TKR Confused

[lindy1]

Hi all, I am 10 days in from surgery. My post surgery notes said to do the floor pedals for 10 mins per day. Initially I didn’t do that and had good leg extension and could hold 90 ROM for some seconds. Finding conflicting advice on Google I decided I should also begin doing the pedals. I had also been walking with walker and doing pumps and sitting on a chair with 90 ROM The last 2 days I have done 10 minutes on the pedals and have been in terrible pain for a few hours afterwards. Also I have had to wait some time for more for pain relief which has been really upsetting. As a result I’ve been unable to do anything much else for the rest of the day due to increased stiffness etc. I am thinking I will only do back and forth on the pedals for 5 minutes now. Just looking at the pedals however is giving me anxiety. I’m worried I won’t reach 120 ROM by 6 weeks if I don’t do enough on the pedals though. Any advice greatly appreciated.

 

[Jaycey]

@lindy1 Welcome to BoneSmart! Which knee did you have replaced? I'll put the information in your signature for you.

I’m worried I won’t reach 120 ROM by 6 weeks if I don’t do enough on the pedals though.

There is no timeline for reaching ROM. Please don't dwell on any "targets". Everyone is different. ROM will come with time.

The last 2 days I have done 10 minutes on the pedals and have been in terrible pain for a few hours afterwards.

At only days out of major surgery your knee is telling you that peddling is too much. Are you icing and elevating? Gentle stretches, ice and elevation are all that is really needed at this point. Plenty of time to strengthen after that knee is healed.

I'll leave you our recovery guidelines:

Knee Recovery: The Guidelines
We are all different, as are the approaches to this recovery and rehab. The key is, “Find what works for YOU.“ Your doctor(s), physiotherapist(s) and BoneSmart are here to help. But you have the final decision as to what approach you use.

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. Here is a very general week-by-week guide. Activity progression for TKRs

6. Access these pages on the website

Oral And Intravenous Pain Medications​

Wound Closure​

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.

 

[lindy1]

Hi Jaycey, thank you for putting my mind at rest. I have had TRKR. I have hired an ice machine so am using that all the time. Your guidelines are basically what I have been doing and felt comfortable with until I began the floor pedal. I will put the pedals aside for now.

 

[sistersinhim]

The last 2 days I have done 10 minutes on the pedals and have been in terrible pain for a few hours afterwards.

Your knee said, "Not yet!" It's too early to be doing this. You can try it again in a few weeks or maybe even a month.

I’m worried I won’t reach 120 ROM by 6 weeks if I don’t do enough on the pedals though. Any advice greatly appreciated.

There is no time limit on improving your ROM. What your PT said is very untrue. We see members improving even up to a couple of years out from their surgery.

I will put the pedals aside for now.

That is a very smart move. Your knee will thank you.

 

[lindy1]

I’m not sure if I’m posting this correctly or whether I need to start a new thread. Anyway I am now 4 weeks post TKR. My knee is still swollen but swelling hasn’t increased, just seems to be staying much the same. I feel I am making improvements though. I am using the floor pedals but not excessively as I did initially. Now I am comfortably doing 25 over forward and 25 over backwards once a day. I am walking outside with a cane half a kilometre there and back every morning. Throughout the day I am doing bits and pieces of light housework but nothing excessive and resting inbetween. I have full extension and I think my ROM is 100 or 105 each day. The surgeon at my 2 week check said he was happy to release me to do my own physio so I don’t have exact ROM measurement. So all in all I feel I am on track, not overdoing things and slowly progressing. My concern is the foot on my operated leg. Ever since the op 4 weeks ago it feels like I have a tight band around my ankle and my whole foot in general constantly feels one step away from full on pins and needles. Also my heel feels uncomfortable resting on anything. These uncomfortable feelings are made worse when resting and especially when elevating. I lightly massage my foot and ankle throughout the day but that really only takes my mind off it. My foot, ankle and calf have not been swollen at all since the operation. The swelling is just around my knee itself. Has anyone else experienced this, especially the feeling of the tight ankle band. If so, what causes it and will it ease. Also how long is it likely to last as it is uncomfortable and keeps me awake at night. Thanks in advance for any help or advice.

 

[benne68]

Yes, @lindy1, you are posting correctly. It's important to keep all your posts in one thread so your history is all in one place. If you'd like a different title for your tread, just let us know.

