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TKR Highlander's New Knee

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Just finished reading your story, one thing for sure, no 2 knees are alike, I've read through probably 50 profiles now, each one of us is different. The one common factor, Rest, ice, and elevate helps more than any PT routine or exercise. Thanks for the information about sleeves, my next purchase. My surgery was on 12/22/2016, and I still have swelling. It's a balancing act between being active, yet not doing too much. Since week 6, I've had a tendency to do too much, then have to slow down for a few days. The hip pain that you mention must be a byproduct of the surgery, I've had similar pain now since surgery, it's much better now, went away about week 6.
You are doing great, keep up the good effort, and encouraging posts, you are one that I will follow for encouragement and I will help if possible.
 
Today I hit 92 degrees flex at PT. Very excited! From 80 to 92 in the last 5 days. Frequent short ROM sessions every day x 4. Feeling good
 
That is real progress! Great news!
 
4 weeks tomorrow.

Back to Rhonda (my PT) this am- lots of ultrasound on my IT band and hip. My new leg is actually about 1/4 to 1/2 inch longer than my right leg as measured by her today. It was 1/2 inch shorter before surgery. So that hip and IT band are going "what the heck are we attached to now?"

My PT explains it like this- the new knee has created new proper alignment- no more bowed out leg. My leg is now longer- but the quads, tendons are still same length and their historical shortness is adding to my resistance, soreness and that tight band feeling at knee and in my thigh. So we have to gently, week over week- lengthen, soften and strengthen these muscles, insertions. IT bands etc.

So thats where the frequent sessions come in. Once a day or 3 times a week wont cut it. 4 times a day- gently do the stretches and range of motion exercises. No crying, no agony, just work it to the point of resistance and push it just a tad each time. Then elevate, ice, repeat. Full time job really.

My knee joint feels great- so much smoother than before- and when I walk its so smooth- it can buckle or hyperextend briefly at times, so still using the cane as a security blanket. But walked 2/3 of a mile on flat track after PT and it felt good.

My hip and IT band ache at night - but the new stretches she showed me today will go into the daily program. Approaching right at 95 degrees flex/ and 0 extension now. I was 51 degrees flex 2.5 weeks ago before I started with Rhonda (my PT). So thats 44 degrees in 16 days.

My strength stuff is really only:

1. just the Nu step machine set on very light resistance- still using that mainly for ROM too.
2. walking daily with proper gait
3. Parallel bar 1/2 squats- with me supporting 75% of my weight on bars.
4. bent short arc quad lifts to help activate quad insertions and especially my VMO

ROM stuff is: Nu step 20 minutes- moving seat up to next notch when I can bottom out every 5 minutes or so. flexion into one step on the stairs, stationary bicycle- rocking pedal back and forth to stretch point for 5 to 10 minutes, heel slides and hold and push with other foot gently, parallel bars- no weight full squats. and walking too!

Ice machine and elevation at least 4 hours per day. Thats it!! On to 100 degrees and 1 mile walking in week 4-- as long as there is no pain in joint or additional swelling of course!
 
Your PT is sensible to warn you that progress with stretching your soft tissues will have to be slow and steady. Try to do it too rapidly and they will get inflamed.
 
@Celle Yes, Im lucky to have her on my team. These are very focused things that have to occur on a repetitive, consistent, and gradual basis. I could not get these things accomplished just doing general daily life activities.
 
@highlander I I am bilateral a day after you. I have one knee doing really well and one problem child. I am hoping adding hydrotherapy to my twice daily gentle exercises on Friday will help
I also have IT band tightness and was wondering if you could tell me what stretches you were given to help it. Many thanks.
 
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@DebM Basically the article @Celle references is right on. I do those plus a variation- using of all things, a dog leash. I put my foot in the loop end of the leash, and laying on my back, bring my leg up straightened, and then cross it over in front of me for the stretch shown in various other exercises in the article. I can control the pressure just by letting up on the leash or letting my leg cross over more. Works well! Thats the only real aching pain I have right now. My left IT band all the way from that bursa spot down about halfway to knee. I just walked another 3/4 of a mile this afternoon on my farm roads- and knee loves it. Hip area- that IT bursa feels it a little.
 
4 weeks and one day today- Continue to do my exercises a least 3 times per day. Organized outpatient PT 3x per week, but I go there the other 2 days as well and do self paced work in the fitness room. Today was another milestone- I got around pedaling the recumbent bike. That is huge for me. It felt good, and I was able to do very low resistance pedaling sessions- 2 today of about 12 minutes each. Flexion is now 95+ and shooting for at least 110 degrees before six week OS visit. Walked 1.5 miles total yesterday in two sessions- no major additional swelling, and no knee pain- hip at the bursa spot still hurts a bit....
 
Congratulations on doing a full revolution on the bike. :yes!: :yay:

Continue to monitor your activity so that it keeps your knee happy.
 
Getting that revolution is great! While walking works wonders for lots of people, biking really helped my knee to loosen up.
 
I really liked short sessions on the bike to loosen up. Congrats on the full rotation!
 
I remember that first revolution on my recumbent bike. What a thrill! Congrats on yours!
 
Just checking in. Two days shy of 5 weeks. I continue to work my outpatient PT and home exercises every day. But never to the point of a curse word or tear :) I have started very light resistance today, adding some 2 and 3 pound ankle weights to a few lifts. And adding time on the nu step and stationary bike. ROM is 95 and hope to be at 100 in another 9 days- before my 6 week check up. I continue to take two walks a day on level ground- and try to total about a mile or so for the day.

I went and bought new athletic shoes and lightweight hikers today- Im a sucker for new kicks- and added an orthotic insert to the right shoes (added maybe and 1/8 to 1/4 lift)- it balanced out my legs nicely. New shoes are great- and it really felt good to get some fresh support for my newly aligned leg and stride.
 
I'm a little late, but...Holy cow! Your PT sounded brutal. Worse than my very young go-getter Physical Terrorist. I had LTKR in November and was just released this last week. This is a great place to reaffirm what feels right and what doesn't. Good luck!


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