TKR Hip & Lower Back Pain

[TIC1015]

Hi! I’m so happy I found this place!!!! I had my left knee mako robotically done on 10/20/22. The right one was done 8 weeks later on 12/19/22. I’m so tired & impatient! I feel like the more progress I make, I can’t wait for more!!!

I am 19 weeks on my first & 10 weeks on my second. I go to PT twice a week & don’t push it in between. I live in a 3-level townhome & I think that has helped. I’m still not walking outside or shopping. It feels too much. I am off my cane, walking with a smooth gate & looking good. However, if I stand still to cook, dry my hair, or wash a dish, my legs are so tight they are gonna lock up. So, I’m still sitting and off kitchen duties.

Nights suck!!! My knees are so tight, I feel like I can hardly bend them & they are sore when I am moving them around. Everyone says I’m doing great & it’s all normal, but I question myself all the time!!! Am I being too lazy? Should I be doing more? When will this tightness end?

I'm so impatient & want some type of ballpark answer other than be patient. Any thoughts, ideas, reflections, or inspirations would be greatly welcomed & appreciated!

I am 57 & overweight. Haven’t gained any during this drama! YAY!!!

TIC

 

[Roy Gardiner]

You are doing OK. Gentle stretching exercises are what you need, progress with continue slowly but surely

Knee Recovery: The Guidelines

We are all different, as are the approaches to recovery. The key is, “Find what works for YOU.“ Your doctor(s), physiotherapist(s) and BoneSmart will offer advice and are there to help. The advice may vary, 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. At week 4 and after you should follow this

Activity progression for TKRs​

6. Access 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 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.

 

[Jaycey]

@TIC1015 Welcome to BoneSmart!

I am afraid there is no magic method to this recovery. Pushing will only set you back. And since you had 2 major surgeries in a fairly short space of time, this recovery requires double the patience.

As Roy recommended - gentle stretching and taking things slow and steady. Lots of icing and elevation. Your knees will tell you when they are ready to do more.

 

[EalingGran]

go to PT twice a week & don’t push it in between. I live in a 3 level townhome & I think that has helped.

I’m still not walking outside or shopping. It feels too much.

My PKR was in October- so my surgery was about the same time as your first. I can't imagine having done it again so soon. Particularly as you live on three floors. I also have a three floor house and mine has no toilet on the ground floor and stone steps up to the front door.
I have found stairs tough and am only just starting to do them normally some of the time.
You probably are getting enough exercise with the stairs but I wonder if going out would help with sleeping and
just generally feeling better?
I started going out quite early ( 1- 2 weeks) with two crutches and being driven to safe places to walk short distances. It really helped my morale to be out and about amongst ordinary people and to meet friends at coffee shops etc.
As to sleep I also found that hard and the tightness has only recently gone ( 16 weeks) but can come back if I walk a lot.
I got sleeping pills from my GP ( zopiclone) which really helped. I know others here ( @beachy ) have used trazadone with benefits

 

[EalingGran]

I still use a cane outside. Mainly just carry it but use it for getting on and off buses/ trains or if very rough/ hilly ground.
I feel it gives me confidence to travel by myself into central London and also alerts others that I need to be careful.

 

[Jockette]

Stiffness/Tightness is a normal occurrence after this kind of major surgery. Your surgeon did major carpentry work and disturbed every millimeter of soft tissue in this area. You aren't tight because your muscle is underused and needs to be stretched and rehabbed. You're tight because your tissue has been disturbed and is healing. It will ease up over time, but complete healing takes an average of a full year or more.

 

[TIC1015]

Thanks everyone for your advice & shared experiences. This whole experience is going to be an exercise in patience & moderation.

My godson, who has been staying with me & helping around the house, had to go home last night. I woke up not feeling well. However, I wanted to show him that I could do the morning chores & get my own coffee & climb the steps. I did it all. Dishes, feeding the cats, etc. It landed me in bed for most of the day, with a heating pad on my back & ice on my knees.

If I feel like this in the morning, I may take a day off of PT & give myself a break.‍
Thanks again!

