Bilateral TKR Halfway there...transitioning issues<<

[mpj200]

I'm doing 8 minutes on the bike, no problem. May work up to 10 next week. But I'm sore afterwards. Also doing non resistant gentle heel slides and a little stretching.

But any movement at all tightens up my knees. Even brushing my teeth can bring on the rubber band effect. Just from my body shaking while I brush.

So I'm perplexed at how stretching though it will help? Riding the bike increases my bend, but it makes the rubber band worse. My Dr's say it's scar tissue. And I need to push through it until my Europe trip.

Seeing the Neurologist next week. But I don't feel any pain except the tightness and occasional pain on the sides of my knees, which my Dr tells me that's where the scar tissue forms.

Has anyone exercised through the rubber band phase? Am I the only one that rides my bike, then gets tighter when finished?


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[KarriB]

So if it's scar tissue it's not inhibiting your bend? Are you riding at 0 tension? If your sore when you're finished I wouldn't up the time. At this point it's just about getting loose, not building stamina or muscle.

How much walking do you do?

 

[mpj200]

Yes. 0 resistance. Bike is unplugged. It's almost too easy once I loosen up and can peddle full circle easily.

I get loose. My bend is better. But that rubber band feeling is tighter than when I started. I guess that's what's confusing me.

I just walk in my normal day routine. Around the house. To work a few hours a day.


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[KarriB]

Hopefully your neuro can help. My experience was doing nothing for an extended period helped my rubber band feeling. Of course I was forced to do this. I didn't ice because I couldn't feel it through the brace, but I did keep my knee up or elevated for that month except for ADLs and dr appointments. I didn't shop, go to church, work, nothing. My knee looked skinny for the first time in my life!

 

[VW54]

I find that I have the same thing happening. After a long walk or 10 min bike or 20 min standing (cooking,tidying up) the tight feeling gets tighter. In the evening it's tight and slightly swollen, mostly on top of the knee. Am being a sloth these 3 days with no rehab. But tight feeling still there.

 

[mpj200]

After 2 months of constant rest, elevation and icing...and not working or exercising, my pain got worse. I was miserable.

I started 3 days a week of moderate exercising. Some stretches (but not to the point of pain) and riding my bike about 8-10 minutes.

My knees get tighter as I exercise. Really tight. But I feel better overall than when I did nothing. I also got some compression braces with support from my Dr. I'm
amazed at how much they help. Even when I'm not wearing them, my knees feel much better than they did a month ago. I have hope again.

If I can just get past this tight rubber band period, I think I will be in good shape. Monday will be 6 months. I'm praying that I can keep moving and stretching and that the tightness will start to go away soon. I've had it for about 3 months now.


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[mpj200]

I'm trying to plan my trip from the US to Europe in a month. Germany, Austria and Switzerland it looks like.

Dumb question maybe, but I'm curious where you can buy ice packs for knees in Germany? I have ice machines at home, but would like to try and buy some Velcro, strap on ice pads when I get there. Any suggestions?


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[KarriB]

Why not order some gel packs from Amazon and pack them in your checked luggage? Then you don't have to worry about finding them or shopping. Here's a link about flying after surgery that may help you plan.

https://bonesmart.org/forum/threads/flying-soon-after-surgery.13054/

 

[mpj200]

Thanks KarriB!


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[KarriB]

@mpj200 I'm answering your post/question from Dvanni's thread here as I don't want to derail her thread.

If you are going to start walking be careful, start slowly, just 10-15 (this is what worked for me) minutes at first and see how your knee reacts. I would continue at that short time period for a week and add 5 minutes every week, again listening to your knee. At this point it isn't necessary to use any weights, just the walking is enough. The Activity progression for TKRs does suggest walking also, but no longer than 20 minutes at first.

 

[mpj200]

The Tight bands have me back in private PT. One on one in a room with just the Therapist. Tried Dry Needling. Didn't like it at all. No relief.

Tight bands also have me going to a Pain Management clinic now. Because I can't deal with this every day.

I'd rather become a morphine addict again for a few months and then go through withdrawal again.

My new PT did say that braces and sleeves are fine. Just not to become too dependent on them and not to restrict my bend with them.

I've gone from 115 to 90 on my bend since the Claw set in.

My recovery is centered around the tight bands. So I would encourage you to stay on topic.

My new PT was fairly mystified at the Claw, but had patients before with it. Said it was rare. He's a private therapist. Doesn't take insurance, so he mainly sees people that are having trouble with recovery. And have already been through 3 months of PT with another Therapist first.

He did say I have a low pulse in my feet and it could be a vascular issue. But he also found some places where it appears I have some soft tissue that still hasn't healed.

His course of action is to ride my stationary bike and do pool exercises, but only what I'm comfortable with.

And he gave me 2 exercises to do daily. One is a gravity stretch where you lay down on your back, pull your knee towards your stomach and let your leg/ankle hang down by gravity. Fairly painless.

The other is laying down and tightening the quad then releasing. I believe this increases blood flow. He doesn't believe in cranking on the knees.

What really puzzled him was the bike. My knees get looser after 5 minutes or so of peddling, and that's normal. But the Claw is full on when I get off. So it's not being on my feet that causes the Claw to set in more. It's simply moving the knee. Any movement makes both of my knees lock up.

Nobody seems to have answers. And maybe it will go away at some point. But for me, it's the focus of my recovery. And the pain is to the point where I'm going to request more (narcotic) pain meds. Tramadol and tylanol every 6 hours was useless for me.


