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TKR Dealing with swelling

Luna

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Hi, I’m new to this site.
I had knee replacement on 18th June.
Until now, my knee still swell, (I don’t have much pain since the beginning) especially when I try to sleep at night. (Many sleepless night since the surgery).
I put my leg on the pillow, use the ice machine. No matter what I did, the tightness feeling of the knee would expand down to area below the knee. I always have to get up, on the average, every two hours to walk a little to relieve that tightness feeling.
Is this normal?
Any suggestion?
Thanks.
 

lovetocookandsew

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Welcome to BoneSmart!

I will leave you our Recovery Guidelines. Each article is short but very informative. Following these guidelines will help you have a less painful recovery.

Knee Recovery: The Guidelines
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
ice
take your pain meds by prescription schedule (not when pain starts!)​

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

5. At week 4 and after you should follow this

6. Access these pages on the website



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.
 

lovetocookandsew

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Often, extra swelling at night is a result of too much activity during the day. My suggestion is to read the above articles, especially the activity progression one, and see if you're doing too much. We don't want you to become a couch potato, but we also don't want you to do more than your new baby knee is ready for. Would you tell us which knee you had done so we may create a signature for you?

Also, would you give us an idea of what you do on a typical day so we may further advise you? Thanks!
 

Jockette

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Hi and Welcome!

Did you just have your TKR this year? I just want to be sure of the exact date before we make a signature for you.
 

Roy Gardiner

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Your TKR is just a month ago. Relax! Ice & elevate as in the guidelines, watch telly, wait. This takes time.
 
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Luna

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Thank you for all your response.
It’s my right knee.
I had the operation 4 weeks ago on 18th June.
I’ve been doing what ever my PT taught me.
1. lay on bed raise leg (front, back, side) slide leg. 20 times for each movement.
2. Sitting and sliding leg with a piece of cloth under my foot to bend the knee 20 times.( I had some oozing until the end of second week so I was preventing of bending more then 90 degree until end of last week) Then using the left foot to help to bend the right knee more for another 20 times.
3. Standing with the support of the kitchen counter raise right knee like in launch position, Raise right leg straight to the side and back; bending right leg toward the back. And lightly squat position on both knee. Each 15-20 times.

I can not stand nor sit (with feet in normal position) more than 10 minutes before my knee and it’s surrounding swells up.
 

Celle

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@Luna - I think your PT is giving you too many exercises and that is adding to your knee swelling. I will comment in red in your list, to suggest how you should modify what you are doing.
I’ve been doing what ever my PT taught me. It is your knee. You are allowed to modify what your PT says
1. lay on bed raise leg (front, back, side) slide leg. 20 times for each movement. Do these only one time for each movement.
2. Sitting and sliding leg with a piece of cloth under my foot to bend the knee 20 times.( I had some oozing until the end of second week so I was preventing of bending more then 90 degree until end of last week) Do only 5 times. Then using the left foot to help to bend the right knee more for another 20 times. Stop doing this. It is bad for your knee.
3. Standing with the support of the kitchen counter raise right knee like in launch position, Raise right leg straight to the side and back; bending right leg toward the back. Stop doing these. And lightly squat position on both knee. Each 15-20 times. Only squat a little way and only do it 5 times.
Your knee only needs a little exercise. It needs time and gentle treatment, so it can heal.

There's no need to rush to get ROM (Range of Motion) because it can continue to improve for a year, or even much longer, after a knee replacement. There isn't any deadline you have to meet:
Myth busting: the "window of opportunity" in TKR

It's not exercising that gets you your ROM - it's time. Time to recover, time for swelling and pain to settle, and time to heal. Your knee has the potential to achieve good ROM right from the start, but it's prevented from doing so by swelling and pain. As it heals and the swelling goes down, your ROM (both flexion and extension) will gradually increase.

I can not stand nor sit (with feet in normal position) more than 10 minutes before my knee and it’s surrounding swells up.
Yes, that is what happens to most of us. It will improve as you continue to heal.
 

kneeper

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Most of my pain came in the form of a stiff achy feeling. Pain meds (or Tylenol) helped.
 
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Luna

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Thank you for the suggestion!
 

allin1

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I'm just going to add my voice to the advice everyone else has already given. When I had the in home PT 3 times a week, when she left every day I intended to do the exercises she gave me. I seldom did, because my knee was usually swollen and sore, so I rested and iced. When I moved to out patient PT, I only did twice a week so I would have more time off. Again, I seldom did anything in between visits beyond normal daily living (functional therapy). Now at 8 weeks post surgery, my PT is happy with my strength and my bend is pretty good. Even now it still feels a little tight when I bend it, so it still needs a little more recovery.
It sounds to me like you have been faithfully following your PT's advice, but I think you should try more rest.
 
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Luna

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after hearing all the suggestions, I did less yesterday afternoon than the previous days and spent more time resting and massaging the knee.... and slept well last night, only got up once before 6 am. First time since the surgery 4 weeks ago!
Thank you all!!
 

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