MUA Festina lente -Hastening slowly

[little red canoe]

When its time to step up you will without thinking. It doesn't require practice, but a healed quad muscle.

It was necessary for me to step up onto a four inch step to get into bed. About two weeks in I got curious and tried it with my operated leg. It hurt. So I didn't do that again for a couple of weeks. Next try it didn't hurt.. This is the equivalent of half a step.

Now eight weeks out I can go up five steps with operated leg first . Then it gets tired and aches. It is still healing. So I don't do step six.

 

[Celle]

try to step up onto a pile of books and try some very shallow squats /standing knee bends. I gave up on heel slides as I just can't do them :-(
Otherwise its just everyday walking about the flat and twice weekly supermarket shopping.

Forget about trying to step up - it can take some people as long as 3 months before they can do steps one leg at a time. Stop the squats - they're a no-no as well, as they put far too much stress on a new knee. In fact, stop all the exercises - every single one of them.

I also think you're doing too much in your everyday life. It's too soon to be doing the supermarket shopping. Read this again:
Activity progression for TKRs

This is what's recommended for your stage of recovery:
Weeks 4 and 5 - add to previous
Increase walks to out in the garden or street; to 20mins or longer if you feel up to it.

Additionally activity:
Gather a little bit of laundry, or put it in the machine OR take it out but not all of it
Now you can do a little dusting and tidying; do a little meal prep (for yourself not the entire family!)

Weeks 6 and onward - add to 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!!

Your knee has been overworked and abused. It's wounded, not lazy. For you, more than most people, it is very important that you stop overworking your knee and let it rest and heal. If you don't, you risk getting chronic inflammation, which is very difficult to cure.

 

[little red canoe]

True but a supermarket is a good thing mentally as its an outing.. Are there mobility carts there for you to use?

I used one for a while and would walk just a bit.. maybe from bananas to lettuce and back.. then carted myself to cereal. I did observe that about 80 percent of everyone using a cart( trolley) leaned on them and used them as walkers!

 

[Spex10]

Thanks. I do know the correct way to do heel slides but I just can't seem to make any progress at all with them. I end up really depressed and just stop.
My quads are in good shape due, most likely, to my pre op exercising them. In fact I think all my knee bending problems are due to swelling. I'll persevere with icing and elevation and will continue with daily living tasks, if nothing else, for the general health benefits of movement.

 

[DodgyKnee]

Hi, some of us are slower than others - that's it, that's just it!

At 6 weeks, I was around 70 - 80 and consultant suggested MUA. It took me about 8 weeks to get to 90. Now, at 4 months, I'm at 120 and I'm still hoping for a little more.

I've always been a post-operative super sweller and the TKR has not been an exception! Stop letting the Physio hurt you, it's just prolonging your swelling.

 

[Josephine]

BTW, where did you have your knee done and who was the surgeon? (Just curious!)

 

[Spex10]

Hi, pain level is negligible. I have paracetamol which I take as required. Its not been required at all over the past few days.
Moderate swelling which can vary a bit. Generally goes down a bit overnight. I measure it with a tape measure.
ROM as measured 2 weeks ago was 67. Might be a bit better now. Maybe 70?
I rest and elevate ++. Only do household tasks like tidying, washing etc. Shopping twice a week. Nothing onerous.
Exercises: Straight leg lifts, standing knee bends, stepping up onto a pile of books. As I find the heel slides so difficult I've tried sitting on an office chair on wheels and trying to flex and bend while seated on that. It seemed the nearest to the one at Physio where I sat on an exercise ball and did the same movements.
I should say that I don't use my stick in the house any more.
My surgery was in Scotland. I'm wary of saying more than that (sorry!)

 

[Spex10]

PS I can completely straighten my leg.

 

[Want2hike]

Thanks. I do know the correct way to do heel slides but I just can't seem to make any progress at all with them. I end up really depressed and just stop.
My quads are in good shape due, most likely, to my pre op exercising them. In fact I think all my knee bending problems are due to swelling. I'll persevere with icing and elevation and will continue with daily living tasks, if nothing else, for the general health benefits of movement.

It sounds like we are having very similar recoveries. I can fully extend, can do daily activities, but still struggle with bending and progress with heel slides. My OS has said that swelling is the issue, so I try to ice and elevate more (icing is getting difficult because I get cold. I actually bought an electric heating blanket to put over the rest of my body while I ice my knees).

