TKR Hoping you can help - My knee gave out under me!

[Josephine]

I know others have already said this but I want to put in my two penn'orth!

a doctor explains about not moving or stretching and why we loose our range of motion if we are not exercising.

Rubbish. And at least Jaycey took the time to study the video properly!

I feel I have to get back to doing my physio 3 x a day or I will not be walking

If you carry on this this you will not be walking! You should read this if you want proof PT: the seriously grave consequences of doing too much of it.

I have a friend who he had 120 or more ROM a few months after surgery and then he quit exercising and now he cannot bend his knee again.

Perhaps he did but you are taking this way too literally. There are a number of issues that can cause a loss of ROM at a later stage other than stopping the exercise. I'd list them all but there is a character limit on these posts!

Just want my normal life back

Yes, we know and understand that BUT you are only 7 weeks out yet. That's still in the early stages of recovery. It's been said on here a number of times that full recovery can take months, even maybe a year. See this chart.

 

[Celle]

One of my best friends is a nurse and she told me to look up Fuzzy Fascia.

Has this friend had a knee replacement?

I'm a nurse and I've had three knee replacements. Josephine is a nurse with 50 years of experience in orthopaedics and she's still working. She's had two knee replacements. You think we don't know what we're talking about?

You're only 7 weeks into a year-long recovery. Time to find some patience, my friend!

 

[kneeper]

You should be able to do some things at your time in recovery--just pace yourself. Depending on where the bird feeders are, maybe you could do one a day? I just have one and it's pretty reachable, so taking it slow and with my cane I was able to do it. But maybe you need someone to go with you if it's hard to juggle?

 

[Rainbow27]

I totally believe the nurses on here are a great access to amazing knowledge and kindness for all of us!

And yes you were right again! Cassy is a young physio therapist that I went to today. She is right in alignment with what you are saying. She said slow down take little steps!

Use the slider board but mostly do motions in your comfort zone. She wants me up and about approx every 30 minutes or so. Walk like a marching band lifting my knees up, walking with my leg facing straight ahead for 10 feet and keep doing it in small sessions. Wear my stockings as my swelling is pretty bad. To straighten the leg - lay on the bed - stomach first - have someone bend my knee up and down with what is comfortable. Do this every day. Stand up straight - squeeze my butt and lean towards my bad knee. Do the straightening leg exercises - small length of time - often. She put the electrodes on at the end and for the first time I could touch my knee without it feeling like an open wound!

So thank you! I am going to slow down! My body needs to heal!

Not sure how I am going to keep my spirits up but I have spa music, beer and normally am optimistic outlook on life, so I will work on it! Huge Thank you to the nurses out there! Do not ever think I do not value your advice! And thank you for the chart!

Big hugs Marilynne , your friend in Canada

 

[sistersinhim]

If someone is moving your leg for you, then you are not using your own muscles. You can also be moved too far and cause damage to your healing tissues.

 

[KarriB]

Don't have anyone bend or push down on your knee. That will positively cause more swelling of your soft tissue. Bend your leg under your own power, rock back/forth on a bike or pedal for 5 minutes if you can get a full rotation. But someone bending or straightening your knee is a .

Four years ago my dad and bff had their TKRs they stopped PT after a few weeks because of the expense. They figured they could do the same stretches at home, however when they told the therapist at different times that this was their last session the therapist pushed down on their knees with all her weight. They were both in extreme pain for days. So when I went to the same office I kept an eagle eye on anyone everyone and NO ONE touched my knee.

 

[Rainbow27]

I should note that when I went to physio last Friday they did not push down on my knee. I guess I was not clear. They just helped support my foot as I bent my knee and lifted my foot laying on my stomach. Today is about 2 weeks that I have only been doing the physio at the hospital 2 times a week and elevating my leg at home and icing twice a day. Doing some regular housework but minimal. The bad news is that I have gone backwards..... I have gone from 110 Range to hardly 90. So I have to get back and do my physio 3 times a day again. A lady had her surgery only 5 weeks ago and I am just over 7 weeks - She was about 80 - hopped on a stationary bike and away she went peddling..... She does her exercises at home religiously - same surgeon. So leg board exercises, lifting my knee on the leg roll, stretching and lifting from my feet while standing etc. I am back at it! Wish me luck! I should say my pain has gone away!!! First day in over 7 weeks I have actually gone pill free for over 14 hours! But I am very afraid of it getting stuck! Do not want a leg that does not straighten and one that I cannot stand or walk on. Will let you know how I make out.

 

[Celle]

Well, I guess you're never going to believe us when we say that you do not have to do all these exercises in order to get ROM.

