TKR Eeek’s recovery thread.

[Mutti3]

The muscles will get stronger on your operative legs through daily walking, activity of daily living. At six months i have very little difference in strength. If your knee allows you to do recipical walking on step, is a great muscle strengthened exercise. I have a two story home, and another flight to the basement. Not a great place for knees!

 

[Jockette]

I have a two story home, and another flight to the basement. Not a great place for knees!

That’s what my previous house was. We’ve been in our current one story house almost 3 years now. Now that I’ve had knee replacement surgery I’m wondering if no stairs really is best. It’s definitely better for my non operated knee, but I’m not getting any better at doing stairs foot over foot for the new knee, since it’s very rare I ever have to do any, even a curb. Surgery was 13 months ago. I have a couple of short steps off my back deck so now that it’s a tad warmer I’m thinking I should use those to help strengthen the operated leg to do steps normally.

If it isn’t one thing it’s something else.

 

[Austinsus]

I’m 5 months out and still don’t have a lot of muscle support in my thigh or calf. I had a sidetrack at 2 months with an unexpected laparoscopic surgery for a ruptured appendix and peritonitis which still affects my strength. I feel as though I am not as far in my knee recovery as I otherwise would have been. I sure feel the “if it isn’t one thing.....”!

 

[HoneyB]

@Eeek - We're on about the same timeline. I had a LTKR February 19 and will be having a RTKR in late May or early June. Like you, I've been able to go upstairs normally, but was having trouble going downstairs. Going down, I still had to do the step-step with both feet on the same stair. My problem wasn't a strength problem; it just felt like my new knee wouldn't flex correctly to let me use it to lower my right foot down to the next step. My front porch has four brick steps. The bottom two steps are one brick high, and the top two steps are two bricks high. I got on the short bottom step, used my non-surgical right leg to lower my left foot to the ground and watched closely how my right knee bent and right ankle flexed during this process. I then repeated this using my left leg/knee to lower my right foot, being careful to make my left knee bend and my left ankle flex like I'd observed for my right. It felt stiff and hurt a little bit for the first few repetitions, but then I felt some kind of loosening and "release" in my left knee/shin area, and was able to do this step down easily after that with a lot less stiffness. I still can't do it with the taller step, but plan to work my way up to that.

I demonstrated this step exercise to my therapist, and he showed me an exercise to stretch the same parts of my left leg/knee. I stand with my back to a low table (table top is about knee height), flex my leg up behind me so that the top of my foot rests on the table top, then while holding onto a chair for stability, I slightly squat with my right leg to stretch the left leg/knee, hold for 10 seconds, rest and repeat.

 

[Eeek]

@HoneyB

Thanks
Will try that. I have an unused bath stool that i’ve got at the lowest level for stretching frontwise.
My left leg has been the bad leg for so long, I hope i can get it into shape to be the good leg over the next three months.

My stairs are all outside, concrete stairs with a railing, pretty much standard height, whatever that is. Plenty of them all over the place, so loads of practice spots, connected by elevators. We live in a big terraced complex built into a hill.

The other thing i’ve been doing is lying on my stomach to read - my favorite position - and bending my left leg with the help of my right.

But i’ll listen to my knee, of course.

 

[kneeper]

I think you're right to start using the left leg a bit more--but gradually. When I was working on steps, I started by just doing a few in a flight normally but the rest one foot at a time. Gradually I built up to a whole flight. But I also didn't do more than 1 flight a day. Even when I went back to work (where ordinarily I need to do stairs about 4 times a day--unless i take the elevator) I would only do one flight. Gradually I got to the point that the only obstacle to stairs was being out of shape.

 

[Eeek]

Was reading some of the excellent exercise recommendations and I decided to try @roy Gardiner‘s flexion exercise with a skate board. No kids, so I bought a really inexpensive one and have been trying it this afternoon. I like it.

A question about swelling.....my operated knee is much softer in the back, feels almost spongy. The right knee is harder. The front of my knee has very little swelling. Is that a consequence of the surgery/prosthesis, or could I have some swelling back there? Maybe I need to ice the back of my leg.

 

[SusieShoes]

Chances are you have some swelling in the back of your knee. You're still just two months out from surgery. My knees stayed slightly swollen for a few more months. Definitely try ice behind the knee! No reason you can't do that.

So you're liking the skateboard? Roy really has some great exercise tips!

 

[Eeek]

So when I saw the OS two weeks ago, he was unimpressed with my flexion, as it was about 95- 100. I need to work harder. And my PT seems frustrated that it’s now barely above 100. he says that if I don‘t continue the stretch, my muscles - I guess my quads - will shorten. Is this for real?

So I am stretching to the point of pain, not beyond, the reality is that - I have a fat leg and it‘s been hard to bend for a while. Physics, flesh all determine this. The PT checked the flexion in my right knee (unoperated) and it’s only 115. That one is in bad shape too. So I stretch, walk, do stairs as much as I can. And that’s all I will do.

