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Revision TKR Against the wind

Your PT is looking at your knee through a different lens. She wants linear progression, better every time. Your knee is an organic structure with a couple of non-organic components, but it's still an organic structure that heals in a non-linear fashion. One day will have less swelling, and the next day might have more. The day with more swelling will mean less bend. The day will less swelling will yield more bend. You will gradually have less swelling in your knees as you keep them calm and lightly exercised. If you have a day of lots of activity, the swelling will increase again. And your PT isn't taking any of that into account.

The knee probably wants to bend a little because it's more comfortable with a bend. My knee didn't get completely straight until recently. It much preferred a little bit of bend for a few months. Maybe that's what's happening with yours? Or do you mean seriously bent? More than just a little?
 
I'm going to have her measure it today. Last time it never improved beyond 15 degrees. Which was what lead and brought about the revision.
 
Went to rehab today and my knee extension was measured at 15 degrees. Didn't bother with ROM since that has not been my problem area. I'm hoping all this works out over the next several months. They added more exercises so I have more soreness and stiffness this afternoon. I just do exercises and stretches. No "hands on" so no pressing, pushing or bending. I see my surgeon in 2 weeks.
I'm not totally discouraged but I'm worried. Overall this 1st 5 weeks has been easier. I'm just beatdown with 5 surgeries over the last 3 years. I've never really gotten even close to 100% during this period. I've been in rehab for most of the 3 years. At times just going once every 2 weeks but never reached a discharge status. I'll follow my instincts and ice, elevate etc and hope that I keep improving.:walking:
 
Pretty sharp uptick in pain after rehab yesterday. Added 4 new exercises. I figured i was going to be sore afterwards. My pain pills had reduced but now I'm back at every 4 hours. I'll take it easy today and let things recover. Just coming up on 5 weeks.
 
skippyhak said:
Pretty sharp uptick in pain after rehab yesterday. Added 4 new exercises. I figured i was going to be sore afterwards.
Click to expand...
Those new exercises were obviously too much for your new knee. At this early stage, you don't need them, either.
It's not exercising that gets you your ROM - it's time. Time to recover, time for swelling and pain to settle, and time to heal. Your ROM is there right from the start, just waiting for all that to happen, so it can show itself.

Just a little, gentle exercise, such as walking around the house and garden, is all your new knee needs.
Your knee is newly-wounded, needing time and gentle treatment so it can heal, not lazy and needing exercise.

Remember - If it hurts, at the time or later, don't do it.
Myth busting: no pain, no gain
 
By the way, skippyhak, would you like to consider a new title for your recovery thread? Now you've recently had the revision, the mention of pain at 10 months seems a bit misleading.
Just post what you'd like your new thread title to be and we'll change it for you.
 
Thanks Celle!!
i needed those words and reminder this morning. Woke up and knee still stiff and sore from over do on Friday. I remember these feelings from my 1st TKR; but not understanding, back then, why it was getting worse. Now its very clear when I've over done it.
The conflicting advice from the PT's of "work harder, don't miss your window of opportunity." Also, my family questions my attitude and approach to rehab, so other than Bonesmart, I feel pretty much on my own. I stay with my PT because she lets me just do exercises and skip the hands on until I'm ready.
Please change my title to "Against the Wind"
Thanks so much!
 
Day 38 4 5mg pain pills per day for most part. Kind of goes like this: middle of night 3 AM, morning 9 AM, afternoon 3 PM and night 9 PM. I've had a few nights where the middle of the night pill was not necessary. Last night I woke at 2:45 AM, went to sleep around 11 PM, quick bathroom break, was unable to get back to sleep knee aching, I call it a throbbing headache in my knee so took the middle of the night pill. The last 2 rehab sessions I've added a few new exercises and my daily activities have increased also. So soreness was slightly more last night. But not significantly. Experience of 3 TKR's is in most cases a BIG +. The big negative is the fear that sometimes things don't work out how we want. Anyway.....my PT said that my stride and gait was looking very good. I think she was surprised; she doesn't say it but I think she'd like to see me push it harder. I think I've got a pretty good feel of how much to do and if I do a bit much I'm learning how to dial it down and increase rest, elevate ice etc. and let it recover. :catbutterfly::doggie: Couldn't do all this without my 2 assistants...Emma & Gigi.
 
PT measured my knee mobility this morning. Day 40 ROM 90 degrees and 15 degrees extension.
Why does my knee want to stay bent? It's like muscle memory? 15 degrees is where I left off last time which ended up getting me a revision surgery. And here I am right back at 15 degrees again!
Help! I don't get why it does this?
When I left the hospital on Day 3 it was at 0 degrees. PT doesn't believe me when I tell her that. But I was there and know it was accurate.:gaah::groan::hissy:
 
It sounds as if your knee has been bent about 15 degrees for some time now, @skippyhak . That means that the soft tissues at the back of your knee (muscles and tendons) have contracted. It will take time, patience and gentle treatment for them to lengthen again. You can't hasten that, or you'll risk tearing some of those tissues.

