TKR 6wks, doing great

[Bikeknit]

Week 10 Tedium. Not much has changed except I have learned that it is easy to overdo. Decided to do some chainsaw work on the hillside--bad idea. Had to take a day off to recover. Maybe if I were younger....

This made me laugh out loud. For most of us overdoing it is walking a half mile too far or doing an extra set of pt exercises. You remind me of a friend who joined us on a kayak ride on the Missouri River just weeks after getting ankle replacements. We wouldn't have asked him to join us if we had known but we were scrambling up a bank when he told us. He's a lot of fun but a warning, most of his bionic parts are on their second rounds.

 

[np7]

Am I done yet (wk 11)? Heel slides dont seem to have much effect anymore--my calf is pushing up against my upper leg and it just doesn't seem physically possible to go much further. In my last video therapist visit she measured my flexion at 119. Wall slides seem to have a bit more benefit. The therapist suggested pulling on the leg, which I believe is contra-indicated here at bonesmart. So...how much longer do I need to continue working on flexion?

I know I have a long way to go on strengthening.

 

[sistersinhim]

So...how much longer do I need to continue working on flexion?

With your flex, you can forget about working on increasing your bend. Just living your life will allow your knee to improve. I never did any PT or exercises letting my daily activities rehab my knee and I ended up with a knee that bends just like my old one does.

 

[Bikeknit]

Am I done yet (wk 11)? Heel slides dont seem to have much effect anymore--my calf is pushing up against my upper leg and it just doesn't seem physically possible to go much further. In my last video therapist visit she measured my extension at 119. Wall slides seem to have a bit more benefit. The therapist suggested pulling on the leg, which I believe is contra-indicated here at bonesmart. So...how much longer do I need to continue working on flexion?

I know I have a long way to go on strengthening.

I'm really curious how they measure range of motion on a video visit. I would think that if your calf is pushing against your upper leg, your flexion is quite a bit past 119°. I can't approach that and I'm about 122°. Also remember that goniometers have a few degrees plus or minus margin of error. Does your pt or doctor have a particular goal that you are aiming for? Are you able to bend enough to do the things that you want to do? Are there activities that you enjoy (bicycling, hiking - probably with hiking sticks at first, others) that might maintain or increase your rom in a more pleasurable way? I have no expertise but those are the questions I would ask.

 

[sistersinhim]

Numbers are not important in this recovery, it's the knee's function. You have the surgery so you can do the things you want to do. That's function. I didn't worry about numbers, neither did my OS. He just wanted to see what I could do with my knee. Never did he measure or push on my leg. I can do the things I want and need to do with, I assume, around 120 bend. I am perfectly happy with that! It's what we can do that matters, not some number somebody else wants to see us do.

 

[np7]

thank you sistersinhim & Bikeknit for your comments. As always, commonsense can be relied on. My therapist encouraged me to continue with the ROM exercises saying that sometimes people regress but I am not concerned.

Bikeknit... Video visits worked out fine for me. Re measurements, I would position my phone to get a good image of my knee while bending it and, I suppose, she just held her tool up to her screen. Sure, I don't think they are ever accurate to the nearest degree, but if I am not 120 now I am real close, close enough.

Need to work on strengthening and aerobic conditioning now. And get ready for my TKR on the other knee.

 

[Bikeknit]

My therapist left me with a few exercises when she released me. She suggested I do them mixed into my life. So I'll do a set of squats or a minute of one leg stands while I'm waiting for a pot of water to boil or something else to happen in the kitchen. I'll do a few heel slides while watching tv. You get the picture. Less tedious that way.

Best of luck for your second knee. As you know, I also was on the 3 month apart plan. I'm approaching 7 weeks on the second knee and feel my life is approaching normal. And best of all, I can walk further and further every day.

 

[kneeper]

If you're going to use a band at all, my PT said don't use it to pull on the leg. But what you can do is bend as far as you're able and use the band/strap just to hold your leg in position for however many seconds, while letting your muscles relax.

Watch out for squats. If they add to your pain, back off. It's easy to aggravate your knee with squats even a couple of months later. Lots of what you just need to do is resume daily activities and bend as you need to for those activities.

Congrats on your progress.

