TKR Frustrated

[LMF]

Hi!
This is my first post. I had left TKR on April 15 and have been diligently going to PT three times per week. There are five therapists at my clinic and I regularly see three of them. The owner of the practice saw me last week and, whoa, he was a bit brutal! He basically said it was time for my knee to be straight and proceeded to push on it until I was sweating! I have four more weeks of therapy so I’ve made sure to only see the therapists who are more gentle. I guess I just needed to vent. I knew this would be challenging, but I am getting very tired of thinking about my knee! (I need to have my right knee done as well, but I’m holding off as long as possible!)

 

[Legseleven]

Ouch that sounds very challenging. The admin team will be able to advise. Meanwhile there are articles and recovery threads to read which may help you.
I’m waiting on a confirmed date for mine. I need both knees done too.
What I’ve already read on here indicates that time is the most important factor, along with normal activities of daily living, and no joints should ever be forced, with what I have already learned on here I’d definitely be avoiding that particular PT.
Well done for asking, this is a great community.

 

[Layla]

Hello and Welcome LMF! Thanks for joining us and an Insider.
I will leave our Recovery Guidelines and type more in a post below.

KNEE RECOVERY GUIDELINES
(Administrative Note: For those reading here, please be aware that these links are a premium service and only available to Insiders Club Members).

As you begin healing, please keep in mind that each recovery is unique. While the BoneSmart philosophy successfully works for many, there will be exceptions. Between the recommendations found here, your surgeon's recovery protocol and any physical therapy you may engage in, the key is to find what works best for you.

1. Don’t worry: Your body will heal all by itself. Relax, let it, don't try and hurry it, don’t worry about any symptoms now, they are almost certainly temporary.

If you want to use something to assist with healing and scar management, BoneSmart recommends hypochlorous solution. Members in the US can purchase ACTIVE Antimicrobial Hydrogel through BoneSmart at a discount. Similar products should be available in the UK and other countries.

2. Control discomfort:
rest
elevate
ice
take your pain meds by prescription schedule (not when pain starts!)
don't overwork.
3. Do what you want to do BUT
a. If it hurts, don't do it and don't allow anyone - especially a physical therapist - to do it to you
b. If your leg swells more or gets stiffer in the 24 hours after doing it, don't do it again.
4. PT or exercise can be useful BUT take note of these
the BoneSmart view on exercise
BoneSmart philosophy for sensible post op therapy
5. At week 4 and after you should follow this
Activity progression for TKRs
The Recovery articles:
The importance of managing pain after a TKR and the pain chart
Swollen and stiff knee: what causes it?
Energy drain for TKRs
Elevation is the key
Ice to control pain and swelling
Heel slides and how to do them properly
Chart representation of TKR recovery
Healing: how long does it take?

Post op blues is a reality - be prepared for it
Sleep deprivation is pretty much inevitable - but what causes it?

Nutrition is of paramount importance. Available here are dietary tips, nutrition basics and additional food supplements. These articles are both general advice on food and specific guidelines aimed at people both pre- and post-surgery.

There are also some cautionary articles here
Myth busting: no pain, no gain
Myth busting: the "window of opportunity" in TKR
Myth busting: on getting addicted to pain meds

We try to keep the forum a positive and safe place for our members to talk about their questions or concerns and to report successes with their joint replacement surgery. While members may create as many threads as they like in a majority of BoneSmart's forums, we ask that each member have only one recovery thread. This policy makes it easier to go back and review history before providing advice.

 

[Layla]

Hi again LMF,
I am sorry you experienced what you did with the aggressive PT. If you ever have to work with that PT again, please do not let them forcefully manipulate your leg. Make it clear that you will only work within your comfort zone, a little discomfort maybe, but pain, NO. You have a right to control what happens to your body.

You are early into the recovery process at only 1.5 months and it can feel like the new joint and recovery are all consuming, but it will get easier as time marches on. It definitely takes time and we understand.
It's okay to vent here, we get that also. So stop by anytime you need support, encouragement, or to let off a little steam.

Keep in mind that regaining our ROM doesn't require aggressive bending or challenging movements, in fact that approach can be self defeating. It is more about consistent, gentle repetition over time. Healing takes time, time for the body to recover, for the pain and swelling to ease, and for everything to settle. Your ROM is already there, just waiting for the right conditions to emerge. In most cases it doesn't need to be forced, struggled for, or stressed over, It will come naturally and gradually.

