TKR Back to needing fellow Bonesmarties input.

[Murphy2013]

Hi WhenimOld! Yes I had an mua and maybe just maybe I will see a group of small improvements over time. I tried to go in pool before mua and my dang knee just locked up in extension when it got underwater. Pool was too cold for the knee and I had to grab the rail and pull myself out. That was fun in the scale of indignities. Now I feel like I can at least start by going in hot hydrotherapy jacuzzi to move the knee first. Have to time it right so no kids around tomorrow.

I can only imagine! I'm so sorry! I started using the hot tub on it nightly As soon as my OS have me the all clear. It gets things loosened up and I sit with the jets on any sore, tight spots.
Keep us posted!

Thank you for the encouragement. I will go tomorrow morning to the jacuzzi and do some walking and then let the jets pulse some sore spots.
One thing I am working on is to be very happy for people who get early easy flexion. It’s like one of the spiritual exercises of my life. My first reaction is (yikes so unattractive) envy and I laugh at myself!
I think if they came out of a 7-11 with a winning lottery ticket, I would be happy for them because they bought the ticket and deserve winning as much as the next guy.
I love this group of bonesmarties and truly want success for all, but it’s still a challenge every day at week 13 and this keeps me sane.

 

[Murphy2013]

Hello this is just to ask for feedback on swimming... haven’t done since TKR 6/17. When I searched data I saw from sistersinhim a comment about needing a week to recover from one lap and I can just see myself doing this. Could you kindly explain what is was that you thought went wrong that caused a setback.was it type of stroke or vigor with leg action.

 

[sistersinhim]

Could you kindly explain what is was that you thought went wrong that caused a setback.was it type of stroke or vigor with leg action.

I'll be happy to. I had to walk in the water to the clear lane and then did gentle flutter kicks in my lane along with a normal arm stroke, then walked back to the ramp. This was too much for my knee. If you read my signature you'll see that I had, had 5 previous surgeries on this one knee, so my experience might be different than what yours will be. I suggest that you start very slowly your first time then see how you do that night and the next few days. Don't forget that everybody's knee is different than any other knee even on the same body.

Water adds resistance to any movement you do while in it. It seems easy to move around and you don't realize how much your knee is going through. While walking and swimming in water it's like using weights on your legs. The stress on it will show up that night and days afterward if it isn't ready for those activities yet.

 

[Murphy2013]

Wow I get it! As much as I want to get back to the water, I have worked so hard to even get forward recumbent rotation. I am not about to jeopardize all that effort to go back to the pain chamber. Thank you so much.

 

[Murphy2013]

Hello Bonesmarties all, I just finished videos from MD panel with Jaime. Very informative! I however wanted to pipe up (loudly, perhaps...) which of you docs have ever had a TKR? I have needed and prudently utilized throughout my challenging recovery the beneficial narcotics that were prescribed without having to defend my choice as we know can be the case. Do I know about meditation, yes. Do I know about CBD, yes. Do I know about multimodal treatment with acetaminophen coupled with NSAID , yes. But there is nothing that helps your healing like the sure fire pill.

 

[Jaycey]

@Murphy2013 Glad you enjoyed the videos. Agree that narcotics are needed in many cases. It's a tough situation! Our panel surgeons were providing alternatives to opioid pain medication as they are under strict control in most areas.

 

[Murphy2013]

Hello especially to Sistersinhim; I did it! I waited until my five month post Surg date until I went back in the water to swim. And boy am I glad. I went very slowly and the knee is not a happy full participant yet because it is so new to the forces and motion of water. I’ve been watching lots of Terry Laughlin Total immersion YouTube videos and was very excited to rejoin the pool. I use a wetsuit and swim snorkel so I am happy to get back to quiet underwater peaceful exercise. Slowwwwwly does it.

 

[sistersinhim]

What wonderful news! There is something so peaceful about swimming. I'm so glad you're back at it and doing well.

 

[Murphy2013]

I am almost 6 mos. post op and can’t get over the theme we all go through; pushing through pain gets us nothing but..(wait for it) more pain. Thankfully I found Bonesmart advice to wait for returning to the activities I love very relevant. Now I need some advice from senior forum on how to progress to a fitness bike outside ...cleats, no cleats...thank you for any tips.

 

[Jockette]

I’ll tag @Roy Gardiner for you, he has good advice about bikes.

I, too, am so glad I found Bonesmart and learned about a much more sensible rehab than the one I was offered by my medical team.

 

[sistersinhim]

I started back on my bike extremely slowly. My first ride was only about a mile. I stopped and wanted to see how my knee would react. I had been riding my recumbent bike a few weeks before I tried my outside bike. I did fine with my slow start.

