Lounge Doctor

TKR Celebrate the little wins

leejaa

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Glad to hear you are seeing the surgeon and hopefully get some answers on the skin reaction.

I am sure your colleagues were glad to see you also. Have a great day and week end.
 

Mrs. Ciz

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@babycatcher
I think I remember reading that you were also having lots of behind the knee pain due to a really tight hamstring. Am I remembering correctly? I also have this problem - still - after 11.5 weeks. It’s driving me crazy!!! I know you’ve been dealing with the infection, but I was also wondering how your hamstring pain was doing.
 
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babycatcher

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@Mrs. Ciz yes I have a tight hamstring but it’s not particularly causing me pain just affecting my range of movement, and it feels tight! I have very little pain usually, just when I first get up from sitting until I get moving and at the max of my ROM. I do get more though if I’ve overdone it but it’s all pretty mild to be honest. In fact it’s much better than before the surgery but it’s just a different sort of pain. I’m at the point now where I don’t regret surgery whereas initially it was a case of what have I done! The surgeon did warn me about it though and said the first few weeks would be brutal and I would be regretting having it done. I did! Anyway will be nice to see him next week as I’d like to see how he thinks I’m doing.
 
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babycatcher

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6 weeks and 3 days post LTKR

A win today. No painkillers at all today! I’m walking totally unaided lots of the time now just using one stick for longer distances and uneven ground. Still a little limp but much better than pre surgery. Tried the exercise bike though and my knee won’t bend enough yet to pedal, but I didn’t make the seat high enough so might try again next week with a higher seat.

Still two tiny areas of my wound to heal but they are getting much smaller every day.

I’m still struggling a bit with standing still for instance if I need to cook so husband mainly doing that but otherwise feeling more positive.
 

Pumpkln

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happy to hear you are doing well. The revolution on the bike will happen, your knee still needs time to heal.
@Roy Gardiner has a progression for exercise bikes that may help you.
 

Roy Gardiner

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Tried the exercise bike though and my knee won’t bend enough yet to pedal, but I didn’t make the seat high enough so might try again next week with a higher seat.
If your leg is stiff and swollen then using an exercise bike for training is not a good idea; but you can still use one for mobility exercises - even if you can't make a single rotation!
  • Set the bike to zero resistance
  • Set the saddle as high as possible and rock the pedals back and forth as far as you can with discomfort but no pain
  • 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
  • And if you get any pain or swelling in the 24 hours after doing this, cut it down until you don't
Then when you can turn the pedals:
  • 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
 
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babycatcher

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Unfortunately Consultant appointment cancelled today due to him having a family emergency so rescheduled for next week!

Saw physio though who remains happy with my progress. Current bend 95 degrees but more if not on couch and sitting on chair.

Wound now healed thank goodness and infection gone. Physio wants me to massage scar area as slightly ‘tethered’ at lower end of scar. He’s also suggested alternating hot and cold to increase blood flow as I still have some swelling.

He also noted that I have very small patellae which sit high on the knee - I already knew this and it’s part of my Hypermobility. Checked daughters when I came home and we have matching knees - she is 22 and quite disabled due to the full Hypermobility spectrum condition, uses a stick every day and a wheelchair user when bad.

Walked around the block today with my husband but without my stick. Bit sore when I cane back and my back felt sore too - readjusting to new gait I suppose.

Another 5 weeks off work to build up strength and stamina!
 

Jaycey

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Physio wants me to massage scar area as slightly ‘tethered’ at lower end of scar. He’s also suggested alternating hot and cold to increase blood flow as I still have some swelling.
You may want to give the massaging a miss. That scar will heal on its own. Massaging may make soft tissues very angry.

You will continue to have swelling. Heat won't do anything to reduce this. Icing as often as you can will help.
 
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babycatcher

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Physio wants me to massage scar area as slightly ‘tethered’ at lower end of scar. He’s also suggested alternating hot and cold to increase blood flow as I still have some swelling.
You may want to give the massaging a miss. That scar will heal on its own. Massaging may make soft tissues very angry.

You will continue to have swelling. Heat won't do anything to reduce this. Icing as often as you can will help.
Thanks. The scar has healed it just feels a little ‘tight’. I think the heat may also have been to help my muscles to relax a bit as they’re also tight.
 

Jockette

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Tightness is a normal occurrence after this kind of major surgery. Your surgeon did major carpentry work and disturbed every millimeter of soft tissue in this area. You aren't tight because your muscle is underused and needs to be stretched and rehabbed. You're tight because your tissue is healing...and full healing takes a full year or more.
 

Foodiegirl

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Obviously we are all different but with the bike, my physio started me pedalling backwards as far as I could and then forwards as far as I could but not a full pedal rotation, next time I started like that and then it just happened that it went to a full pedal. Slowly and surely - am now up to 10 minutes on the bike with some resistance!

Also interestingly, the top of my scar was very similar to yours about the same time, I had TKR on 12 August and thought it was infected. I returned to my surgeon and it was the internal knot stitch that had not dissolved. He was able to remove and it healed very quickly. It will be interesting when you return to the Surgeon to see what he says.
 

sistersinhim

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Many find that heat increases their swelling making the tightness even worse. Inflammation feeds on heat. Ice helps to reduce that inflammation and swelling. Tightness is a normal feeling for many months.
 
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babycatcher

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Obviously we are all different but with the bike, my physio started me pedalling backwards as far as I could and then forwards as far as I could but not a full pedal rotation, next time I started like that and then it just happened that it went to a full pedal. Slowly and surely - am now up to 10 minutes on the bike with some resistance!

Also interestingly, the top of my scar was very similar to yours about the same time, I had TKR on 12 August and thought it was infected. I returned to my surgeon and it was the internal knot stitch that had not dissolved. He was able to remove and it healed very quickly. It will be interesting when you return to the Surgeon to see what he says.
Physio suggested this to me too. He said just kind of ease it a bit then relax then do it again. He’s very much of the opinion of not pushing to pain.

When I spoke to the surgeon on the phone he said that sometimes the body tries to expel the knot as a foreign body and causes this irritation. The way he does his suturing is that he uses sutures to the deeper layers then glue to superficial and skin. My scar is incredibly neat! As a midwife I suture (not knees though ) and I appreciate a good scar and appreciate what it takes to get one!

Current photo attached! Week 7 post LTKR
 

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babycatcher

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That photo was a couple of days ago as the two ends are now even better.
 
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babycatcher

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That's looking much better.
Isn’t it just!!! I feel so much more positive now. Just need to get my ‘bend’ sorted - 95 degrees so far! Back to work in 5 weeks!!!! Need to be much more mobile to cope with my shifts!
 

sistersinhim

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As you heal more and your swelling goes down, your bend will improve. It happens naturally.
 

Jockette

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Your bend will sort it’s own self out and you can’t rush it. Don’t worry if you don’t see a drastic improvement in the next 5 weeks. As sistersinhim said, the bend progresses as you heal. It often takes longer than we’d like and it doesn’t care about our schedule.
 
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babycatcher

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@Jockette you know in the info you give out it says to go to uncomfortable but not pain I don’t seem to have this setting! It’s pain free then straight to sharp intense pain at height of ROM.
 

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