 

[np7]

best strengthening exercises? I am too impatient to just rely on daily activity to rebuild strength as I really want to get out and hike but I can't get out every day and the readily accessible trails are all hilly so I want to be working on strength when I can't get out. Three days ago I re-started a routine I had been doing prior to the TKR in August which really increased soreness in both knees, especially the non-repaired one (TKR scheduled for 12/2) so haven't done any exercises since then, although pretty active around home. I think the problem might have been the 2minutes of wall squats with a ball (thanks Kneeper); or the strengthening exercises involving bands. Getting bored with just leg lifts with 5lbs weight.

 

[np7]

TKR #2 in 3 days, 12/2/20. #1 was roughly 3 months ago and recovery/rehab on that is going well so, since I am just aging in place here, decided to proceed with #2. Actually, both knees have been bad; I need both replaced to return to active hiking. I used to do a lot more, but I will be happy if I can just go for several hours in the hills.

Having done one recently, facing the second is emotionally easier. Knock on wood, but I do hope this one goes as well as the first. Some other medical issues have cropped up to complicate things, but they will have to wait.

Side note: while working on strengthening I always included both legs. As I was taking up the weights for leg lifts--for example--my knee with the original equipment suddenly became the bigger problem so I have backed off from challenging that leg at this point.

 

[Poctdb]

@np7
I am at two weeks on my second TKR. The thing that came home to me quickly was even though it is the same surgery, man, do these knees act differently. First one pain and localized swelling. The second literally no opioids and epic swelling from ankle to hip.
I did no preparation with exercises as you have been doing with the first, but did 8 weeks of PT before the second.
I agree with your “emotionally easier” comment.

 

[np7]

The thing that came home to me quickly was even though it is the same surgery, man, do these knees act differently.

Boy, that is sure true for me--so far very little correlation be tween the 2. After #2 I can still barely lift my leg and usually use a device that hooks over the foot. The pain and swelling is much greater than before. And now, which is more troubling, I am getting flashes of plantar fasciitis that are very painful. I struggle with PF for almost year about 15 years ago. If this is here to stay then my goal of hiking will be out the window! (my 2nd knee was done Wed 12/2 roughly 3 months after the first.) My seated flexion looks almost 90 degrees now, so I assume ROM will come bak pretty well.

I know I have to be patient for strengthening but why would I see such a difference between the two surgical consequences? #2 leg may have been weaker going in, but this is a really big difference. And what can I do about plantar fasciitis?

 

[Jaycey]

I know I have to be patient for strengthening but why would I see such a difference between the two surgical consequences?

Because every joint replacement is different - even on the same person. You surgeon may have has to work a bit harder on the latest TKR.

Please don't worry about ROM. You will get it all back. That knee needs to heal first.

I'm going to tag my colleague @Pumpkln to see if she has any tips about your plantar fasciitis.

 

[Pumpkin]

np7,
Stretching your foot and lower leg, rest, ice, and OTC pain medication (OK'd by your MD), for home care.
If you see no improvement, see a podiatrist, or ask for a referral to PT.

Stretching by Bob Anderson has excellent stretches for your foot and leg.

 

[np7]

Week one after 2nd TKR. It definitely seems like there is more pain and swelling this time around, although many in the medical field will say that we tend to forget pain, a view my OS has after having done hundreds (thousands?) of TKRs and THRs. The pain is unrelenting and nighttime discomfort and wakefulness disturbing. If you are bothered by this yourself then I recommend doing what I just did--go back over the BoneSmart links/articles. For me it was a necessary reminder to: take pain meds on schedule, dont even think about trying to cut back at this point in recovery; Rest, nap whenever I can and if awake at night read; Elevate, I love my LoungeDoctor wedge (thank you BoneSmart); Ice, I find ice packs both more effective and easier to handle than ice machine. [Some say writing things down helps remember and commit]

This time I am not trying to shift from the walker to cane as fast as it seems like the walker allows me to focus on my gait better and to be more balanced, upright by just lightly holding with each hand. Any of you have thoughts on this?

 

[sistersinhim]

Using a walking assistance device will definitely help you develop a better gait. I used my walker outside of the house for at least 6 weeks. Being able to concentrate on the heel to toe step and not worrying about falling made it much easier to develop a good walking stride and gait.

 

[Bikeknit]

Glad to see you got that second knee done. Sorry the second knee is the stinker. Though I think you are right about forgetting pain. When I was looking for a doc I asked people how their recoveries went. Anyone more than 3 years out said it was a piece of cake.