TKR Anxiety about TKR - now it's done!

[Josephine]

There is nothing new. Why would it suddenly hurt?

There doesn't have to be anything new. It's just the persistence of the exercises you are doing.

As a matter of interest, what kind of PT exercises and exercises at home are you doing? How much and how often? (and detailed details would be appreciated, please! **Reps, sets and sessions** and all that)

** If you're not familiar with this, it goes like so:
1 lift of your leg = 1 rep (repetition)
5 reps and then a brief rest = 1 set
5 sets and finishing = 1 session.

 

[jenng2003]

I have weak/angry hip flexor muscles, so I have pt for hip, low back, and knee.
All exercises are 10 reps/3 times unless otherwise indicated.

I really only do heel slides (5 every hour or so depending on my activity level for the day...if I am out and about, I may not do them as often). I ride the bike for 5 minutes twice a day. I do stretching at home because of my back and hip. They have flared in this recovery. Below are the pt exercises I only do at pt.

Standing leg extensions--3 directions (front, back, and outside direction)

Standing marching in place (hip flexor again)

Heel slides

Leg over the table bent and I extend (I do not have full extension yet...I am close).

Climbing and descending stairs (5 times only)

Stair stretches (hamstring stretch using short stairs, not normal ones..these are 3 for 1 min).

Stretching...nothing prone. These are 3 times for 1 minute hold. Hip flexor--I lie with my backside almost off the table and stretch the hip flexor. Hamstring and calf stretches are assisted since those muscles (specifically hamstring is tight). Assisted knee bend--no force at this point, just support thigh while knee bends with gravity.

Bike 10 minutes


I had an awful evening/night last night after being upright all day either sitting or standing. The shin area was swollen and puffy (painful as well). I iced but not as much as I was (yesterday was close to what a normal work day will look like starting Wednesday). I am concerned I will hurt myself and be out longer. I don't have anymore days at this point :-(





LTKR. October 27th 2014

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[Josephine]

I have weak/angry hip flexor muscles

You're 7 weeks out. Your muscles are neither weak not angry, they are injured! Big difference!

Your exercises - my comments in bold
10 repsx3
heel slides x5 every hour or so - that's okay but NEVER cause yourself pain with this one Heel slides and how to do them
ride the bike for 5 minutes x2 - do it once every other day
stretching at home because of my back and hip. They have flared in this recovery - yes you recovery is making them flar4e because you are doing far too much

Standing leg extensions--3 directions (front, back, and outside direction) - these are not really knee exercises and anyway, they are far too much
Standing marching in place (hip flexor again) - marching is a terrible exercise to you and very punishing
Heel slides - see above
Leg over the table bent and extend - half leg raise - be careful with them
Climbing and descending stairs x5 - again, be careful, these can cause a lot of muscle pain
Stair stretches - same as before, very punishing exercise
Stretching...nothing prone. These are 3 times for 1 minute hold. - okay
Hip flexor--I lie with my backside almost off the table and stretch the hip flexor - no, no! This is an awful exercise to do - will cause you muscle pain
Hamstring and calf stretches are assisted since those muscles (specifically hamstring is tight). - okay
Assisted knee bend--no force at this point, just support thigh while knee bends with gravity.- okay but don't let it hurt you at all
Bike 10 minutes okay

So all in all, much of your pain is being caused by the exercising you are doing. I kid you not.
It's a great myth that you 'must' do all this to achieve a good outcome when in fact the exercises themselves will inhibit your recovery and cause the very situation they are purported to prevent. Read this PT: the seriously grave consequences of doing too much of it

 

[kneeper]

If you're like me and have gone years on bad knees, it is not surprising that some of your muscle groups are weak or unbalanced. You can gradually work on them as the knee gets better.
I can't remember the various exercises/stretches they gave me, but they weren't too intense. And PT always told me they shouldn't hurt. maybe pull a little, but not hurt. And I think it was always 5-10 2x/day, depending on how I felt.

 

[jenng2003]

My low back and hip were not cooperating before surgery. It's been 10 years of arthritis, but 15 years since the original surgery/begin of the decline. The hope was this would correct it and besides the muscle tightness on the upper thigh (which is also on the other leg), the hip pain is better.

My hip flexor hurts worse on days I don't do pt, as does my low back. I can't do my back strengthening activities right now (I keep up the ab work though). My shin pain is definitely something with the anterior tibia something according to the dr. I guess they are blaming my bike riding so I am backing off that. I could see a few other things that might be bad as well.

I'm paying for today's activities right now. I went back to work and had to rearrange my classroom. The sub adjusted it for his liking but didn't move it back to be knee recovery friendly. After the third stumble, I moved desks and tables. It's not swollen, but muscle sore. I'm surprised it's not more sore. I guess that's another success/step in the right direction. I definitely wouldn't advise anyone to do this 7 weeks out, but you do what you have to do to make it through. Four more days til
Winter break...


LTKR. October 27th 2014

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[jenng2003]

I didn't do much in physical therapy except bike and stretching. I'm in so much pain after returning to work. I hope this goes away soon. I am miserable today. I wish I didn't have to go to work tomorrow.


