TKR Cycle again?

[Orange Blossom]

Thanks. I just returned home from PT. My therapist got me to 95* today. I’ll be (4) weeks PO tomorrow. Is 95* around average or a bit below average.

 

[sistersinhim]

Most OSs don't expect 90 degrees until 6 weeks so you are way ahead of the game.

My therapist got me to 95* today

What does that mean? Did he push you to there or did he verbally encourage you to get there? If he pushed you, that is the wrong thing for him to do. Besides, he did it and not you with your own muscles so it doesn't count.

 

[Rockgirl4]

If your therapist "pushed you" to that 95 degrees, don't be surprised if you end up with a painful night and less range of motion tomorrow. Thus begins a horrible cycle of "what am I doing wrong" and "well, it bent to 95 yesterday so why not today?" ...I hope this isn't the case for you, but we see it here allllll the time.

This is why it's crucial to take things slow and never let a PT force your knee to bend or straighten. My surgeon forbids it and says that kind of therapy is why he sees people struggle horribly from weeks 3-12 with chronic inflammation and pain that SHOULD be lessening. If it's not lessening, the cause is almost always from doing too much and/or being pushed by PTs trying to meet a numeric goal instead of a functional goal.

I've only met 1-2 other TKR patients in real life (meaning other than on Bonesmart.org) that were told the truth about TKR and a 12-month recovery. I've had 11 knee surgeries in 20 yrs, more PT than you could ever imagine, and asked LOTS of questions over the last 5 yrs because I knew this TKR was inevitable. Bonesmart was the first place I heard about the 12-month recovery. Then I found a wonderful surgeon who said the same and made a point to dispell all the myths floating around. He's a keeper!!!!!

 

[Orange Blossom]

31 days PO and I’ve developed a shooting pain down the outside of my knee/leg. I guess this is the IT Band? Any known stretches to fix this? Having trouble straightening my leg as well.

 

[Celle]

Well, it might be the IT band, or it might not. Here's an article about it anyway:
ITB (ilio-tibial band) issues and treatments

How much activity and exercise are you doing? At only a month post-op, you should still be doing only a little. Your knee is still healing from this major surgery, so you shouldn't expect it to perform well yet.
If you do too much, you are likely to get inflammation of your tissues and tendons.
Check your activity again with what's recommended in this article:
Activity progression for TKRs

I know it's frustrating but, honestly, taking recovery slowly and gently is the best way. If you try to rush your knee, you could well end up with problems.

 

[Orange Blossom]

6 weeks PO. Still a lot of swelling, pain, and stiffness. I’m off the cane. Still having trouble staying asleep at night, although I can at least stay in my bed most of the night without walking the floors. Therapist got me to 105. Feels like I’ve kinda stayed stuck there all week. If I raise the seat real high on a stationary bike, I can spin the pedals, although it is very painful. Therapist thinks I have possibly tweaked my sciatic nerve. I have pain that shoots all the way down from my back to my foot. Sometimes I wish I could get in a time machine and get past this phase.

 

[Helizabug]

Sometimes I wish I could get in a time machine and get past this phase.

Amen, my friend! Even on a pretty reasonable recovery path, I am so done with the debilitation.

 

[Jockette]

Your ROM will improve with time and healing. 6 weeks is a drop in the bucket in this 52 week (one year on average) recovery. My ROM continued to improve even as far as 2 years post op. There is no window of opportunity.

Therapist got me to 105. Feels like I’ve kinda stayed stuck there all week

This means that your knee is just not ready to do that bend yet on its own, since it was the PT who got you to that number. But it will. I know patience is hard but it’s a must have in this recovery.

 

[WendyEL]

I'm 5 months out of a total knee, and my advice to you is be really careful getting back on the bike this early. Mountain biking was my main recreational activity before my knee surgery, and I was so eager to get back to it that I over did it in PT, which resulted in significant hamstring and hip issues. I"m now dealing more with those issues than my knee, so be careful not to cause more problems than you start with.

I was able to get full rotations on the bike within a month or two, but I've found that it causes my hip to shift out of alignment and cause awful deep hip and/or back pain. I'm not sure if it's sciatica or not, but it's a real problem. I think I don't know how to just spin with no resistance on a bike, so I find myself trying to ride too fast and to turn up the resistance so that it starts to feel more like a workout. But it's not doing me any good at all, so this last month I've basically stopped trying to get back on the bike. I know it will come eventually.

This surgery is a huge mental challenge for those of us who enjoyed "working out" prior. I've had to really adjust my mindset, and seek happiness in the quiet around me. Patience is not my strength, but this surgery is forcing me to incorporate it.

Good luck!

