Bilateral TKR 9 week post op frustration...help!

[Titianlady]

With my first knee replacement, it took me a few weeks to get my extension to 0. I was stuck at 2 for some time. I was fortunate to have a PT that could have come right from BoneSmart! The only exercise he gave me to increase my extension was to lay on my back and put a small rolled up towel under my heel, then using my muscles make like your trying to get the back of your knee to the bed. NO manual pushing the knee down ever!

The only thing my PT did was massage my leg, and tell me to do my heel slides, my extension with the rolled up towel, and to elevate and ice!!!! NO horrible pushing and bending. He said the knee needs to heel as it's been assaulted. He came three times a week for a month to monitor my progress, and no outpatient therapy at all.

Please take it easier. Your poor knee needs to heal. Your extension and flex will come in time. Remember, this was a MAJOR surgery and your knee has been taken apart.

 

[LMALove]

Please take it easier. Your poor knee needs to heal. Your extension and flex will come in time. Remember, this was a MAJOR surgery and your knee has been taken apart.

Good morning and boy did I need to hear this today...thanks Titianlady! I've been awake for and hour and miserable this morning. The aching goes deep. Cried for the first time in awhile. So frustrated! Grabbed the ipad to vent and read your post. I will be so happy when days like this don't exist. I finally caved and took 1 hydrocodone. I typically don't on non PT days. Back in bed icing and waiting for it to kick in. Both knees are pretty equal most of the time but today left seems worse. Mornings are hard in general but this is one of those doozies. As badly as I need to clean and get ready for my trip, today might be a DVR day...or at least this morning. So tired of feeling this way

 

[LMALove]

Hi @LMALove I am up for bilateral TKR on Wednesday 28th... what a shame you did not discover Bone Smart earlier - the advise support and information in this site is magnificent - enough of yesterday - you have found it now.

Please heed the advice of the advisers on this forum - all of the knee Smarties follow the mantra and I think have had better recoveries than if they had not. Listen to your body and take care of you. I have your thread on my "watch list" and will be interested in the outcome of the 1-2 week test outlined above. Cheers for now - Maggie x

Good luck with your surgery tomorrow! Hope your hospital stay is adequate for rest and recovery. Over here they like to boot us out ASAP. My surgery was Monday 11/24 and I was home Thursday 11/27 so really only 2 days post surgery day. I was happy to come home but in hindsight should have stayed just for the better rest and PT that comes to you. Please update me on your progress when you are up to it!

 

[vinny]

@LMALove hello...I have had a terrific recovery but never came close to the amount of exercise that you are trying to do...I did a great amount of work before the surgery but have eased up since...4 hours on stage is a lot particularly if you have done a lot of work during the day...are you sitting on stage? I would suggest you take a step back from some of the activities as you are likely worn out by the time you get to extension exercise....I believe you will improve with less..

Vinny

 

[oldrugbyprop]

Hi @LMALove. I agree with @vinny and the rest. Less is more sometimes. The other thing is Pain management. Pain hinders healing, stretching and general quality of life. I'm at six weeks and still get pain while trying to sleep or when doing PT. And also when I over do it. I still take pain meds when this happens. Also for extension I do something like @Titanlady I rest my feet on a foot stool that is higher than my chair and I then put my gel packs on my knees to help weigh them down. The ice helps with pain while I do it. Good luck and I hope you feel better as time goes by.

 

[LMALove]

@LMALove hello...I have had a terrific recovery but never came close to the amount of exercise that you are trying to do...I did a great amount of work before the surgery but have eased up since...4 hours on stage is a lot particularly if you have done a lot of work during the day...are you sitting on stage? I would suggest you take a step back from some of the activities as you are likely worn out by the time you get to extension exercise....I believe you will improve with less..

Vinny

Hi Vinny...you are about 10 days ahead of me so am glad to hear from you as our recoveries are happening now! Yes I sit on stage. I play keyboard and sing and normally would stand. Was hoping to be able to stand Sat. But not ready. I get up and move around between sets but am always pretty sore the following day. Because I want to feel my best going to my daughter 's for 5 days....I will be very kind to my knees today and just do the leg hangs from bed (tummy time...PTs most recommended exercise for extension) and will do the extension on a rolled towel with ice per oldrugbyprop. I can see how the ice would help with the pain and maybe allow more time in the stretch. Can I ask where your ROM is measuring at this point? Esp your extension?

