TKR Confused and Conflicted

[Sbow3111]

Would love to know where you are with ROM? I'm a few days past five weeks, and my flexion is about 107. Is that horrible?

 

[Layla]

Hello and Welcome back to BoneSmart!

Please share the exact date of your TKR and identify which knee it was so we’re able to create a signature for you. Thanks in advance!

Congrats on your new knee and thanks for joining us again! Please don’t worry about a timeline with your ROM. In addition, we advise to refrain from engaging in movement that causes discomfort or pain or allowing anyone to forcefully manipulate your leg. While your range of motion is currently limited, it will naturally increase as the swelling subsides and the pain eases. Give it time.

I will leave our Recovery Guidelines with best wishes. Please stop by often with updates. We’d love to follow your journey and encourage you along the way.

Best wishes for a great Sunday and week!

KNEE RECOVERY GUIDELINES

As you begin healing, please keep in mind that each recovery is unique. While the BoneSmart philosophy successfully works for many, there will be exceptions. Between the recommendations found here, your surgeon's recovery protocol and any physical therapy you may engage in, the key is to find what works best for you.

1. Don’t worry: Your body will heal all by itself. Relax, let it, don't try and hurry it, don’t worry about any symptoms now, they are almost certainly temporary.

2. Control discomfort:

rest​

elevate​

ice​

take your pain meds by prescription schedule (not when pain starts!)​

don't overwork.​

3. Do what you want to do BUT

a. If it hurts, don't do it and don't allow anyone - especially a physical therapist - to do it to you​

b. If your leg swells more or gets stiffer in the 24 hours after doing it, don't do it again.​

4. PT or exercise can be useful BUT take note of these

the BoneSmart view on exercise​

BoneSmart philosophy for sensible post op therapy​

5. At week 4 and after you should follow this

Activity progression for TKRs​

The Recovery articles:
The importance of managing pain after a TKR and the pain chart
Swollen and stiff knee: what causes it?
Energy drain for TKRs
Elevation is the key
Ice to control pain and swelling
Heel slides and how to do them properly
Chart representation of TKR recovery
Healing: how long does it take?

Post op blues is a reality - be prepared for it
Sleep deprivation is pretty much inevitable - but what causes it?

There are also some cautionary articles here
Myth busting: no pain, no gain
Myth busting: the "window of opportunity" in TKR
Myth busting: on getting addicted to pain meds

We try to keep the forum a positive and safe place for our members to talk about their questions or concerns and to report successes with their joint replacement surgery. While members may create as many threads as they like in a majority of BoneSmart's forums, we ask that each member have only one recovery thread. This policy makes it easier to go back and review history before providing advice.

 

[Layla]

Check out this post from current member JusticeRider in regard to ROM -

JusticeRider’s thoughts -

“I just want to add, for all those coming along, a note on ROM. I want to share this because nearly all of us have a tremendous amount pressure put on us to increase our ROM by certain deadlines, or else.

Mine has been extremely slow coming. First I had to wait out the swelling, which in my case took more than 5 months. Yes, months. At that point I began to see real progress. It has continued to this day. I have seen improvement in the last 2 weeks. It’s still going. A this point I think the limiting factor is tight muscles, ligaments, and tendons from 3 yrs of very limited ROM and actually about 25 yrs of somewhat limited ROM. Those tissues are slowly stretching.

I have had to be willing to let my flexion improve at a glacial pace, be very patient, and tune out the dire warnings of my surgeon, PA, previous PT, and some well meaning acquaintances. I refused painful PT and refused a MUA. I have absolutely no regrets. I know my body, and I believe those things would have caused a domino effect of swelling and pain that may have derailed my recovery long term and even possibly have torn soft tissue, etc. I now know I have the added challenges of hypermobility and an immune condition that causes an inflammatory reaction. I think a MUA would have been very harmful to me.

Instead of forcing it, I have relied on weekly massage and using my stationary bike as a stretching aid every single day. I have been very active, but I have ramped up really, really gradually. I have not measured my flexion, because honestly I feel almost a PTSD type of reaction around it. All I care about is function and what I can do. My knee is very functional now, and still improving. I love my new knee. I’m glad I let it heal on its own timeline even though it was so much longer than everyone (most of all me!) would have liked.”

 

[WFD]

107 at 5 weeks is great. You are well on your way, no worries.

 

[Razorback 1983]

Thats where I was at about 4 weeks and by the 7th week I was at 120

 

[benne68]

Welcome to BoneSmart @Sbow3111! Please tell us more about yourself.

 

[sistersinhim]

Your bend is outstanding! Most OSs expect 90 degrees at 6 weeks. You have surpassed that already!

 

[Tentcamper]

Wow, I'm jealous! At 5 weeks I had so much swelling that I was at 40.