 

[Rainbow27]

Sorry Celle..... I love all of your advice - the exercise bike examples on how to use it, pain medication advise and many many other items you have helped me with. It is just that my husband is in my face about it every day and at physio there are over 6 total knee replacement people that are doing the physio daily and it is working for them. BUT and a big BUT .... if I get back to the big swelling and pain again once I start up again ... I am sticking to your advice as like you said every knee is different. I had huge swelling before surgery and as many of you explain the swelling is totally doing to stop my range of motion no matter what I try. Like an example you have on your site about having a cast on your leg - swelling is the same. Will keep you posted. hugs Marilynne

 

[kneeper]

I did some exercises daily--but very few and only few repetitions at a time. If I had a busier day I did fewer.
Also as the recovery went on and I was able to increase other activity I didn't need to do so many exercises. Remember activity is felt cumulatively in the knee and sometimes you don't know right away that you overdid.
Swelling isn't always obvious. Probably your decreased bend is due to overdoing and the responding swelling.

 

[Rainbow27]

MAJOR ACCOMLISHMENT! Surgery Feb. 15/17 - I can now drive my 1996 Z3 Roadster BMW!!!!!! I got in and out of it by myself (sits very low to the ground) And I can use the clutch (it is a stick shift) I am soooo happy as it is 20C today - Time to take the top down! Exercising only once per day - Hired a new physio therapist - she is smart and young - My other one said last week my time was running out for OHIP to cover the expenses and there was very little he could do for me! NOT a good attitude from him! I use the OHIP one as it is free for 65+ but you get what you pay for! You exercise pretty much 99% on your own so why am I there? Cassy my new physio therapist stays with you 100% of the time during the hour. Costs me money but worth it. And she is like you guys - Do not overdue it - She believes in teaching the knee new movements to train it to get back to normal. So having an amazing day this Easter! Going to take the Beemer out for a nice cruise tomorrow with the top down but will not go far as I know I have a limit. Happy Easter everyone! Wearing my surgical compression socks again as I am still dealing with swelling - so wear them when I can in the daytime and ice ice ice. hugs Marilynne
oh - I stepped normal on the stairs yesterday thinking I could do it- OUCH! Nope not yet! But I will one of these days! Need to increase my range - It is still only a comfortable 90 ROM - not much but it will come

 

[sistersinhim]

 

[Jamie]

Just remember that you are still in the VERY early stages of recovery yet. Lots and lots of time left for things to get better - and they will. Some of us just heal more slowly than others. It's why we say over and over to never, ever compare your recovery with anyone else's.

Glad you found a good therapist.

 

[Rainbow27]

9 weeks since Knee replacement - Thank you Jamie! That is totally what I needed to hear. I am now at 102 ROM and I was able to go 10 minutes on a stationary bike - finally made a full rotation (with the seat back a bit and my feet fully in the straps of the pedals) I cried with a few tears of joy on that one! But alas my older physio guy at the hospital said I should do more - He said I should be at 120 by now and I am getting very close to a point where I may need either a scope or manipulation under anesthetic to break thru the scar tissue. I go again today to him and also my new younger, smarter physiotherapist. Two days in a row & same day just worked out that way with Easter. The old one wants to push the seat back up and see if I can make a rotation that way - NOT - I have very long legs and I am not going to have him put me thru that pain! Will be interesting what Cassy the younger one says - Old one is at 8:30 am and the young one is at 11 am. Either way no one is going to put me thru pain or break it! I know I have to exercise at home more. My leg is still not straight and I need more than 102 degrees. But I was crippled for over 4 years with swelling and bone on bone. Question ** Does anyone know how I can get the swelling down? I am massaging the scar tissue, icing twice a day, raising my leg on a pillow once a day. Do I need a diuretic prescribed from my doctor, Do I need to wear the compression socks again? The swelling is not helping my range and still have some pain. But no pain pills now! Which is amazing!!!!

 

[Rainbow27]

Oh Josephine! I do not know how I missed it but maybe it is fate I just read it now - Your documents on what can go really bad if you exercise too much! WOW...... I am going to be very careful - steady and slow. And NO physio therapist is going to break my leg! I am going to get my chin up and carry on! And P.S. I am not driving my little sports car yet - soon but not yet - So I smile driving my pick up truck and just dream for a bit longer when I can get my leg into my wee sports car. I am GOING TO MAKE IT! SOMEHOW, SOMEWAY but I guess it will just take a bit more time! Thanks everyone for your help! You know I would be a lot more scared, less informed and probably very depressed if you did not have this site! I have hope, a good spirit plus time to get it to 120 ROM the healthy way! Just because an 80 year old has 120 ROM easily after only 6 weeks does not mean she got there with exercises that are killers - It means her knee is different than mine. Somehow it will all work out!

