TKR Feggie's TKR Journey <

[Josephine]

1.My pain level when resting is 1. When I walk 6. When I try to bend 7.

Okay but never ever do anything that causes you pain! Never!

2. I take Tramadol 50 mg twice a day.
I also take Celebrex once a day.

If you are getting consistent pain at the rate or 6-7 every day, then this is not enough, certainly not as 6 weeks. The six week point is the high point for pain. You should take the Tramadol, 50 or 100mg, every 6hrs. You should also take Tylenol 1,000mg with every dose. However, when your pain is low, you can just take the Tylenol on its own.

3.My swelling is moderate

And you did remember that swelling is a form of pain, didn't you?

4 ROM: 90 bend, extension straight out

Okay, don't fret about it - it will come. Remember this: It's not the exercising that gets you your ROM, it's time. Time to recover, time for swelling and pain to settle and time to heal. One thing that seems to be missing from all the PT's protocols is that all your ROM is there right from the start, just waiting for all that to happen so it can show itself. In the general run of things, it doesn't need to be fought for, worked hard for or worried about. It will happen. Exercise as in strength training is counter-productive and in the early weeks does more harm than good. Normal activity is the key to success.

5. Icing 4x day for 30 min.

You accomplish little or nothing in 30 minutes. Ice for at least 40-60mins and more than 4 times a day.

6. Elevating several times per day

Okay, got that. But elevate while you are icing, okay?

7. I am walking around the house all day, doing laundry, cooking, no housework. I have been out to lunch with friends and was sore from my leg being down for extended time.

Did you read this article in the recovery threads Activity progression for TKRs?

It says: Weeks 6 and onward - add to all the previous
Start taking car trips to the shops but keep them short and sweet at the start, no longer than 15-20 minutes
Take at least one 5 minute rest while you are out
Activity: a very little ironing, washing, meal prep but get someone else to clear up after. Wash up but someone else clears the table, brings you the dirty dishes, dries and puts them away after, NOT you!!
So the moral of this story is that you should NOT be going out to lunch, not yet! Nor 'walking round the house all day'!

At home I do heel slides, 3 reps of 10 twice a day - you don't need to do these, you're already at 90
knee bends 3 reps of 10 twice a day - you've not said how you do these (to me they are the same as heel slides!) but you don't need to do them. You already said it hurts when you do so stop doing them!
back kicks, (kicking toward my backside) 2 reps of 10 once a day - this accomplishes nothing except more pain!

At PT
leg lifts 3 sets of 10 (hurts) - then refuse to do them!
back kicks 2 sets of 10 - same here - refuse to do them
hamstring stretch 10 times - these are okay assuming you HAVE hamstring pain!
machine that does leg press for 10 minutes - do not, I repeat, do NOT EVER use this machine. It can cause considerable damage to your new knee like making the tibial component come loose.

I was at PT last two weeks 2x/week. After last Thur I was in so much pain (therapist stretched me to point of agony)... My doc said to take this week off.

I suggest you stop going to PT altogether. You really don't need it. Remember that paragraph I posted earlier, in blue? You need to remember that and decline all PT. Also stop doing home exercising.

There are lots of members on this forum who have done their TKR recovery yet did no exercising at all. I was one of them and we all got great outcomes anyway. I recommend you read my recovery thread to see how little exercising I did for either knee! Knee recoveries UK style Parts I & II (Josephine). I suggest you follow suit.

If you are concerned about refusing to do therapy, you need to read this Saying no to therapy - am I allowed to?

 

[Feggie]

After my week off from PT I was back Tues and Thur this week. I was amazed that with no exercise I went from 90 to 120 degrees. It's true that the bend is there and will happen. It happened without PT but from rest.

I am not an exerciser but I think PT probably does my fitness good. I told the therapist no leg lifts because that is what gave me so much pain and caused me to call the Dr. My old Bakers cyst came back after all the leg lifts. My doc told me to take the week off.

It's been 6 weeks since my surgery. I can only sleep if I take Excedrin PM. It works well for me. I am taking Celebrex 200 mg 1xday. I probably should take more pain meds but I can't take anything with Codeine and Tramadol doesn't seem to do anything for me.

I am icing several times per day. I was advised by the therapist to wear a compression sleeve on my knee for the swelling.

Is it normal to feel tightness (which I am sure is from swelling) to the point that my knee feels like it could pop like an overcooked sausage? Also, my knee clunks and clicks so loudly, that my husband can even hear it? My friend who had both knees replaced AT THE SAME TIME said hers don't click, and never did.

I would appreciate hearing opinions on the clicking. Should I call the Dr? I am not supposed to see my OS for a few weeks.

 

[traceys]

@Feggie
Thank you so much. without realizing it you just said some things I needed to hear to help me out. I’ve been debating taking a pt break for a while and thinking it was too late or I would lose all movement. In short I’m scared to stop.

You gave me some hope.

As for your questions...
My knee made the funkiest noises about week 5-7 and now happens a lot less. It’s more a sensation now but a lot of people on here have talked about it.

