TKR I'm back again

[Layla]

Yesterday both knees were bad and my dog walk was not enjoyable with the stiffness in BOTH knees.

Was this after watering plants, cutting grass and hanging laundry? If so, with exercises also thrown into the mix, it was likely too much activity for now.

Rather than get all hung up on numbers of reps, hold times, google predictions, consider trying to just get on with life as much as possible, by this I mean, your daily dog walks (30 mins) watering plants, hanging laundry. Activities of daily living like normal walking around your home, climbing stairs, getting in and out of chairs, dressing all help retrain your body to move in natural, necessary ways. This type of daily living activity engages the muscles around the joint helping to rebuild strength and endurance gradually. It also helps to keep the joint from stiffening, while improving your ROM.

Your posts often contain a lot of numbers. Numbers of reps, how many minutes you're holding, how many times per day you're engaging. I feel like this is causing you stress and I'm sorry for that. If you can simply go about your day, your body will likely recover naturally. You will heal and your ROM should increase unless you're laying around in bed, or sitting on the sofa for lengthy periods of time. Instead, get up and move engaging in small simple tasks that keep you bending, stretching, reaching, your blood flowing freely. Plan the day out ahead of time if it helps, so you don't easily fall into a trap of non activity. Reorganize a drawer, a closet, clean out the refrigerator, organize kitchen cabinets, meal prep, do some light tidying or cleaning. It doesn't matter if you have a cleaner come in periodically, you're doing it to benefit yourself physically and mentally. Staying busy / active will take your mind off of all this recovery biz and hopefully provide peace of mind and ward off tears all while increasing your ROM. Throw some icing and elevation into the mix also.
I hope you have a nice weekend, Dolphin.

 

[Jockette]

Rather than get all hung up on numbers of reps, hold times, google predictions, consider trying to just get on with life as much as possible, by this I mean, your daily dog walks (30 mins) watering plants, hanging laundry. Activities of daily living like normal walking around your home, climbing stairs, getting in and out of chairs, dressing all help retrain your body to move in natural, necessary ways. This type of daily living activity engages the muscles around the joint helping to rebuild strength and endurance gradually. It also helps to keep the joint from stiffening, while improving your ROM.

@Dolphin5 I agree 100% with what Layla wrote. All these activities will give your knee all the healing movement it needs to heal. It’s what I like to call “natural PT.” But they are spaced out timewise, so are much more gentle on our body than 10-20 reps of a certain movement.

And, I was never told to do that sit to stand exercise. Doing X amount of those are too much stress on your body, not just your knee. Every time you sit down during the day, and get up some time later, you’ve done that “exercise” but in a natural way.

 

[Jamie]

Stiffness is part of recovery and may be with you for quite a while. Like 6 months or more. The fact that you’re feeling that in both knees does indicate you’re doing too much. Layla’s advice is right on target. Sorry, but laser treatments won’t help here. You need to find a better balance between activity/exercises and rest.

 

[sistersinhim]

Yesterday I watered all my pots which takes 15 minutes, put washing out and cut the grass.

I hope you didn't do exercises after doing all this in one day. This is all the PT you need for that day.

I only got up about 4 times so perhaps the fluid is becoming less

The way I looked at these nightly bathroom visits is that I was doing PT just by getting up and doing it! As I have said before, I never did any exercises and I have recovered just fine!

 

[EalingGran]

Yesterday I watered all my pots which takes 15 minutes, put washing out and cut the grass.

There is no way I could have mowed the lawn at your stage and I had a pretty good recovery overall.
If you are on your own and having to do things like putting washing out and lawn cutting you should factor that in as a pretty intensive workout. I did no housework for months but my husband wanted me to go out and socialise early on ( he gets cabin fever if he is stuck inside) and he and my daughter took on the chores.

 

[Jockette]

Yesterday I watered all my pots which takes 15 minutes, put washing out and cut the grass.

