Revision TKR Here I go again!<<.

[Jordon6]

Thanks @jmp65! I'm open to any advice. My therapist would end my sessions with that treatment and seemed to help but with 2 MUAs and arthroscopic lysis within 6 months, they probably weakened even further. I think my quads have been weak for some time, even before surgery cause I limped around for 2 years prior to surgery. Someone on this forum said that quad strength is not lost or gained overnight. I'm just sooo impatient!

 

[skigirl]

here are a few exercises from our library. I especially like the ones for pre surgery as they work on the quads and hamstring muscles. Most of all, be gentle, don't do 10 sets the first day. Also, just call his office and say that you want a referral to PT. You don't have to go to PT, but even once a week would be good to mark your progress.

Exercises - for gentle strengthening
Exercises for pre-TKR surgery patients

 

[skigirl]

My PT uses E-stym which is the electrical charge which wakes up the quad. It was helpful to me. You need to check out a few PT's near your house. Just walk in and look around and then talk to the owner of the clinic. Say that you need help with your quads and they will be glad to help you.

You have been through the mill---you need a rest!!! But, PT always got me going!!!

 

[Jordon6]

Thanks @skigirl. I will call the doctor Monday to get a referral. I know a good PT near my house. I will make sure I discuss my goals- strengthening my quad so that they create an individualized plan not just the typical protocol exercises.

 

[skigirl]

Good move on your part!! I also went to several PT clinics until I found the one that I wanted. They can probably get a fax from the doc, so get their fax number before you call the doc's office. Just say you want 8 or more) weeks of PT at such and such a clinic, here is the fax number.

 

[Jordon6]

@Josephine 1. what are your pain levels right now? (remember the 1-10 scale: 1 = no pain and 10 = the worst you can imagine) pain at rest-2, pain at activity-6/7. Pain spot-RF2/D. Painful at bend during walking

2. what pain medications have you been prescribed, how much are you taking (in mg please) and how often?
Tramadol-50 mg as needed-usually around 10 am at work, Tylenol as needed

3. how swollen is your leg compared to these? Moderate

4. What is your ROM - that's flexion (bend) and extension (straightness) ROM-90/95, -3/4 extension

5. are you icing your knee at all? If so, how often and for how long? No icing anymore, I elevate nightly for about 30/45 min.

7. what is your activity level? What do you do in the way of housework, cooking, cleaning, shopping, etc., and
work daily-teaching. On my feet 8+ hours a day, light housework, shopping, cooking

8. what kind of PT exercises and exercises at home are you presently doing? How much and how often?
This is the most crucial question so please help me by using the format I have left as an example
(which means please make a list and not an essay!) Im doing quad sets, leg lifts, stretching. Mainly things to increase my quad strength. No PT anymore. Done at home about 2 times a week.

 

[Josephine]

I'm doing quad sets, leg lifts, stretching. Mainly things to increase my quad strength. No PT any more. Done at home about 2 times a week.

You haven't answered my question fully. I need to know how many reps you do each time and how many times a day. This is THE most important question.

Pain spot-RF2/D.

About here then?

pain at rest-2, pain at activity-6/7.

Okay - got it

Tramadol 50 mg as needed, usually around 10 am at work, Tylenol as needed

Again, you've not told me how much Tylenol and how often? I need this information.

Swelling: Moderate

I see

ROM 90/95, -3/4 extension

Okay

No icing any more, I elevate nightly for about 30/45 min.

You accomplish little or nothing in that time. Elevate for at least 40-60mins and you should ice too if your pain is as high as 6/7.

work daily-teaching. On my feet 8+ hours a day, light housework, shopping, cooking

Got it

I'd comment more but I need you to answer more fully those points in red

 

[Jordon6]

@Josephine 1000 mg Tylenol at night and once a day usually mid morning. Leg lifts and quad sets 3 reps of 10. Yes that is the spot that's most painful.

 

[Josephine]

Thank you

1000 mg Tylenol at night and once a day usually mid morning.

This is insufficient. Tylenol is only effective in the system for about 4-5 hours so you are spending most of the day with no coverage. To adequately manage the pain you need to take that dose every 6 hours.

leg lifts 3 sets of 10 reps - if you can do leg lifts then you don't need to do them any more!
quad sets 3 sets of 10 reps - these are unnecessary as your ROM's not that bad, your extension is exceptional. Apart from which, these exercises are the cause of your pain which is most likely this Iliopsoas syndrome. Stop the exercising and this will settle down. In addition, you may even find your ROM improves. Try it and see.

 

[kneeper]

It sounds like they think working on your quad strength will help keep your knee from buckling on you. IMHO it's ok to do the quad exercises, but don't do too many at once. When you overdo you can actually work your way into a bout of tendonitis which can be difficult to get rid of.

 

[Josephine]

@Jordon6 I've moved these last four posts from this thread '[TKR] - pain/mobility 6 months post-op to here as that was Ladywells' recovery thread and you and I derailed it! The questions I left weren't actually intended for you but for her! Nevertheless, the answers are yours and are applicable! But in future, please keep posts about your recovery in THIS thread which is your recovery thread. Okay?

 

[Jordon6]

@Josephine Sure that was not my intention. If you noticed, I was was replying to her to let her know that I understood her concerns and offering her my best wishes!

 

[Jordon6]

@skigirl How long did it take for you to fully recover after the scar tissue removal? I had a lysis of adhesions and MUA 5 months ago and I still struggle with moderate daily pain. Not much swelling. I've learned to live with my poor ROM of 90/95 but still very unsteady and limping. Just wondering!

 

[skigirl]

I had a really slow recovery----I waited 3 weeks before any PT, then did only table exercises until 8 weeks. At 8 weeks, I began gentle strength training. It took me a full 3 months to be recovered. My surgeon stressed that if you exercise a hot, swollen knee, you cause more adhesions to form, so I was very gentle with my recovery.

 

[skigirl]

Are you still working with a PT? I think quad sets are one way to wake up the quad muscle without doing too much weight bearing. You have had a lot of stress on your knee in a short period. I had my lysis 2 years after my initial surgery and have never had a MUA.

Right now, I think you need to concentrate on getting your quad up and working and really, resting the knee a little. As you have said, "impatience" is part of the problem. Have you changed your shoes?? I had to change all of my shoes after tkr since my gait changed and the old wear problems hurt my feet. Also, doing too much when the knee is inflamed is counter productive. Are you working right now?

 

[Jordon6]

@skigirl I have not changed shoes! It's on my Christmas list!

I think I could be more patient if my friends and family would stop asking me-"are you not better yet?" I'm tired of explaining. Until you go through it, it's just hard to understand. I guess I'll keep building up my quads and resting-especially over this holiday break!

Happy holidays!

 

[Celle]

I think I could be more patient if my friends and family would stop asking me-"are you not better yet?"

It's hard for people to understand that recovery from a TKR takes so long. Most recoveries take about 6 weeks, but this is a year-long recovery.
Try not to get stressed when friends and family ask. Just explain that this is different and full recovery takes a year, although you will be improving all the time.

When I was asked, I just used to reply "I'm getting there, but it will take a while." And then I would change the subject.

 

[sistersinhim]

I don't know how many times I've heard that and then told them it takes a year or more to heal from this. I'm not lazy, I'm still healing!

 

[Jordon6]

Guess I'm on the 18 month plan!

 

[Jordon6]

@sistersinhim me too! Makes me so angry! Even my husband gives me the "look" like I'm being lazy or over exaggerating!