Bilateral TKR 9 months post op and new pain<^
- Thread starter DLC1128
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United States
Think of it as doing your job to heal your knee!
Try not to think of resting as "lying around, doing nothing." Instead, think of it as working hard, to give your knee the best possible chance of healing well.
It really is worthwhile investing time in allowing your knee to heal.
OP
OP
DLC1128
junior member
One thing I wonder...by week six, do I still need to elevate and ice? I keep my legs elevated but not to the extent that I did in the first few weeks. There is no swelling anymore (at least visible swelling) however, I still have the stiffness when I have been in one position for a bit.
I walk around the house a lot! I am living with my daughter while I recover, so there is lots of activity here with grandchildren and life!
I have been shopping a few times and will admit that occassionally I rely on the motorized carts in the store. I can handle short bursts of shopping, but nothing that takes very long. My knees just get tired.
Patience....that's what I keep telling myself. At six weeks, I still have six more weeks of good solid healing to do....
I walk around the house a lot! I am living with my daughter while I recover, so there is lots of activity here with grandchildren and life!
I have been shopping a few times and will admit that occassionally I rely on the motorized carts in the store. I can handle short bursts of shopping, but nothing that takes very long. My knees just get tired.
Patience....that's what I keep telling myself. At six weeks, I still have six more weeks of good solid healing to do....
It's a good idea to keep on elevating and icing your knees. You'll find that they tend to swell a bit more whenever you do any additional activity.
The stiffness after being in any one position for a while tends to linger for months. I think it happens because your knees don't make the lubricating fluid while they are still - they get a bit like a rusty hinge.
You're doing very well, but beware of doing too much. It's really a bit too soon for going shopping, but if you must, do use the motorized carts.
Check your activity against this article:
Activity progression for TKRs
The stiffness after being in any one position for a while tends to linger for months. I think it happens because your knees don't make the lubricating fluid while they are still - they get a bit like a rusty hinge.
You're doing very well, but beware of doing too much. It's really a bit too soon for going shopping, but if you must, do use the motorized carts.
Check your activity against this article:
Activity progression for TKRs
I found I could not use those motorized carts because my knee didn’t bend enough! Once your energy drain is less, walking in the store is better for you anyway. Shopping at this point for me gives me a great walk. ( 7 months post op)
SusieShoes
Former BoneSmart staff member
Keep elevating and icing as long as you have pain or swelling. I still elevate and ice after exercise or long days, more just in case than because my knees hurt — they don’t hurt at all, but I want them to remain that way, so I ice for forty minutes to an hour, legs up, and watch TV or read or whatever. It’s a pleasant habit. But I think one reason my knees have done so well is that I spent much of any time off my feet elevating and icing.
I was at around six weeks when I made my first trip to the grocery store. I just did a little shopping, then had to sit down on a bench near checkout while my husband finished for me. The next week, I could do the whole store (though not every aisle and while using the cart as a walker) and, yes, it tired me out. Your energy drain will likely remain significant for a while yet Just kind of go with the flow: if you get tired, rest; if you have used your knees for a while (for any reason), ice and elevate.
I was at around six weeks when I made my first trip to the grocery store. I just did a little shopping, then had to sit down on a bench near checkout while my husband finished for me. The next week, I could do the whole store (though not every aisle and while using the cart as a walker) and, yes, it tired me out. Your energy drain will likely remain significant for a while yet Just kind of go with the flow: if you get tired, rest; if you have used your knees for a while (for any reason), ice and elevate.
Hi D
I’m now about 9 months btkr. I agree with a lot of the posts in that, you should feel like your PT is in sync with you.
My PT’s were awesome and frankly pushed me to do just a bit more than I thought I could. But also tempered with the reality that us bilaterals have gone through some extra stuff.
You are SO early in your recovery I think your main things would be elevating and icing. These two things cannot be stressed enough!!
But I think if you’re icing and elevating, and you’re moving as much is you comfortably can, and straightening and bending as much is you comfortably can, I think that’s all anybody can ask of you!!