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[mpj200]

I started seeing a private Physical Therapist last week. Gave me a few exercises to do daily. Lay on back and pull knee towards check, let gravity pull knee/ankle down to stretch as much as I'm comfortable with. Also a quad tightening then release exercise to help with blood flow. He had no real solutions for the Claw. Said to keep doing bike and pool but don't push it.

He tried some dry needling and got some places that hurt like ****. He thinks I have some soft tissue still healing more in some spots.

I am starting to get a better handle on my pain. The Claw is painful. But I also have a burning sensation and soreness still on both knees. At 7 months post op.

So sick of the pain every day when I wake up. I dread getting out of bed.

Looking at going to a Pain Management center and getting back on meds. Feel worse after 7 months than I did after 7 days. Of course I was on hospital meds then too.


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[KarriB]

Biking with no resistance was helpful for me, but remember it can take a full year to recover. I agree with the PT, don't over it. Too much exercise can cause pain and swelling. I had pain when walking even a year post op, but building up my walking helped immensely.

 

[mpj200]

Thanks @KarriB ... It seems possible, if not likely this burning sensation is coming from swelling and maybe soft tissue still not healing? I don't think I overdoing it. I get this burning soreness just from walking around the house. But I am riding my bike for about 10 minutes with no resistance twice a week and doing some pool walking and mild stretching once or twice a week. I guess that is keeping things stirring inside my knees.

I have a month before I leave for Europe now. At this point I'm just trying to heal a little and feel a little better before my trip. But Dr and new PT keep telling I have to keep moving the knee. Not aggressively, but not being a couch potato either. I'm working on finding that balance again.


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[SusieShoes]

Something tells me you are not a natural couch potato. It is beneficial to move the knees. They rather like it, because that's what they are built to do, but finding the balance between moving and resting the healing knee can be tricky. If you find an exercise your knee likes and tolerates without swelling, that's the way to go. Like Karrie, I like walking. For you, it might be the bike, or something else. We're all such individuals, even our knees!

 

[KarriB]

I had the rubber band feeling early (first month) but it went away after my infection surgery when I did nothing but walk around the house for a month. I actually think using the bike daily is good for loosening the knee, but I'm not sure about water walking because water creates a natural resistance similar to weights which aren't good for a knee that still has soft tissue damage. I LOVE water and swim daily in the summer, but my opinion is regular dry land walking is better for a knee. It's what you want your knee to be able to handle throughout life.

 

[mpj200]

That's true Susie. For me, no matter what I do. I get that clamped Claw feeling. It's always there. I wake up with it. Walking to brush my teeth makes it tighter. It's an all day thing.


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[mpj200]

I agree @KarriB. I'm dropping swimming. It gives me sinus issues anyway. Walking really aggregates the Clamp, but not as much as biking. I have found that for me, loosening the knee does not prevent the Claw. It only worsens it when I finish biking. And my new Therapist was mystified on that.


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[Jockette]

I am 6 months post op and frustrated with my recovery also. My knee still has that tight inner feeling, which I know is going to be with me for a long while yet.

I was coming along, slowly, but coming along, and then towards the end of July we went away for the weekend and I totally over stressed my knee. It took almost 4 weeks before it to begin to feel better and then my son got married and there were 2 days of wedding activities that further stressed my knee. I cannot seem to recover these set backs. My rom is much worse now than it was at 4 months.

I am beginning to realize that this is just the way my knee is recovering and trying to remember that the knee is in charge. I try to keep the knee happy.

A couple of weeks ago I tried walking in my neighborhood thinking I wasn't doing enough to encourage my knee to improve. The walk was only a half mile and the second time I did it within a few days my knee rebelled. I really think I should be able to walk a half mile at this point.

Interestingly I find my knee happily walks around my super Walmart, and I'm sure I do more than a half mile in the hour or so I am shopping, it's a big store and I usually cover most of it. My theory is that the floor is very smooth as compared to outside walking surfaces, and I'm pushing the cart which I call an incognito walker. Also when shopping, you walk a little, stop to pick up what you want, and repeat that pattern so I figure I get a bit of rest in that moment of stopping.

I had to stop going to my community pool because I was spending an hour and a half in the pool visiting with my friends and stretching the knee the whole time and totally overdoing it.

I think for some of us we are just going to have more discomfort than others and somehow we have to find a way to accept that and just do the activities that we can. I am still working on that acceptance.

I will admit there are still times that I am angry that before surgery nobody told me how painful and long this recovery would be. It was a shock to me when I found this out at 4 weeks post op when I found Bonesmart! I just wanted to fix the pain in my knee, I had no idea that 6 months later I would still feel worse than I did before surgery. And I had a partial replacement which means there is a good chance I will have to have it revised to a total in the future. I wish I had waited.

And, I can relate to pain in my knee while brushing my teeth! I think that maybe we lock our knees a bit while standing there then leaning over the sink puts a different pressure in the knee. I feel it every time! So now I try to relax my knee with just a tad of a bend to it.

So best wishes to you as we struggle through this recovery.

 

[DebM]

I agree with you about neighbourhood walking vs shopping walking. I work as a delivery driver 2 days a week and do about 13-15,000 steps a day. Yes I am very tired and quite sore by the end of the day but generally recover quite well. Yet waking the neighbourhood 1-2 miles is quite uncomfortable.
I am sure it is because I alternate between walking and sitting/driving. Similar concept to walking/stopping when shopping.