Now you've had the revision, there is no mechanical impairment to straightening your knee, but your soft tissues still need to adjust. That your extension was zero immediately post-op shows that there is no permanent impairment that will prevent you from straightening fully. But, those soft tissues have reverted to how they were pre-surgery. If you like, their memory is similar to stretching a rubber band. You can stretch it, but it will revert to its shorter length once you let it go. Does that make sense to you?

There are some exercises to help with extension suggested in this article:
Extension: how to estimate it and ways to improve it
Just choose one or two that you like, and do them gently, never to the point of pain.
 
Thanks Celle! Appreciate a sound medical reason to what's happening! Here's another question. Does time help this process of re-gaining extension? In other words... tissues etc. heal more, swelling and inflammation reduced so knee now more accepting of being exercised to regain extension and ROM? In other words will I have better success waiting or start working now to gently stretch things back?
Thanks again for your advise, help and support.
 
I'm glad to help, @skippyhak - not sure if what I said was truly "a sound medical reason", but it makes sense to me.
 
6 weeks completed. Visit to the surgeon on Tuesday. I'm continuing rehab twice a week and little by little I'm increasing my walking and activity at home. Overall I'm on my feet about 1 mile per day. I'd estimate by week end I'll be at 1. 5 miles. My knee is my guide on activity. Soreness increases or swelling then I back off some. My ROM is 90 and extension 15. I'm more confident that extension will come around over the next several months. I've increased the amount of time each day I'm stretching my knee extension. I'm hope my surgeon confirms my plan after my exam Tuesday. I'm sleeping thru the night more frequently. Last night I slept 6 hours, awoke to use the bathroom, and then was able to get back to sleep for an additional 2 hours without the need for a pain pill. I'm taking 325-5 percocet 3 times a day. A week ago it was 4 pills a day. So little by little its coming down. Appetite is still spotty but returning gradually. Constipation is an issue but been manageable with stool softeners. Most days I'm napping for 30 to 60 minutes.
My knee still has moderate swelling and stiffness but again there's improvement each week. Slow but steady and that's OK.
 
It sounds like you're really coming along well! You are rehabbing smartly and it's paying off for you!
 
I love that you have a plan, a very sensible one, and are sticking with it. People should take control of their own rehab. I hope you get good results from your OS visit. :yahoo:
 
Day 48. Saw my surgeon this week and gave thumbs up on my progress so far. Not concerned about poor extension; "just keep working on it." Took xrays and examined knee and was pleased. not sure if pleased with my knee or admiring his work. :loll:Anyway.... PT mentioned that knee extension looked better while doing exercises.
So no reason to complain but I will. No real reason to complain other than sick of rehabbing, sick of sore knees, bored with my life of seemingly endless "working on my knee." it's been 15 months with a 3 month window in the middle where I was almost close to a return to a "normal" for me life. Sorry for whining. I have lots to be grateful for but at moment just sick of the whole mess. :censored:
 
@Skippy17 I hear you! I've been on this knee rehab rollercoaster for 2 years and 3 surgeries! I am grateful that it's much better but I feel like you--it's so exhausting! Keep posting updates I love reading how others are coming along. Not to compare --just need reassurance sometimes!
 
jordon6 I went and read your posts and content since you started and indeed you've been thru the ringer!
I'm starting week 8 tomorrow. My step goal is 3000 per day for the next week. Last week 2500. Seems like tissues above my knee have softened slightly in the last week. Rock hard before and seem to have a bit more give to them. Range of motion also seems slightly better; notice a slight difference when I go up the stairs.
 
Beware of the PT. You will heal without their bending and pushing or them looking at you like it's your fault. They will tell you you have to be at 'this ROM' by a certain date or your knee will never bend. They put weights on and push down on a wounded knee and tell you if it hurts it's good. Yeah I'd like to bend their knees back behind their ears.

I'm sorry I will rant but it is a hot button on me because they hurt me so bad for so long.
A little pain is ok but don't push yet. Let your knee calm down. It's very angry now, you can push later.

You sound to me that you are a fortunate one, take easy on that knee. Your body is amazing and designed to heal itself. Pain is the sign that says STOP, THAT'S THE WRONG THING TO DO, SO IF YOU DO IT I'M GOING TO HURT YOU MORE.

Listen to that knee and you know to try not to stress it. Sounds to me like you are doing great, all will be very good. Many people wish they were where you are at, though it doesn't seem like it. Take heart, you are ahead
 
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