TKR Cyclist - Managing My Recovery

[saultlooser]

I'm sure your checkup will go well. I had mine last week and it went well. My OS will do my other knee next may!

 

[Roy Gardiner]

why am I hurting after biking?

Lots of stuff on exercise and cycling on this thread, just picked this one quote.

It is generally the case that if your knee (not the muscles) hurt after any exercise, it's too much for this stage of healing and one should cut down to something that doesn't hurt at the time or afterwards, or cause any swelling.

This completely varies from person to person, just use your own body as a guide, not what someone else does.

 

[Tennis Nut]

I've decided that cycling is too much for my knee right now. I rode only 10 mins around my neighborhood on mostly flat pavement this sat Thursday. Haven't slept past two nights due to aching and throbbing. This am, it's no better after ice, Celebrex and two tramadol. I know some of you were able to hop right back on and go to it but I just can't seem to right now. I can do recumbent and stationary upright but not the real deal. It's going to be 9 weeks Monday and I don't think I will try again till 12 weeks. I see my OS Tuesday and will check with him.

Meanwhile I will just be really envious of you guys cycling the roads again. Hope I'm there before much longer b

 

[patbike]

Tennis Nut
Tennis, stationary may not be as much fun but it will keep you feeling good and fit. Actually I like it just as much if there is someone to talk to. I saw my Dr' physician's assistant a couple of days ago and every issue I described they had a reasonable and acceptable explanation for. Eg. low appetite (normal) hypersensitivity of my toe tips on both legs (not unusual) some twinges now and then (normal) , warm knee (normal) Rom not progressing (normal) etc. The only thing that bothered me was the x-ray made my kneecap look like it was tilted. The PA explanation was that there is some fluid underneath pushing on it but not unusual and it will resolve. When I feel both knee caps side by side I can't really tell any difference. However, I am sending my surgeon a note and asking him to look at my xray and give his opinion as well. I did see him briefly in the hall after the PA meeting and I mentioned it but he had not seen the xray and did not seem concerned but I want him to take a look. I did ask about my biking and he said no problem as long as I rest and ice as and if necessary should there be any discomfort or swelling. I also asked him if at the end of 12 months would it make any difference to healing weather I biked or didn't bike and he said no difference with respect to healing.

I will let you know how it goes. I had anxiety about loosing fitness but I think it is ok and while I did loose some weight and I am sure some muscle along with fat I think I am OK. I hope to go with a group soon at least for 15 or 20 miles and that will give me a good feeling as to where I am.

By the way on rom my surgeon said that my extension willl probably not go past zero because the device wont let it but the device will alow flexion up to 135 to 145. I only around 1 0r 2 degrees and about 120 flex.

 

[Tennis Nut]

I'm still hanging at 120 flexion too and have full extension/0. I think that will definetly improved when the internal swelling, that really cant even be seen, is totally gone. I've got twinges too and the warm knee. Last night it was a hot knee around 2:00 am. Just frustrating. Want to be 100% and am so motivated. I have lost weight and muscle too except in my non surgical leg. It looks awesome with muscle. TKR leg looks like an old lady leg. Got a 25 year old leg and a 60 year old leg. UGH!!!!

I have a quad attachment that seems to move strangely in my TKR leg. Going to ask the OS this week. Just impatient and ready to get on with everything I want to do and with no pain.

 

[referee54]

I think that will definetly improved when the internal swelling, that really cant even be seen, is totally gone.

Good point---there is that nasty little internal fluid that we do not recognize---but it is a hindrance.

Want to be 100% and am so motivated.

Remember---recovery is something that happens---take it slowly and gently, and you will be fine; you will get to your destination of being fully recovered!

Just impatient and ready to get on with everything I want to do and with no pain.

You are at a stage that many of us went through---I have been in recovery/rehab long enough---I am ready for bigger and better things! I felt that way and I would say that many of us felt exactly the same---but it took me six months to be at 80%-85% and eight months to be around 90%-95%. Trust me, you will arrive at the destination of being fully recovered.

I'm still hanging at 120 flexion too and have full extension/0

That is, in itself, pretty darn good!

 

[Tennis Nut]

referee54

You're so right. I've got tons to be thankful for and this forum is one of them along with my OS and ROM. My doc told me to expect one year to pass before my knee felt like it was totally mine again. I feel like I was well prepared by him and his team as to expectations. It's so comforting to have such a wealth of experience in those of you who have been there and done that.

 

[referee54]

I asked my OS if I could return to the classroom at eight weeks---he said that I could. for some reason, I thought that, at eight weeks, I was going to be "good to go." No such luck. I went through some long months ---especially January, February, and March (I had my BTKR on November 8th), and when I umped my first baseball game the first week of April, I still had an ever-so-slight limp.

I kept asking myself, "Is today going to be the day when it all comes together?" I thought that I had gone through recovery long enough. It was not until around the middle of May-to the first part of June that things began to feel "normal" again---and I new that my knees were no longer as troublesome. It was not until the end of June /the first week of Jul that I could say, "Hooray!"

I remember those days---around eight weeks or so---it seemed like enough time, but I now look back and understand why I had a ways to go---

You will arrive at your destination of being completely recovered--do not rush things, just let them happen.

 

[patbike]

Tennis Nut
Just an aside. The hospital called me a few weeks ago and wanted to know how i was doing and if I had any issues with the general service they provided. Part of their service was a pre-op class on tkr and recovery given by a nurse and a PT. I had attended and I told her that they should have mentioned that the knee was not going to bend for a while and was going to hurt bad if anyone tried to bend it past where it wanted to go or faster than it wanted to get there. I also complained that the pain pills and their side effects should be covered and how one should carefully manage and balance the amount of pain meds vs. pain and how miserable, funky and whacked out they can make you feel in some cases like me. She laughed and said that if they talked to much about and stressed all the discomfort and issues many people would probably cancel. I responded "good point" and thanked her for what I thought was pretty good medical service.