Can you hire someone to cut the grass for you? Some things might seem expensive, but turn out to be “priceless” if it helps us physically, so it could be worth the cost. I can’t imagine cutting the grass as early as you are, in recovery.

Those activities that you listed are just as much a type of physical therapy, as any list of exercises. In my opinion, the natural activities are more useful for recovery.

 

[Layla]

Hello and Happy Sunday,
How did the overnight go and how is this Sunday going so far, Dolphin? I am sure you have a lot to think about and it's difficult to know who to listen to, which advice to take.

Keep in mind that no two recoveries are the same, yours will follow its own path. While the BoneSmart philosophy successfully works for many, there will be exceptions. Between the recommendations found here, your surgeon's recovery protocol and any physical therapy you may engage in, success comes from finding the approach that fits you best. Trust and let your body be your guide.
Enjoy the rest of your day and know that we're here for you.
@Dolphin5

 

[Layla]

Hey Dolphin,
We haven't heard from you in a few days. I hope you're doing okay.
Just noticed it's one month to date since your MUA. Wishing you a good week!
@Dolphin5

 

[Dolphin5]

Hi all. Sorry for not responding sooner to your posts, for which I thank you. Sometimes I need to try and block out my situation, including going on this site.

I have just re-read the posts going back to last Thursday. Firstly to say that I do pace myself. So when I cut the grass, that would've been several hours after walking the dogs.

I need to point out, and please don't be offended by me saying this, that my situation is different from others on Bonesmart. Recovering from the TKR nearly 6 months ago I did the PT pushing to pain, I did the PT gently, and I even did no exercises at all for a week just doing my normal activities. NOTHING worked and I stayed at a miserable 45o. The MUA/Arthroscopy 4 and a half weeks ago got me to 90o under anaesthetic but now it seems that I'm around the 70o according to the physio who measured me.

I did no exercises for 2 weeks prior to this surgery and the surgeon told me my knee was about 30o. So you'll understand my fear of my ROM decreasing if I don't do the exercises. Layla you admitted a couple of months ago that you'd not come across anybody in my situation.

My operated leg still doesn't seem to have recovered from the stand/sit exercises. The physio had said I needed to make the knee more weight bearing. I never mentioned my daily dog walking which IS weight bearing of course so I believe these exercises, about 11 sets every day, were far too much.

For the past few days I've been doing the heel slides 4 times a day. 10 reps instead of 20. Currently holding each one for 15 seconds. After about 5 reps I've got the foot back 2 inches, but again I'm back to square one when I start my next session.

My leg aching, right up to my thigh, during the night,wakes me up and I take paracetamol. This didn't happen prior to the sit/stand exercises.

I find doing the heel slides only 4 times a day helps me mentally than doing them every two hours.

Should I try and increase the time I hold each one? Gradually. Perhaps up to 20 seconds.

I'm seeing the consultant tomorrow. I'm going to write down what I've been doing the past 4 and a half weeks and also question him on the discrepancy of the ROM.

Physio the following day with a different physio so it'll be good to get a different perspective.

I'm seeing my son on Saturday. First time in 5 weeks that I'll see the sea. He'll drive us to a car park where I'll try driving.

Thank you again for your support.

 

[EalingGran]

I'm seeing the consultant tomorrow. I'm going to write down what I've been doing the past 4 and a half weeks and also question him on the discrepancy of the ROM.

That's a good idea.
I do wonder about holding the heel slides though. I don't ever remember holding mine. It was more about just doing them for movement rather than holding them.

 

[stockie73]

Dolphin - as a basic member I’m not allowed to post much detail but I am certainly well versed in the long, difficult recovery being like you almost 6 months from my TKR and still at 60 degrees but as I said previously I’ve been driving for 3 months now at least but still stick at 60 so at 70 you’re now ahead of me at least

So I for one definitely do understand how tough this has been/continues to be for you indeed for both of us, all we can do is keep going and hoping things eventually improve.

