TKR Dealing with RLS after TKR<

[Softtail]

Thanks Navy. Figured it was part of the process either twisted it slightly ,irritated some tissues, or new Pt move didn’t agree with it. Bright side stomach not so crampy tonight.

 

[Softtail]

Ok 3 full weeks, and it’s wild how the pain in leg moves around. I am sure the pain goes up and down also based on when pain pills are taken. Continuing to take 500 mgs. Tylenol 4 to 6 hours apart. As suggested being just 3 weeks out I decided to maintain ,at least thru week 4 this regiment to keep pain meds b@lanced.

Not a lot of sleep last night ,but was able to go to bed and fall asleep for 2.5 hours. I grab 1 to 3 hours more between 5 n9, so seems to be adaquate for now. I was mentioning how pain moves around , so my new area is in mid to upper calf, and the wrong twist or side pressure on leg, can really hurt for second. Little leg stiffness , but goes away after walking, so that’s expected. I am also thinking the new exercises Pt introduced, target some new muscles that are not to happy with me yet. Keep the marathon going, n sitting here I do really enjoy my Ossur ice machine bathing that knee with all that soothing coolness lol.

 

[DLR]

@Softtail i agree I have an Ossur machine too, love the cooling on my picky knee. I am still on 1000 mg Tylenol 3 times a day (8am, 3 pm, 10 pm) it seems to keep me moving and able to cope with the moving pains and still sleep. Hoping for improvements ahead for you. I mentioned to someone else I am starting to think of this knee as the princess and the pea. The littlest thing can throw it for a tantrum.

 

[Softtail]

Saw my outpatient PT tech today, and first thing I told him if he is gonna push the pain threshold, it won’t be with me. He was recommended by my home Pt tech, and after our meeting I walked away thinking I got the right guy.
Spent a lot of time talking to me,showed me the 2 exercises he feels are crucial, (leg slide, and putting knee on chair , leaning forward to stretch it but in no terms, crouch down while doing so since this puts undo stress on knee. ). Showed me both of these and he was right . Correct one caused a relatively pain free stretch, while other one hurt some. Also told me not to overdo walking first 8 weeks, since this is how long it takes for bones to heal. Another day under our belt

 

[Kiwigirl62]

@Softtail, I think that makes sense re the bones taking that long to heal......NOTE to self...remember this!

 

[Softtail]

Morning bonesmarties, it’s been 5 days since last post ,so I thought I would update progress. If you have been following my posts you know I am an old school jock. Lived and breathed sports,and exercise, and still do best I can. Up till operation, played golf 4 days a week ,even though I could barely walk from cart to green by 16 th hole. Hobbled along best I could on pickleball court 2-3 days a week. It hurt, but doing nothing was not an option. Like everyone here I want my legs back, so here I am nearly 4 weeks post op. I love this site , and the many recovery stories offer a wealth of information.

I pretty much don’t know any other way than trying to exercise my way back to health, so in a way I am making myself the sacrificial lamb , giving in to my phisotherapist approach to recovery. In my last post , I indicated I had met with him ,and liked him , and would go with his regimen, as long as he didn’t try and push the pain. He assured me that was not his style, so here are the results of day 1 Pt.

Intense ,is the one word that comes to mind ,but not painful. I started on exercise bike for 20 minutes, setting seat so I would get a soft stretch at first ,and leg would lock out when fully extended. As I warmed up, I increased the flex angle slightly to get a little more. 20 minutes later leg was tired. Continued rest of session with various flexion,stretching and extension exercises, till by end my leg new it had been worked pretty good. At a couple of points where he was aiding my stretch , I had to wince a bit, at which time he immediately backed off. 1 hour later, I iced down my knee for twenty minutes and, left with some home exercises he wanted me to do on off days. Important to note , that while I like the active approach to my recovery, my down time is devoted to rest, elevation ,and icing. Not an option for me . I feel if I am going to push it when I am working it, I also need to baby it when I am not. Next appointment Thursday.

Possibly I overdid it first session , since knee was a bit more painful in evening, but I did not notice any swelling. One thing I did notice was my walking gate was a bit closer to normal Tuesday evening and Wednesday morning.
By that I mean my leg did not feel as tight when I extended my leg on it’s normal stride. Could be just a fluke, but hope it’s not. Today is mostly relaxing day, cause I do like my downtime too. Time to read some other posts on the forum.

 

[Kiwigirl62]

Thanks for update as i am 10 days behind you. Like you also exercise has been important part of my life although gave up jogging several years ago and replaced with long walks until 1 month prior to op( then down to 2 blocks). However took up cycling (road) 6 years ago -best ever for knee for reducing swelling for me -so pre op had good quads an flexibility. 1st PT is next week and although i like to be active I'm not into pain....I'm more of a stretch person so at this stage happy to have hands OFF instruction from PT...we'll see how it goes.
It's defiantly a fine and measured balance between exercise and rest/ icing. Also a big believer in good sleep for repair
You seem to be getting the balance

 

[Softtail]

Kiwigirl, yes no pain is what we are all after, and PT is not where to find it, so don’t let that happen.
I had my 2nd Outgoing PT session , yesterday, and again worked pretty hard there. I am Stressing that by hard I don’t mean painfully, but I stretched , extended , and exhausted my leg muscles. I mentioned after Tuesday , that night my knee was more sore than usual, so after today’s session he put a Tens unit on my knee for about 20 minutes along with ice.

