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TKR Feeling stiff and sore

Kimbo1

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Hello all. I had a right TKR on March 9, 2020. I'm a tad over 3 weeks post-op and being told that I have to get to 90 degrees by this Friday. I'm doing my exercises and icing and elevating, but I just feel really stiff and sore. My therapist wants to push my leg, but I can't stand the pain. Any suggestions or tips on pushing through. They keep using that term, but when I push to the point of tears, I'm so sore the next day.
 

Jockette

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Hi and Welcome to Bonesmart!

First of all, there is no set date by which you must achieve a certain degree of flexion. You will regain it as your swelling goes down and as you heal.

Also, please stop allowing your PT to push on your leg, it is not necessary, and it is not even helpful. All it does is increase your pain and swelling, which in turn reduces the ROM everyone wants you to regain. You are allowed to tell them that you won’t let them do this, or any other thing they want you to do that causes you additional pain.


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.

Especially read number 4, about PT, and the article about the “window of opportunity.”

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 to 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 the 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 the member’s history before providing advice, so please post any updates or questions you have right here in this thread.
 

Defender

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Hello all. I had a right TKR on March 9, 2020. I'm a tad over 3 weeks post-op and being told that I have to get to 90 degrees by this Friday. I'm doing my exercises and icing and elevating, but I just feel really stiff and sore. My therapist wants to push my leg, but I can't stand the pain. Any suggestions or tips on pushing through. They keep using that term, but when I push to the point of tears, I'm so sore the next day.
Hi Kimbo 1
I had a Ĺ T K R February 12th so I am about 7 weeks post op I have been stuck at 70 degrees for this amount of time my physiotherapist kept trying to push push by the time I got out I was in so much pain I was nearly in tears.
If you read through the many posts on here you will see there isn't a time limit we all heal at different times.
My other T K R although painfull I recovered much quicker.
My knee is still very swollen which is stopping me to get past the 70 degree bend.
When I feel low I always come back here for advice and reassurance.
Don't let your physiotherapist push your knee.
If they are pushing it to the point of pain they are not helping.
 
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doodlebug60

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hi. Kimbo1
I had ltkr on 13 February. I am also 7 weeks post op. I have 115rom and -1 on straightness. incision is healing well; almost sealed up. still have swelling some after being on legs for awhile. haven't had any PT since surgery. just walking and daily activities as knee will permit. ice and elevate and rest once swelling starts. ROM and straightness will come as swelling goes down. I promise. your knee knows how to rehab itself. I learned this from bonesmart moderators and I am doing well. prayers for a speedy recovery. Doodlebug60
 

Roy Gardiner

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Any suggestions or tips on pushing through
Yes. Don't do it.

You don't need hard work. Imagine 'working hard' to recover a broken leg or a sprained muscle; you can't, and walking on a broken leg or exercising a sprained muscle are counter-productive, obviously. It's much the same with TKR, you have damage needing healing, not unfitness needing training.

All you need is to help retain mobility (not fitness or strength) until healing is complete. This is done with gentle stretching exercises, without pain.
 

Tykey

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In what language does "pushing through" make sense.
Immediately on leaving the surgery, my ROM was 95 which showed the implant was OK.
As I started pottering around, I had a bit of swelling and it went down.
I was sent home with instructions to do a few gentle exercises and to get on with life.
As the swelling went down, the ROM came back up and up. All it needed was time to heal!
Time for my favourite descriptive word
Your physio is talking codswallop.

Hands up all those of us who did no PT and are walking around with a stiff leg because it set like concrete.
 

Defender

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In what language does "pushing through" make sense.
Immediately on leaving the surgery, my ROM was 95 which showed the implant was OK.
As I started pottering around, I had a bit of swelling and it went down
The day after my op my ROM was 75.
It's about that now but still very swollen.
Am I right in thinking during the surgery the movement is tested.?
 
