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TKR Coach’s Recovery, 43 yrs old

Believe it or not, you'd make progress even without PT. It sounds like you are making really good progress! Before you know it, you'll be back on that bike outside! I could hardly wait to get back on mine. I really enjoy a nice leisurely ride where I can check out the scenery!
 
Coach_HL said:
Roy, even from a mental perspective throwing my leg over the bike and sitting on the seat is good for me mentally. I’m glad I brought it upstairs even to rock back and forth a few times.
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:thumb: Rule 1 is 'what works for YOU' so good luck with it!
 
Flex was 81 degrees today at PT, so I’m making slow and steady progress there.

New question or situation for the group, looking for input. A few days ago after sitting in our vehicle for an extended period of time I developed a lump at the top of my butt crack. I would say the size of a couple quarters. This has for the most part gone away. Yesterday I was on my bike three or four times for a few minutes each time rocking back and forth. This morning I have the same type of swelling on my lower butt, basically where I sat on the bike seat. This swelling is about the size of my hand. So I have inflammation, not tender to touch, no open sores, not really hot. I called my surgeon’s nurse who suggested I call my primary doctor. Has anyone encountered something similar?
 
You will certainly be sitting on the bike differently. Perhaps you are wearing different kit than before TKR. Perhaps you haven't been on the bike for a while and the 'toughness' has gone away. So it could be just a physical reaction; bike saddles are quite unforgiving if you're not used to them.
 
Roy, I hear what you are saying but this is weird. Never experienced anything like it. I did call my general dr. And spoke with her nurse, she used the word infection more than I cared to hear. Waiting for a call back once she speaks with the doctor.
 
Coach as much as you want to make progress, use caution putting so much focus on that ROM number. Putting too much emphasis on that number as a measure of your success can be bad for you mentally over time. I hope that the odd swelling ends up being nothing serious.
 
I wasn't suggesting for a moment not to consult your doctor! Just trying some possibilities. Hope you get it sorted.
 
@Roy Gardiner my blood work came back and no infection so that is good news. The dr. Had put me on an antibiotic that I was allergic to, so welts and swelling of my lips have been around for past two days. Stopped the antibiotic on Saturday morning, taking Benadryl currently which is slowly helping. I believe I’m on the down hill side.

PT this morning bent to 87, felt good on the recumbent “stair stepper” and recumbent bike as well.

Tomorrow I will try to stretch on my trainer only once and see if any swelling on my rear end happens and then go from there.

I appreciate everyone’s input.
 
Update for my recovery. Went back to general dr. Today and received a steroid shot for the allergic rash. That worked well, itching is gone and almost all of the swelling from the reaction is gone.

This evening I rode my trainer/rode bike, clipped in and was able to make full rotations with an “ankle roll” at the top. So the stroke wasn’t pretty but a big mental win for me today.

My mental state has been much better the past few days, the first 14 days were tough mentally. I appreciate this site.
 
Question for the group.

Is it normal three weeks post op to have continual tightness in the knee throughout the day every day. What I mean by this is my flex is currently at 90 degree range, but everyday it becomes a “battle” through stretching to get it back to this point. Waking up in the morning my functional flexsion is probably 15-20 degrees and then I walk stiff legged for a while. Then I would say through rocking in the glider and normal activities I have about 75-80 degrees of functional flexsion. By functional flexsion I mean it’s not uncomfortable or feeling like I’m work to stretch my quad and soft tissue. Not sure if I’m even asking this in a way that makes sense????
 
Coach_HL said:
s it normal three weeks post op to have continual tightness in the knee throughout the day every day. What I mean by this is my flex is currently at 90 degree range, but everyday it becomes a “battle” through stretching to get it back to this point.
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At 3 weeks you are still quite swollen both inside and out. That's why you are stiff. Most OS don't expect 90 degrees until 6 weeks after surgery and here you are already there! All you need to do is your daily activities to rehab your knee.
 
@Coach_HL, what you describe is perfectly normal and will be for a while. Based on your avatar and your user name, you like to keep fit and may subscribe to the mantra “No pain, no gain”. If so, you might want to get a change of perspective for this recovery. If you don’t, it may well be a very long, very painful, and very frustrating recovery. Unlike other injuries, TKR recovery needs a lot of time to just heal and for swelling to go down. The new knee and surrounding soft tissues are easily aggravated and swell in the early weeks / months. I was not able to get in the gym to do leg exercises without negative side effects until almost 6 months. No issues with the knee implant itself, just the soft tissues. You may find you can do so sooner, but you still have to give it time.

BTW, the following article helps explain the tightness and stiffness you describe: https://bonesmart.org/forum/threads/tight-band-feeling-across-the-front-of-my-knee.11734/
 
@NavyGunns thank you for the article, that helps and makes sense. I truly feel like I’m being a “good” patient. I enjoy PT which might place me in the “naughty” category on this site and enjoy doing what PT asks me to do at home which might make me a total outcast. My day to day swelling is moderate based on photos other moderators have shared in other threads. I don’t get noticeable additional swelling after PT or home routine. I ice and elevate on the backside of PT and then throughout the day. This recovery has been described as a marathon and that’s frustrating mentally for me but I understand thats what it is. I appreciate your words and experiences.
 
Coach_HL said:
I enjoy PT which might place me in the “naughty” category on this site and enjoy doing what PT asks me to do at home which might make me a total outcast.
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Not at all! We aren't against PT. We are against aggressive PT that causes pain and swelling. This is not good for your knee's healing. Discomfort is OK. Pain isn't. Pain is your knee telling you it needs to do more healing before doing that particular activity. Wait a few weeks and try it again. I bet it won't hurt then. Healing should be your #1 priority. Your knee isn't unfit, it's injured!

Coach_HL said:
I don’t get noticeable additional swelling after PT or home routine. I ice and elevate on the backside of PT and then throughout the day.
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It sounds like you're doing it just right! Your PT is having you doing things that are good for your recovery! That's a big plus! Good!
 
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Some of us are against PT because we’ve been unnecessarily hurt by a therapist and sessions that take days to recover from. That’s what my PT was like. I followed their instructions the first month until I realized it was counterproductive for me.

Maybe I’d feel differently if I’d had a better experience.

But, Bonesmart is about giving us good information about different recovery approaches so that we can choose for ourselves how we will recover, and then supporting us through our chosen approach.
 
@Coach_HL, my response couldn’t have been any better than what @sistersinhim stated! I, too, enjoyed PT, but it was the result of a serious conversation I had first with my therapist. Once he understood I was in charge and bought into what I expected from pt, everything went great. If you are getting benefit from pt and not getting pain and swelling, then don’t feel guilty about going.
 
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