Wishing you a great Sunday and week! Please don't be a stranger here, we love updates!
@LMF

 

[benne68]

So happy to see you've started a recovery thread, @LMF! We are here to help!

As Layla said, you are very early days in this recovery. I've been through two knee replacement recoveries and can assure you that it's normal to still be having pain and swelling at just 7 weeks post-op.

The owner of the practice saw me last week and, whoa, he was a bit brutal! He basically said it was time for my knee to be straight and proceeded to push on it until I was sweating!

He is absolutely wrong about this. There is no timeline for regaining ROM. And pushing/forcing the knee is counterproductive because it makes the swelling worse and your ROM will decrease!

Unfortunately, there are many therapists out there who have never been trained in how to help someone recover from joint replacement, so they apply techniques used for sports rehab. This approach is very old-fashioned. Please do not let him do it to you again.

Please do read through the articles Layla shared above. I think you will find the following especially helpful
Myth busting: no pain, no gain
Myth busting: the "window of opportunity" in TKR

 

[Jamie]

Welcome to our community. We are here to support you in whatever way we can, so don’t hesitate to ask about anything that concerns you. You’ve received excellent advice about being in control of how your therapy is conducted. But it sounds like you had the right idea as well. Good for you!!!

I hope you get a chance to read the articles posted for you. They will help you understand the healing process, which can be a bit longer than most people think. This is a pretty tough surgery and the trauma to your body takes times to resolve. But our bodies are amazing healing machines and you WILL get there.

I’m looking forward to reading more about your recovery.

 

[benne68]

How are you doing, @LMF? Please give us an update when you have a chance. We are here to help you through every stage of this recovery.

 

[LMF]

I’m 8.5 weeks out from a LTKR. I’m feeling really discouraged. I don’t feel like I’m making decent progress at PT and my whole leg just aches by the end of the day. I’ve only had one really painful session at therapy since most of the staff are gentle with manual extensions and flexions. I don’t understand why my knee is still hurting so much. I do regular chores during the day…housework, gardening. I’m icing a couple of times per day, which feels good but makes my knee even more stiff. I did the surgery to get rid of pain, but it hurts more know than before. Has anyone had a similar experience? Have I done something wrong?

 

[Jamie]

It sounds like you have been overdoing things. I’m happy to hear that your therapist has led you through gentle exercises and manipulations. But you are still healing and you need to watch how much of the “normal” things you attempt at this stage.

Is your leg ever visibly swollen? Even it it’s not, when you attempt too much too soon you can get swelling within the knee compartment. It’s a very small space and it doesn’t take much fluid for things to tighten up.

I suggest you take a couple of weeks and concentrate on resting and elevating your knee much more during the day. Use ice when you are elevating. If you have therapy on one day, make that your activity and exercise for the day. If you need to do a chore or run an errand, that’s your day’s activity. Just be sure that you include some walking around the house for 5 minutes or so and gentle bends and stretches every couple of hours throughout the dat to keep your knee lubricated. If you are hurting take 1000mg of Tylenol and see if that helps. You may want to take it on a schedule through the day and night to keep any pain at bay. You can take this dose every 6 hours for a total of 4000mg per 24-hour period. Just be sure to count any other meds with acetaminophen in them in your daily total.

 

[Jockette]

I did the surgery to get rid of pain, but it hurts more know than before.

The surgery caused a lot of surgical trauma to your body, which produces its own pain, which is why you hurt more now than before. Over time this pain will lessen. Healing a TKR can take an average of a whole year.

By the way, I merged your newest thread with your original recovery thread, as we prefer that members in recovery have only one thread.

This benefits you because all your information is in one place, easy to find, and maintains a nice journal for you.

This also benefits our staff, as your information is all in one place, and we often go back through your thread for previous details, so we know what you‘ve been through which helps us advise you better.

So, please keep all your posts in this thread. If you’d like a new title, let us know what you want, and we’ll change it for you.

Many members bookmark their thread in their computer browser, so they can find it when they log on.

Thread 'How can I find my threads and posts?'

Dec 8, 2019

There are a couple of ways you can find categories of threads on the forum. You are able to use links in the main forum toolbars at the top of the screen to quickly access certain types of threads: your own threads, threads with your posts in them, and watched threads. You can also use links in your profile to accomplish the same thing.

Finding threads via the toolbar

You should see two toolbars at the top of your screen: a blue one and a secondary light gray one below the blue bar.

If you only see a blue tool bar, you'll need to locate the...

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Best wishes on your continuing recovery!

