TKR Cyclist - Managing My Recovery

[Tennis Nut]

I had the quad sparing done too. It's just the best way if its a fit for the patient. People have been amazed at my recovery. And I agree with pat that biking causes less pain than hiking or walking. If I walk too far, I get some pains here and there. When biking, I feel nothing. Ordered my new bike today. Carbon hybrid. So light I can lift it way over my head and throw if necessary. Don't think I need to throw it but love the lightness. Can't wait till it gets here. I think my ROM is 125+. Not sure since I haven't seen a pt since the last week of June. I'm doing exercises that make me a little sore but I don't see any swelling. I had no swelling prior to surgery and not much after. None in thigh or calf. I feel it though in some stiffness after a big busy day.

Looking forward to vacation in NM in Oct. and hiking to pueblo ruins, etc.

 

[referee54]

It was as if it was not even there. It was just going along doing what knees do without me even noticing it.

That is exactly how a knee implant is supposed to feel---like absolutely nothing is actually new---it works just like the old knee did when it was young and healthy!

 

[patbike]

I rode with a different group this Weds AM. I worked hard but really didn't have any problem with the pace of the group. It was about 45 miles and i iced afterwards just in case but I really dont think there was any swelling. My pt told me yesterday that the rough tissue that i can feel between the edge of the kneecap and the near edge of the bone is scar tissue and that i can lessen it by pressing on it and massaging it. That technique worked on my main scar where it was a little lumpy. I just pressed down on it regularly over the course of several weeks and it flattened out. I went shopping this afternoon and noticed some intermittent discomfort which happens from time to time but it was very transient and not at all unusual. These little feeling of discomfort here and there seem to come and go but less and less frequently as time goes by. My therapist encouraged the biking as a strengthening and balance exercise and I really think it helps. My left quad is about 1 1/2 inches smaller in circumference than my right leg and this disproportion has developed over the years of favoring my right leg. I am set on correcting it
with exercise and trying to favor the new knee leg in daily use particularly when I get up from sitting.
I will keep u posted.

 

[patbike]

I am about 3 and half months out and things are going pretty much as BoneSmart predicted ie the trend is gradual improvement with ups and downs. One thing I am finding helpful is continuing and increasing the exercises that the PT gave me. My left leg muscles had atrophied somewhat compared to right leg due to my favoring of the good leg for 5 or 6 years. However with the new knee I am now able to exercise the left leg with no pain (I do get a little intermittent sensation in the knee at time but I would not describe it as painful or irritating just noticeable). The exercises consist of stepping onto a raised platform. Stepping down from a raised platform leaving the left knee on the platform and single leg squats. I also have some stretching exercises and clamshells. I am also trying to stop favoring/using my good leg when getting up from a seated position. This is hard but I am working on it.

My big goal of getting back into the cycling groups is going well and in the last week or so I have been out with the groups 4 or 5 times The rides are about 2-3 hrs and I have felt comfortable with the distance and pace of the rides. This has given me a great sense of relief and a mental boost. Also I think the cycling should help with the ROM over time.

Wife and I are headed to the Mtns next week and I am really looking forward to hiking. I am using a hiking stick. (I have not been able to hike without pain for a number of years) Hiking progress has been slower than biking but has been steadily improving. My appetite is still a little off but I think is gradually returning to normal. Also the weird funky feeling I would get in the afternoons crops up once in a while but I think is almost gone and is way less than at the beginning.

My main goal now is to strengthen my left leg and to stop favoring the right and to keep daily focus on improving ROM (flexion mainly).

 

[patbike]

I am now 4 months out and continuing to improve slowly. Main improvement is quad strength which I work on daily. I see that it is improving but has a way to go. The Mtns were great and my walking stick broke so I was stickless. I did the same walk I did 6 weeks ago and this time I did not notice any soreness or pain afterwards like I did 6 weeks ago so I assume that the tissues around the knee are improving. I have not been able to hike without pain for years. I also did a lot of biking along the river with several thousand feet of elevation gain.
I think my biking is around the same level it was prior to the op. I would still like to see my flexion improve and I am continuing to do heel slides hoping that will help. I think only time will tell. It is around 125 degrees and the end of range is uncomfortable. There is no pain except occasionally if I am making a steep step up on the new knee and the pain that does occur is more of a transient discomfort. I hope too that it will fade over time.

 

[referee54]

I am now 4 months out and continuing to improve slowly.

Yep---slowly---slow progress. you are doing fine, though, at four months I still did not have the ROM that you have---mine took five to six mnths and eight months before I felt close to 90%-95%.

There is no pain except occasionally if I am making a steep step up on the new knee and the pain that does occur is more of a transient discomfort. I hope too that it will fade over time

This should slowly fade away---again, as yo build strength and flexion---until you hit your limit---you may have a little bit of tenderness here and there. My ROM is in the low 130's and that is plenty for me and for what I want to do. I am sure that you will continue to make slow but steady progress for some time to come.