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Kimbo1

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Thank you all so much for validating what my tears were telling me all day yesterday. I did very little exercise except for walking and 1 round of my list of exercises. I actually slept last night and woke up to less swelling and redness on my knee. I'm going to take it easy on myself again today. It helps so much to not be alone in this recovery of such a major surgery. I love your codswallop word. You are right on!! Back off my knee. :)
 

Jaycey

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@Kimbo1 Keep icing and elevating. Ice will help ease the swelling that is limiting your ROM. Ice and gentle stretches. Slow and steady is the tried and tested approach to this recovery.
 

bikinglynn

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I think you will find that not only is painful PT causing you physical pain, it is also stressing you out at a time that you don't need additional emotional stress. I dreaded my upcoming appointments, and felt like a weight had been lifted when I finally quit going to PT.
 

pamsknees

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My bilateral TKR was Mar 16 & my PT was cancelled due to covid 19. Reading about your PT & others who have been pushed to pain , I am glad mine was cancelled! I’m surprised you still have PT with all the covid concerns.
I do the exercises that were in my notebook that was given before surgery, but never to the point of pain. I don’t know what my rom is but I know it’s improving as I can sit in my shower without my legs against the wall. Yesterday I overdid it so I was hurting last night -lesson learned! I’m grateful for what I’ve learned in this forum! My ice machine is my best friend.
 

sistersinhim

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@Kimbo1, you should not even be going to PT with the virus out there. Haven't you been listening to the news? You might not have the virus, but who know how many before you have been to that PT who might have it! Your health is much more important that taking formal PT. All the movements you do at home is PT. Your knee doesn't need to be shown how to rehab itself. It knows perfectly well how to do just that.

Many of us never took formal PT or did exercises. I am one of them. I had 11 knee surgeries, 2 of them kneecap removals and 1 tkr. Even after those I never took formal PT. But, I didn't just sit around and do nothing. I used my knee as it was intended to be used by walking around to take care of my daily needs. As I healed I was able to do more. Icing and elevation was a huge part of my recovery.

Listen to your knee. It will tell you if you're doing too much by increased pain and swelling. When that happened to me, I found that resting, icing and elevating helped. Your knee knows how to rehab itself without being told what to do.
 

Jockette

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you should not even be going to PT with the virus out there.
I don’t think I would let a PT come to my home either, during this current virus situation. I’m not allowing anyone I don’t know into my home, and people I do know, are not coming anyway.
 

Sara61

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For the time being you should take it easy on yourself and look after your knee, recovery from a TKR is not a race or a competition everyone heals at different paces, Rom & extension come naturally after swelling goes down and swelling will only go down if the knee and tissue surrounding the knee isn't aggravated it's a "catch 22" Most PTs are used to dealing with sport injuries and have very little knowledge of TKRS hence their aggressive approach, if it hurts then tell them no- it's your knee it will heal itself in its own time.
Gentle home exercises and DLA is all you need at this stage plus plenty of icing and elevating, stay safe xxx
 
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Kimbo1

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Thanks everyone. Reading the articles and your stories and comments gave me such confidence yesterday. I had a call from my OS nurse telling me that if I didn't get to 120 flexion by 6 weeks, they would do a MUA. I told her I would thank him for his opinion and go elsewhere. After feeling so much better yesterday and today, I'm convinced it was my PT pushing too hard. You are all correct. With the virus, I don't need anyone coming in my home. I'm going to work on it myself. I appreciate all of your kind words. Be safe too.
 

Celle

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I had a call from my OS nurse telling me that if I didn't get to 120 flexion by 6 weeks, they would do a MUA. I told her I would thank him for his opinion and go elsewhere.
That nurse was probably just conveying a message from your surgeon. Far too many surgeons (and PTs) think that you need to rush to get good ROM, but we know that isn't correct.

It's your knee and nobody can do anything to it without your permission, so you have the right to say you don't want an MUA, or to ask for a time extension. You're the only one with a right to say what happens to your knee, and to decide whether or not to accept advice about it.
CONSENT: what it means and how it can be used
Saying no to therapy - am I allowed to?

As the others have said, your knee doesn't need a lot of exercises at this early stage. Just walking and doing your activities of daily living is enough, but if you want to do some gentle exercises, these are all you need:
Heel slides and how to do them properly
Extension: how to estimate it and ways to improve it
 

InkedMarie

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Hi @Kimbo1 ! Glad to read you’ve “come to your senses “, so to speak. I wish everyone would join BonesSmart and learn what *not* to do. I interviewed a couple physical therapists prior to my TKR and the one I chose had never heard of BS but his views are what we believe here.
 
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Kimbo1

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A little over 4 weeks now and taking it day by day. Love reading everyone's stories here. Makes me feel better and not alone. This is super hard and times are very different. I purchased an app for measuring my ROM and have gotten to 93 and -1 on my own. Woo hoo!! Question, has anyone else had closure with sutures and glue? I'm wondering if the glue comes off on its own after time. Thanks for your input. Hope you're doing well and staying safe.
 

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