TKR 7 week pain back

[Pandi]

I had total knee replacement on my right knee on October 30th 2023. Happy Halloween to me. It’ll be two weeks Monday and I feel stuck and frustrated. My in home therapist says I should be at a 90-100 bend by now but can’t seem to get past 75-80. I feel like I’m falling and it’s causing stress and anxiety to the point I’ve been crying on and off for two days straight. I’m not sleeping, not from pain but simply can’t. I’m exhausted and trying to do stretches is tough because of no energy. I don’t know what to do. Trying to bend past 80 I get a sharp stabbing pain in the center of my knee cap. I haven’t increased my ROM at all this whole week. I’m feeling deflated and lost
What can I do?

 

[Layla]

Hello and Welcome to BoneSmart and recovery, Pandi. Thanks for joining us!
I am sorry you are feeling anxious, stressed and frustrated.
First, take a deep breath and relax. You're going to be okay. At only twelve days post op, your body is in healing mode from major surgery. You don't need to worry about numbers and unrealistic timelines at this point. Your energy is going toward healing first. While your range of motion is currently limited, it will naturally increase as the swelling subsides and the pain eases. Please, give it time. Forcing movement that is causing you sharp stabbing pain is your body signaling for you to STOP.

Right now, you should be taking meds on schedule, resting, icing and elevating and taking some walks around the house. PT can come later, if necessary.

I will leave out Recovery Guidelines and encourage you to read through each article, then read other Knee Recovery threads on the forum, I believe you'll find comfort in doing so.
Cheer up, brighter days are on the way!

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​

elevate​

ice​

take your pain meds by prescription schedule (not when pain starts!)​

don't overwork.​

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

the BoneSmart view on exercise​

BoneSmart philosophy for sensible post op therapy​

5. At week 4 and after you should follow this

Activity progression for TKRs​

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.
@Pandi

 

[Jammy]

These stories break my heart. Take a breath. You are doing nothing wrong. I suggest you call the agency where your therapist is located and ask for a different home therapist, or cancel it altogether for now. You just had a MAJOR MAJOR SURGERY. Right now you mostly need to rest, take your meds ahead of the pain, elevate your leg when you can (in bed, on the sofa), and place a nice covered ice pack on the knee. And eat protein, drink liquids, juices, etc. Please do not beat yourself up. It's not you, it's THEM. They are not helping any. You are not a number. Read other posts from TKR survivors. Many of us have had to "fire" our physical therapists when they wanted to push us too hard, so hard that we were in tears. Please do not worry about upsetting your PT. You have to take care of YOURSELF.

 

[mendogal]

I'm glad you're here to share your woes because we have been there and can reassure you....

My ortho team was insistent that during the initial weeks "Less Is Better!" and, as I've learned here, 90 degrees is a six week goal for other orthos as well - but there's also a LOT of people who took many long months to get there.

If you rest, ice, and elevate you're on the right track. My team was happy to have me do my ankle circles for circulation and walk a little every hour. When I felt up to it, I did a few quad sets just to start waking them up - but plenty of folks here did fine without that.

 

[Jockette]

My in home therapist says I should be at a 90-100 bend by now but can’t seem to get past 75-80. I feel like I’m falling and it’s causing stress and anxiety to the point I’ve been crying on and off for two days straight. I’m not sleeping,

Hi and Welcome!

There is no “should” in this recovery. We are all different and recover in different time lines. At 2 weeks post op, your body is still trying to figure out what happened to it!

There is no date by which you should be any certain number.

Myth busting: "window of opportunity" in TKR

This "six week window of opportunity" surgeons often speak about is little more than a myth. It presupposes that all patients have the ability to create adhesions which is far from the truth. It also ignores the simple fact that in the first 3-4 weeks after surgery, swelling reactive to the...

bonesmart.org

Post op blues is a reality - be prepared for it

Post op blues is feeling depressed, weepy, nervy, shaky, fearful of the future, anxious, overwhelmed by what is happening to you, convinced it's never going to get any better and finally, uttering that most intense of all cries "I wish I never had this done!" It arises out of a variety of...

bonesmart.org

Sleep deprivation is pretty much inevitable - but what causes it?

Time and again members complain about not being able to sleep and after a while, that it gets to making them feel frustrated, despairing, depressed and even ill. I thought perhaps a short treatise on the reasons for disturbance of sleep patterns was long overdue. It won't help you to sleep but...

bonesmart.org

 

[EalingGran]

Definitely agree with all the above.
I would ignore the aggressive PT and concentrate on getting better sleep and rest.
I struggled with sleep too. ( Have had problems for years and found post op pain just made it worse).
My GP was sympathetic and gave me a month's worth of zopiclone which really helped. Everything looks better after some decent sleep.

