TKR Cbet’s TKR Questions

[sistersinhim]

I was wondering if anyone else is experiencing leg spasms

Oh yes, many of us have experienced these. They are annoying, but harmless, except for keeping us from sleeping! Some have found that heat will help to relax those muscles. But, be careful to not let that heat get close to your knee, heat can feed inflammation which will cause more swelling. Are you icing and elevating enough? That will also help to relax your leg and reduce that swelling.

 

[Cbet]

Hello, just finished a few of my exercises and now noticing that the shin of my TLKR is tender half way down and across the shin. I haven't felt this tenderness before and wondered if that would be a normal spot to have discomfort? The exercise that I was doing mostly consisted of dangling my legs and swinging them to help my ROM. I am 3 weeks 2 days since surgery so still fairly early in mending.

 

[Jockette]

Almost any pain at this point is normal, and it will vary in intensity and location. I was never told to dangle and swing my legs at any point in my recovery. It sounds a bit early to try that. If you don’t like the way it feels, now or in the future, don’t do it again.

People are all different, as are the approaches to this recovery and rehab. The key is, “Find what works for you.“ Your doctors, PTs and BoneSmart are available to help, but you are the final judge as to the recovery approach you choose.

Regaining our ROM is more about Time than repetitions of a list of exercises.

Time to recover.
Time for pain and swelling to settle.
Time to heal.

Our range of motion is right there all
along just waiting for that to happen so it can show itself.

In the general run of things, it doesn't need to be fought for, worked hard for or worried about. It will happen. Normal activity is the key to success.

 

[Cbet]

I am 3 1/3 weeks out from surgery but only at 90% flexion, my knee seems tight and I worry if I push it I could injure myself .... is there a chart to follow with regards to expectations on flexion with a time line ....I recognize everyone is different but with the wealth of knowledge I have found here I thought I would ask the question

 

[Jockette]

There is no timeline. Don’t push your knee past discomfort. The ROM will return, but it can take a while, and that’s ok.

Regaining our ROM is more about Time than repetitions of a list of exercises.

Time to recover.
Time for pain and swelling to settle.
Time to heal.

Our range of motion is right there all
along just waiting for that to happen so it can show itself.

In the general run of things, it doesn't need to be fought for, worked hard for or worried about. It will happen. Normal activity is the key to success.

 

[Cbet]

Just wanted to say hi and hope everyone is having a great day
I was struggling on how to do heel slide when many areas in my house are carpetEd ...well I found a solution that I think is genius and wanted to share with everyone...I got a furniture slide which glides easily on either carpet or tile .... super easy to do heel slides with on any surface

 

[sistersinhim]

What a wonderful idea and you can pick these up just about anywhere!

 

[Cbet]

I went to physio today and tried the bike and got to the top and all of a sudden the pedal dropped down with a speed I wasn't expecting and buckled my knee....ouch....now I am home and worried I may have damaged it. My knee is very stiff

 

[Jockette]

You most likely have not damaged the implant, but you have upset the healing soft tissue in that area. Stop your exercises for a couple of days, or a week, to let this set back heal. ADLs (activities of daily living) and short walks are all you need for mobility. Rest, ice and elevate.

 

[sistersinhim]

I went to physio today and tried the bike and got to the top and all of a sudden the pedal dropped down with a speed I wasn't expecting

I had that happen on an upright bike at home. Man, did that hurt! It took about a week for my knee to settle back down to where it was before. The next bike I rode was a recumbent bike. Those pedals don't drop as easily.

 

[Layla]

I was struggling on how to do heel slide when many areas in my house are carpetEd ...well I found a solution that I think is genius

That is genius!! I’m think stealing that idea!
So many people own a set of those and it’s better than the old plastic shopping bag trick.

I hope your knee is better from the Friday incident you shared above. I read about your hospital stay on another’s thread. Sounds brutal, so sorry you had to experience that.
I hope you have a great week!

 

[Cbet]

So today I had my 6 week checkup with the surgeon and my ROM is at 90 and he offered to do MUA within the next 3 weeks ugh. I had a lot of swelling which hampered my ROM so I went last Friday to get a lymphatic massage to help with draining the swelling which worked amazing....he is giving me a week to decide so I am to determined get my ROM to 110 by next Monday so I can tell him no MUA ..... do you think that is possible? I also have to tell my PT to work me harder as per OS .....

