TKR fiona4269<<

[fiona4269]

1.4
2.None
3.Moderate
4.Flexion 110 other one don't know degree, but, almost straight
5.Only at night before bed
6.Unable to do so at work, so again only at night
7.Doing all of the above including gardening. And, yes I know this is not helping.
8.Straight leg lifts *10
Knee bends *10
Knee flexion using pillows *10
Bridge *10
Scissors *10
Squats using 3/5kg weight *10
Squats no weight *10
Bike 20 minutes
Step up *10
Step back not putting foot on floor bending and holding on knee *10
Toes on step and raising onto tippy toes * 15
All of these only in the morning
PT down to once every 3 weeks, where he adds in something more difficult and tweaks anything I am having difficulty with.

 

[Josephine]

18 weeks out

1.pain: 4

Okay

2.meds: None

Okay

3.Swelling Moderate

Got it but your knee shouldn't be that swollen now - I think that's because of all the exercises you are doing

4.Flexion 110 other one don't know degree, but, almost straight

That's kind of okay. You can estimate your extension - read this Extension: how to estimate it

6.elevating unable to do so at work, so again only at night

How long have you been at work? What is your work and how many hours do you do?

5.Icing only at night before bed

Did you miss the bit about how long?

7.Doing all of the above including gardening. And, yes I know this is not helping.

That should be okay for 18 weeks out.

My comments in bold
Straight leg lifts *10 - a tip about SLRs, once you can do them you don't have to do them any more!

Knee bends *10 - how do you accomplish these? Heel slides?
Knee flexion using pillows *10 - do you mean you put a pillow under your ankle and press your knee down?
Squats using 3/5kg weight *10, Squats no weight *10 - squats are hard on your knees and you should never use weights
Step up *10 - don't do step-ups, very hard on the knee
Step back not putting foot on floor bending and holding on knee *10 - that's a kind of squat
Toes on step and raising onto tippy toes * 15 - toe steps are hard on the knee
You have here six exercises doing flexion. This is all totally unnecessary.

Bridge *10 - don't do bridges, they are very hard on your knees
Scissors *10 - unnecessary too
Bike 20 minutes - this is okay but no resistance

All of these only in the morning - I suggest you do none, you're 18 weeks out and past needing any of this anyway
PT down to once every 3 weeks, where he adds in something more difficult and tweaks anything I am having difficulty with - I suggest you give up PT altogether. You're 18 weeks out and don't need it.

You are, as I have said, 18 weeks out. You have moderate swelling in your knee. All this exercising is causing the swelling and stopping your ROM from reaching its full potential. Please stop it all before you progress to a stiff leg and other problems. I would suggest that your PT has some financial incentive in keeping you doing exercises this late out. Take charge and quit!

 

[fiona4269]

Thanks for the reply. Back at work since the 15th June and doing 7.5 hour days. Try to do leg extensions during the day. I get very stiff from all the sitting but, I try to get in a nice walk once I get home to soften out. I still experience the skidding out from under me sensation if I try and walk too fast. Does this eventually go away? It is a horrible sensation when it happens.

Ya , it kind of thought the physio is going on a long time and at €50 a session I must have given him over €700 at this stage.

Always know when I do too much my sleep suffers.

One final question, is it possible to improve the ROM continuously by working on it, or is 120 the best I can hope for? This is something that is not explained enough before a TKR, I didn't realize how much movement I was going to lose.

 

[Celle]

ROM can continue to improve for at least a year after a knee replacement, so you still have plenty of time for improvement.

You don't have to work hard at it, either. Just a few, gentle exercises once a day, plus normal everyday activities are all you need to do.

 

[Josephine]

Try to do leg extensions during the day.

I did advise you to "stop it all". I still advise that. You said your extension is 'almost straight' which means you don't have to do any such exercises. Normal walking will improve it if it needs any improvement which I doubt.

I still experience the skidding out from under me sensation if I try and walk too fast. Does this eventually go away? It is a horrible sensation when it happens.

The don't walk too fast! It will eventually dissipate but you need to take it gently. Don't try to 'run' before you can walk properly!

One final question, is it possible to improve the ROM continuously by working on it, or is 120 the best I can hope for?

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 does more harm than good. Normal activity is the key to success.

Read these articles written by members about their own experiences
ROM: it's worth the wait for ROM
ROM: it's never too late to get more ROM!

 

[fiona4269]

Just had my 6 month check up with the arthroplasty clinic. X-ray are perfect and show everything is where it should be. They were happy enough with my mobility. Have started cycling at least once a week. Takes me a while to loosen out when I get on the bike first, and the bending is pretty painful for a while. But, once it loosens out I am off. Started out at 15 mins and have built it up to 1 hour 30 mins and 26kms.

Gets pretty stiff afterwards, but, the freedom while on the bike is wonderful.

Every so often I have an issue with what feels like cramp or a stitch at the back of my knee. When this happens it seems to make me limp. Wondering it anyone else has suffered from something similar and could offer some advice how to deal with it.

 

[Josephine]

Every so often I have an issue with what feels like cramp or a stitch at the back of my knee. When this happens it seems to make me limp.

Can you tell me the exact site of your pain using this chart?

 

[fiona4269]

Thanks for the reply. LB3 D and E.
I can only describe as like cramp and it get progressively painful.