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BarabooProud

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Hello everyone!
I had a total knee replacement on my right knee on October 26. I stumbled upon Bonesmart one day while icing and elevating in bed. Thank goodness I found this site! It has been a tremendous amount of support for me when questioning if what I'm going through is normal or not.

The past 3 weeks have been very frustrating. I guess I should've found Bonesmart before my surgery so that I would have a better idea of what this recovery would entail. The first 10 days were so painful and exhausting! I started to feel like I could crawl out of my cave (bedroom) at 10 days, which felt like progress. Since then I have had good days and bad. I felt like I was doing very well 2 days ago when for the first time, I didn't need my oxycodone during the day and only took Aleve and Tylenol. That afternoon I went to PT and I ended up going backwards again! He had me doing way too much, I believe. I had been going to PT since 3 days post-op and all was well. I was progressing well with ROM and strength. But, 2 days ago he had me go on the bike for a few minutes, mini squats, mini lunges, and also did my other routine exercises. I had a VERY rough night that night. One of the worst in a long time. He had also encouraged me to use my bike at home for 5-10 min twice a day along with my exercises. Unfortunately, I did the bike for 5 min yesterday and I ended up on the sofa with icing and elevation all day/night again. Back on the Oxy. Needless to say, biking is not for me for a couple more weeks. I need to take a few days to do just gentle stretching and basic exercises before I try the bike again.

I had hoped to go back to work after 6 weeks, but now I think I may just take a few more weeks to recover. I don't want too many setbacks.

Looking forward to continue my recovery and get a little better each day. Trying to keep my chin up since I know 3 weeks out is very early. :)
 

Roy Gardiner

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:welome: to BoneSmart

I had hoped to go back to work after 6 weeks
BoneSmart recommendation is 12 weeks.

Unfortunately, I did the bike for 5 min yesterday and I ended up on the sofa with icing and elevation all day/night again.
Try this, when your swelling has gone down:
  • Set the bike to zero resistance
  • Set the saddle low enough so that a single rotation is a challenge; difficult but not painful. When a rotation becomes easy right from the start, lower the saddle a max of 1cm.
  • Gently turn the pedals, through discomfort but without pain.
  • Continue until the knee is 'warmed up' and the rotation is now easy, or for 2 minutes, whichever is the shorter time.
  • Repeat several/many times a day, but don't go mad. Diminishing returns will apply; my guess is that half a dozen reps would be enough
  • Do not pedal fast or for more than 2 minutes, this is a stretching exercise, not training.
  • And if you get any pain or swelling in the 24 hours after doing this, cut it down until you don't
Here is a bit more chat and some pix and how 'healing' and 'training' are different

and

Knee Recovery: The Guidelines

We are all different, as are the approaches to recovery. The key is, “Find what works for YOU.“ Your doctor(s), physiotherapist(s) and BoneSmart will offer advice and are there to help. The advice may vary, but YOU are the final judge as to the recovery approach you choose.

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

2. Control discomfort:
rest
ice
take your pain meds by prescription schedule (not when pain starts!)​

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

5. At week 4 and after you should follow this

6. Access these pages on the website

The Recovery articles:

There are also some cautionary articles here


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.
 

Scaredycat10

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Oh.My.Goodness.

I am a week ahead of you and I am one who put months into prehab; am [was] fit and has had no real pain since my op.; am doing extremely well in the rehab stakes going by others' experiences on here but lunges? I'm sorry but to be blunt, your physio needs his head examining. Truly. I'm not just saying that to be kind. Yes I too am doing mini [very very shallow] squats but only to the level I know suits me.

I went on the static bike at your stage and regretted it and that was only one full rotation. I had dreadful discomfort. However, last Monday I had three quarters of an hour of acupuncture and my physio's elbow and managed a full rotation on the bike with less difficulty and I did a short session on it but only short.
Don't be pushed into anything which is remotely painful. My physio pushes me to the edge of my comfort zone but we do not veer into pain territory. I think that's how it should be,
 
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BarabooProud

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@Scaredycat10

Thanks for your reply. Yes, looking back, I cannot believe he had me doing lunges. Granted, I used the even bars to do them, but still. Oh, and he has me doing these leg presses on a machine. Is that something you've done? I wonder if I went too low while doing those? I will definitely tell him it was too much. I have always worked out and have been in shape so he must've assumed I'd be okay given the progress I've made so far. I think waiting a couple of weeks before trying to bike again would be a good idea. You're right that I need to stand up for myself and not be pushed into anything which is remotely painful. Thanks for that reminder!
 

Scaredycat10

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Yes I am already back on the leg press machines and have been for two weeks, but I am using the seated one and not my usual lying press. I am on light weights compared to pre op and I make sure the seat is far back so there's little movement at the moment as obviously, I don't have the range of bend I used to have and I have my non operated leg on full alert just in case anything slips.
I am also using the adductor and abductor machines although again, being careful of the knee position and not the same weights as before the op [not too far off tho'].

To give you an idea of my rehab progress, I am walking around the house without aids but use one crutch now when walking around the track at the gym.
I have a tight hamstring problem which my physio and I are working on but at no time will I venture into operated knee pain territory. Hamstring stretches yes, knee, no.
 