That major stiffness, major major stiffness that I had your stage of the game, believe me that goes away, but this whole thing takes time, it just takes time, and you’ll get there be patient . But I think it’s really important that you find a physical therapist that you feel good working with. Trust me this is a team effort and you need to have a PT that you know is right with you for you
I’m now about 9 months btkr. I agree with a lot of the posts in that, you should feel like your PT is in sync with you.
My PT’s were awesome and frankly pushed me to do just a bit more than I thought I could. But also tempered with the reality that us bilaterals have gone through some extra stuff.
You are SO early in your recovery I think your main things would be elevating and icing. These two things cannot be stressed enough!!
But I think if you’re icing and elevating, and you’re moving as much is you comfortably can, and straightening and bending as much is you comfortably can, I think that’s all anybody can ask of you!!
That major stiffness, major major stiffness that I had your stage of the game, believe me that goes away, but this whole thing takes time, it just takes time, and you’ll get there be patient . But I think it’s really important that you find a physical therapist that you feel good working with. Trust me this is a team effort and you need to have a PT that you know is right with you for you
OP
OP
DLC1128
junior member
I'm at 6 1/2 weeks out and have decided to discontinue PT. He does the same exercises each time and last time he wanted me to do knee presses and use bands for hip abduction/adduction exercises. The next two days walking was very painful and my knees were swollen. I felt like I had taken three steps backward.
I have flexion over 100 degrees it is mostly my extension that is causing me problems but I figure I have time and continue to work on that everyday on my own. I know the right exercises to do and have been walking quite a bit as well.
Any insight on other things I can do on my own to continue to improve my ROM?
I have flexion over 100 degrees it is mostly my extension that is causing me problems but I figure I have time and continue to work on that everyday on my own. I know the right exercises to do and have been walking quite a bit as well.
Any insight on other things I can do on my own to continue to improve my ROM?
Over 100 degrees at just 6 1/2 weeks is wonderful! You don't need PT, you're already there and you know what to do with your extension. The more your lengthen your stride, the better you work on your extension. Many of us had a slow extension to come back, but it does!
SusieShoes
Former BoneSmart staff member
I don’t know why PT so loves to rush to strength training on new knees. Mine was the same way, and I just said no. My OS released me from PT on my seven week checkup because I was walking really well and had very good flexion and okay extension. He told me more extension and flexion would come, to just keep up my walking,
In addition to walking, I found stair climbing to be excellent for ROM. It builds strength in the leg muscles, which makes for better stair-climbing (always good), and you can use the stairs to do very gentle bends/lunges. Never to pain, of course, just to a good stretch. I have two really high steps in front of my house (nearly a foot high) and worked up to doing those foot over foot. More bend is needed for higher steps. It took a couple months before my laggard left knee was happy to do those.
Bicycles are another great way to work on ROM. You can adjust the seat for more or less flexion needed. Be careful not to overdo at first! Start with a high seat and low (or no) resistance and work your way up to lower seats and higher resistance.
Six and a half weeks is still very early in recovery, so be quite deliberate and patient with adding exercise of any kind. Just one thing at a time. If it works for you, do it for a week or two before increasing difficulty or adding another thing.
In addition to walking, I found stair climbing to be excellent for ROM. It builds strength in the leg muscles, which makes for better stair-climbing (always good), and you can use the stairs to do very gentle bends/lunges. Never to pain, of course, just to a good stretch. I have two really high steps in front of my house (nearly a foot high) and worked up to doing those foot over foot. More bend is needed for higher steps. It took a couple months before my laggard left knee was happy to do those.
Bicycles are another great way to work on ROM. You can adjust the seat for more or less flexion needed. Be careful not to overdo at first! Start with a high seat and low (or no) resistance and work your way up to lower seats and higher resistance.
Six and a half weeks is still very early in recovery, so be quite deliberate and patient with adding exercise of any kind. Just one thing at a time. If it works for you, do it for a week or two before increasing difficulty or adding another thing.
