TKR Gunu_21's Recovery Thread

[Gunu_21]

Hi , I had my total knee replacement surgery on June 2nd , I am still having trouble lifting my leg though I can walk with the aid of the walker but my knee really hurts a lot and there is still a lot of swelling which impedes my bending for physiotherapy. I feel I am really lagging behind in my recovery .My stitches will come out on 16 th June

 

[Celle]

Hello @Gunu_21 - and

I've copied your post from the June Sunbeams and used it to start this recovery thread for you.

Please post any updates or questions about your recovery in this thread from now on, because it is your own thread. We will see them there, as someone checks all the new posts every day.

If you need an urgent response to a question, just tag a member of staff.
Tagging other members and answering tags

If you prefer a different thread title, just post what you want and we'll get it changed for you.

Just in case you couldn't find your thread, here are the instructions on finding your thread,
How can I find my threads and posts .

A helpful hint - Many members have found it useful to bookmark their thread so they don't lose it.

Best wishes,
Celle

 

[Celle]

I am still having trouble lifting my leg though I can walk with the aid of the walker but my knee really hurts a lot and there is still a lot of swelling which impedes my bending for physiotherapy. I feel I am really lagging behind in my recovery

It's only 10 days since you had this major surgery and you are not lagging behind at all.

Recovery from a knee replacement can take as long as a full year, although you will be able to do most things by about 3 months.

There is no time line by which you have to achieve certain milestones of achieve good Range of Motion (ROM). You have plenty of time, because ROM can continue to improve for a year, or even longer, after surgery.
Myth busting: the "window of opportunity" in TKR

Of course your knee is still swollen - it's been through major surgery and it needs time and gentle treatment, so it can start to heal.

Swelling takes a long time to go down completely, but you an help it by doing lots of rest, elevation and icing.
There are articles about elevation and icing in the recovery guidelines, which I will post for you in my next message.

Don't let anyone tell you that you are behind, because you're not. Your knee will recover on its own agenda, not some artificial timeline set by your physiotherapist.

In any case, it's not exercising that gets you your ROM - it's time. Time to recover, time for swelling and pain to settle, and time to heal. Your knee has the potential to achieve good ROM right from the start, but it's prevented from doing so by swelling and pain. As it heals and the swelling goes down, your ROM (both flexion and extension) will increase spontaneously, whether you do formal PT (physiotherapy) or just let your normal Activities of Daily Living (ADLs) be your exercise.

 

[Celle]

And here are the promised recovery guidelines - lots of short, helpful articles:
Knee Recovery: The Guidelines

People are all different, as are the approaches to this recovery and rehab. The key is, “Find what works for YOU.“ Your doctor(s), physiotherapist(s) and BoneSmart are here to help, 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​

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. Try to follow this

Activity progression for TKRs​

6. Access to these pages on the website

Oral And Intravenous Pain Medications​

Wound Care In Hospital​

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 the 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 the member’s history before providing advice, so please post any updates or questions you have right here in this thread.

 

[kneeper]

Can you lift the leg, just with pain or is it a case of not being able to get the leg up? For me it was just painful. You may be doing this already, but I always tightened the muscle, then lifted. That's a little trick my PT told me about to make it less painful.

 

[doxiemom2017]

I couldn’t lift my leg for a while. My husband would lift it for me. In addition to what @kneeper said, squeeze your quad and abdomen muscles can help when you’re ready to lift your leg on your own. Also you can use your other leg (the foot of you non surgery leg) under your ankle to boost your leg a bit.

 

[Jockette]

I couldn’t lift my leg for a while. My husband would lift it for me.

Same here!

 

[Rollem1]

I couldn’t lift my leg for a while after then one day I got onto the sofa and lifted it without realising- give it time - my knee gives me new surprises everyday ! Xx

 

[GiantFinnegan]

Last night I lifted my leg onto the bed (it's kind of tall)! I was so excited.

 

[Sisterpat]

Gunu, boy are you in early stages! Congratulations on your new knee! Do not push yourself nor let anyone else push you! Your new knee will dictate how far to go and it’s never to the point of pain. Recovery is long and patience is needed. It will be a roller coaster ride for a while.
Like the others, I couldn’t lift my leg for quite a while, then all of a sudden it was there. Relax and know you are not alone in this challenging journey.

 

[Gunu_21]

Hi, thanks a lot everyone for replying to me. Further to my story, today I am exactly three weeks post-op. Got my stitches out on 16th June, my incision had drops of blood when they cut them and they put steri strips on my incision. My knee is swollen and not completely closed yet.

