and do nothing, I used my knee as it was intended to be used by walking around to take care of my daily needs along with the necessary house and yard work. As I healed I was able to do more. Icing and elevation were a huge part of my recovery.

Listen to your knee. It will tell you if you're doing too much by increased pain and swelling. When that happened to me, I found that resting, icing, and elevating helped. Your knee knows how to rehab itself without being told what to do. Just use it as you naturally would and let it be your guide on what you can and can't do without added pain and swelling.
 

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Hi Deva, I also had my LTKR on May 5th too and I am in the same boat as you. My leg is tight and not bending as I think it should but as others on here have said it is a huge surgery and each of us are going to heal in our own time. I startEd my physio 4 days after my surgery and it hasn't help too much, I ice, elevate and use a tens machine to try to help it along. I still struggle to lift my heel off the ground can only do it if I really concentrate which is scary to me. Hope you rest, relax and let nature take its course as I am doing as well.
 
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Deva

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Thank you for the encouragement. I shall use my knee as it is used to being used and have faith that all will be well. I was so depressed yesterday but you all give me hope that I will walk normally again - and be able to get in and out of a car!
 

MaryCat

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I don’t think you can control when the swelling goes away. I was worried when I went for my 2 month checkup with the ortho. He said it would really improve in month 3 and it did.

I had to back off of any weight bearing exercises for longer than expected and do range of motion and gentle stretching. Some work that I did in the pool and stationery bike, Icing and elevating helped a lot too. And when I overdid it I would have to take a break for a day or two.

I’m almost 5 months from my surgery and it swells and stiffens if I’m on my feet for a long time but have been able to really do more each week.

Fingers crossed that it gets better for you soon
 
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Deva

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Just want to thank this site for the invaluable advice & encouragement. I was feeling so depressed at 3 weeks as my recovery didn’t fit with the advice given by the majority of websites. Having been told to relax, stretch to some discomfort but no more, I’ve seen a gradual improvement and now, a month after surgery, I reckon I have reached 90°. I had physio for the first few days but thereafter have been on my own. In the uk we are left to sort ourselves out when we leave hospital. Your site has given me the confidence to believe that my leg will sort itself out in time. Thank you!
 

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sistersinhim

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I had physio for the first few days but thereafter have been on my own. In the uk we are left to sort ourselves out when we leave hospital.
I believe you are much better off doing the recovery this way. You are the proof that not having physio is OK and a good recovery can still be had. Too many focus on repeated exercises that keep the knees inflamed, worsening ROM. We are better off just letting the knee repair itself and not force anything.

You are better than 90 degrees! 90 degrees would have your foot even with your other foot. You are bending it further than that!
 
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Deva

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By the way, it’s my right leg that’s in recovery so certainly not bending as much as the left one!
 
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Deva

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Now nearly 7 weeks post op & so grateful for the advice on this site. I don’t have PT & have been gradually bending my leg to the point of discomfort but not pain. Now reached 107 - measuring with the app on my phone - & feel my recovery is slow & steady. Without this site I’d have continued being depressed that my recovery was not like that recommended by some so called experts. Thank you so much.
 

Jaycey

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Great update @Deva ! Well done on adopting the slow and steady approach. It works every time!

I'm sure you will continue to see your bend increase. Just keep doing what you are doing!
 
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Deva

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@Deva , what app do you use on your phone to measure flexion?
I use Orthophysical - I believe it only works on iPhones but there is a different one for Android.
 

itsallgood21900

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Hi! I’m in the uk & went abroad for my RTKR on May 5 as the waiting lists are so long here. I stayed for 10 days rehab but felt nauseous & dizzy during that period so exercising fell by the wayside.
I’m now 3 weeks post op, my knee is swollen & tight & after any exercise it just seems even tighter & more rigid. I’m certainly not yet at 90°.
I’m using crutches to get around the house, have not ventured outside yet & the knee barely bends at all.
We do not have physio provided on the NHS & reading on here what some people have endured at the hands of their PT, I am loathe to find one privately.
Am I risking permanent disability by having so little progress at this stage?
On the positive side, the wound has healed beautifully!
im same, had mine on may 18 and am only at 85 bend, tomorrow we are measuring again but ive had a lot of pain and swelling as well, i keep telling myself that my stiffness won't go away but trying to remain positive the best i can
 

itsallgood21900

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Thank you for the encouragement. I shall use my knee as it is used to being used and have faith that all will be well. I was so depressed yesterday but you all give me hope that I will walk normally again - and be able to get in and out of a car!
I've been depressed and sad several times since surgery but I'm keeping the faith that ill get through this
 

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