 

[Murphy2013]

Thank you so much. Just to dig in a little...did you feel like you could use either knee to put on the ground at a stop or did you have to use the non-TKR knee? Was their anything unexpected on the first ride? My right quad agreed today to do its first leg lift without assistance so I am planning my next outside challenge. I am thinking of getting an old school bike trainer to begin the process.

 

[Roy Gardiner]

Now I need some advice from senior forum on how to progress to a fitness bike outside ...cleats, no cleats...thank you for any tips.

I never had much trouble with cleats going back. I use Speedplay, so much easier to engage IMO.

Thank you so much. Just to dig in a little...did you feel like you could use either knee to put on the ground at a stop or did you have to use the non-TKR knee?

It makes no difference. If you stop correctly your leg bears almost no weight at all, it's just balancing the bike. Once should never use a foot on the ground as part of stopping. You slow down, unclip, brake to a halt, foot gently down. This has to be done in the right order unclip too late and down you go!

Was their anything unexpected on the first ride?

Absolutely. I had to learn how to pedal all over again; my legs were straight rather than bow-legged and I had to learn to stop pedalling 'knees-out' as I had been for years.

My right quad agreed today to do its first leg lift without assistance so I am planning my next outside challenge. I am thinking of getting an old school bike trainer to begin the process.

An 'old school' static bike trainer is perfect.

Using a bike to gain ROM, as opposed to training for fitness, is pretty simple:

• Set the bike to zero resistance
• Set the saddle low enough so that a single rotation is a challenge; difficult but not painful. When a rotation becomes easy right from the start, lower the saddle a max of 1cm.
• Gently turn the pedals, through discomfort but without pain.
• Continue until the knee is 'warmed up' and the rotation is now easy, or for 2 minutes, whichever is the shorter time.
• Repeat several/many times a day, but don't go mad. Diminishing returns will apply; my guess is that half a dozen reps would be enough
• Do not pedal fast or for more than 2 minutes, this is a stretching exercise, not training.
• And if you get any pain or swelling in the 24 hours after doing this, cut it down until you don't

Here is a bit more chat and some pix and how 'healing' and 'training' are different

 

[sistersinhim]

did you feel like you could use either knee to put on the ground at a stop or did you have to use the non-TKR knee?

I used my old leg for support and still do. But, I think it's because I've done it this way for years and it's just a habit. My new knee is strong enough to be the bike's support, but old habits are so hard to break!

 

[Murphy2013]

Thank you all so much. My click out cleat was my right foot which I trained in for a long time. When I started in cleats, I let both sides share the job which resulted in (of course) an embarrassing slow speed fall on the bike trail. I want to go back to letting it have the job someday but maybe work in slowly. I will train inside first. Thank you Roy for the outline. You’d love our living room. We have six bikes including a steel frame Eddy Merckx throughout the room. my husband is the original roadie at 83 (kind of a Marinoni clone).
Upstairs we have a recumbent trainer that I have used for ROM but not the same as the out of doors.

 

[Roy Gardiner]

You’d love our living room. We have six bikes including a steel frame Eddy Merckx throughout the room

Goodness, there's keen. My bikes are in the cellar.

 

[Murphy2013]

Hello to all Tkr friends. Just when you thought it was safe to go back in the water... I am 8.5 months post op and thought well, this is it. I’m all through with this knee. I can do what I want.
I am sure that my Sunday is gloomy and painful because I overdid it on a Flexionator machine that was left at my house during the pandemic. My knee feels stiff and clunky and kind of glitches at times. Back to the ice packs.
I really just need to hear from a moderator that this is a common experience.
I spilled coffee coming down the stairs from a pot I didn’t empty thoroughly so this is a weekend of notes to self.

 

[Jockette]

Well, at least you tried, right? Evidently your knee, which is different from anyone else’s, is not ready for that machine, and/or the length of time you spent on it. And that’s ok. It is healing on its own schedule, in this year long, on average, recovery. You can always try it again in the future. Or not. It’s up to you.

Don’t worry about this setback, just give it time to settle down.

 

[Jockette]

And I’m sorry about the coffee spill, its so annoying when things like that happen!

 

[Celle]

Oh you poor thing! I hope your weekend improves from now on.

As Jockette said, your knee wasn't ready yet for that machine. Never mind. You gave it a go. It's quite hard to judge what is too much for a knee and what is just right. There's a lot of trial and error involved and you're not the first to find out the hard way. It's only a temporary setback, though.

The knee stiffness should improve slowly if you give it additional rest, ice and elevation. It might take a few days, but you will get there.

This recovery is often a series of two steps forward and one step back. It's bit of a trial of patience, isn't it?