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BarabooProud

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I am so impressed you're going to the gym! You're 4 weeks out? I can't imagine doing that at this point. I feel like all I do is exercises twice a day, walk around the house doing basic things, and lay in bed or on the couch. I'd love to do more, but every time I do, I have more pain. I am still using a cane, although I think by 4 weeks I could think about moving beyond that. Hopefully, my setback won't hold me back from that progress. So happy for you that you are going to the gym on a regular basis. Must be nice for your mental health to get out of the house.
 

Scaredycat10

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Don't be too impressed. I'm going to the gym because my physio has a clinic in the same building and the gym has a great running track for me to walk around. The pavements are too dicey with wet leaves for me to venture walking outside.
I am used to all the machines but I know my limits because of that familiarity. At no time will I consciously overdo anything.
I am just pleased I will be able to drive there myself this week but there again, all minor roads and only a mile away.
 

sistersinhim

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Doing anything that causes pain or swelling is a setback in your recovery. You have to recover from the setback before you can get back to where you were before your setback. You've learned that what that PT had you doing is not right for your knee at its stage in healing. Lunges and squats are awful on a baby knee. Also, the leg press is bad for your 3-week old knee. Your incision might be healed, but you have all those stitches inside your knee that have to heal. Stressing them like you have been doing is upsetting them, as you have found out. Just do your normal things around the house for a few days until your knee settles down then you can resume your PT. In this recovery less pain=more healing!
 
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BarabooProud

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Another question I have is about stiffness. I told my PT on Monday that I had a lot of stiffness going on. He asked how much icing I was doing and I told him that I ice a lot throughout the day and night because it really helps with pain. He said I should start limiting my icing. Maybe 20 min before bed and a few times for 20 min throughout the day but other than that, I should let it breathe. What are your thoughts, everyone? I feel like I struggle without icing frequently!
 

Scaredycat10

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My next PT is on Friday afternoon and I think I will refuse to do the leg presses, squats, lunges, and bike for a couple weeks.
Not many people have had the luxury of having their own very experienced physio, who is familiar with joint replacement rehab, overseeing their prehab and I agree with all sisterinhim says but I will add a rider that when 'you' are comfortable in all you do, are very familiar pre op with the any equipment and most important, have said physio overseeing everything/ with you, then I have faith in starting very slowly getting back to seeing to my muscle tone, muscle tone which is very quick to go, sadly, as I get older.
At the end of the day, you are in charge, not your health professional and if he is not familiar to you pre op, then you are the professional here.
 

Scaredycat10

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Another question I have is about stiffness. I told my PT on Monday that I had a lot of stiffness going on. He asked how much icing I was doing and I told him that I ice a lot throughout the day and night because it really helps with pain. He said I should start limiting my icing. Maybe 20 min before bed and a few times for 20 min throughout the day but other than that, I should let it breathe. What are your thoughts, everyone? I feel like I struggle without icing frequently!
My knee is stiff as a board at times. It eases as I move around but stiffens up again pretty quickly. I'm pretty sure that's normal at our stage.
I ice when it starts aching so couldn't help re 'optimum amount'.
 

Jaycey

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Maybe 20 min before bed and a few times for 20 min throughout the day
Rubbish! Twenty minutes will do nothing. Ice for 45-60 minutes several times per day. The stiffness is caused by swelling. Ice reduces the swelling.
I think I will refuse to do the leg presses, squats, lunges, and bike for a couple weeks.
You are not in training - you are healing. Please stop all this and let that knee settle. When you are healed there will be plenty of time for strength training.
 

Carol Anna

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I ice three to four times a day for 20 minutes. First thing in the morning,after morning excercises, after afternoon excercises (if I do them depending on how mobile I have been in the morning) then I ice just before bed. I have very little swelling but still the awful sharp pain in the sameplace I had pain before op but I am hoping this is tissue damage waitin to repair.
 

Carol Anna

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Maybe 20 min before bed and a few times for 20 min throughout the day
Rubbish! Twenty minutes will do nothing. Ice for 45-60 minutes several times per day. The stiffness is caused by swelling. Ice reduces the swelling.
I think I will refuse to do the leg presses, squats, lunges, and bike for a couple weeks.
You are not in training - you are healing. Please stop all this and let that knee settle. When you are healed there will be plenty of time for strength training.
there appears to be a big difference of opinion between the nursing profession and Physio's. Hospital physio's said to ice one per hour nurses strongly refuted this saying the knee needs time to heal and freezing it stops the process. As far as I am aware they are still arguing about this after I questioned the difference of opinion.
 
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BarabooProud

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Thank you, all, for your replies. I have spent my day resting, icing, and napping. Very few exercises. Just gentle ROM stretches. I am feeling a bit better today, both physically and mentally, thanks to the support here. A few more days like this and I will hopefully be back to where I was before the intense PT.
 

kate97497

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I found different options on icing between my physical therapists. One told me no more than 20 minutes at a time, another said an hour was fine, don't worry about it. No wonder we are confused.
 

Jockette

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