And the swelling? Lord yes!! It’s been my major issue since my TKR sept 11. The visible swelling is down considerably but the internal makes my knee feel like it’s going to rupture with the slightest bend. And I can feel it drain and move as I roll over or stand.

 

[kmak81230]

The clicking is quite common - some can hear it, some only feel it. My PT said it was a good sign that some of the internal swelling is going down - if it doesn’t hurt it’s likely fine. Glad you are doing so well by resting.

 

[sistersinhim]

My knee still clunks. I can hear it and feel it. But, it's not painful.

 

[Celle]

Is it normal to feel tightness (which I am sure is from swelling) to the point that my knee feels like it could pop like an overcooked sausage?) Also, my knee clunks and clicks so loudly, that my husband can even hear it? (My friend who had both knees replaced AT THE SAME TIME said hers don't click, and never did.)
I would appreciate hearing opinions on the clicking. Should I call the Dr. ? I am not supposed to see my OS for a few weeks.

Yes, that tightness is very common. Apart from swelling, it's also one way in which you feel knee pain. Rest, elevate, ice, and take your medications on time. The tightness will decrease gradually, although often it lingers for several months.

The clicking knee is normal too. We even have an article about it in the library:
Clicking/clunking knee joint after surgery
As long as it doesn't hurt, try to ignore it.

Some knees make noise and some don't. My right knee made clicking noses for about 2 years, but my left knee never made any noise. Both knees are fine now.

 

[Josephine]

I was amazed that with no exercise I went from 90 to 120 degrees. It's true that the bend is there and will happen.

Woo hoo! See, it does work!

I told the therapist no leg lifts

GOOD for you!

Is it normal to feel tightness (which I am sure is from swelling

Indeed it is - it's a manifestation of pain so should be treated as such. I would have advised you on your issues but you never answered the extra questions I left you in post #49. And I asked again in post #55.

 

[Feggie]

I am so happy to hear that you got something positive out of my ramblings! That is what this wonderful site is all about! Hugs!

Thank you for that reassurance, kmak81230! Can't believe how the extra icing and rest is helping. Also my big wedge I got from Amazon is so helpful and soothing and makes elevating so easy.

sistersinhim, I agree it's not painful, but it's actually so loud that others can hear it! I never was able to play a musical instrument, so maybe I can be in the percussion section now....

 

[sistersinhim]

If they are close to me, others can hear mine, too. Of course, I don't have a kneecap to muffle the sound any!

 

[Celle]

@Feggie - I have merged some of your posts.
When you want to quote someone's post in order to respond to them, you don't have to start a new post to write your reply. Just go ahead and type your response in the same post, below the quotation.
How to use the quote feature

 

[Feggie]

I saw my Dr. for the 2 month check up and he said my Range of Motion and Extension was perfect. He said I only need to continue PT if I want to for muscle strengthening! In that case I will pass, since I usually am swollen and sore when I leave there! I am riding my recumbent bike at home that I bought on Amazon. Any advice on other exercises I could do to strengthen my quads? I continue to ice as it keeps the swelling down.

 

[Jockette]

Your quads will strengthen with your daily activities as you heal. It’s still a bit early to do any specific strengthening exercises, especially since you’ve said you’re swollen and sore after PT. Take a break and treat your knee gently and it will come along in time.

 

[sistersinhim]

I agree with Jockette. We don't recommend strengthening exercises for 3-4 months. Your swelling is telling you that a whole lot of inflammation is still in your knee and needs to calm down. Treat it gently and just do your daily activities.

 

[Feggie]

Thank you, Jockette and Sistersinhim for the encouragement! I just called my PT office and cancelled all appointments. My husband said "Thats good...every time you go there you come home swollen and miserable...."
I just grit my teeth and smile when well meaning people tell me to work hard at PT or I will be sorry.......
After 13 years of not climbing stairs properly, it's hard to remember how to do it the right way! (That's when I tore my ACL completely and this whole knee mess started!)
Question: I have pain deep in the joint when I walk sometimes, is this normal at this stage?
Thank you Bonesmarties!!!

 

[traceys]

That’s uncanny! I just called my pt clinic to request to talk to the manager about changing pts. And today I have some aching way inside when walking that’s a new thing.

Hopefully you get some progress now.

 

[Josephine]

he said my Range of Motion and Extension was perfect

Feggie, are you under the impression that Range of Movement (ROM) applies only to flexion (bend) because it doesn't! It applies to BOTH flexion and extension!

I just grit my teeth and smile when well meaning people tell me to work hard at PT or I will be sorry.......

Well you never got told that here!

I have pain deep in the joint when I walk sometimes, is this normal at this stage?

Must I assume you've been ignoring my posts? In several of them I have answered this question.

 

[Feggie]

Feggie, are you under the impression that Range of Movement (ROM) applies only to flexion (bend) because it doesn't! It applies to BOTH flexion and extension! Well you never got told that here!

The doctor said my bend and extension were great for this stage. 120 flex and 0 extension.

Must I assume you've been ignoring my posts? In several of them I have answered this question.

I am not ignoring your Posts, Josephine! Sorry you think I am!!

 

[Josephine]

The doctor said my bend and extension were great for this stage.

I got that but that wasn't my question.