 

[WendyEL]

One more thing, I feel like i need a minimum of 115 flexion to have a normal pedal stroke. I'm sitting around 110 comfortably, and I can get to 125 if I really force it but it doesn't feel great. I end up dropping my toe to make rotations still, so my theory is that I need to have a nice flat foot at 115 before I'll really be ready to resume riding. Dropping my foot gets me into my hip, which is causing other problems....

Hope this helps.

 

[Orange Blossom]

Thanks Wendy. Sounds like your doing well but struggling with the patience thing as well as myself. I appreciate the advice. I rode a mile on the stationary bike last night. With every rotation I had to adjust and lift with my hip. It got very painful at the end of the spin. It’s just frustrating not being able to get that bend when you know your capable of so much more.

 

[sistersinhim]

With every rotation I had to adjust and lift with my hip. It got very painful at the end of the spin.

I hope you haven't overdone. Being painful is a symptom that your knee has had enough and you need to stop.

Lifting my hip is how I started off, too. Before long you won't have to anymore. You'll surprise yourself and go all the way around with your backside still seated all the way down. I was thrilled when I noticed I was doing that!

 

[Orange Blossom]

Thanks sistersinhim. I notice you have the Virginia Creeper Trail in the back ground on your picture. I live near the trail in Meadowview. I’ve made it a tradition to ride from the trail head to the trail end on Whitetop and back every January 1 (around 66-67 miles) the past four years. Tradition stops this year I’m afraid. How many weeks did it take before you could peddle painlessly?

 

[sistersinhim]

Yep, you're right, that's the Virginia Creeper Trail. I rode 34 miles in 2 days. This was an amazing trek for me because I had broken my foot/ankle about 4 months before that. My knee was not quite a year old when I had my breaks and I had ridden, at the most, 8 miles at one time. I have to travel to get a good ride in, so I'd do just small trips around home.

My first short ride was at about 5 months out. But, you have to realize that my knees have gone through much more than an average person's knees, so you can't judge yourself by my recovery. Each person's recovery is unique to them.

I started out in the house on my recumbent bike. I was up to 5 miles at about 4 months. That's when I was ready to try outside on the 'real' bike. It was so scary and I went only a mile the first time and then waited to see how the knee reacted. I added time as it allowed.

How could you stand the cold on Jan. 1st? I'm a sissy and stay off the bike til warmer weather comes.

 

[Macknit]

Just popping into give you a word of warning....I'm quite a bit ahead of you (15.5 weeks) and will also tell you that it is not the linear progress we all expect. You can have some great progress then suddenly go backwards and have to recover again! I hit 14 weeks and just overdid it, which caused a repeat swelling and stiffness. I have had to stop all walking and the only exercise my PT says I should do is my recumbent bike and stretching.... slow and easy!

So like all have said, patience really works the best for us! Good luck with your progress!

 

[amymhere]

It WILL come. Take it easy and don't push too hard too fast. You aren't even 6 wks out yet! You are coming along. I think I started to feel like I turned the corner at about 6 wks. after my right knee. My left knee has not been so easy though. Anyway, hang in there!

 

[Orange Blossom]

Thanks all for the advice.
Sistersinhim, wow! Broke legs with a new TKR. Now that’s tough! Not sure I want to hear that story.
I am an avid cyclist and have logged 6k plus this year on the road. I have the cold weather gear for longs trips up the mountain. Living in this area it is a necessity. Before the surgery I could cycle with only little pain but walking was a different story with bone on bone pain.
My rom is coming back slowly. It’s just locked in around 110 with a lot of pain and cobwebs when it sets still for awhile. Therapist said today the knee is starting to soften to the touch and should break free soon. He says I have several weeks of rehab left though.

 

[Orange Blossom]

In therapy today with a young lady who was 78. She had a RTKR last Tuesday. Her rom is already 120’. Im fighting for 110’ after 6 weeks. I’m very happy for her. I wish I would have had a chance to ask what her secret is but I was to busy laying on my back crying out in pain while a guy laid on my leg trying to bend it.

 

[Jockette]

We are all different, and amazing as it is, some people just get their ROM back faster than we do. I was one of the slow ones.

but I was to busy laying on my back crying out in pain while a guy laid on my leg trying to bend it.

If you want your ROM to progress faster, stop allowing your PT to do this. What he is doing is keeping your knee upset and causing more swelling, which prevents ROM from increasing. It is counterproductive to do this. It just boggles my mind how many PTs think this is the way to rehab a knee. I will never allow that again.

 

[Orange Blossom]

Rode 2 miles in a controlled area on my road bike this afternoon. It was very painful and stiff. I had to warm up my knee before it would make the rotation. I had to stop because of the pain.