I have a recumbent exercise bike at PT and home. I set the distance to where my knee can't quite make it all the way around. I pedal forward until my knee gets stuck, hold the stretch (feel a stretch but no pain) for a few seconds then reverse the pedals and do the same thing. I do this for about 10 mins a day. Each day I can get the pedals a little closer around. Once I can comfortably get the pedals all the way around, I decrease the length a setting and repeat the process. For me, this has been more effective than heel slides in working on the bend.

 

[referee54]

Recovery is not something that you work at---it is something that merely happens. The harder one works at recovery---the more you work your new knee joint---the more that surgical knee will fight back.

I know that many of us have been taught that hard work will solve many issues, but this is not the case with a TKR recovery. Fight the urge to exercise, and treat that new knee like royalty!

Ice, elevate, and rest---and remember---the PT works for you, not the other way around. You draw the line in the sand, so to speak, and let them know what you will tolerate and what is unacceptable. Do not let them bully you or force you into a painful session.

 

[Spex10]

Thanks all. Physio tomorrow. Am dreading it but am resolved to take a firm line.
Was a bit too active today. I notice that when I'm sitting with my knee up in the approved position it gets very hot. Clearly something is going on! Its not infection. I suppose its something to do with blood flow.
The swelling does subside a bit overnight but soon expands again.
I've sent away for my own goniometer so I can measure my ROM and cross ref with swelling. Once a researcher always a researcher. Without measurement there can be no management! Don't worry I don't plan to obsess on this just collect data to present to surgeon if necessary.

 

[referee54]

It is normal after a TKR for the knee to feel warm, as there is increased blood flow and healing going on.

I've sent away for my own goniometer so I can measure my ROM and cross ref with swelling.

Numbers are not important. Quantitative aspects of this are not where it is at---what is really important is what you will be able to do with you new knee---it is all about the quality, not quantity.

 

[ks1960]

Alex, I confess to ordering a goniometer too, although I am struggling to get it aligned correctly

 

[Spex10]

Don't worry Referee54 I'm absolutely set on the qualitative aspect of recovery. I'd just like a way of measuring the physical improvements (if any :-( )

 

[referee54]

Something else to remember during this recovery---it is very much like a roller-coaster ride---some days you will have more ROM and then, for some reason only known to the knee itself, your ROM will go down a little bit. In the end, though, when one is fully recovered it is amazing to see what you can do again, and without pain.

Recovery is a general upward trend, much like the stock market, but you will have some regressions during recovery, too.

 

[Spex10]

Hi, yes I've definitely noticed that there have been better days than others and even within one day there can be times when my knee and muscles generally seem more flexible.

 

[KarriB]

My OS never measured for ROM or mentioned numbers at all. He just wanted to know what I was able to do in my daily living.

 

[sistersinhim]

Many of us didn't and don't do PT after knee surgery. I have had 11 knee surgeries without going to PT. I just used my knees. Right after the tkr I followed the Bonesmart activity schedule as much as I could. Icing and elevating all the time I was sitting was a normal thing. I am single, so I had to take care of myself, house, yard and 11 rescued cats. If you use your knee, it knows how to snap back to where it needs to be. I never pushed or pulled my knee or let anyone else do it. I refused PT and my OS never asked me about it. At my 6 week visit he was very happy with my ROM. Read the threads of people who didn't take PT. You can do the same thing without all that agonizing pain and swelling. This recovery takes a lot longer than anyone ever expected. I hit my 6 month out this past Friday and sometimes still swell and then ice. This is perfectly normal, and I don't worry about it. Your body knows well how to heal and rehab itself. Just quit PT and all the extra exercising and use your knee. You'll be much better off in the long run.

 

[Spex10]

Thanks. I'd hope that will work for me but its a bit discouraging to have zero progress in knee bending since the op six weeks ago today.

 

[Spex10]

Feeling very naughty. Cancelled physio appt today. My daughter pointed out everything that you'd all been saying and suggested that both the physio and I would be the better off me not going and telling her why I would be resting rather than letting her push my poor knee about! Hope I don't regret it. Seeing surgeon tomorrow. Worry worry worry...