 

[LMALove]

Hello...seems we are also on a very similar path with regard to timing of surgery and our age. I'm curious also about your ROM measurements. Seems I live and die by them right now. Yesterday my cold measurements were 115 flex and -7 right; -8 left for extension. I also gain motion by 2'or 3 degrees with both by the end of the hour. Problem is my cold measurements have not improved the last 3 sessions. Would hope to gain there as well. Thanks for reading and for your advice
Leah

 

[vinny]

Have not had any measurements since my Physio sessions ended in Dec at that time I was 125 and zero in the left leg and 120 in the right which is not yet at full extension....I would suggest you do very little on the day of a gig ...I have not had any pain but still ice everyday ...I tend to be a little Obsessive Compulsive and it has been difficult to reign myself in.....if you are having any pain less is most certainly more..

Vinny

 

[vinny]

Leah I would also add that I try to do little things during down time..if I watch TV I do extensions while pointing my toe and gently push my knee down and massage my knees and do little squats in a hot shower...nothing heavy duty..

Vinny

 

[Awriterafoot]

I noticed that you are going to see your grandson--that will be so healing emotionally, I'm sure!--but remember, little kids are exhausting! With my first knee (August), it was about a month before I could keep her for more than an hour or so at a time, and I'd be so tired that I'd have to take the next day off. Be sure you take lots of time to rest while you're visiting.

As for feeling sick of taking so long to feel better, one of my PTs used to say, "Have you seen the videos of knee surgery? They use hammers and saws. It's brutal and long and hard." It has only been two months and you're doing great. The expectation of doing better is what gets depressing. DVR days are a good thing.

I also like what your PT said--that every fifth day should be a rest day. I'll have to remember that.

 

[LMALove]

Ok...I'm getting up and at it for a bit. Maybe an hour of some easy household stuff then will rest/ice. Thanks all again for your encouraging words. And yes...cannot wait to see my grandson. That alone will be therapeutic. Am lucky he is a very well behaved 2 yr old who can entertain himself playing for hours! His Mom and Dad are both there but just have incredibly busy schedules for the days I'm there so I will only have him on my own during the day. And he still takes a good afternoon nap. Thinking the drive (6 hours) may be the hardest part but am getting in a day early so I can rest good if need be. I will stop and stretch my legs often on the drive. A good audio book always makes the drive fly by!

 

[Titianlady]

Hello...seems we are also on a very similar path with regard to timing of surgery and our age. I'm curious also about your ROM measurements. Seems I live and die by them right now. Yesterday my cold measurements were 115 flex and -7 right; -8 left for extension. I also gain motion by 2'or 3 degrees with both by the end of the hour. Problem is my cold measurements have not improved the last 3 sessions. Would hope to gain there as well. Thanks for reading and for your advice
Leah

Oh, sweetie, don't live by those numbers!!! It will drive you crazy!! The harder you try to get them to change with over effort, the more you may set yourself back actually. It seems that your extension is the number that is
concerning you. Depending on how much work the surgeon had to do with your ligaments while balancing them during the replacement can make getting to 0 take time. Slow and steady, EASY stretching will get you there.

It takes TIME. Some folks are fortunate and can get great numbers relatively quickly, and some folks take time to get there. No two peoples surgeries are alike, nor is the recovery time.

I was lucky to get good ROM. 150+ and 0. But don't compare anyone's numbers to your own. We all get there when our bodies decide.

Take it easier, please sweetie. I learned the hard way that just because we can do something doesn't mean we should. I paid the price more than once overdoing my activity because it didn't bother me while I was doing it. But boy did my knee let me know later!
Keep ahead of your pain also. Take your pain meds. Don't wait until you are hurting really badly.

