TKR FitGal’s Recovery

[FitGal]

Happy Veterans Day!
My husband is RA Retired.

@marieltha - Thank you so much! Happy Veterans Day (belated) to you and your husband as well!

 

[FitGal]

Hi Everyone! Just wanted to provide my Bonesmart Family with my 6-mos post op update on Ms. Puff (my Right Knee)!

As most know, I stopped physical therapy in early October 2019 at 10-weeks post op. However, due to my crazy work schedule and traveling, my knee continued to swell and my ROM remained around 100 for about two months. I started having some trouble with my left knee, since it was still doing most of the work and tried to return to my OS so that he can take a look at the left knee, or give it a cortisone shot or something. Well, my OS required a new referral from my PCM (since it was a different body part ). When I finally got an appointment with my PCM to get a referral, my PCM said that I absolutely needed to return to Physical Therapy due to how Ms. Puff looked. Besides being referred back to my OS for my left knee, he also recommended I see an Army OS to see what this knee means for my career.

So, after seeing my original OS, he said that he was not worried and that I had to push through some physical therapy if I wanted more ROM. He said that the knee is still "hot" and was still healing. He agreed with the PCM about the Physical Therapy and recommended eight weeks of therapy and a return visit for February 2020. The Army OS said that he would recommend a scope within the next few months if I can't increase the ROM, as he felt there was a "hard stop" and could see that there was a lot of scar tissue going on in the knee. The Army OS also recommended more Physical Therapy. So, I found the AWESOMEST physical therapist.

So, I returned to 2x a week physical therapy since mid-December and I have seen some awesome progress with my knee strength as well as less swelling and a little increase in ROM. We are starting to discover some of the main issues besides scar tissue with the ROM - my quad. My quad is so tight and weak that it prevents the darn flexion. So, we have been really working through that as well as deep tissue massage on the knee and other exercises. My therapist is trained in BFR (Blood Flow Restriction) and that has quickly improved my overall quad strength (it is amazing!).

My ROM progress from week 20 is as follows:
Week 20 - 104 (when arrived therapy)/110 (when I left therapy)
Week 21 - 104/112
Week 22 - 110/115
Week 23 - 115/115
Week 24 - 105/112

Given the ROM is somewhat improving, we are trying to figure out why it is not "sticking", but it seems to all be going back to the limited stretch on the quad. Once that gets stretched, I seem to get the ROM. Needless to say, my left knee has not seen any love, although with my right leg finally getting stronger and Ms. Puff becoming less "puffy", the left knee is starting to feel a little better.

I will check-in next month with another update. Til then, hope everyone has a phenomenal New Year!

 

[Roy Gardiner]

Stretching

The Bible is Bob Anderson, Stretching, ISBN 0-7207-1351-X

I may have misread what you're saying, if so I apologise in advance; here's my take on it:

I don't know what kind of stretching you are doing, but it is certainly the case that you should not expect to go from 104 - 112 in one session and expect the next time to go from 112 - somewhere. Stretching should be done little and often, and it will improve things only slowly.

I wouldn't expect twice weekly PT with nothing between to be any use. I would by contrast expect twice daily gentle sessions to be better.

Your 'crazy work schedule and travelling' won't be helping, either.

 

[Steelergal]

@FitGal Good to hear from you! I came here to provide a similar update, but read your post and can't tell you how much it's helped. My knee has been difficult lately with some stiffness and discomfort. I just can't wrap my head around the fact that after 6 months I'm still having so much trouble with this darn knee. I'm experiencing similar issues with my quad being unbelievably tight and weak. My flexion is around 100-105, but the soreness and scar tenderness is pretty constant. I saw my OS this past week and he said swelling is still an issue for me, so I'm back to being more diligent with the ice machine. I'm still doing PT once a week, Pilates once a week, and we're going to try dry needling to see if that helps. While I'm not happy that you're still having issues, hearing your story helps me realize I'm not a freak or doing something wrong. Hang in there and I'm sending good flexion vibes your way!

 

[FitGal]

Stretching should be done little and often, and it will improve things only slowly.

I wouldn't expect twice weekly PT with nothing between to be any use. I would by contrast expect twice daily gentle sessions to be better.

Hi @Roy Gardiner! So I am cycling at least 20-30 min 4-5 days a week and walking at least 5000 steps a day... trying to remember to be diligent at stretching. What is causing the tightness (so I’m told) is my desk job and traffic commute....so I am now working on stretching in between sitting...and while sitting with my rolling chair....definitely progress with this PT ref swelling and strength though! Wish I went to her initially!!!

 

[FitGal]

@Steelergal - yep, we are like TKR twins! Sending you good healing vibes sista!

 

[Roy Gardiner]

So I am cycling at least 20-30 min 4-5 days a week and walking at least 5000 steps a day.

That's a heck of a lot, on top of everything else you're doing. Biking that much is training, not stretching. I think you're heavily overdoing things.

What is causing the tightness (so I’m told) is my desk job and traffic commute....so I am now working on stretching in between sitting

Hmm, maybe. Certainly driving, especially with a stick-shift (if you do) won't help.

Doing less is the key to reduction in swelling, not exercise or stretching.

 

[Jockette]

Another thought on tightness:


I read this that one of our other advisors wrote:

“Many members think PT is needed to alleviate tightness. Tightness is a normal occurrence after this kind of major surgery. Your surgeon did major carpentry work and disturbed every millimeter of soft tissue in this area. You aren't tight because your muscle is underused and needs to be stretched and rehabbed. You're tight because your tissue is healing...and full healing takes a full year or more.”

 

[Poctdb]

@FitGal

Good to know you found an AWESOME PT....my numbers also went up and down....they were always better after massage.
Hmm....maybe Ms. Puff is not to blame after all.

From experience, muscles can be trained....but it takes a while. (Like you do not know this already...) Your ROM will stick when the quad is ready.

Great to hear from you. May 2020 be the best ever.

 

[marieltha]

Good to hear from you @FitGal !

@Roy Gardiner Thank you for the stretching book info!

 

[luvcats]

Thanks for the update! I'm glad to see you are in the care of a great PT now and the surgeon doesn't think there will be a long term negative impact on your career.