TKR Fibular Head Pain, Stopping Recovery<

[jaschembra]

Those post op blues are normal and come along sometimes when you least expect it and figure, "I should be over this already". It's okay and it's normal.
Yep, I'd say focus and concentration will be a struggle at first with work. Be sure and get up if just to get a drink every hour or so as you'll get stiff. I would be propping my leg up so it's comfortable and not down (gravity has a tendency to bring on pain)
Don't let the OS scare you with the word manipulation. Mine used it at 4 weeks and said I was doing great at 8 weeks. Sounds like you're doing well. Don't overdo those exercises.

 

[cycling67]

@SusieShoes: thank you for your thoughts. I am indeed stressed about working because i am still unable to fully concentrate. I will simply do my best and talk to my boss. I have worked at this company for 20+ years, they need me back but i have earned time away. i will even work from the couch icing and elevated if i can.

I am not sure if i am overdoing... i dont think so but... i ride my indoor bike for about 15 minutes light to warm up, then do bending exercises, quad sets, 2x10 leg lifts and walking. I generally do this twice a day.

I am currently off crutches except for the morning when i use one. Last PT i reached 90 by myself and 95 with a push (from me). I generally feel better although just feeling down and not wanting to do this anymore.

 

[cycling67]

@Jockette: you are so sweet thank you for your thoughts! It is such a hard surgery. Right when i think i have the patience i lose it! When i get like this then i get mad at myself which doesn't help. We need to be gentle with ourselves!!! You r the best!

@jaschembra: i tell myself ALL of the time i should be better than i am. Argggg stupid expectations, are hard. The recovery is a mystery and patience and persistence is the key. I know this but i sure have gotten down. I appreciate your thoughts, helps to know there are others out there. OS wanted me at 90 degrees at 6 weeks so i think i am just there.

 

[Celle]

I am not sure if i am overdoing... i dont think so but... i ride my indoor bike for about 15 minutes light to warm up, then do bending exercises, quad sets, 2x10 leg lifts and walking. I generally do this twice a day.

That sounds like a great deal of exercises for so early in recovery.
Can I suggest you only do them once a day, and cut down the number of repetitions even then?
A tip - once you can do leg lifts, you don't need to keep on doing them.

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 ROM is there right from the start, just waiting for all that to happen, so it can show itself.

 

[SusieShoes]

I got so used to working from the couch (legs up on an ottoman, with or without ice) that I sometimes don't sit at my desk for a week! Not sure if that's a good habit, or a bad one. It is, however, quite comfy.

 

[cycling67]

Yup @SusieShoes the couch with ice has been my office today. Not too bad. Although the list of things i need to do is a biy scary and al i want to do is take a nap. Yup nap wins, work will still be there when i wake up.

 

[cycling67]

Update: well i saw my PT and Ortho surgeon yesterday and today. In PT I reached 96 degress active flexion and 106 passive flexion. At OS i was 95 degrees cold. He said i was doing well and wants me to attain 10-15 more degrees of flexion in the next 3 weeks before i see him again. I think this is attainable...

My plan is to continue as i have been with stationary bike, walking and gentle knee flexion stretches and hope for the best.

I would love those smarter than me to see how this all sounds to you!?!?!?! Thoughts?

 

[Celle]

It sounds to me as if your knee is doing well. However, don't let your surgeon's expectations of increased ROM within a short time frame influence you too much. You've already passed 90 degrees, so there should be no talk of needing a manipulation (MUA).

ROM, both flexion and extension, can continue to improve for a year, or even longer, after a TKR. There's no need to rush, no deadline you have to meet:
Myth busting: the "window of opportunity" in TKR

Above all, don't try to gain those numbers by working harder at your exercises. Doing that often backfires, because working too hard increases your knee's inflammation and swelling, which then slows down progress:
TKR: work “smarter” and not “harder”
TKR: Pushing to gain ROM - don't do it - have patience!

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 ROM is there right from the start, just waiting for all that to happen, so it can show itself.

By the way, please don't let your PT push on your knee to get ROM. Doing that can slow down your progress, because it causes irritation. The only numbers that count are the ones you achieve by using your own muscles.

 

[SusieShoes]

Well, I doubt I'm any smarter than you are, but I like your plan. Elevate often, ice often (and whenever needed), and exercise moderately in whatever ways keep your knees happy. Chances are your OS will be happy with the results, and so will you.

 

[Jockette]

I think gaining 10-15 degrees in 3 weeks is very optimistic. Please don't be upset if you don't attain that.

I think all these desires and expectations from surgeons and PTs is our biggest problem, not our current rom or lack of it.