 

[sistersinhim]

he is giving me a week to decide so I am to determined get my ROM to 110 by next Monday so I can tell him no MUA ..... do you think that is possible? I also have to tell my PT to work me harder as per OS .....

No pressure because you are already bending well and don't need a MUA. The best way to improve your bend is to work less, not more. The more you work, the more you inflame your knee and it reacts by swelling. That is what causes a less bend. All you have to do is do your daily activities, no extra exercises or PT, and that knee's inflammation will decrease and your bend will increase. It's common sense. You can't bend your knee well when it's swollen.

 

[Jockette]

he is giving me a week to decide so I am to determined get my ROM to 110 by next Monday so I can tell him no MUA

I don‘t think you will go from 90 to 110 in a week. There is nothing wrong with 90 at 6 weeks. If you don’t want an MUA, just say no.
Saying no to therapy - am I allowed to?

I also have to tell my PT to work me harder as per OS .....

This is only going to increase your swelling, which will decrease your ROM. Don’t let your surgeon‘s impatience interfere with your recovery, which your body is in charge of, not your surgeon. We all recover on our body’s own timeframe, not the “one size fits all” that many medical teams have. You would think by now they have seen enough patients to know this.

 

[benne68]

Hi @Cbet Why is your surgeon pushing an MUA at just 6 weeks post-op, when your bend is good? Most OSs are thrilled to have their patients at 90 degrees by the 6-week post-op visit. You are well within the normal recovery.

That myth about the "window of opportunity" for ROM is just that, a myth!

Myth busting: "window of opportunity" in TKR

This "six week window of opportunity" surgeons often speak about is little more than a myth. It presupposes that all patients have the ability to create adhesions which is far from the truth. It also ignores the simple fact that in the first 3-4 weeks after surgery, swelling reactive to the...

bonesmart.org

There is no magic number or fixed timeline for this recovery. We have members who didn't get to 90 degrees bend until 4 or even 5 months out, and whose flexion continued to improve well into their second year, getting to 120, 125 or even higher.

Say no to this procedure and give yourself more time to heal rather than creating more trauma for that poor knee.

 

[Jockette]

This is what one of our members, TortiTabby, experienced:

(Just so you know, ADL means Activities of Daily Living.)

“At my six week appointment this is what my OS wrote in my visit summary: "She reads an online website called Bone Smart which states to not push through pain following knee replacement. If she were to follow this direction, she will have to learn to live with a knee that only reaches to 85 degrees of flexion. I believe this website is very misleading."
It has now been 20 weeks and all I do is ADL and this is what my ROM has done:
3.5 wks: 75
6 wks: 85
7 wks: 90
10.5 wks: 95
14 wks: 100
17 wks: 105
20 weeks (where I am today): 110
I am so thrilled it keeps improving and improving and I know now that I will get to my goal of 120 (or even better, dare I say!)
So, if a OS or PT bullies you into thinking your ROM will not improve over time they are wrong. By the way, I haven't been back to see the OS since that horrible appointment at 6 weeks, but I sure am going back when I reach 120 just to say, "Ha! You were wrong, BoneSmart was right!" “

And,

“Just an update for those who are apprehensive about gaining ROM:
It has now been 26 weeks and all I do is ADL and this is what my ROM has done:
3.5 wks: 75
6 wks: 85
7 wks: 90
10.5 wks: 95
14 wks: 100
17 wks: 105
20 weeks: 110
26 weeks (where I am today): 120!!!
I did it! My goal of 120! No "pushing through pain", no PT after the first 3 visits, and most importantly to me: No MUA! My surgeon who said I would never get beyond 85 ROM without pushing through pain was wrong, wrong, wrong. I'm excited to see if it gets even better. “

 

[Jockette]

@Jockette I think my worry is that if I am not where my surgeon thinks I should be that he will delay my right TKR.

Is there a certain timeframe that is important to you, to have the second one done?

Have you seen your surgeon again since having the MUA discussion?

 

[Cbet]

@Jockette no there is no timeframe but I would like it sooner rather than later. This will be the first time I see him since I declined the MUA ... just praying that the stiffness will ease and my ROM will be more fluid and less grimacing from me

 

[Jockette]

We would all like to see it sooner rather than later.

 

[Cbet]

So today I got the call for my RTKR .... Sept 22 .....