 

[patbike]

four and a half months out.
After two week of no cycling early this month I have resummed group rides and have done 140 miles in the last 5 days including 62 miles yesterday. I still have some non paiful sensations in my knee from time to time and expect that will continue for up to 9 months or a year post surgery but on a decreasing trajectory. Particularly as I am doing regular knee bends to strengthen the support muscles. I also still have some mild warmth in the joint which I expect will just take time to resolve. I am so happy I got the tkr. I could bike before but walking and hiking were a real drag.
Now I find myself wanting to go on hikes because it is so amazing to me to be able to walk with absolutly no pain.

 

[westsea]

Your story is encouraging to me - the slow steady improvement getting to where you are now, which is great! I am one month out today and working on extension and flexion. I'm a little worried about flexion (80) but am seeing very slow improvement. Maybe I'll get the recumbent exerbike pedals all the way around if I move the seat all the way back.

The pain meds (vicodin etc) made me feel yucky too. When you take plenty they reduce your appetite and other body functions. Dose off anywhere. There is a different yucky when you back off on the dosage, like nausea, jittery, little aches keep you awake, yucky. I quit mine last Sunday morning and am now feeling almost normal again appetite wise. Sleep wise, not so good because my knee complains just enough to wake me up. I'm just afraid if I take one to sleep that it will revert to the same yucky withdrawal feeling during the next day. I think I'll go take a cat nap till my knee complains at me. And then try the exerbike.

Good job, you!

 

[patbike]

I think I must have developed a dependence on the pain meds. My goal at the time was to not worry about the meds and just make sure I was well medicated for PT and that I could sleep. The trade off was a yucky feeling every afternoon until I stopped the pills. The yucky still hung around for about a week or two.

for me swelling was the initial problem with getting flexion to improve and I still have some swelling that was around pre-op which may or may not go away.

You will soon be turning the pedals and it only gets better from there.

 

[westsea]

I did turn the pedals on my recumbent exerbike with the seat all the way back today! Another dimesion for exercising and stretching. I am from the Bay Area too. I miss the Sierra. We live south of Seattle now and I do like it a lot here. Rain is nice! We'll be going to Eureka for a son's wedding in a month. My knee should be more flexible by then, and there is always the back seat to ride in. Road trip yeah!

 

[patbike]

Keep rotating but of course take it easy which to me meant don't do things that cause pain or swelling . In my opinion the recovery pace is governed by healing time ie time for your tendons,ligaments and muscles to adjust to being connected to a properly working knee. I don't think you can speed it up so you just have to adjust your activity level to compliment the healing process. A month out is very early but I remember that I was impatient and worried that if I did not get out and bike that I would loose muscle and aerobic fitness. Well it didn't seem to be that big an issue in the end and fitness wise things seem pretty much normal. Plus I am now able to re-build the left leg muscle which was lost due to the years of favoring the good knee. A long car trip might make your knee sore, so having the option to stretch it out is a good idea.

 

[Roy Gardiner]

:iagree:

You cannot speed healing. Gentle rotations on the bike will help gain flexion by stretching, but no need actually to push the pedals (i.e. set resistance on zero) until there's very little or no swelling.

 

[patbike]

Just an update.
I am about 5 and 1/2 months out and I love my new knee joint. I no longer dread walking and actually seek out opportunities to hike or walk extra distances. This past weekend I went to a 3 day horse show to help and watch my daughter compete. Lots of walking (easily 5 or more miles per day) and lots of manual labor, hitching horses to carriages, cleaning stalls, washing tack and carriages etc, etc. Before my new knee an activity like this would have been near impossible and extremely painful as my knee would get more and more tired and I would get more and more irritable. Plus I would have to ride around in a golf cart or ride my bike rather than walk the miles required throughout the weekend.

I still have a few non-painful sensations and some warmth in my knee which I expect will continue to diminish. Also I sometimes feel discomfort if I move my knee up and sideways like when getting in a pickup but I expect this to diminish as well.

I am riding my bike fairly regularly and last Weds went about 55 miles including several thousand feet of climbing.
I have no negative symptoms after riding.

Other issues like appetite and hyper sensitivity of my toes(not sure what caused that-both left and right) is also nearing normal.

Pat

 

[patbike]

I had my one year check up yesterday. The surgeon said all was fine and to keep doing the biking and any thing else I want to do except jumping and running. My ROM is almost equal to my good knee and I am very pleased with the result. I had a Zimmer Persona device. The surgeon wants to see me in two years. He also said to keep taking the antibiotics before any dental visits at least for now.

The heat in the knee has been disappearing gradually and is almost totally gone. Every time I set out on a walk the knee feels better than painless. It sort of feels like my leg is being propelled along and just wants to keep on walking.

 

[trailspud]

@patbike
Congrats on the milestone. I haven't looked at the cycling thread on the social forum so how is your cycling? Any good stuff to report there? Best wishes.

 

[patbike]

@trailspud Cycling is at or better than pre-op level. I tend to do 100 or so a week unless I am away from home.
My wife and daughter are into competitive horse activities so I get called on a lot to help them out which I also enjoy.

I really like the group rides around here. There are many and they tend to do 30 to 40 miles.
I try to get out a couple of times a week with them and the rest on my own. I'm still using my hardtail Mtn. bike with road tires. I think about road bikes but I like the flat handle bar. I may go to a Giant Bike free demo in two weeks and see what they have just for fun.