 

[Loulou67]

Your post could have been written by me a week ago….
I had my op on 20/10. I’m struggling with my bend and I’ve had days where I’ve despaired, felt useless , cried, and then I’ve posted on here, and I’ve read and re read other people’s journeys and it’s helped me massively.
I’m struggling to sleep at night but it’s definitely got easier this past week.
Yesterday I stopped doing my heel slides, I bent my knee as far as I could go, which isn’t that far still tbh, but I rocked my leg back and forth and it helped . I’m at physio tomorrow so I’ll see what my bend is at 3 weeks post op…. When I left hospital it was 80 and then it dropped back to 60 so I’m hoping it’s improving….
I’ve now finally taken on board what everyone’s telling us…. We’ve had MAJOR surgery!!! Recovery is slow but we need to be patient. If I need to cry, I’ll cry…. I’m so stir crazy at home my partner bought me a colouring book and coloured pencils to keep me occupied .. and it really helped…. Hang in in there, keep posting on here and you’ll get all the support you need. Take care

 

[sistersinhim]

I’m exhausted and trying to do stretches is tough because of no energy.

At your early stage, your body is concentrating on healing, so there is a good reason you are exhausted. Give in to it and rest more, much more. Let your body heal!
Energy drain for TKRs

 

[Pandi]

Thanks everyone for your encouraging words. Reading from others that have gone through this has definitely helped calm me down.
I woke this morning with a pounding head and dizzy, I’m either getting a head cold or it’s effects from the anxiety attack I went through yesterday. But seeing all your kind words has given me the strength to tell myself to rest and take it easy today. Not worried about exercising today. I’m playing couch potatoe lol
I’ll keep updating how I’m doing as I find writing it here helps get it out instead of bottling it up inside.

 

[Jockette]

Don’t look at resting as doing nothing, look at it as giving your body the best circumstance in which to heal.

 

[Dmcfad2]

I’ll keep updating how I’m doing as I find writing it here helps get it out instead of bottling it up inside.

I agree. I love writing out my thoughts and experiences here. It’s good therapy.

 

[benne68]

Oh my goodness, @Pandi. You aren't even two weeks post-op yet! Be kind to yourself -- your body needs time to heal from what it just went through!

My docs insisted that my "job" for the first few weeks post-op was to rest, ice and elevate so I would recover. No PT. Nothing but healing.

 

[Pandi]

Had Lynn for PT today, explained what happened after the PT nurse that was here Friday, that sent me into my anxiety attack.
She was so sympathetic and said I’m doing great. I’m going to progress slower as I am also a Type 1 insulin dependent diabetic.
But believe it or not taking the weekend off from pushing myself and only doing a couple simple stretches, I finally got my ROM to 86! No longer stuck at the 75-80! I feel much better today and will progress at my own pace. Taking me time when I need it!!
So if I learned anything, it’s some PT are jerks and have no bedside manner, and I’m me and I know my body better than anyone as far as how much I can do!! So today starts a new day of doing me!!

 

[sistersinhim]

I know my body better than anyone as far as how much I can do!! So today starts a new day of doing me!!

Yes! Now, that's the way to do it.

 

[Jockette]

So today starts a new day of doing me!!

You go, girl! We have to take charge of our own recoveries.

Keep in mind all people are different, as are the approaches to this recovery and rehab. The key is, “Find what works for you.“ Your doctors, PTs and BoneSmart are available to help, but you are the final judge as to the recovery approach you choose.

 

[CatieViv]

@Pandi
I have T1D as well. I am a little past 6 weeks. The first 2 weeks were horrible. The pain was bad and fighting to get pain meds didn't help any. Keeping BG in range adds to the challenges. Especially since I had no appetite. Rest rest rest. This is a great place to hang out and vent. I have done no exercises at home except walking and activities of daily living. I've just recently added my Flexstride pedaling. Physio has been pretty gentle and I don't push it into pain. Feel free to connect anytime. You are the only T1D that I have come across on this forum.

 

[Jockette]

You are the only T1D that I have come across on this forum.

We have had a few others that mention this specifically, in the past.

Search results for query: Type 1 insulin dependent diabetic.

bonesmart.org

 

[Layla]

Good to hear you're taking control, Pandi. Sadly, not everyone in the medical profession is warm, considerate and compassionate. I am sorry you had a bad experience, but hopefully now that you've taken charge you'll have a smoother healing process. Best Wishes, Pandi!
@Pandi

 

[benne68]

believe it or not taking the weekend off from pushing myself and only doing a couple simple stretches, I finally got my ROM to 86!

That great news! Remember this the next time you hit a plateau (and we ALL hit them!) --it will help you get through it.
Best wishes for your continued recovery.

 

[Jammy]

That is great news. Please try not to be so concerned about the numbers you're at, you will get there--in your own time! Also, stretching is really helpful. If you can stretch some and walk a bit, do that. Then rest. Ice. You're in the baby stages and have far to go. I'm glad you have Lynn now for your PT. Hopefully she can keep seeing you.