TKR After 1 year, advice?

Schaargi

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My mom is 87 years old and had a TKR on March 14, 2019. She is at 115 ROM, and has trouble going down stairs and getting up and down from the ground as a result.

She also has generalized (whole leg) pain at night that interferes with sleep.

She is still doing her ROM wall slides, massage, and recumbent bike, in addition to her much loved dog walking. She loves to walk, loved yoga and pilates before having trouble getting up and down, loves social group exercise (but doesn't like patronizing instructors who treat seniors like children).

She needs some hope that she might be able to increase ROM and get back to favorite activities.

Any ideas?
 
ROM wall slides, massage, and recumbent bike,

Sorry to hear your Mother is having difficulty with stairs and on/off the floor.
Her ROM of 115 is adequate for most activities. Has she seen a PT for instruction in on/off the floor, they can help her problem solve what works for her.

Suggest she stop doing the ROM wall slides and recumbent bike, they may be causing her knee/leg pain. Only way to find out is to stop them for a week+.
We have members who have gained ROM at two year, so it is possible for her to continue to gain ROM.

Instead of wall slides, she may benefit from,
Heel slides and how to do them , she can bend her knee to discomfort and hold it there for a prolonged stretch, she can start with 30 seconds and increase as tolerated. She should have no pain or swelling afterwords.

I have added her surgery date to your signature so we can better advise her, thank you for providing the date!

Keep us posted on how she is doing.
 
I had a very slow healing my first year post op, but continued to improve in my second and third year. I didn’t do any specific ROM exercises after the first few months and my ROM continued to improve those 2 years after, as my whole leg continued to relax and heal.

I’ve only been on the floor once, since my surgery 3+ years ago and it was definitely a struggle getting up!
 
ROM wall slides, massage, and recumbent bike,
Suggest she stop doing the ROM wall slides and recumbent bike, they may be causing her knee/leg pain. Only way to find out is to stop them for a week+.
@Pumpkln Thank you! I am partway talking her into stopping the bike and wall slides. She shouldn't start the heel slides, right? Lay off of all ROM for a week?
 
Believe it or not, your mom doesn't need to do any special exercises. She just needs to use her knee in her daily activities in a natural way. Many of us never took formal PT or did any exercises. I am one of them. I had 12 knee surgeries, 2 of them kneecap removals, and 1 tkr. Even after those I never took formal PT. But, I didn't just sit around and do nothing. I used my knee as it was intended to be used by walking around to take care of my daily needs. As I healed I was able to do more. Icing and elevation were a huge part of my recovery.

Tell her to listen to her knee. It will tell her if she's doing too much by increased pain and swelling. When that happened to me, I found that resting, icing, and elevating helped. Knees know how to rehab themselves without being told what to do. They just naturally rehab as we use them like they are supposed to be used by walking.
 
With both Pilates and yoga there are adaptations. A reformer can be as high as a massage table and blocks and other adaptations can be used in yoga. She just may need to chat with an instructor to see how to minimize the floor work. I do my Pilates on my massage table.
 
Thank you, @Poctdb!

She is a little self conscious to ask for modifications (as well as being self conscious about getting off the floor with grace), but is getting there. She quite athletic and isn't accustomed to not being able to do anything she wants.:)

I appreciate your input!
 
Corpse pose is really easy on a massage table...... :wink:
 
Here's an update on my mom. She stopped doing the wall slides,and she thinks she's walking better (yay!). Yesterday I was behind her going up stairs and I realized why she's frustrated with her 115 ROM. It's because shes only 4 ft 9 inches and stairs are a bit steeper for her than for the rest of us!

She started the bike again today because it relaxes her, but I wanted to let you all know that we are ditching the wall slides for good. We tried the heel slides per the forum instructions and even the smallest motion causes hip flexor pain, so she will lay off those.

Thanks, everyone!
 
I'm 15 years younger than her, and even now have trouble getting up off the floor. I have also done Yoga, and use downward facing dog position to get off the floor.
Not elegant, but effective.
 
@Schaargi ... I think your mom sounds amazing! Please give her my best and tell her that I’m inspired by her activity level and spirit!
 
Show your mom this post from a member who kept track of their ROM for 6 years.
From Campervan - she discovered that her flexion had increased even at 6 years post-op:
"I had a slow recovery. Here's my flex measurements at various points:
92 - 8 weeks post op
105 - 10 weeks
107 - 5 months
110 - 6 months
112 - 7 months
116 - 9 months
119 - 11 months
118 - 1 yr
120 - 1yr 2 months
125 - 1 yr 8 months
128 – 6 years "
 
This is what @TortiTabby experienced. (Just so you know, ADL means Activities of Daily Living, which means just go about the normal things you do in the course of your day, and not doing a “list of exercises.”)
Just an update for those who are apprehensive about gaining ROM:
It has now been 26 weeks and all I do is ADL and this is what my ROM has done:
3.5 wks: 75
6 wks: 85
7 wks: 90
10.5 wks: 95
14 wks: 100
17 wks: 105
20 weeks: 110
26 weeks (where I am today): 120!!!
I did it! My goal of 120! No "pushing through pain", no PT after the first 3 visits, and most importantly to me: No MUA! My surgeon who said I would never get beyond 85 ROM without pushing through pain was wrong, wrong, wrong. I'm excited to see if it gets even better. :happydance:
 
Hi - I am 50yo and 6-months post op. I had fluid behind my knee which was limiting my ROM. Once I took a strong anti-inflammatory for a couple of weeks my body reabsorbed it and now my ROM is much better. I went from 108 to 120 in a week. Also, I find a compression sleeve to be really helpful for pain. Neither my doctor nor PT suggested it, which surprises me as I think its helpful. Also, I cannot get up and down from the floor yet without holding on to something and looking pretty awkward. I hope I’m as active as your mom in 30 years! She sounds awesome!
 

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