I’m putting up with the PT because in 3 months, I’m having my other knee done at the same facility. Once both are done, I’ll think about more PT there. I guess I am just frustrated and need to vent.

I’ve started to use a crutch/cane for my right side. I used one for the left for so long, it’s confusing. It helps though and allows me to walk more easily.

I’m really looking forward to having the right one done. I understand now the appeal of bilateral replacements.

 

[sistersinhim]

I need to work harder. And my PT seems frustrated that it’s now barely above 100. he says that if I don‘t continue the stretch, my muscles - I guess my quads - will shorten. Is this for real?

Working harder just makes you swell more. What happens when you swell? Your ROM is restricted. So, working harder has an opposite affect on your knee. It makes the ROM less. Just use your knee as you normally would in your daily living. That, and walking is the very best way to increase your bend. Oh, and don't even think about it. It will come on its own when you least expect it! Your quads will not shorten either, as long as you are walking!

 

[kneeper]

Stretching is fine, but you don't need to make it your full time job. I did it once in the morning and once at night. As I've said elsewhere, I had restricted bend for many years pre-op. I found stretching helpful (still do) but the bottom line is that swelling impedes bend too. And overdoing=more swelling.
At your point in recovery doing stairs once a day is plenty. Stairs are hard on a recovering knee.

 

[Eeek]

@sistersinhim and @kneeper

Thanks for reinforcing this for me.

 

[Eeek]

So one day last week I spent 6 hours on a train (broken into two 3 hour trips) and walked around outside for an hour or so. I was exhausted the next day, but quite ok.

My big accomplishment was going up and down stairs to enter the train. Till now, I‘ve been choosing trains that don‘t have stairs. But it was fine!

I have traded my crutches for walking sticks, but don‘t use them so often. In fact, I think I might need the one for my right (unoperated) leg more than for the left. Walking is a lot easier, and will be even better once the other knee is replaced.

Yesterday, finally, I took my dog for a walk on my own. I‘ve waited because it‘s down a hill and she can pull, but i’m ready. That was fine too.

I notice things like increased stability with my left leg....I stood on just my left leg the other day while waiting for something(and holding on for support) and it was a great improvement!

My ROM is just around 100 and when I bend my left leg back too far, it hurts. I continue to ice and elevate for a few hours each day. My knee is not very swollen, although no doubt there’s a lot of soft tissue inside that’s recovering.

 

[KarriB]

It took me over a year to get my full flexion, so it sounds like your doing well for 2+ months post op. I found it difficult to walk or be on my knee for an hour at a time even at 5+ months post op.

 

[Eeek]

This is what I find so annoying. My surgeon did a great job.....given the relief I feel, anyway.....and even he said that it was a year long recovery. In the next sentence he said I needed to work harder because my flexion was not where it should be. My PT also said that it is a year long recovery but that if I didn’t put more effort into this, my quads would shorten and I would not achieve good flexion. And then in the next moment, he checked my unoperated leg and found it to be only 115 degrees - operated is just over 100. My knees have been bad for a while.

So there’s the automatic speech and what they observe in individual patients. I’m happy with my progress though sometimes I do waver.

 

[Jockette]

. I’m happy with my progress though sometimes I do waver.

We all waver through this recovery, especially when we are pressured by our medical professionals to work harder to achieve faster. It only takes a little comment to throw us off our confidence.

Trust your intuition that you are recovering at your own pace, not theirs, and that you are doing well. If you do it their way you will have more pain and frustration for sure!

 

[SusieShoes]

I'm so happy to hear you are walking your beloved dog again! Bet she's happy too. Congrats too on using steps to get on and off the train. Returning to conducting life as normal is what this surgery is all about.

As you resume your usual energy and activity levels, you will find your knee to gain more flexion, too. Part of what you will be getting back is muscle strength, which helps power that flexion (though the biggest factor remains reducing the swelling inside the joint). One thing that helped my flexion was doing stairs. Not aggressively, but just taking opportunities to do them. That and lying in bed in the morning, pulling my thigh toward my chest, and just letting gravity pull my lower leg down, which gives a nice gentle stretch to the bend. Of course, if it hurts... don't do it.

 

[SherrieT]

Getting to walk your own dog is such a great feeling! We're you able to walk on the train any?
I spent 7 hours ( 2 separate 3.5 trips) yesterday on the bus. I was on aisle and was able to extend legs and it just took a few minutes of walking after each trip to get them back to normal.
It really does sound like you're doing quite well but I know that sometimes we feel like we just want to be normal RIGHT NOW

 

[Eeek]

@SherrieT - i did walk on the train a bit. Going it wasn‘t crowded and I had plenty of room. On the way back, it was more crowded and a bit more difficult, but ok.

 

[Eeek]

Today I did a couple of complete revolutions on the exercise bike. Both backward and forward. A big accomplishment.