OP
OP
DLC1128
junior member
I am eight weeks out now. Second visit to OS and he seemed disappointed in my flexion. I seem to be doing okay with extension right now and other then the stiffness when I first get out of a chair, my legs seem to straighten up pretty well. They do get tired as the day goes on and get stubborn about getting straight, but I can live with that. (I think!)
My flexion for both knees is a little over a 102 degrees. He told me I should be at 120 by the 3 month mark, so that is 4 weeks or so away. I am in no way going to undergo a MUA. I have read too many negative things about them and have no desire to endure that pain post-op.
I confess I probably am not as diligent about my exercises for flexion as it does not take much for it to become painful and I am ever hopeful about the posts that people did little exercise and got full ROM back.
Any suggestions? Or was he too hopeful for an 8 week visit? I wasn't worried before my visit with him as my PT was pretty happy with where I was at...now I'm not so sure.
One more thing...I am active..this last weekend we went to visit my grandson at college and walked around the campus. When we went to bed that night my knees hurt so bad that I could barely lay still. I took ibuprofen and that eventually helped. I actually think I have not rested enough and have tried to push it too hard. I still do have pain in my knees and they are sometimes hot so still inflammed. Could that impact my flexion?
My flexion for both knees is a little over a 102 degrees. He told me I should be at 120 by the 3 month mark, so that is 4 weeks or so away. I am in no way going to undergo a MUA. I have read too many negative things about them and have no desire to endure that pain post-op.
I confess I probably am not as diligent about my exercises for flexion as it does not take much for it to become painful and I am ever hopeful about the posts that people did little exercise and got full ROM back.
Any suggestions? Or was he too hopeful for an 8 week visit? I wasn't worried before my visit with him as my PT was pretty happy with where I was at...now I'm not so sure.
One more thing...I am active..this last weekend we went to visit my grandson at college and walked around the campus. When we went to bed that night my knees hurt so bad that I could barely lay still. I took ibuprofen and that eventually helped. I actually think I have not rested enough and have tried to push it too hard. I still do have pain in my knees and they are sometimes hot so still inflammed. Could that impact my flexion?
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SusieShoes
Former BoneSmart staff member
Your ROM is good for your stage of recovery. Really, it is! And it's entirely possible you will have 120 flexion at 3 months. But if you don't... that's okay, too. I can't imagine a surgeon would take a knee with 100+ flexion and want to subject it to an MUA. It makes more sense to give that knee more time. Your knees will continue to gain ROM for months still, even after a year. Being patient with them, especially with your already good flexion and extension, is sensible!
Being diligent about exercises will not give you more flexion. But there is one thing that will: reducing your swelling and inflammation. Those angry, swollen internal soft tissue physically block your knee from bending. They take up space and prevent bend, not much different from the way a hose filled with water is tough to bend.
In a normal, non-injured knee, these soft tissues are efficient and sleek and fit amazingly into their small space. But when your surgical, still-healing knee is aggravated and inflamed, that space remains the same size but the soft tissues swell... that's why irritating your new knee early on is such a negative. The swelling hurts; it hampers function (and hurts more when pushed); and it slows down healing.
So, yes, you already nailed that you were a bit too active the other day. At eight weeks, I could walk around the grocery store without much problem, but a college campus? I wince just thinking about it. And given the above explanation about the connection between flexion and swelling... yes, that kind of thing impacts your flexion. Mine could easily go up and down 5 degrees depending on whether or not I'd had PT the day before (down the day after PT, and up when measured again at the next PT).
And it only went up, never down, after I quit PT.
So don't worry about your flexion. It's there. It'll show itself when the swelling inside your knees goes down. You're having a really good recovery, so pace yourself.
Being diligent about exercises will not give you more flexion. But there is one thing that will: reducing your swelling and inflammation. Those angry, swollen internal soft tissue physically block your knee from bending. They take up space and prevent bend, not much different from the way a hose filled with water is tough to bend.
In a normal, non-injured knee, these soft tissues are efficient and sleek and fit amazingly into their small space. But when your surgical, still-healing knee is aggravated and inflamed, that space remains the same size but the soft tissues swell... that's why irritating your new knee early on is such a negative. The swelling hurts; it hampers function (and hurts more when pushed); and it slows down healing.