 

[EalingGran]

do regular chores during the day…housework, gardening

That sounds like a lot for 8.5 weeks.
I really skipped the housework and garden for a few months and concentrated on walking, pilates ( my chosen PT) and lots of rest and elevating.
The standing and bending involved in chores is more stressful to a new knee than a good walk. I could walk miles before I could comfortably stand in the kitchen to cook or bend to clean.

 

[benne68]

Hi @LMF. Thanks for checking in.

my whole leg just aches by the end of the day

I don’t understand why my knee is still hurting so much.

I've been through 2 TKRs, I can assure you that this is completely normal for someone barely two months into this year-long recovery.

You are recovering from a major surgery that caused your body a lot of trauma. The surgery impacts all the muscles and soft tissues up and down your leg and it can take 12 weeks -- or longer -- for them to recover from the trauma. Unfortunately, our surgeons are "bone" doctors and they focus on whether the implant is properly placed and the bone is regrowing. They don't warn us about how long it takes for the rest of our bodies to heal.

As the others have said, you are probably doing more than your body is ready to handle so early in this recovery. I can't imagine gardening at that stage. I was happy to be able to stand in the kitchen and cook meals. (If you want to read my knee recovery stories, you'll find links in my signature below).

Sending hugs

 

[Layla]

Good Morning LMF
Recovery can certainly feel like a long haul, especially when your progress isn't matching your expectations.
The swelling / stiffness later in the day is common after activity, even at this point in the process. Pain is not uncommon either and can be inflammation as part of the healing process. At less than three months post op, discouragement can set in. Normal for many.

Consider using an ice pack that's not completely frozen, and see if that is more comfortable. Or do a few heel slides or something easy after icing to basically rewarm the joint and circulation.
Keep in mind that you're healing from the controlled trauma of major surgery. You will have setbacks, good days and bad days, celebrate each victory, no matter how small. You'll get there!
@LMF

 

[Neecey]

Hi!
This is my first post. I had left TKR on April 15 and have been diligently going to PT three times per week. There are five therapists at my clinic and I regularly see three of them. The owner of the practice saw me last week and, whoa, he was a bit brutal! He basically said it was time for my knee to be straight and proceeded to push on it until I was sweating! I have four more weeks of therapy so I’ve made sure to only see the therapists who are more gentle. I guess I just needed to vent. I knew this would be challenging, but I am getting very tired of thinking about my knee! (I need to have my right knee done as well, but I’m holding off as long as possible!)

Next time just say NO!! With my first knee they put me on a “bender” machine and a piece of my patella broke off which put me in a brace for two months while I worried if I’d ever walk again. Thanks to my wise surgeon-who opted not to go back in to try to fix it but rather waited until it healed on its own-I’m fine now tho the knee doesn’t bend beyond 90 degrees. It’s been two years since I had both knees done and I’m so thankful I did it -got my life back!! You will too. Good luck.

 

[eaglemom]

I think the pain you are feeling is your knee telling you that your simply doing far too much at this stage of healing. I know you want to be able to go go go, but the knee has had a traumatic experience. It's wanting to rest and recuperate.

It is fine to do some household things, but not everything. As for gardening, I can't image even attempting that. Now, if someone would drag the hose to me, I could see me watering the plants, but that's it.

You'll get there. And when you begin to feel a little better its hard not to overdo it. Be kind to the knee and you'll have less discomfort.

 

[LMF]

I appreciate all the support and encouragement. As a former teacher, I’ve always thought of myself as a patient person…perhaps that’s not entirely true! I have a hard time saying “no” to people who need my help and letting things go. I guess this is an opportunity to learn how to prioritize. ‍

 

[Jockette]

This is a time to put your healing first, and let others help you, the way it sounds you’ve helped them.

 

[Layla]

Happy Two Month Anniversary, LMF!
Your most important job right now is taking care of you. Recovery from major surgery takes time and your body is still healing. Those who care about you certainly want you strong and healthy so give yourself the time and space. you need to heal, you've earned it.
Wishing you a lovely day and week!
@LMF

 

[benne68]

Hi @LMF

We haven't heard from you in a few weeks, so I'm checking in to see how you are coming along. Are you noticing improvement since your last post? Give us an update when you have a chance and let us know how we can help.

 

[Layla]

Hey LMF,
Stopping by to wish you a Happy Three Month Anniversary!
How's everything going for you? The three month mark is often a big one and we'd love to hear how you're doing with recovery. Are you noticing improvements with your mobility and gaining strength? Drop us an update when you have a chance and know that we're here for you.
Have a great week!
@LMF