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TKR BoneSmart Works!

@NeedaThneed the more ideas we toss out based on what we've tried, the better!

I was introduced to both the theracane and the various trigger point balls back when I was recovering from ACL surgery in 2001 by another martial artist, the woman who had done graphics for the original Travell, Simons and Simons book. My personal preference over those was the foam roller for quad trigger points (scar tissue wasn't an issue) and a plain rubber ball (pink spalding or pensey pinky) in a long sock for self care of my back (ball between the wall and me, the long part of the sock lets me hold it in place from my shoulder). Just as I can't abide the stationary forms of yoga or meditation, my body seems more responsive to the slow rolling or rocking approach. Different "wiring" I expect!

My current PT used a scraper tool to try and break up the scar tissue. It irritated the outer tissue to the point of bruising and inflamed the inner tissue - worse than useless. Some folks here over the years mentioned using a rolling pin and I'm finding it very useful for me.

The day I used the rolling pin then went to the gym to get on the bike was the loosest it's felt since surgery!

Activating those lateral quads - for me standing quad sets against resistance, using a 16" ball against the wall placed behind the outer back of the knee allows me to target ONLY the lateral quads and is a good workout.
 
Rehab update: I found a gym buddy via nextdoor, a woman, Helen, two years older than me, member of my gym, and happy to try the slow focused system I use. It requires a stop watch and recording weights and times, so is much more efficient with a buddy!
The owner-manager of our local franchise met with us yesterday morning to get us on the same page and to record the right machine settings for Helen.
We then worked out.
Well. I did the leg extensions and curls, starting at 30# , and purposely not working to muscle exhaustion as I needed to give it 24 hours to assess for swelling or pain.
My gait was fine afterwards - after lunch I met a friend and we walked a mile to a cafe and after beverages a mile back.
I have had ZERO swelling and in fact my knees felt looser and more relaxed. My chronic R knee evening lower lateral quad pain related to flexion from sitting was probably 50% improved. The scar tissue seems a bit more pliable.
This is incredibly heartening!
I'm going to continue to keep the weight at 30# for now but definitely feel more secure about increasing the time over yesterday's. Helen and I will meet weekly but I' ll aim for a second solo gym session to warm up on the bike, then do the machine again.
 
11 month update!!!!

Today at the gym:

I increased my quad extension weight from 35# to 40# and did slow reps for 1:47. When I exceed 2 minutes at that weight I'll increase to 45# .

I increased my hamstring curls from 40# to 50# and did slow reps over 2 minutes, so will increase to 60# next time.

I did leg abduction (out) at 30# for over 2 minutes, so will increase to 35 or 40# next time.

I tried leg adduction (in) at 30# but within 45 seconds developed soft tissue pain - not muscle ache - on my L medial knee, so I will not do these. Similarly there's one or two upper body machines I avoid because they aggravate something in my R shoulder (the one that hasn't had surgery, and I really don't need to stress it!).

My R lateral quad with scar tissue still bothers me with prolonged flexion, and I suspect this I will have to live with (and certainly can), but it's nice to see it now engaging so well during quad extensions.
 
My second knee turned one year old yesterday!!! :yes!:

Here's a summary of milestones because I'm sometimes asked; it makes sense to have them in one place.

Post op day 1: independent in and out of bed, independent with hygiene.

Post op day 8: transition from walker to walking stick.

Post op day 24: puttering in place at home without the walking stick, tolerating 10 minutes sitting up on a chair (yes I used timers a lot!), graduated off of the elevated over-toilet commode.

Post op day 34: graduated off the shower stool, walked solo on our street with walking stick, got down on the floor and back up, tolerating 15 minutes sitting.

6 weeks: 1/2 mile non stop walking on our street with walking stick, up and down a flight of stairs sequentially, accompanied my husband to the Farmers Market and to a store (different days) and having brunch with a friend at a cafe.

8 weeks: graduated completely off the walking stick, driving.

9 weeks: finally did a full revolution on the recumbent stationary bike.

10 weeks: a stay in the ODIC and gave myself permission to reduce activity and stay on a plateau for a while!

12 weeks: walked 3/4 mile non stop and on non-walking days started gardening and house chores that required repeated semi-squats.

3 months: walking a mile nonstop or doing 15 minutes of yardwork and my knee lost interest in icing except if I slightly overdid it (put away the Breg and just started using an ice pack).

15 weeks: 1.8 miles non stop or 1/2 hour of yardwork.

16 weeks: 2.25 miles non stop.

5 months: 3 miles non stop including up a hill while visiting friends whose hillside home has three flights of stairs.

6 months: began targeted activation of my painful lateral quads and ramped up massage of related scar tissue.

7 months: tolerated sitting during a two hour movie without needing a walking break partway through (I still do take a walking break during a movie to avoid painful stiffness and expect this might be forever due to scar tissue).

10 months: resumed tai chi class after a years long break and for the first time ever was on my feet for the entire one hour class; visited my hillside friends again and was on my feet 2.5 hours including their stairs, walking up and down hills, walking up a steep outdoor staircase, walking around the hill and standing still to watch birds - no need to elevate or ice.

