TKR Gait and walking 7 weeks post op

[Misspastor2]

Glad I found this forum! 7 weeks post op tkr. My gait is still off and I still experience pain when standing or walking too much. Mornings it's not too bad but as the day goes on its like i am dragging it. Pain upper and lower areas that wasn't there before. Not sure it i am doing too much or not pushing harder. PT 2 x week till 6 week and now 1 x plus exercises at home.

 

[Layla]

Hello and Welcome to BoneSmart! Thanks for joining us.
Please share the exact date of your surgery and which knee you had replaced so we're able to create a signature for you. This information is helpful for those stopping by your thread to read updates or comment.

Discomfort and pain are not unusual at this point. Recovery can take a full year and even longer for some. If you're not icing, please read the article on ICE in the Recovery Guidelines below. Icing should help with the pain you describe. You mentioned six weeks of PT winding down to one session per week and it's likely that the PT coupled with the home exercises may be the cause of the pain. I'd suggest you consider stepping away from both PT and exercises for a couple weeks and see if you notice a difference. It's likely you will.

As for your gait, if you're limping, here’s a tip -
Try heel-toe walking when you're limping.
This involves striking the ground with your heel first, then rolling through your heel to your toe, and pushing out of the step with your toe.
It takes a concentrated effort, but I believe you'll notice a difference. Give it a try.

Stay in touch and let us know how you're doing and enjoy the rest of the weekend!

 

[Layla]

KNEE RECOVERY GUIDELINES

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.

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?

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.

 

[Misspastor2]

Thanks I had surgery 12/8/22 on my right knee

 

[benne68]

My gait is still off and I still experience pain

I had the same problem. My surgeon explained that it is very common because I was probably favoring the bad knee for a long time prior to my surgery, causing the rest of the body to get out of alignment. As everything realigns, our muscles and tendons and soft tissue have to relearn what that they are supposed to do. That can also cause pain in places that didn't hurt before surgery!
You will improve. Just give it time!

 

[Misspastor2]

I am trying to pay attention to gait more. Night time is worse. I work from home and made the mistake of starting back at 2.5 weeks. Sitting at desk is hard so I get up every 30 minutes to walk. I am not sleeping. I have tried all positions and pillows between leg. Nothing helps so I go without sleep. Foe some reason it hurts to have anything touch it at night, even covers.

 

[EalingGran]

I am 13 weeks out from PKR. Sleep is better and more comfortable but still not perfect. I sleep with my Aircast cryocuff iced sleeve just resting on my operated knee and I refresh it when I wake.

 

[EalingGran]

I also got some sleeping meds ( zopiclone) from my GP. I took them sparingly and still have some left. It helped just to have a better night sometimes.

 

[sistersinhim]

For some reason it hurts to have anything touch it at night, even covers.

This is a common complaint. You need to start desensitizing your knee. To do this, gently rub a very soft fabric across your knee numerous times. When this no longer bothers you, go to a coarser cloth. Continue until a really coarse cloth doesn't both you anymore. It took me a couple of weeks before the cloths didn't bother my knee. But, it was a big relief!

 

[Misspastor2]

8 weeks post op. Have been doing better then the past few days I am having weird pain in the knee cap and bottom like where the rod is attached. It's like I feel it. I was released to drive and have driven short distances but moving my foot from pedal to brake causes a weird pain again at the bottom of knee like it makes a popping sound. Not pushing the driving but so frustrated that I am not able to do better at things.

 

[Layla]

At less than eight weeks post op, you're still pretty early into a healing process than can take up to a full year for most and even longer for some. You will experience different odd sensations, discomfort and pain that is normally short term. Patience is key, so please try not to be frustrated with your progress, but instead grateful for the strides you're making and will continue to enjoy.

As for the popping sound, while I'm sure its irritating, it's usually not a problem. The prosthetic is settling in with the surrounding soft tissue and all will work smoothly with the passage of time. If noises or sensations are accompanied by pain that is increasing in frequency or intensity, consider calling your surgeon to speak with a member of his care team for advice or reassurance.

Take good care and enjoy the rest of the week!
@Misspastor2

 

[Misspastor2]

Thank you. It's reassuring to get this advise!!

 

[beachy]

That popping (without pain) can leave then come back in a few months. Most of us veterans have experienced it. Don't be alarmed.

 

[trinket]

Hi! We are in the same place in our recovery! I'm experiencing most of the same things as you. I am working on my gait, and find the heel/toe walking Layla describes definitely helpful. I also practice taking a longer stride and the heel/toe comes more naturally.

I have aches and pains that move around/come and go as well. I've found they resolve themselves so don't worry too much about them anymore. I think my new knee is settling in and getting adjusted to its new home. My knee was also very swollen and very sensitive. the swelling is finally going down a bit. I have found that using different coarseness of fabrics has helped to desensitize my knee. It has been impossible to wear anything but a soft knit, but today can finally wear denim. Small victory!

 

[Misspastor2]

I slept better last night, but still have such stiffness. Not alot of swelling, but it's still like the new knee is foreign to my body. I know this will get better but I guess my expectations for recovery were different

 

[Misspastor2]

Just wanted to also share that I did PT 3 times a week for 4 weeks then 2 x plus doing my home exercises. The therapist constantly pushed me to get to 120 bend. I would pull all I could and suddenly they would push! I would have tears running down my face from the pain! My husband questioned this and they said I only had a small window to get there. Then put me on the bike. I couldn't make the full turn and they just pushed my foot on around. It was a horrible experience and would take 2 days to recover. I stopped PT 6 weeks.

 

[Layla]

That was a lot of PT early on while your body was only beginning to heal from the trauma of TKR. I am really sorry to read that a PT pushed you to the point of tears. Please refrain from engaging in movement that causes discomfort or pain. Do not allow anyone to forcefully manipulate your leg. While your range of motion is currently limited, it will naturally increase as the swelling subsides and the pain eases. Give it time. As far as a window of opportunity, it’s simply not true.
Here is an article - Myth Busting - Window of Opportunity
Wishing you a peaceful, relaxing weekend.
@Misspastor2

 

[kygirl13]

I am at 9 weeks and I quit PT before 6 weeks about the same as you. I couldn't take the pushing and the negative comments on my progress. I do just gentle stretching and normal activities. My husband thinks I'm not doing enough but he has noticed the improvements in my stair climbing, all done without PT. Just listening to my body has been the right thing to do. Hang in there!

 

[Misspastor2]

Thanks for your feedback. My husband's sciatica flared about the time I stopped PT. So even though I am not doing PT I am having to take the dog out and do things around the house that he was doing so I feel I am getting exercise in a different manner and making my own small improvements.

 

[beachy]

I'm in a similar situation. At 2 weeks post op my husband needed surgery and I shared some household duties with my son that I hadn't been doing. My first PT appt was at 3 weeks. Therapist was surprised I had 95 bend with no PT.
Those additional ADLs do help your ROM naturally.