 

[Tennis Nut]

You're right on all counts. When it happens, it will be awesome. I still have goals though and one is to cycle in another month or so and to play with my tennis team at sectionals in December. Hope I can but it will happen when it happens. Thanks for the encouragement referee. Today, I was in need of it.

 

[patbike]

Just an update approaching 12 weeks. extension improving that last little bit, I think it is near zero. Went to concert last night. Emy Lou Harris, joan baez, jackson brown. 3000 rocking baby boomers. I bet there were a lot of artificial joints there. Not much space for the knee so we had to move to another seat where I could stretch out the leg. I don't think the extension range is improving much. I will just have to give it time. Quad is getting stronger and I can do one leg knee bends on it now. Biking is continuing and feels stronger and better as time passes. Heat in the joint is less and less.

 

[patbike]

Just past 12 weeks.
while I am still struggling with improving my flexion beyond 120 degrees the main event is that last night I went on a group bike ride up our local mountain. This is my first group ride since the surgery and was a milestone for me. My route was about 26 miles round trip. It was a good outing and I felt great. Knee is fine this A.M. as if it hadn't done anything significant. I hadn't gone with this particular summer group before and they have some fast riders. My heart rate was around 95 - 100% for much of the trip and while I fell behind the group I did make it to the top and back in a respectable time. Until very recently I was feeling some minor discomfort under my knee cap when I stood up in the pedals and I would have to lean forward or back to get rid of the sensation. However that has passed and I was up out of my bike seat and standing quite a bit while going up the hill and (knock on wood ) I didn't feel any problem.

I am still doing daily exercises and ranging my leg. Also I am still going to PT but that will end soon unless I choose to extend my number of visits. I think my leg extension is at or near zero and I am almost able to lock my leg in a standing position without discomfort. Appetite is improving but something is still different in that some foods I used to like are not very appealing but I think this will gradually return to normal.

 

[patbike]

I can report that biking is easier on my knee than hiking. I have been biking a lot lately including 36 miles on Saturday with no post ride issues. However I went on a hike Sunday with lots of ups and downs about 5 miles and my knee was a sore and stiff afterwards although I think it it is back to normal this AM. I have PT in about 30 minutes so I can see if there has been any range of motion improvement. I will let you know.

 

[patbike]

Range was actually better at PT today. It was 124 when i arrived and 126 when i left after having been stuck around 120 for weeks. Extension was at zero which may be all I can get with the artificial knee. I also was told to start doing knee bend/squats on the new knee and leg only rather than using both legs. My exercise for flexion is still heel slides on the wall.

 

[bottomshollow]

Why would you want more than 0 extension? This is a perfectly straight leg which is ideal. You certainly don't want -17 hyper-extension which looks like this: This was my hubby's knees before knee replacement--now he has 0 extension: These are thumbnails and can be enlarged if you click on them.

 

[patbike]

bottomshollow
I was born with -3 and my right leg is - 3 so I thought that should be my goal. I also thought it would be helpful for standing in a knee "locked position" . But I am realizing that 0 ish or what ever I am winding up with is just fine(my surgeon said that the mechanical knee will probably not go past zero) By the way, I was so happy about extra flexion after my last PT that I think I over did my bending exercises trying to improve it faster and as a result caused some discomfort and swelling which I think may have but me back to 120. As of today it feels good and I will slowly work my way back. I have bee biking almost everyday (about 130 miles for the week) and it feels great and seems to improve the knee. I have made 3 trips with the local riding group and feel like I am close to where I was prior to surgery. Biking was never a problem for me, just couldnt walk. . I am working on building my quad strength back and strengthening the areas around the knee. I will be doing some hiking as we are up in the mountains for two nights and hope the knee does well.

 

[patbike]

Went on a hike with wife, about 4 miles over rough terrain but not steep.
I was amazed that for most of the hike I could not feel a thing in my new knee. It was as if it was not even there. It was just going along doing what knees do without me even noticing it. I have a PT tomorrow and will see how my range is doing.

 

[patbike]

Had last PT session today. extension is fully at zero and flexion at 126, which I would like to increase at least 10 more degrees. I will keep doing the daily exercises with the goal of getting the strength in the left leg to equal the right leg. In addition to exercise I will try to favor the left leg over the right when getting up from a sitting.
Will post progress later.

 

[Hwa1538]

Had last PT session today. extension is fully at zero and flexion at 126, which I would like to increase at least 10 more degrees. I will keep doing the daily exercises with the goal of getting the strength in the left leg to equal the right leg. In addition to exercise I will try to favor the left leg over the right when getting up from a sitting.
Will post progress later.

Pat, you have a remarkable recovery. No question about that you worked hard, but I also think partially can be contributed to the fact you did not have sever pain and bad bad swelling, which allowed you to do many exercises. You mentioned that your surgeon is on top of the edge. May I ask you whether he uses quad sparing approach and your incision is short?

 

[patbike]

Hwa1538
yes quad sparing. the incision is about 6 inches to 6 1/2 depending on if the knee is bent or not. interesting that the scar was cut through the old scar from when I was 16. So it still looks like just one scar on my knee.

You are right I did not have the thigh or calf swelling , just the knee and I dont think it lasted too long. Mine was also swollen pre surgery and I think I may be back to that point now or close to it . I am hoping that the old swelling will also reduce now that the arthritis that caused the old swelling has been removed. I will update here.
This am I am going on a group bike ride with one of the groups i had started riding with a few months before surgery. I have not seen this particular group since the surgery. I am a little anxious about my ability to keep up with this group but they are good about waiting if someone falls too far behind.