NOW!
My left knee, done over 16 months ago, is a reliable workhorse. It still clicks like a metronome and occasionally stiffens a bit from sitting or overnight sleeping. The numb spot slowly decreases in size and severity.
My one year old is functional. Most of the chronic lateral swelling is gone. The scar tissue is present but more flexible, and there is still major evening lateral thigh aching from accumulated periods of sitting.
My targeted resistance training on machines started April 29 at 30# for quads, for hamstrings, and for abductors (adductors hurt my L medial knee) and this past week I was at quads 50#, hamstrings 65#, and abductors 45#. Each of the three were for over three minutes under load, so will increase 5# next week!
 
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@mendogal - Bookmarking this fantastic record of post op progress for future reference! Thanks so much for taking the time to distill your excellent record of things into one spot!
 
DizzyBlond said:
@mendogal - Bookmarking this fantastic record of post op progress for future reference! Thanks so much for taking the time to distill your excellent record of things into one spot!
Click to expand...
I'm glad you're finding it useful.
We often say no two knees are the same, even on the same person. I have a few advantages:
- mild joint laxity means that, while overall I'm more at risk for injuries, in this situation I had good flexion unusually quickly
- my skin likes to grow so I am prone to all kinds of skin tags, moles, etc but overall I seem to heal more quickly than the norm.
 
Great progress and good to have a detailed record!
I still get occasional painless clicks in my 18 month pkr. It is if I step backwards and twist slightly. I usually notice it in the morning after brushing my teeth when I step away from the bathroom mirror. My surgeon says it is popliteus just catching slightly on the implant and nothing to worry about.
 
Thank you @Jen53014
The righty is probably going to have long term residual ache/pain from that lateral quad, but I'm thrilled to have two functional lower limbs again - I had adapted to a level of partial disability a long time time and have zero regrets!
 
My left knee is officially 18 months old!

My weight training started in earnest three months ago.

At that time my settings were 30# for quads, hamstrings, and abductors (which actually are targeting my glutes the way I do them).

This Monday I did quads at 60#, hamstrings at 75#, and abductors at 50#.

My upper body is also making slow steady progress. Better muscle tone and function is a wonderful thing!

My L knee does sometimes complain with prolonged standing. The numb area is smaller and definitely less numb (I accurately feel light scratching). My younger R knee still has the presumed scar tissue creating discomfort with prolonged sitting. There's mild, not unpleasant dysesthesia of the shrinking numb area.

They are both clickers! The ROM is more than adequate for anything I actually want to do.
 
Really great reports! I think it is so useful to hear much longer recovery stories.
mendogal said:
The numb area is smaller and definitely less numb (I accurately feel light scratching).
Click to expand...
Like you I still have gradual improvement and change in the numb patch. I really don't notice it now unless it is knocked- when it is still odd and unpleasant.
 
@mendogal , your updates are so great--both for practical ideas and also to hear your honest assessment, which always includes progress and also acknowledgement of nagging issues which are normal and to be expected! Please keep sharing these! Yesterday I finally played some tennis with my friends--hitting was fine but moving was pitiful--but it's a start. I also know that I need to start working on strength (wasn't so good at that BEFORE surgery--there's no time like the present!)
 
@EalingGran Ta! Your dedication to your ongoing fitness is inspirational.

@AnnYo Thank you! You're really on that cusp in your recovery where it's safe to take some challenges, ready to back off as needed and still keep exploring your evolving capacities. Brava for a new milestone!
 
Tomorrow R knee, the original Bad Knee but the second to be replaced, turns18 months old!!! (Lefty turns two years old next month.)

It's doing well despite ongoing issues with that lateral quad/ITB still being affected by some scar tissue that creates aching with prolonged flexion. The funny thing is that a few hours after doing a gym workout there's a temporary loud but non-painful snapping as I walk. There's no feeling of friction when it happens. Near as I can tell it's the scar tissue, and things feel nicely looser for a day or so.

When I started at the gym in April I was doing 30# weight for both quad extensions and hamstring curls every week. Now I'm doing 90# on both of those, twice weekly, plus once a week doing the leg press at 180# . The muscles are slowly coming back from visible atrophy (I'm making sure to protein load after each workout).

I haven't increased my walking distance from a little over 3 miles because Weather (our season of too darn hot led to season of alternating too darn cold and too wet'n'windy!). I do continue to do a full hour of tai chi, no breaks, every week in a formal class. I can stand at the easel to paint for 45 minutes at a time. If there are limits to my yardwork it's not at all because of my knees.

There's literally nothing I WANT to do that I can't, though both knees may ache a bit at night - that R lateral especially - and I have to reposition in bed once or twice if I've been sidelying with knees flexed too long.

Overall, so far, so good!!!! My advice to anyone reading is Prioritize Healing. Literally surrender your ego to the needs of your healing joint and don't let anyone tell you there are shortcuts.
 
A milestone at just over 18 months!

I've been mindfully consciously kneeling for ages but....

This afternoon I went to clean our master bath shower's floor, and without even a millisecond of thought just got on my knees with scouring powder and scrub brush in hand.

I was done and walking away before I stopped and said, "wait, what!?!?"
 
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