 

[Sbow3111]

Wow, so encouraging to hear from everyone! I'm 63 years old, and five weeks post-op TRKR. This is my second replacement, my left knee was done in 2015. My experience this time has been so much better. (A lot has changed in the surgery in eight years!) My biggest fear has been PT, as it was not a good experience last time. When I mentioned to my therapist that it hurt, she said "Oh, I haven't even started to hurt you yet!" You can imagine why I was so nervous about it this time! I had two home visits, which were fine, and I went to PT at the clinic four times before I decided I would be more comfortable doing it at home on my own. I try to walk a lot during the day, and I'm doing some of the exercises that I was taught. Mostly, I'm living my daily life, which includes stairs ... and typical housekeeping. I'm praying every day that these actions will keep me progressing as I heal.

 

[Jockette]

I'm 63 years old, and five weeks post-op TRKR.

Please don’t forget to give us the date, we’d like to update your signature.

I went to PT at the clinic four times before I decided I would be more comfortable doing it at home on my own. I try to walk a lot during the day, and I'm doing some of the exercises that I was taught. Mostly, I'm living my daily life, which includes stairs ... and typical housekeeping. I'm praying every day that these actions will keep me progressing as I heal.

You do sound like you’re doing very well!

 

[Sbow3111]

Sorry I forgot... my surgery was 8/18/23.

 

[Axx72]

Sorry u had such a frustrating experience with your first knee. Keep doing what you are doing with this one. Seems to be working well.

 

[Layla]

I'm praying every day that these actions will keep me progressing as I heal.

It sounds like you're doing very well on your own and the activities of daily living should keep you comfortably mobile. You're not overdoing it and you're making good progress...so stay the course!
Best wishes and Happy Tuesday!

 

[sistersinhim]

When I mentioned to my therapist that it hurt, she said "Oh, I haven't even started to hurt you yet!"

You should have run from this therapist! This kind of PT causes excess pain and swelling, meaning its outcome is a setback in your recovery!

I decided I would be more comfortable doing it at home on my own.

Oh yes, you will recover much better doing it yourself than going to that therapist. Bad PT is worse than no PT. The thing is, you can do your own PT all by yourself and stay at home, not burn the gas, and not pay the copay. I did my own PT after each of my 12 knee surgeries and have ended up just fine!

 

[Sbow3111]

I'm 5-1/2 weeks post op TRKR, and for some reason I can't get it out of my head that I need to get off the Tramadol. However, every time I try, I hurt!! So many people seem to be off meds by now, and I'm wondering if I'm making a mistake by continuing it. I'm scared that if I don't taper off now, my doctor won't give me another refill when it's gone.

 

[Sbow3111]

I'be been on Tramadol, Gabapentin, Celebrex and Arthritis Tylenol since Day One. I recently finished the Celebrex, but still taking the others 2xday.

 

[Jaycey]

You are not even one month out from surgery. Take your medication as prescribed. When you start forgetting doses it's a sign that you are weaning off them.

You will notice that I merged your newest post with your original recovery thread. For several reasons, we prefer that you only have one recovery thread:

• That way, we have all your information in one place. This makes it easier to go back and review your history before providing advice.
• If you keep starting new threads, you miss the posts and advice others have left for you in the old threads, and some information may be unnecessarily repeated
• Having only one thread will act as a diary of your progress that you can look back on.

Please post any updates, questions or concerns about your recovery here. If you prefer a different thread title, just post what you want and we will get it changed for you.

If you need an urgent response to a question, just tag a member of staff.

Many members bookmark their thread in their computer browser, so they can find it when they log on.

 

[Sbow3111]

I apologize if I'm posting this on the wrong place, as I'm not completely sure I'm navigating this site correctly.

I'm in the US, where they have a very different attitude towards PT following surgery. In following comments in groups on Facebook, it sometimes seems so competitive... as if folks are bragging about how quickly they've achieved a certain ROM, etc. "Push push push through the pain" seems to be the mantra. In reading posts on BoneSmart, however, I feel as though I should relax and just let my body heal and progress at its own rate.

I'm not sedentary ... I walk every day, go up and down stairs, and drive short distances. But I haven't been doing "formal" PT for a couple of weeks.

I'm so confused and nervous, and have fears such as "will my knee freeze up and never get more bend??!" Would appreciate your input!

 

[sistersinhim]

I'm so confused and nervous, and have fears such as "will my knee freeze up and never get more bend

Not so, there is no time limit on when anyone has to achieve ROM. Members even improve theirs in their second and third years.

 

[Jockette]

Yes, I was very conflicted, also, by all the different opinions. However, after 4 weeks of painful PT before I found Bonesmart, it only took me seconds to agree with the sensible advice I got from Bonesmart, and follow it going forward.


By the way, I merged your newest thread with your original recovery thread, as we prefer that members in recovery have only one thread.

This benefits you because all your information is in one place, easy to find, and maintains a nice journal for you.

This also benefits our staff, as your information is all in one place, and we often go back through your thread for previous details, so we know what you‘ve been through which helps us advise you better.

So, please keep all your posts in this thread. If you’d like a new title, let us know what you want, and we’ll change it for you.

Many members bookmark their thread in their computer browser, so they can find it when they log on.
How can I find my threads and posts?

Best wishes on your continuing recovery!