Also, please give us the exact date of your surgery and whether it was the left or right knee, so we can create a signature for you. This will help us respond to your questions.

Ever since the op 4 weeks ago it feels like I have a tight band around my ankle and my whole foot in general constantly feels one step away from full on pins and needles. Also my heel feels uncomfortable resting on anything.

Yes, this is a very common complaint post-surgery. Remember that all the soft tissues and nerves in your leg -- not just the bones -- underwent significant trauma during the surgery. Your body needs time to heal, and it takes more than a month for everything to recover. I found this chart really helpful in understanding why it takes so long:

 

[LD of Michigan]

Great chart!

 

[lindy1]

Thank you so much. One less thing to worry about. The chart also is very helpful. I had LTKR on 22/3/23.

 

[sistersinhim]

Thank you for your surgery's date. I'll add it to your signature for you.

 

[VA Mom]

Hi @lindy1
congrats on being 4 weeks out! I don’t have the ankle band pain, but I did have tenderness on both heels, especially when resting. I found that putting a colloid dressing on my heel, as a sort of padding, seemed to help some. I attributed the tenderness there to just so much pressure on the heel for such long periods of time while otherwise fairly immobile.
I hope you find some relief soon!

 

[lindy1]

Thank you for sharing your experience. It really helps to know others have similar things going on. I will try the dressing.

 

[Tino2You]

@lindy1 It sounds like you are on your way. Your ROM is fantastic! As for the heel, I did not experience that. The swelling knee I have. I use (still use) a Dr Lounge (elevation pillow) and the Breg Ice Therapy machine every day (sometimes twice). Yesterday I used my knee more than I should have and I will be icing and elevating a few time through the day.

 

[lindy1]

Yes I’m feeling more confident about my ROM now and it is def improving each day. The swelling in my knee hasn’t changed much in 4 weeks but it hasn’t gotten any worse so I’m thinking that’s a good sign. I had an iceman machine for three weeks and now use an ice pack that wraps round my knee. It helps with pain but I guess swelling will just take time to go down. The heel thing and tight band feeling around my ankle drives me crazy though. I bought an elevation pillow - arrived yesterday. Def better than a pile of pillows and my heel is not resting on anything which is great. I hope the feet issues resolve soon as they keep me awake! The night is long!

 

[Layla]

I hope the feet issues resolve soon as they keep me awake! The night is long!

I am sorry. Rough nights are no fun. You lay down, tired, hoping to drift off into a comfy slumber...then stare at the ceiling!
If the heel issue you mention is a sensitivity issue, many have found relief in resting heels on a sheepskin. Give it some thought. You seem to be doing really well. Rest assured that swelling can last for months. My OS once told me, even up to a year for some. Happy Spring, lindy!

 

[lindy1]

Heel issue and feeling of tight band around my ankle I think must be a nerve or sensitivity issue. Pain pills don’t help and elevating makes it worse. Walking around seems to help but there’s a limit to how much of that I can do. I’m worried my knee will heal and I will be left with this foot issue. I don’t have a sheepskin but will try to find something similar and give that a go. I dread going to bed as I’m not sleeping because I can’t get comfortable with this silly foot issue Thank you fit your help

 

[beachy]

You're not quite 4 weeks post op and the swelling will continue. Mine continued until about week 8 until I started to see and feel improvement. The first 8 weeks were not fun. Keep up with icing. Its a shame elevating causes your foot/ankle area to hurt.
Yes, nights were long for me those early weeks til about 8 weeks.
Maybe you should leave a message with your surgeon's office about ankle pain. It may put your mind at ease.
Hang in there...it does get better!

 

[Layla]

Hello and Happy One Month Anniversary!
I do hope sleep, swelling and your heel issue has improved since you last posted.
The early weeks can be tough, but persevere, it does improve over time.
Wishing you only the best.
@lindy1

 

[lindy1]

Thank you for your message. Into my seventh week, sleeping better, still have some swelling in outer knee and unfortunately the heel sensitivity and numbness has not yet improved. Weirdly it feels better when I am wearing shoes but as soon as I take them off the heel issue and numbness is just as bad.

 

[Layla]

You're welcome. I am sure it's rather annoying, but give it more time, it's still very early days for you in the entire scheme of things.
I hope you have a nice day and rest of the week!
@lindy1

 

[lindy1]

Thank you