TKR Bionic's final op - fingers crossed<

[Bionic]

Had appointments with physio and OS today. Physio said I have to work harder and either I could do it myself or they could help if I wanted. Opted for physio help. It was pretty panful but not too bad. Within just a few minutes got my ROM from 70 to 75. The best thing is that I wasn't in any pain when he finished.
2 more apps booked for next week but I have to,do exercise every 2 hours at home.

OS agrees with the approach and told me to take oramorph 30 mins before physio.

Apparently during the op a sample was taken and sent off. OS said its been confirmed that I have the start of rhumatoid arthritis. He is referring me to a colleague so it can be controlled before it gets worse.

 

[Jockette]

have to,do exercise every 2 hours at home.

What exercises did they tell you to do?

 

[Celle]

Physio said I have to work harder and either I could do it myself or they could help if I wanted. Opted for physio help. It was pretty panful but not too bad. Within just a few minutes got my ROM from 70 to 75. The best thing is that I wasn't in any pain when he finished.
2 more apps booked for next week but I have to,do exercise every 2 hours at home.

OS agrees with the approach and told me to take oramorph 30 mins before physio.

Painful PT, either at the time or later, is counter-productive. It upsets all your knee tissues, making them hot and inflamed - and it's a good way to set back your recovery. Keep up that sort of treatment and you're likely to end up with chronic inflammation and a knee that doesn't bend properly.

In addition, taking pain medication specially so you can get through painful PT is dangerous. Pain is a warning that you're doing too much for your knee. Mask or ignore the pain, and you could damage your knee without realising it.

Your surgeon's approach is not the only way.
My surgeon doesn't allow any PT at all for the first month after a knee replacement. He says your knee needs that time, to start on its journey of healing. For that month, we rest, ice and elevate our leg, and walk around the house.
After that month, we just go to PT once every 2 weeks, where we are shown a few new exercises to do at home.
His patients all do well and achieve good ROM, as I did, and he hasn't had to do a manipulation to help with ROM for the past 4 years, not even one. I think that speaks for itself.

What's the rush anyway? Your knee isn't going to set at a small ROM if you don't achieve a certain number within a certain time frame.
There's no need to rush to get ROM (Range of Motion) because it can continue to improve for a year, or even much longer, after a knee replacement. There isn't any deadline you have to meet:
Myth busting: the "window of opportunity" in TKR

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.

 

[Bionic]

@Jockette
The exercises for home are gentle versions of what they intend to do at physio.
Try bending the knee up onto the next step. Not actually climbing the step but just getting the bend.
Sitting on a table and seeing how much I can bend the knee backwards towards the table.
Sitting down with the knee bent as far as I can stand it.
Moving the new knee on and off the bed without the help of the other leg.
They are all fairly simple. So they just want me to do little and often.
I did ice yesterday evening but the knee was no more swollen than any other day.
Interestingly the pain that I have experienced in the inside of the knee since the op seems to have gone. That's a real bonus as it's been a problem sleeping.

 

[Bionic]

Thank you @Celle
Not being able to bend the knee isn't just about ROM for me. Having the leg stuck out when I sit down is uncomfortable itself and difficult when I go out. So I do need to find a way of improving the position.
I am typing this at 4.20am as the dog wanted to go out but other than that this has been the best nights sleep I have had in the 6 weeks since the op. I realise that physio were not very aggressive, especially after reading some reports from others, but my knee never hurt afterwards and i never took any meds before this session. I began to feel as if there is some light at the end of the tunnel.

 

[Celle]

I did ice yesterday evening but the knee was no more swollen than any other day.

One session of icing is not going to make a difference. you need to ice for 45-60 minutes at least 4 times every day. Even then, don't expect instant improvement. This is a long recovery and nothing is going to happen that fast. Complete recovery takes a full year, not just a few weeks.

Not being able to bend the knee isn't just about ROM for me. Having the leg stuck out when I sit down is uncomfortable itself and difficult when I go out. So I do need to find a way of improving the position.

Yes, of course you want to bend you knee more, but it will happen gradually, not fast. It's a slow, steady progress, not a fast recovery.