I am having PT twice a week for half an hour each. My PT does some massage on my quads with oil and makes me do some semi squats, heel slides, and lunges now (earlier just heel slides), which tells me to do them as per my comfort level. I try and do exercises on the bed from some videos shared by my hospital PT as my PT didn't share any more exercises. After my stitch removal, my doctor's PA called my physio and told him he can now give me some proper exercises to get better flexion, extension, etc. After which my PT gave me a massage where he had me screaming murder and insisted on trying to massage and handle my knee even though my doctor's PA had asked not to massage the knee yet to me. That was a bad day and I was laid up in bed for a day and a half and had to ice a lot. Later I spoke to the PT and told him I don't want him to do a brutal massage like that and he agreed that he will do the massage gently and won't touch my knee ( just beyond my comfort level but not hurting me)

I am concerned as I am unable to lift my leg till now. I use a strap to do leg raises on the bed and use my other leg to lift my surgical leg while sitting on the chair. My knee bend was around 50 after a week but is now around 80 only. My extension is 5. My knee is rather swollen still. I can't ice it much as I start getting the chills if I do it for a while. I feel a huge tightness on my scar when I try to bend it more and it feels it will split open. I do walk around the house but still need a walker. They stopped oxycontin after 11 days so now I take naproxen and paracetamol for pain relief. Though overall my leg hurts a bit less than before so it's manageable, nights are a hit and miss. I don't have uninterrupted sleep but I do manage to sleep a bit. I can walk around the house for 15 minutes and do some stuff like folding laundry, a bit of dusting, etc., but nothing major yet. Taking iron for my anemia and am able to eat a bit now ever since I stopped oxycontin.
Please pour in your advice as to how can I wake up my quads so I can lift my leg and safely try and increase ROM. Thanks in advance

 

[GAsue]

I found lifting the leg to be one of the most frustrating things in the first few weeks. Then, all of a sudden, I was able to lift it. My suggestion is to just keep trying and I think you’ll find the same will happen.

 

[Sisterpat]

Gunu, you will be able to lift your leg when your leg is ready and not before. You can’t do anything to force it. I would be very wary of doing any kind of squats or lunges this early in your recovery! It sounds like you are working that knee way too hard! Your range of motion will come bit by bit and this is way too early to concern yourself with numbers. You need to step back, rest the knee, elevate the leg and use ice. If your therapist tries anything that hurts, change to a different one or stop therapy if you must. Your swelling needs to go down before much progress will be made and if you aggravate that new knee, it will not go down.

 

[70somethingsusa]

Hi Gunu_21!
Welcome to this place of common sense!
come here often, read and be supported.
I had my knee replaced June 1, our story is somewhat similar, tho when staples removed, the incision was not together, I ended up canceling physio, so have only been once.I do at home gentle stretches, will be returning to physio tomorrow.We are provided 5 visits here in Western Canada.
My experience is similar, swelling, tightness, .
One day, about a week ago, my leg lifted itself! For exercises:
I put a rolled towel under my knee , tighten the quads , with toes pointing up.
Also, rolled towel, under ankle and press down., doing each exercise as much as able, several times daily..Don't forget..the quadriceps were cut..it's needing to heal.We'll get there, when the universe decides.

 

[Jockette]

I couldn’t lift my leg for a while, and all of a sudden I could, so don’t worry, it will come back. It’s just upset right now from the surgery.

Your ROM numbers are fine. They are improving. You still have a lot of swelling, which prevents your knee from bending. It will improve with time and healing.

Regaining our ROM is more about Time than repetitions of a list of exercises.

Time to recover.
Time for pain and swelling to settle.
Time to heal.

Our range of motion is right there all
along just waiting for 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. Normal activity is the key to success.

 

[sistersinhim]

.Don't forget..the quadriceps were cut..it's needing to heal

The vast majority of these tkrs are done without cutting the quads. They are just moved to the side out of the way.

 

[sistersinhim]

My PT does some massage on my quads with oil and makes me do some semi squats, heel slides, and lunges now

It is way too early to be doing squats of any kind yet. The same goes for the lunges. Both of those are very bad on a healing knee.

my PT gave me a massage where he had me screaming murder and insisted on trying to massage and handle my knee even though my doctor's PA had asked not to massage the knee yet to me.

YOU are in control of what happens to your knee. Your PT should never have touched your baby knee much less leaving you screaming. This caused a setback in your recovery. Tell them hands OFF!

he agreed that he will do the massage gently and won't touch my knee ( just beyond my comfort level but not hurting me)

Again, he should not be touching your infant knee at all. Your knee has many layers of internal stitches that have to heal. Having someone push on this area does nothing but harm at your early stage of healing.

I can't ice it much as I start getting the chills if I do it for a while. I feel a huge tightness on my scar when I try to bend it more and it feels it will split open.

You need to ice and elevate. That will help to get the swelling and pain down. Wrap up in a blanket or even an electric blanket if you have to, put please realize that icing is a very important part of this healing process. I iced and elevated 24/7 when I was sitting or laying down for the first couple of months. It was the middle of the summer, but I still got cold and would step outside to warm up. Soon I learned to use an electric throw. It felt so good!

 

[Jockette]

Don't forget..the quadriceps were cut..it's needing to heal.

As sistersinhim said, they no longer cut the quad, they work around it. Here’s an article from the Bonesmart Library:

Quads cut - why and when do they cut the quads tendon/muscle

This can be confusing as there are two definitions here - one is the standard method of accessing the knee joint, the other is old-fashioned. Even then there are a variety of different incisions but they vary only slightly. All start with the incision in skin which can vary greatly - but the...

bonesmart.org

Here’s a link to the whole list of articles in the Bonesmart Library. Lots of topics there!
https://bonesmart.org/forum/threads/library-index.14830/

 

[70somethingsusa]

Thanks, to all for the correction of my post. I was told by various medical team members that the quads were cut.

 

[Gunu_21]

@sistersinhim thanks for all the pointers , I shall keep this in mind from now and will start icing more often.