Left PT and went to lunch with my wife. I am driving ok , since it is my left leg that was done, but I continue to be uncomfortable in any sitting position where I can’t elevate my leg, so driving puts my pain level at an annoying 3/4. Same when sitting and eating for any length of time. Left lunch , went home and as is my custom, got my leg elevated and iced. For comparison sake let’s jump back to Wednesday night where my knee was acting up and was painful throughout evening at a level of 3/5. I don’t use any narcotics for pain just Tylenol, which usually works, but was not so useful Wednesday night. Bouncing back to Thursday, once I was done with icing around 2:30, my pain disappeared . I mean for the rest of the day and night, pain was 0 to.5. Only thing different, other than PT was use of Tens unit.

Curious has anyone else experienced the use of Tens unit in their recovery process??? I know when I was receiving the stimulation at PT center it felt good, even if it didn’t change my discomfort sitting right away. I know our knees have a mind of their own, when it comes to symptoms when and where they show up, but if anything I would have expected a sorer knee Thursday night. . I thought what the heck, some of the Tens units are not expensive so I ordered one on amazon (Tens 7000 unit $26.00) , just to further evaluate its effectiveness if any. Supposedly it disrupts pain signal to brain, and anything that is not chemical, that can do that for my knee is worth adding to my repertoire. I will comment on this further down the road either plus or minus as observed.

 

[NavyGunns]

@Softtail, my pt included TENS after therapy. Loved every bit of it, except if it was turned up too high. I was always given a remote controller to adjust the intensity. If I got it too high, my quad muscles would start to quiver, contract. If I didn’t back it off, the muscles would then be sore and the knee would ache. I found that the key was to keep the intensity below that point.

Never bought one myself, but might look into it for future uses.

 

[Mutti3]

I had a tens unit for home use, worked great!

 

[DLR]

@Softtail my daughter who is a bodybuilder uses a tens so I have borrowed it and find it helps

 

[Hood1980]

You may also want to check a NMES unit vs a TENS unit. It’s a different type of stimulation. NMES= neuromuscular electrical stimulation vs TENS=transcutaneous electrical nerve stimulation. You may want the muscles vs the nerves stimulated therefore you should choose the NMES. That is the the one my doctor recommended.


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[Jockette]

Does the brand matter when buying either of theses units?

 

[Kiwigirl62]

Interesting conversatins and am follwong closely. Saw a TENS unit discussed in another thread last week an started researching a bit....then my mind got sidetracked on other things.....

 

[Softtail]

Great response everyone. Navy, I know exactly what you mean about muscle contracting, cause I could feel that slightly and maybe that’s why I was uncomfortable for a time right after using it at lunch. I googled a utube on the Tens unit and the one I was watching was pointing out just what you said about not having muscle twitch.

Jockette. I didn’t want to spend a lot to try out a unit so in googling up “best”units for 2018, the 7000 series I bought thru Amazon popped up on a few reviews, so went with it to try. I am guessing this is far from the holy grail in pain management, but any Little bit helps

Anyway , I hope to find out more about them , and can only hope it adds to the bonesmart arsenal of useful tools to help with our pain control. More later.

 

[Hood1980]

@Jockette I don’t think the brand matters. I bought a Chattanooga Primera. It was what they used at my PT offices and was rated highly on Amazon and inexpensive. [emoji6]


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[Softtail]

I agree , if it was expensive , I might have passed. Amazon says arrives tomorrow, so definitely gonna get to try it out tomorrow after home exercises

 

[Softtail]

Searching among the bonesmarties for an answer to this. At the top of my scar ,just above my knee ,there is a hard spot . It’s about 2 inches long by1.25 inches wide. If you run your hand down from top of thigh , it becomes very noticeable as a hard lump. It does not hurt, and PT guy guessed it could be where they pulled tissues together to suture. Curious if anyone else had this type of lump, and maybe had a better explanation. Tech also guessed it could be some scar tissue. Again no pain involved and I rub it constantly to see if I can soften it up, but so far it just remains hard.

 

[Jockette]

I had that, I always assumed it was swelling where my implant is. I don’t notice it anymore.

I wouldn’t rub it constantly. Treat your knee gently and just let it heal, it’s had a rough time. Don’t feel like you always have to do something.

Allow your knee the privilege of sorting itself out. (One of my favorite quotes from Josephine!)

 

[Jacimarble]

Yep I have a spot like that. I presume its scarring??? I do some gentle massage over and around the spot. About a week ago it started to feel less stiff around there. That's also about the time I started to be able to move more easily! If/when I tighten the quads thats the spot I feel the most.