Your knee knows what it's doing. It's going to recover on its own schedule, not yours and not your surgeon's or your PT's.
Where are you in recovery?? (TKR)

 

[Irish471]

@Bionic , sorry to hear the news about the rheumatoid arthritis. It's good you had the replacement to avoid further damage.

I am doing all of the same things with my physical therapy, too. I walk out of each session feeling much better. We never work to the point of pain, just slight discomfort and that is all dictated by me.

I remember the first time we went, I could barely bend enough to get my leg in the car even though the seat was pushed back all the way. It's much easier to get into the car after two weeks. I take that to be an improvement.

Do you feel like your quad muscle is tight? We worked on that today. The physical therapist had a stick and he rolled it all over my quad for a while. You can accomplish the same with a kitchen rolling pin. It helped!

Hang in there. We will both get there soon

 

[Lindylee]

Sorry to hear about the RA, but on a positive note, it's good it's been diagnosed and you've been referred.

 

[Bionic]

@Irish471
I dont have any quad pain (one less thing to worry about )

What I did find strange is that both physio and the OS had their hands all over the scar area, touching, prodding etc, something I haven't wanted to do, but maybe thats what resulted me in having little to no pain last night.

The outside of my knee and going downwards for a bit is very numb. OS explained where he cut and why that area is numb. Its good to understand why things feel the way that they do.

I put oil on the area this morning and husband encouraged me to actually oil the scar too (surgeon said that was ok) I did manage it but didnt feel comfortable doing it.

Now that he said its ok for me to have a bath I am going to look for something I can put in the bath that will help the dry skin.

 

[JDinCT]

@Bionic Sounds like you are moving forward overall…. Best of luck with the bumps in the road...

 

[Mojo333]

Hi my hippy friend.
Just wanted to wish you a good weekend and let you know I'm rooting for you.

 

[Celle]

The outside of my knee and going downwards for a bit is very numb. OS explained where he cut and why that area is numb. Its good to understand why things feel the way that they do.

That numb area is normal and it's inevitable to get it.
Numb area after TKR: how long will it last?

I put oil on the area this morning and husband encouraged me to actually oil the scar too (surgeon said that was ok) I did manage it but didn't feel comfortable doing it.

Now your incision has closed, the more you touch that area, the better. Touching it and massaging it will help to de-sensitize it, so it doesn't annoy you when your clothes touch it.

 

[Bionic]

Thank so @Celle
The information about de-sensitising the knee is a good one

 

[tylermit]

After my PKR incision healed, my PT would massage my scar every session. At first it did not feel good at all. She said it breaks up the scar tissue under the incision.

 

[Celle]

She said it breaks up the scar tissue under the incision.

Massaging is OK, but there's no need to break up scar tissue under the incision, because that scar tissue is normal and it's holding the layers beneath your skin together.

 

[Mojo333]

Continued best wishes my bionic friend!

 

[tylermit]

Massaging is OK, but there's no need to break up scar tissue under the incision, because that scar tissue is normal and it's holding the layers beneath your skin together.

It was light to medium massage. It was uncomfortable but not painful at first but after a few times not bad at all. It made my scar very smooth. I compare it to my quad tendon repair scar witch is lumpy feeling and did not receive the same treatment. I have had 8 different physical therapist over the last 6 years and all had different techniques.

 

[Bionic]

Well, that was nearly a disaster.

OS said I could now have a bath so bought some E45 bath emollient, it's the sort of stuff they use for people with skin conditions, and no perfume.

I put on shore shoes so that I didn't slip but found that as they were coated in the oil they did slip so I couldn't get out. Called husband, he decided to let all the water out and then put the shower mat in the bath but my feet still slipped. Took the shoes off, still no luck.

Put a towel on top of the shower mat but the mat rucked up underneath and slipped.
Husband went out to the garage to get something robust the I could sit on that would raise mu further up. While he was gone I tried the towel on its own and SUCCESS

Phew... I thought I was stuck there for the night.

 

[Jockette]

I’m so sorry that went so badly.
I’m kind of glad I prefer showers over baths, but things can happen in the shower, too.

I’m glad you got yourself out!

 

[Kctsh2019]

Bionic Glad you got out safe! I would have paniced for sure. I have been wanting to soak in the tub and relax. I was afraid I couldn't get out. So I have attempted that yet.