TKR 8 months post TKR and still swollen

[leejaa]

What wonderful news and a great example of doing your own PT at your own rate and getting great results. I had in home PT for my second knee and she was great - gentle and doing some massages and showing me how to deal with some muscular problems myself. I had full flexion and extension with her gentle help so chose not to do any formal OP PT either-- Like you I really believe the slow and gentle with lots and lots of icing and elevation to get the swelling down really helps.

I still get some swelling in the knee when I use it a lot which is more often now since I had to return to work.

I am sure your recovery will continue wonderfully well and it is so nice to read your posts. Have a great day. Lee

 

[earlybirds13]

hi Mal in West Sussex. My op was 21st Oct, TKR. In the first two days I got to 80 deg but now it hurts to get near to that and then it all swells up again. I know what you mean about pain at night, have got to be on my own at night because I throw my leg as you have said.

Pills, I have gone back on to co-codamol 2 every 4 hours with 1 diclofenac every 12 hours. My walking is good with no pain. I can walk unaided, for longer walks I use crutches though. Hope it goes better for you. Mal.

 

[Minivertible]

I absolutely love hearing from our UK friends. You're only about 2 weeks out. Don't rush the walking. I found @ 2weeks I was still using the walker all the time. My flex @ 2 weeks comfortably was about 80 degrees but I could stretch to 90 with discomfort. Keep up with the icing & elevation. This worked better than anything for me. I had a lot of very lazy days where I did absolutely nothing but eat & sleep. A day or 3 won't stop progress. I'm thinking of having a lazy day again this week where I just relax with no work or exercise. A couple of them a month would be nice. Thank you again everyone for all the help & support. It has made a tremendous difference. When I had my hip done last spring I had not discovered this site & felt a bit isolated. It's so helpful to have someone to share recoveries with. Thanks.
Helen

 

[mrs cricklewood]

wow you are so lucky..good on you !

 

[armywife]

Hi all,
So I'm 7 weeks post op from a right TKR. I'm 41 years old and a normally very active Mom to 2 small kiddos. My first 4 weeks of recovery were, honestly, awful. I didn't sleep, eat, interact or do much of anything. My progress is finally coming along (took Ambien for a while to finally sleep)! My concerns are with my ROM - I've been religious about PT and elevating and icing but can't get much past 95. I AM making slow strides though.

Other than my flexion - I am concerned with the way my knee has felt in the past few days. The best way I can describe it is as heavy feeling. It doesn't really hurt but I can certainly feel it every time I move. It does hurt when I bens a lot but mostly it is that heavy feeling. Any ideas?!

And I was taking Celebrex twice daily and my OS put me on a 6 day pack of steroids last week as my swelling was much above average. He also has me back in compression stockings for that leg. I had to stop the Celebrrz due to stomach problems. Now I'm only on Tylenol and my heartburn meds. I'm afraid the swelling will come back. Ugh

Other than my lagging flexion - the "heavy" knee feeling is my big concern. Any one have this sensation?

Thanks,
Heather

 

[Tykey]

My first idea is that it's only 7 weeks! It takes a long time to fully recover, 6 months is normally the time people think they are recovered (although things continue to improve after that). Be patient!!!!!!!!!!!!!!!!!!!!!
Second thought is that it's always of concern when people say they have been religious with their PT, yet have issues with ROM. Quite often these two are linked, too much aggressive PT actually causes poor ROM, not help it. Could you expand on what PT you are doing, so we can check that you aren't overdoing it. Anyway, 95 isn't that bad at this stage, it often goes down when you start getting active again(due to swelling) before it gets better.

 

[Roy Gardiner]

:iagree:

If your PT (a) hurts (b) causes any swelling or pain in the 24 hours after doing it, you're doing too much.

Hint: at this stage, no force should go through the knee. You are not training, you are healing.

Illustration: perhaps the best flexion exercise is to sit in a rocking chair, feet flat on the floor, rock gently backwards and forwards to the point (but not beyond) where the knee resists.