 

[KarriB]

The only way to diminish the swelling is to ice/elevate the knee and not abuse it with aggressive PT. It appears you have 2 back to back PT sessions. That's half a day of therapy which is bound to cause more swelling.

I was released from PT with a ROM of 109 and it continued to get better without PT, just riding my bike and living my life.

 

[sistersinhim]

You are doing way too much PT. Your knee will stay swollen unless you cut it out. The swelling is keeping your knee from increasing your ROM. It's a domino effect and will not improve unless you cut way down on your exercises. They keep you swollen. Even now, at 10 months, if I do too much my knee will react with swelling. No wonder yours is staying swollen at 2 months! You haven't been following the activity guides: (https://bonesmart.org/forum/threads/activity-progression-for-tkrs.14334/) These work. There is a lot of experience on this site to prove that!

 

[ltkr001]

@Rainbow27 glad to hear your doing better. Yes, swelling is one my major issues too. I'm at 2.5+ months post-op and have been doing PT practically since day 1. I have ROM of extension: 0 with a little jiggly room to go negative and flexion: 128 degrees. I'm a bit younger than most to get TKR so I tend to be a bit more aggressive with PT and my recovery. But, trust me, if you overdo it, you're knee is gonna swell and hurt and set ya back.

I did that not too long ago and literally took 4 days off of any real motion (aside from stretches and quad sets at home) with lots of ice and elevation. Much better now. Back to normal swelling amounts - haha!

Best of luck to both of us and here's to your recovery at your own pace.

 

[Rainbow27]

Well I was saved by luck! My 2nd physio session was cancelled as they were off ill. I have only ROM 102 but I also took a good look at the people lying in the bed next to me at physio who had 120! They have Zero swelling! So taking it a little slower. And no one is going to push hard on my knee at physio- Ever again! My knee has been swollen since the scope 4.5 years ago. And almost same swelling after surgery as it has been since last November, 2016 when I went bone on bone. I had a scope Dec., 2013. It caused a bakers scist behind my knee and a handful of swelling on upper right on the inside of my left knee. Still same swelling now almost 4 years later. **So my plan but any changes to it that you suggest is totally appreciated**
1. Wear compression stockings in daytime (bought some pretty ones on the internet)
2. Ice 3 times a day
3. Do exercises daily but not aggressively 1 or 2 times a day - Do normal life - shopping etc.
4. Make appointment with doctor for Monday to see if there is any medication or anything else to take the swelling down (My knee never goes to normal without some swelling) The incision healed excellent but I can feel lots of scar tissue under the skin so massaging this with my thumb and my hands. Somehow I am going to get a normal knee! I should also mention I have a baker scist behind my knee and a fist full of swelling just on the inside upper right side of my knee that has been there since the scope (the scope that never worked) Thank you for your comments as everyone has been so helpful!

 

[Rainbow27]

NO MORE MAJOR PAIN! Just had to add this! I had extreme pain after surgery - I was still crying and scared of the major pain I was feeling even under morphine in this hospital! And now... no pain. Soreness yes but less than from the arthritis that was in my knee. No more major pain pills. If I overdue it well .... I have to sit down and rest and ice but no more tears! Josephine, Karri and all the wonderful people who hung in there with me when all I could do is cry daily - Thank you! You were right! It gets better! And NO knee is alike. Each one of us have a different journey but some of it is the same. Thank you all for being there for me when I needed help at a time that seemed like my darkess moments. All of our knees will get better and the pain does go away!
I was on oxycodone in the hospital days 1 - 3, then morphine by needle days 4 & 5. Talked the doctor to keep me on the oxycodone as he wanted me on Tremodol but I knew it would not do it for me. On oxycodone for weeks 2-4 weeks. Going from 2 every 6 hours to just 1 every 8 hours or so at 4 weeks. Then Tremadol for weeks 5-6 but had a reaction as it felt like it was eating a hole in my stomach. Changed to Tramadol/acet 37.5/325 mg Weeks 7 - now week 10. Went from 3 a day to now maybe 1. Have 1 always in my purse in case I overdue it shopping or being out. But I realized just this morning - I woke up with NO PAIN! You cannot imagine how wonderful this feels! I was so scared this pain would go on with no end in sight! Before surgery I never took any pills. I did not even take aspirin! So I am not use to this in my life. There is a huge rainbow at the end of this journey and cannot wait to tell you I have 120 someday! Have no idea when that will be but it will come. Just need patience and be smart about it. Take the journey slowly. I should say most patients in the hospital did NOT experience the pain I did. hugs Marilynne