 

[Jockette]

This whole experience is going to be an exercise in patience & moderation.

Yes!

If I feel like this in the morning, I may take a day off if PT & give myself a break.‍

Very good idea!

Regaining our ROM does not require forceful bending or painful exercises.
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.

 

[Layla]

Happy Anniversary! Five months for, Lefty, and Three months for, Righty!
I hope you're doing well and feeling stronger with each passing week. We'd love to hear from you when you have the time to share an update. Until then, All the best!
@TIC1015

 

[TIC1015]

Thanks for the thoughts! I’m getting there, but the fatigue & emotional rollercoaster is still getting to me.

I’m trying to push myself to work a bit and get out there. It’s hard because I work as a psychotherapist via zoom since the surgery.
I find myself many days sitting around and binging tv, while making a few calls or making “to do” lists. I have started getting out for a lunch or dinner here and there and tried going to the market. I ended up having to find a place to sit down in the produce section. I live in a 3 story townhouse & the stairs are still an effort. I can’t believe after all this time how much of an effort it is to shower & dress or get in bed at the end of the day. The journey is daunting!

It’s been 6 1/2 months for my left knee & 4 1/2 for my right. I am still sleeping till 10:30-11am everyday & feeling exhausted. I have been going to PT twice a week for 6 months. My left knee only feels like a small cinder block is there & my right, about 40%. I am walking almost normally, but very slow & unsteady.

I have hypothyroidism & am post menopausal. Does that play into the fatigue?

I don’t know if I’m doing too little or this is part of the process? Should I be counting time since the last knee was done? Am I really only 4 1/2 months along? I don’t know! I question myself with EVERYTHING!!! I don’t think anybody gets it really, unless they have been through it!!! I only cry two to three times a week vs daily. Progress, right?. I have read that the depression is real & can take up to a year to dissipate. Anybody going through or gone through this?

I know I’m getting there & hate to post, only when I’m struggling. However, the last 2 days have been hard & I want to get up early again & be productive! I see people hiking & smiling & I struggle to just function at 75%. I feel like a lazy failure sometimes.

Any similar experiences or words of encouragement would help greatly! If I talk to anyone else, they just tell me to stay off the internet & be patient. It’s hard!!!

Hope everyone else is doing well

Lots of love,
TIC1015

 

[Layla]

Well...It's only been a little over 6 months since your first THR, followed by another only two months later. That's two major surgeries within a very short period of time. I can see why you're feeling short on energy. Your body is using energy first to heal from the two controlled assaults, not leaving a lot for anything else. Our body does it's best healing while we sleep, so all of that sleep is a good thing right now.

I think any medical condition or physical change we go through can affect our healing time. Regarding a timeline, your first recovery which is still underway, rolled into your second recovery, both still ongoing. Give yourself a year from your latest surgery, but it may take even longer since many notice improvement into their second and even third years post op. That could very well be your experience after two major surgeries within such a short span of time.

As for the crying and depression, I'm so sorry. Possibly getting out of the house a little more, even if its only to sit outdoors somewhere, around other people, may help you feel more normal, like part of the world again. If that sounds like too much, consider inviting a friend over for coffee, or planning more meals away from home with a friend or family member for awhile...if the budget allows. Life isn't cheap these days!

I know I’m getting there & hate to post, only when I’m struggling.

Don't worry about this. Most of us are / were here for the support and encouragement needed during the healing process, so no apologies or guilt, please.

Maybe consider taking a couple weeks off PT and use the Activities of Daily Living, along with the three flights of stairs and a daily walk outdoors as your PT, just to switch it up a bit. You may have established a routine that feels boring and unfulfilling and switching up a bit may provide a positive shift in your mental health. Recovery can get stale and boring. You sound kind of stuck right now and this may be just the reset you need.
Something to ponder...

We're here for you any time you need us. I hope today is a good one!

 

[EalingGran]

don’t know if I’m doing too little or this is part of the process? Should I be counting time since the last knee was done? Am I really only 4 1/2 months along? I don’t know! I question myself with EVERYTHING!!! I don’t think anybody gets it really, unless they have been through it!!! I only cry two to three times a week vs daily. Progress, right?. I have read that the depression is real & can take up to a year to dissipate. Anybody going through or gone through this?