So, yes, you already nailed that you were a bit too active the other day. At eight weeks, I could walk around the grocery store without much problem, but a college campus? I wince just thinking about it. And given the above explanation about the connection between flexion and swelling... yes, that kind of thing impacts your flexion. Mine could easily go up and down 5 degrees depending on whether or not I'd had PT the day before (down the day after PT, and up when measured again at the next PT).
And it only went up, never down, after I quit PT.So don't worry about your flexion. It's there. It'll show itself when the swelling inside your knees goes down. You're having a really good recovery, so pace yourself.
OP
OP
DLC1128
junior member
Hi SusieShoes!
thank you for your words of encouragement! It is a long road and I am impatient! I know I have been doing too much since about week 2..can’t seem to help myself. Living with my daughter and her three teenagers is an adjustment for me and I am having to learn to live with the chaos!
My question though may seem silly.
Since my surgery I am drenching night sweats and hot flashes. I have NEVER had night sweats! I am well past menopause and and even when I went through menopause I did not have hot flashes or night sweats. It was relatively easy for me. No HRT because of family history of heart disease.
I searched the forum to see if there were any other questions about this, but most of what I found was about stopping HRT before or after surgery.
No pain meds except for ibuprofen mostly at night or maybe mid-day. Haven’t been taking narcotics since week 2.
Any information you can give me would help. Otherwise I am going to have to go see my FP doc!
Diana
thank you for your words of encouragement! It is a long road and I am impatient! I know I have been doing too much since about week 2..can’t seem to help myself. Living with my daughter and her three teenagers is an adjustment for me and I am having to learn to live with the chaos!
My question though may seem silly.
Since my surgery I am drenching night sweats and hot flashes. I have NEVER had night sweats! I am well past menopause and and even when I went through menopause I did not have hot flashes or night sweats. It was relatively easy for me. No HRT because of family history of heart disease.
I searched the forum to see if there were any other questions about this, but most of what I found was about stopping HRT before or after surgery.
No pain meds except for ibuprofen mostly at night or maybe mid-day. Haven’t been taking narcotics since week 2.
Any information you can give me would help. Otherwise I am going to have to go see my FP doc!
Diana
All I remember is freezing. I had ice on me all the time for the first couple of months. I imagine after this surgery our hormones go crazy!
OP
OP
DLC1128
junior member
I am at 10½ weeks post-op. It is to the point that it is slow and steady. I’m at about 110 degrees flexion. So not quite at the 120 everyone would like but I’m not going to stress about it. I am doing more stretches and have had a couple of deep tissue massages that have really helped.
I still have a ton of stiffness and inflammation which I am really ready to be done. I’m tired of icing but am trying to be a good girl. This is the part that is still bothering me. I can’t sit very long or when I get up I walk like an old arthritic woman. . How much longer can I expect the stiffness and inflammation to continue?
Diana
I still have a ton of stiffness and inflammation which I am really ready to be done. I’m tired of icing but am trying to be a good girl. This is the part that is still bothering me. I can’t sit very long or when I get up I walk like an old arthritic woman. . How much longer can I expect the stiffness and inflammation to continue?
Diana
SusieShoes
Former BoneSmart staff member
It’s like kneeper said, that stiffness after long sessions of sitting or standing, or being in the car for a long ride, or sometimes even in the morning still, might be one of the last things to go away completely. You’ll notice it getting better soon, I predict. I’m seven months out and my stiffness is mostly all the way gone... but on a trip I took last week (six hour drive to Cleveland to see one of my sons and his family, no icing for four days, no elevating at all for four days, lots of standing and sitting around) I had a bit of stiffness at the end of the day. It was gone each morning. But the long car ride led to me being stiff on exiting the car. A few steps and I was back to pain-free. That kind of thing will continue until healing is really, truly, all the way complete.
It takes at least a full year for full recovery, so I expect we’ll get there one day.
It takes at least a full year for full recovery, so I expect we’ll get there one day.