Hang in my dear..you WILL get there

 

[LMALove]

So a quick update after being offline for awhile. I am 12 weeks out and ROM is finally improving. Esp extension which has been my battle. I measured -2 today on both knees and was thrilled. My walking is almost normal and I think people who don't know don't see that there is something off. My biggest issue now is with continued pain. I am consistently at about a 4 or 5. I try to use OTC meds but they honestly don't really touch it. I will go a day or 2 w/out hydrocodone as long as I can be home and resting but to do any activities that require me being out and/or up and moving for hours at a time the hydro just takes that edge off and gives me the relief and energy to get through it. Even on those days I try to keep it to 1 pill timed to kick in w activity. Mornings are still awful and feel the need to ice...esp on left knee where my MCL was nicked during surgery. That is fairly new information for me but certainly explains why I'm having so much more pain on that knee and that spot. Also...my lower back is in constant pain. Went to chiropractor and she couldn't move me at all. Need some massage therapy to get it loose enough for an adjustment so will start that next week. So I guess my main concern now is not as much ROM but will the pain ever go away? I know in my head it is way better than first month or so but I'm still hurting enough that it is constantly on my mind. So waiting for the day I can realize I haven't thought about my knees yet! Hope you are all well and warmer than we are. Sub zero temps getting old. Ready for spring!!

 

[oldrugbyprop]

Good to hear its coming along hopefully the pain will ease up for you. That day were you stop thinking about your knees will come. Kind of like the end to this godforsaken Winter. I have five feet of snow on my lawn, and it reached 0 Celsius yesterday for the first time since December. it's -16 right now.

 

[referee54]

First of all, welcome to the forum---and welcome to the highly respected BTKR International Club complete with a super-secret handshake!!!

PT is still incredibly painful. The concern is with my extension which is (cold measurement) at a -9 on left and -7 on right. Yesterday my PT was able to PUSH me to a -5 and -4 but was at about a 9 pain level.

Remember, you are in charge of your recovery---and the PT's work for you---you set the limitations and you tell them what is acceptable and what you will not do---and it seems like you are doing waaaaaay too much! Take it from another BTKR alumnus, these recoveries can be slower than we would like ti to be and longer than we expect it to be---but consider that you have had two bones in each leg amputated---and much pounding of implants into both knees, and you will realize why your knees have sustained tremendous surgical trauma.

Anyway...I'm starting to worry that without another month of this painful therapy I will get "stuck" and never get the extension back to zero without a manipulation (this is per my therapists and surgeon).

Also using heat before stretches at home. Not sure if it helps but the heat feels good too!

Make sure that you heat only the muscles---that can help to warm up the muscles, but do not heat the joints, as that will cause more swelling and stiffness.

I have been so frustrated and having been so active before the surgery...just thought somehow this would be easier.

I was very active, too, and I was, as many of us were, totally unprepared for the length of time that a BTKR recovery can take---but again, when one considers how traumatized the knees were during surgery, one can then see why it will be slower than expected to recover. Patience is needed---in large, mega-doses.

Patience, Grasshopper, Patience!!

And you're doing 4-hour gigs in a band. And you're exercising 6 times a day. I'm betting you are also doing errands and maybe things around the house.

Yep---again, as a BTKR alumnus, I agree---too much, too soon. It took me five months to lose a pesky little limp---six months I was at about 80%-85%, and eight months I was at 90%-95%. You cannot rush this recovery.

He also believes in taking a whole day off every 5 days or so

I went to therapy twice a week---I returned to the classroom after my BTKR at eight weeks, which was much too soon---and you are feeling the same things that I felt.

I took Sundays off---after church, I iced, rested, and elevated all day long. I would also listen more to your knees and fight the urge to exercise everyday---at times. "less is more" and it is not "no pain, no gain, but "no pain, more gain"----you are not training for an athletic activity, but recovering from a very traumatic surgery---let your knees rest and heal.

I will be sending you the DVD of the BTKR World-wide Alumni Club Super Secret Handshake!!!

Rest---Relax, and take it easy---and remember that "less is more" when it comes to a successful TKR or BTKR recovery,

Please take a look at this articles.
TKR: work “smarter” and not “harder”
Lose the Work Ethic While You Are Recovering!
TKRs and our fast food society
TKR recovery and an analogy to athletic training
Life in the slow lane
Where are you in recovery?? (tkr)