I only had a single PKR at the same time as your first surgery and I find that tough enough.
I really would have struggled hugely to have had another knee operation on top.
I still question how well I am doing and am pretty obsessed with my knee and its various twinges/ aches.
I think this whole process is a bit like the crazy first year after a baby is born-where you often feel in a complete fog and there are a tiny number of smug superior types who seem to be sailing through....
And a few people like you with twins who we all wonder how they manage at all!

 

[Ghostpipe]

I had bilateral, and although the most progress was up to about 18 months, I didn’t feel that things had completely settled until the two year mark.
Remember that your body is healing two major ops., it can only do so much!

 

[TIC1015]

Thank you all for the support. Still exhausted, but trying!!! Went to PT yesterday & he said my hips are so weak & it’s making my lower back hurt. He focused solely on my hips and it was great! I felt heard and understood. Went to Costco after & could feel it. I was tired!!! Gonna go to sit at the beach one day this week & have lunch. Also, try to go to the pool & hot tub a few days.

I just gotta stop comparing. I’m me! The depression is real! Slow & steady wins the race!!!

Hope everyone is doing well! I’m on Los Angeles and it’s in the 80’s. Motivation!

‍

 

[FionaW]

Hello @TIC1015 , I’m having both my knees replaced (in what they call ‘staged’ bilateral surgery - so one after the other, rather than both together) so I’ve read your posts with interest. I had the first done 5w1d ago and I’m having the second done in 2w2d. A lot of what you say resonates with me too: taking it slowly, weak hip and back muscles, depression… I’ll be watching your progress with interest. Best wishes!

 

[TIC1015]

don’t know if I’m doing too little or this is part of the process? Should I be counting time since the last knee was done? Am I really only 4 1/2 months along? I don’t know! I question myself with EVERYTHING!!! I don’t think anybody gets it really, unless they have been through it!!! I only cry two to three times a week vs daily. Progress, right?. I have read that the depression is real & can take up to a year to dissipate. Anybody going through or gone through this?

I only had a single PKR at the same time as your first surgery and I find that tough enough.
I really would have struggled hugely to have had another knee operation on top.
I still question how well I am doing and am pretty obsessed with my knee and its various twinges/ aches.
I think this whole process is a bit like the crazy first year after a baby is born-where you often feel in a complete fog and there are a tiny number of smug superior types who seem to be sailing through....
And a few people like you with twins who we all wonder how they manage at all!

Thank you for making me laugh & feel totally understood!

 

[TIC1015]

I had bilateral, and although the most progress was up to about 18 months, I didn’t feel that things had completely settled until the two year mark.
Remember that your body is healing two major ops., it can only do so much!

That makes me feel much better from someone who’s been through it!

 

[TIC1015]

Hello @TIC1015 , I’m having both my knees replaced (in what they call ‘staged’ bilateral surgery - so one after the other, rather than both together) so I’ve read your posts with interest. I had the first done 5w1d ago and I’m having the second done in 2w2d. A lot of what you say resonates with me too: taking it slowly, weak hip and back muscles, depression… I’ll be watching your progress with interest. Best wishes!

Good luck! I’ll keep you posted! Honestly, the first was a breeze compared to the second. I wished my doc would have done them together. It’s 7 months & still takes all my energy & a good nightly cry, most nights, just to get in bed. I’m praying for the day when nothing really hurts & I feel a little more stable! Most 90yo’s walk better than me & could beat me in a race!. But this too shall pass & it is all worth it!

I just lost a friend to cancer at 57. We are lucky!

 

[Jaycey]

I just lost a friend to cancer at 57. We are lucky!

So very sorry for your loss!

Keep up the slow and steady routine. You will get there! And don't compare any other recovery or gait to yours. It's all temporary.

 

[TIC1015]

I just lost a friend to cancer at 57. We are lucky!

So very sorry for your loss!

Keep up the slow and steady routine. You will get there! And don't compare any other recovery or gait to yours. It's all temporary.

Thanks!