Rom will come when it comes, and it might happen a tad sooner if they just told us it would, that we're doing fine but it's just going to take a while and stop pressuring us.

 

[cycling67]

Thank you everyone for your thoughts. I am torn between feeling pressure of the expectation in a time limit vs having a good goal to work Smartly towards. I dont plan to do anything different, in terms of exercising, than what i have been doing which i am tolerating nicely. I am obsessed with icing and elevating ao no problem there.

In the end my flexion will be what it is in 3 weeks and as long as i give 100% to my plan all is well. I am VERY blessed to have a PT whose philosophy is nearly equal to bonesmarts.

I wish each of you the very best and want to thank you again for yours thoughts. This group allows us to feel less alone and part of a group who actually "gets it".

 

[Bikesouth]

If you want my two cents worth your numbers are good. More flex in 3 weeks no problem, just don't worry about the number as long as it improves. Being that you are still under a certain age makes a little difference too. Personally for me my improvemen's & healing have slowed considerablely at 54 compared to 52.

 

[kmak81230]

Sounds like you are doing well. I agree with Jockette: don't get down if the improvement goes slower than the "artificial" 3 week timeline. Your knee will continue to improve if you gently work on it: biking, walking, gentle stretches. But it has it's own timeline. I stayed at 110 degrees for at least 8 weeks and since then have only gotten to 115. As my PT told me, many surgeons see things as black and white-they have specific ideas about ROM and recovery that they ascribe to all patients - yet we know that we all heal and recover differently. Hang in there! You'll get there.

 

[Jockette]

@kmak81230 I like where you said many surgeons see things as black and white ....My check up is in 2 weeks

I am worried I won't be where he wants me, but it is what it is. If my knee is not up to his expectations it's not my fault, we don't all progress the same. My knee is in charge of the time table. Why don't they get that.

 

[bottomshollow]

My knee is in charge of the time table. Why don't they get that.

Because, bless their little hearts, they have never had a knee replacement themselves.

 

[kmak81230]

@Jockette: I have to see mine in about a month and I've been putting off making the appt. I won't be where he wants me either - particularly in extension but I've improved in the past two months and I expect I'll improve more in the next month. I've seen a lot of improvement in functionality if not as much in ROM. We definitely know more about how our own bodies have recovered than our surgeons.

 

[JJ65]

@cycling67 I think you are doing really well. Just be careful not to overdo things.

 

[canoewoman]

I am 5 months out of a TKR and I use the cane when I go out but not at home and have very little pain or swelling anymore and just finished physiotherapy with an ROM of 117 and can lay my leg flat at last. I feel so much better than I did this time last year after a hip replacement and if all goes well this is the end of surgery for me as my other knee and hip are fine. Right now I am walking 2 miles a day when I can and have time and I go out to lectures and community events and last weekend I helped my little grandson into his crib and walked him up the stairs. The stairs are still hard so I have to keep practicing one after the other rather than pulling the surgical leg up but for the few stairs I have to climb I am not so concerned. I still sleep with a pillow elevating my leg a bit but its just become more comfortable that way.

I think the biggest relief from all this pain and surgery and endless trips to the PT and medical appointments is the enormous weight of not facing anymore surgery is over. I had a top notch surgeon, one of the most renowned in the country and a very nice man on top of that and I ran into him in the hardware store and he had me walk down an aisle while he observed and he was very pleased. He retired a month after my surgery except for followups to his surgical patients this past year.

A year or so ago I would not have thought any of this possible to be so rid of arthritic pain and to have had successful surgeries. Best wishes to all of you recovering and about to get the work done. It will be 100% super better a year from now and you will look back on it and will have felt such a huge change in your life.

 

[Pheebs52]

Because I am a "Slow-Bending Super Swelling Stiff," I have found the best gift to myself has been to let go of all numerical expectations. On any given day, the knee is *different*, and as such, I just have to accept it is what it is, and it is subject to change. From past experience with a hip replacement, I know that eventually, I will get *there*, wherever there might be. It may take a full year and possibly even more, but, it's out there on the horizon. In the interim, it's my job to aid the healing, not hurt myself, and enjoy some of my newest abilities that didn't exist pre-surgically.

You're doing very well and just need to remember that contra to all previous experience, less is more.

 

[kmak81230]

@tcdc135 - yes, the shiny red box of patience is definitely a must for this recovery. I was not able to do a pedal stroke until week 6 and then for several weeks just a few minutes at a time with zero resistance (I rode in excess of 3000 miles a year prior to surgery). I still ride with pretty low resistance, but can go for longer periods of time at 5 months out. This recovery is humbling.