LTKR. October 27th 2014

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[Jamie]

Frankly, you don''t need any therapy if you're working. Activity is activity so count your work as your therapy and let the other go until you are safely at home on break. At not quite 8 weeks, you are really pushing yourself....that's what your body is telling you with that pain.

 

[jenng2003]

I only have two weeks of therapy left. I was in horrible pain before I even got to therapy. Gentle stretching helped some of the pain (hamstring and calf stretching). I really wish I could wait to go back to work. My rom obsessed pt didn't even try heel
slides or measuring yesterday. The goal was gentle yesterday. If I didn't already have appointments set up, and the appointments weren't free, I'd cancel, but since it's free, I might as well have them stretch the muscles gently. My hamstrings are so tight normally that I get horrible low back pain. I can't seem to get a good enough stretch by myself at home.

But there isn't any sleep tonight...yippee


LTKR. October 27th 2014

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[chestnc]

Hi @jenng2003, just happened upon your thread. You seem to be having a bit of a tough time and you just went back to work. That must be touch. I understand we have to go back when we have to go. Wishing some of that pain will ease up. Does ice help at work? Are you able to ice? I actually went back @ 3 months so I would not loose benefits for my son and myself. I was very anxious about going back as I was afraid I would not be able to make it through the day and of having pain at work. I ended up being fine, but I had my ice pack and would ice periodically during the day. Hope you continue to improve and have less and less pain. My best to you.

 

[jenng2003]

I strapped ice to my leg. Problem is that I can't really sit and it's been less than 8 weeks. The swelling is horrible right now, and I didn't have much swelling before returning. I only have two more days before a longer break, but I am not sure how it will respond when I return b


LTKR. October 27th 2014

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[jenng2003]

I spoke with pt about increased pain and swelling. They said it's normal for going back to work. I am to try to sit and ice as much as possible (but they know it won't happen). I am upset that my os thought it was a good idea to go back. Os should spend a day in my classroom before saying teachers having sedentary jobs. Yes I am not doing physical activities, but I cannot sit longer than 30 sec before a child needing my attention.

I was doing so well, and now this is quite a setback :-( we did not do much in pt except gentle stretching and massage to help get the swelling moving (it doesn't hurt and actually gives some relief). Pt said it was good that my swelling is worse at night but goes down by morning (isn't completely gone, but is significantly less). Heel slides were done as well. I spent all day with ice on me knee (and even icing now in bed). The swelling is down, but not gone.

It's swollen on the lateral side above the knee cap. It also have tibial pain about four inches below the joint line. That is believed to be some tendon/muscle pain (I forget the actual term used anterior-something) from using my leg opposed to actual surgical pain.

It's 2:05...I guess I should try to get some sleep. Tramadol and tylenol are taking the edge off, but neither helps with sleeping (I am also taking Celebrex to help with inflammation).


LTKR. October 27th 2014

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[Minnie's knees]

@jenng2003 so sorry you are having pain with going back to work. I knew it wouldnt be easy but hoped it would be okay for you. Rest, ice and elevate once you are off. Take care of yourself!

 

[jenng2003]

The swelling finally went down yesterday morning after icing all weekend. I did not do much at work yesterday, and the swelling stayed away. Let's hope that I can do the same today! The insomnia still exists. I cannot wait until tomorrow! Last day before the holiday break!!!


LTKR. October 27th 2014

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[sandbar525]

@jenng2003 Glad you're swelling has gone down. Fingers crossed for little or no swelling after work today. I'm not going back to work for another two weeks but have been following your return with interest. Sorry about the sleep issues! That certainly doesn't help dealing with back to work. Glad you've got the holiday break coming up. Please use the time to rest, ice and take care of yourself! :gifts:

 

[jenng2003]

The swelling returned yesterday. My supervisor gave me class coverage again, so I lost an hour of icing and elevating. I came home and iced and elevated. I go to pt this morning. No sleep again last night. Knee is still swollen this morning, but not as bad. 8 weeks is way too early for me to go back. Hopefully the extra week off next week will better prepare me.


LTKR. October 27th 2014

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[Minnie's knees]

@jenng2003 glad you are now off for awhile. 8 weeks sounds like a long time but its not with TKR recovery. Hopefully your knee will get some rest and feel better. Just try not to over do it while you are off.

 

[Angel1978]

SonnysWife

 

[jenng2003]

Thanks! Resting seems to be helping. Of course, the kiddos shared some germ with me last week, and I am having a rough time fighting whatever this is.

My knee is doing better. Flexion is 115 degrees. Resting and icing helps. I am not excited to go back to work in a week. I am done with pt on Friday. Yay!


LTKR. October 27th 2014

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[jenng2003]

My knee cap has been making a lot of grinding noise lately. Pt said its okay, but I'm not sure. I know I don't have a button behind my knee cap. My os doesn't use them unless absolutely necessary. Apparently his research doesn't support the use of them.


LTKR. October 27th 2014

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[Angel1978]

Bless your heart. I will be praying for you. I know what it fills like. But I do have the button. But I admit I am worried.


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