 

[armywife]

Thanks for the replies. I'm not doing anything at PT that hurts - except that they do manipulate and slide my knee cap around because I have some serious scar tissue. I do lots of quad raises then heel slides, heel raises and have added very light weights in the leg press and hamstring extension. I get on the bike for 15 minutes (very slowly) then ice and compression. At home, I mostly do some stretching and some gentle bending. I don't do the full PT stuff at home for sure. I do sit in the rocking chair and rock, as well.

I only go to PT 2 or 3 times a week, also. I'm not doing tons around the house (not even cooking dinner yet as standing for long is uncomfortable). I really don't feel like I'm overdoing it. I occasionally wonder if I'm not doing enough.

I love elevating and icing and do that throughout the day to deal with the swelling and discomfort. I'm afraid that being off the NSAID and done with the steroid dose that the swelling may return.

The bright side is that I'm sleeping really well - and that was a serious issue for the first 5 weeks. No meds required to sleep and in my bed now recliner and couch hopping.

Heather

 

[maryo52]

Heavy knee! Mine still feels a little bit that way but, boy, for the first few months it felt monstrous. I hated it.

I think there is variation in how long people have this experience. But the good news (and bad news!) is that it's normal.

Some people creep along in their ROM. Other's shoot out of the starting gate. If you're a creeper, then pushing your knee will actually slow down progress. I think instead of "pushing" our slow knees we have to gentle "challenge" them. NO WEIGHTS my dear! And don't do "lots" of anything!!

One strategy I like is 3 gentle slow bends per hour, holding the bend for a minute. This creates less inflammation (which results in swelling and that heavy feeling). Yet, over the course of the day, there's plenty of gentle challenge. And there's really only one other exercise that helps, again very little of it is needed, and that's a few straight leg lifts. Always start low and go slow with a post-operative knee. Because the soft tissues were horribly injured during the surgery. You really need to be at six months or beyond to be using weights. So also practice saying "No" to your PT if they push you. So no to weights, to resistance exercises, to pain.

I think back to when I had two little ones. I cannot imagine going through TKR with the two kids I had. On the other hand, I did suffer horrible cluster headaches, and they were really wonderful to me. Your kids have an opportunity to learn to accommodate someone who is needy, and that's a gift. Though it may not appear that way now.

And by the way even though you've had a rough road, that's par for the course, and in the big picture, you are doing quite well. ROM can increase for years -- most doctors and PTs don't seem to realize that -- you are headed toward a really good outcome.

 

[Roy Gardiner]

I do lots of quad raises then heel slides, heel raises and have added very light weights in the leg press and hamstring extension. I get on the bike for 15 minutes (very slowly)

OK; if it's not affecting you, I'd say fair enough.

But some of this is training, not healing, and you don't actually need it at this stage; quad raises, heel raises, leg presses come into this category.

For another example, on the bike you don't need anything like 15 minutes for flexion stretch. The first turn should be hard (but not painful) work to make the rotation, getting easier with each one until, after about a minute or two, you can turn the pedals easily. All against zero resistance from the machine. That's all you need, as many times a day as you like.

 

[armywife]

Thanks again. I feel like the PT is going well and not causing issues. Plus their ice contraption (Game ready) rocks!

Having a 5 and an 8 year old during this has been tricky. Thankfully, my Mom (she's 64 and very healthy) has been staying with us. We have to walk the kids to and from school (no buses and the kindergarten kid has to have an adult). I'm certainly not at that point yet. I'm not driving yet (right knee). Incidentally, I'm also from Maine (and will go back in less than two years after hubby has his 20 years in the Army done)! Woo

The flexion isn't too much of a concern. It just feels so strange the last few days.

I had 5 previous surgeries on this knee (ranging from clean up scopes to a micro picking to an osteocondryl autograft transfer). I needed the atKR for about 5 years but had to wait for the baby to start kindergarten. So, I had limited flexion to begin with and lots of scar tissue.

Thanks again! Love this forum!

 

[mrs cricklewood]

hi..trust me your ROM is better than mine is..and I am at 12 weeks! ...regarding the swollen knee I have just finished another course of anti inflammatories prescribed by my normal doctor...if my knee wasn't so swollen I am sure I could get more of a bend. Anyway I have just got some tumeric capsules and going to start on them tomorrow as it is supposed to be an amazing anti inflammatory..maybe you could try that ??

