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[TKR] 4 weeks past TKR

jdm56

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My home therapist has me on a list of stretches, leg lifts, and knee bends. He bent my knee aggressively while I was laying down. Extreme pain, a couple of pops, and my knee was sore for 2 days. I thought this was the normal routine for the physical therapy recovery, but after reading some of the posts, I'm surprised to see different thoughts! He did this 3 times. Any thoughts? Also I'm on Gabapentin and Celecoxib for pain and swelling. I'm doing leg elevation to help with the swelling, which is improving. Stopped icing. Taking the meds twice a day, with Tylenol. How long can I take these meds without worrying about liver damage? Going for walks, starting stair exercises. Sleeping on my back with my legs up on a bed wedge above my heart. Thanks in advance!
 

Jaycey

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@jdm56 Welcome to BoneSmart and the other side of surgery!
He did this 3 times.
Do not let anyone force your knee. As you have already found this is totally counter productive. Forcing the knee only results in swelling and pain. It's your knee - just say no.
Stopped icing.
Why? Ice is a natural pin killer. Ice as much as you can throughout the day for at least 45-60 minutes per session.
How long can I take these meds without worrying about liver damage?
Please don't worry about taking meds. You are taking them for a reason. When you start forgetting to take doses that is the sign you are weaning off your medication.

I'll leave your reading list here for you to refer to:

Knee Recovery: The Guidelines
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 Activity progression for TKRs

6. Access these pages on the website

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.
 

Celle

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Hello @jdm56 - and :welome:

Please will you tell us the full date of your knee replacement and which knee it is, so we can make a signature for you? Knowing that will help us to advise you appropriately. Thank you.:flwrysmile:

I think your PT therapist has you overdoing the exercises and that's not a good idea. Doing too much will keep your knee angry and inflamed, which tends to increase pain and swelling. Your knee isn't lazy or unfit - it's wounded after major surgery, and it needs time, rest and gentle treatment, so it can start to heal. At the moment,just walking around your house is enough exercise for your knee.

PT therapy should never hurt. Discomfort is OK, but pain is not. So, take control of your PT sessions and tell your therapist you will no longer allow the things that cause pain. You have the right to do that, because it's your knee and your recovery.
Saying no to therapy - am I allowed to?

You won't get liver damage from taking Tylenol as long as you stay within the recommended safe daily limit of 4,000 mg, divided into doses no larger than 1,000 mg each time, with 4-6 hours between doses.
Check all other medications you're taking, to make sure there is no Tylenol/ Acetaminophen/ Paracetamol in them. If there is, scale back one or two of your regular doses, so you stay within that safe 24 hour limit of 4,000 mg.
 

Tykey

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Honestly, you are making life difficult for yourself.

Stop PT
Take your meds as regularly on maximum dose and as often as possible
KEEP ICING!!

Sorry if I come over blunt, but I'm honest
Good luck.
 
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jdm56

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Thanks everyone for the advise! Great reading and I don't care to have my leg bent like that again!
 
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jdm56

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I had a total knee replacement on my right knee on 9/12/19. When I was looking before my surgery at what to expect post op, I saw a lot of things about the buildup of scar tissue and avoiding it by starting the pt on the same day after surgery. I haven't seen it mentioned on the forum....thoughts?
 

Jockette

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Scar tissue is a general term with different meanings for whoever uses it.

When you have a wound, whether induced by an injury or surgically induced, your body produces some type of scar tissue to heal it, it’s what knits your wound back together. That’s scar tissue that is necessary and a good thing.

Here’s an article from the Bonesmart Library:

Be sure to read the link in that article that talks about adhesions.
 

Jockette

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We here at Bonesmart don’t warn against scar tissue because we feel that post op swelling is the most often cause of not being able to bend your knee it’s fullest potential. We feel time and gentle treatment will give the knee the best opportunity to heal.

Working hard with a lot of painful exercises and forcing the knee to bend to a painful place is counterproductive by keeping the inflamed and swollen, thus reducing the bend that everyone wants.

And yet outside of Bonesmart we are all warned about a mythical “window of opportunity.”
 

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