 

[Dkneeded]

Don't know if it normal or not, but I have the same exact feeling, it started last night and I'm 18 days post op now. To me it feels like one of those 5 pound ankle weights is wrapped around my knee, or inside my knee! The thought that went through my mind was that my artificial knee parts are made out of lead, not titanium.

 

[maryo52]

Well, this process involves a lot of wait and see : |

When I read "army wife" my mind leapt to Sarah Smiley. She writes a column that appears in the Bangor Daily News. So informative of the life of a military wife. I love her writing and her insights. I adopted Maine after growing up near DC and later discovered I have an ancestor from the town where I live!!

Anyhow, if things start to hurt more or feel heavy, that may be a clue to back off on activity. Doing more rarely remedies these issues. If you have a history of scar tissue, more the reason to go easy, even though you feel (as I did) I wasn't doing enough. P.S. Massage may not solve anything but it feels great, might be a much-needed treat, and it's TLC for the hurtin' knee.

I didn't figure this all out at the time, but I've learned from the many stories on this forum.

 

[kgang1957]

If it makes you feel better, I'm 7 weeks also (10/11/13 surgery) for right TKR and my flexion was just measured at 95 also. I, too, was bummed about that until I started reading all the posts here and now I know that 95 degrees is just fine, for me. It'll come eventually I'm sure. The one thing I realized I wasn't doing enough of, and learned from this site, is elevating and icing. I figured since I had no swelling (at least not visible to me) I didn't need to elevate any longer. I did ice 3x/day for 10 mins at a time, but as I sit here writing this my leg is elevated and I have an ice pack on it! Good luck with your recovery!

 

[kgang1957]

I sure do wish I could pedal through a revolution on the bike....at 95 degrees I cannot do it yet.

 

[referee54]

What you all are feeling is all quite normal. Remember, seven weeks seems like a rather long time, and our minds are telling us that we should be healed. Our knees---our surgical knees, are sending conflicting stories though.

Remember that recovery ---full and total recovery---can take upwards to a year to go through. Mine took close to eight months or so to be all back to "normal."

We have to realize that it is slower than we would like it to be and that we have to be patient.

Take a look at this ---it may help you out.

Where are you in recovery?? (tkr)

 

[Josephine]

And I was taking Celebrex twice daily I had to stop the Celebrrz due to stomach problems. Now I'm only on Tylenol

That's inadequate pain management for this stage.

I'm afraid the swelling will come back

Well it will if you don't take proper pain meds.

The best way I can describe it is as heavy feeling. It doesn't really hurt but I can certainly feel it every time I move. It does hurt when I bend a lot but mostly it is that heavy feeling

This is all pain. You may not think it is but pain comes in many guises and this heavy feeling is one of them.

they do manipulate and slide my knee cap around because I have some serious scar tissue

What is your ROM? I haven't seen you mention it yet. And I seriously doubt you have any inappropriate scare tissue. More likely an excess of swelling which you've already mentioned more than once. Did you read the recovery articles?
BTW, I merged your threads so they are now in post #6. Please read this One thread for your recovery please


I also have some questions to ask you:

1. what are your pain levels right now?
(remember the 1-10 scale: 1 = no pain and 10 = the worst you can imagine. And don't forget that 'pain' also includes soreness, burning, stabbing, throbbing, aching, swelling and stiffness)

2. are you still taking any pain medications, if so, what, how much (in mg please) and how often?

3. are you still icing your knee and if so how often and for how long?

4. are you still elevating your knee and if so how high, how often and for how long?

5. what is the detail of your daily activities? What do you do in the way of housework, cooking, cleaning, shopping, etc., and

6. what kind of PT/exercises are you doing? How much and how often? Details would are required!

I'll be back shortly!

 

[Josephine]

I sure do wish I could pedal through a revolution on the bike....at 95 degrees I cannot do it yet.

You shouldn't expect to do a full rotation at only 2 weeks!
Read this Progression of activity for TKRs.

 

[kgang1957]

Thanks Josephine, but I'm 7 weeks out now! Surgery was 11 Oct 2013