 

[Andypandy]

@Dolphin5 I still have interrupted sleep, 3 months mua, 7 months tkr, can affect any part of the leg and definitely dependant on what I have been doing. Saturday came against an incline, down to start but 2 hours later, had to go up. So that really aggravated my knee, and back and paid for it Monday. However, it's all part of recovery and makes you aware of the hurdles we have to meet. Way to go!!!!!

 

[sistersinhim]

I'm seeing the consultant tomorrow. I'm going to write down what I've been doing the past 4 and a half weeks and also question him on the discrepancy of the ROM.

Be sure and tell him everything, including all your daytime activities besides the exercises, like cutting the grass, walking the dog, and all your household chores. These add to your exercises and he needs to take them into consideration.

 

[Layla]

Hi Dolphin,
I'm glad you took the time and space you needed mentally. Sometimes we need to step back from it all.
I'd like to acknowledge something that's on my mind since reading your update. When you asked about your ROM, I answered honestly based on what I've seen here over the years. With that said, I wasn't implying that your situation is beyond hope, or trying to make you feel alone in your struggle. Many face challenging recoveries in a variety of ways. Some recoveries are very slow, many unpredictable and dealing with set-backs and complications. A lot comes into play in recovery, your pre-op function, any pre-existing health issues, age, surgical technique, your pain tolerance, etc. Please know you're not alone in facing challenges and hopefully you continue to make strides in your recovery and know that we're here to support you however we can.

Consider asking the consultant if you can discontinue the heel slides. They seem to cause you a lot of angst and clearly aren't your thing. Hopefully if you can share the type of activity a typical day holds for you, he will tell you whether the heel slides are still necessary, or if your current level of activity is enough. Possibly you'll make better progress in a more natural, less forced way. Mention you want to be a "Retired Heel Slider" you're done, you've had enough!

Good Luck tomorrow at your appointment! Enjoy the time with your son on Saturday!
@Dolphin5

 

[EalingGran]

that I'll see the sea. He'll drive us to a car park where I'll try driving.

Good luck! Hope it goes better than the first time I tried driving post surgery. I was really careful but still managed to get done by a speed camera in a 20mph zone. Had to do an online course!

 

[Dolphin5]

Thank you again for your time with your comments. I'm so thankful to have a genuine, caring surgeon. I'm so anxious about stopping something like the heel slides in case my ROM decreases. Remember I didn't do any exercises for 2 weeks prior to the recent op and was told my ROM was 30o. From 45o. . I don't mind doing the heel slides so much now that I'm only doing them 4 times a day but still wonder why it takes me getting half way through them to get the extra 2 inches.

I got in the car again yesterday. I'd never noticed before that the accelerator pedal is an inch or two BELOW the brake pedal. Aaaaah. So I'll have to lift my foot to get it to brake. Funny the things you have done previously without thinking, then you notice things. It's made me think that driving again is not going to happen yet. A real blow if that's the case. I'll know on Saturday when I try. The nearest sea with walks is only 3 miles away. Also a small supermarket. So with lots of care and attention, really focused........

Regarding the heel slides again, and 'challenging' the knee, I would have thought the heel slides a necessity. And increasing how long I hold each one for, to TELL the knee, this is what's expected of you, you naughty knee.

I'll report back to you about my visit to the consultant later. I also have physio tomorrow. A different physio so it'll be good to get another perspective and viewpoint. (3 miles away, so about 10 minutes in the car, but nearly an HOUR on the bus!!!).

 

[Layla]

I don't mind doing the heel slides so much now that I'm only doing them 4 times a day

That's great...then keep it up!

I hope you like the Physio tomorrow and you're able to take a taxi to the appointment over a long one hour bus ride.
Good luck, Dolphin!

 

[Jamie]

The reason it takes a while during your heel slides to realize the better movement is that you are still retraining your muscles and ligaments to do the proper thing. This is not a short-term task. Remember hearing the old adage that it takes 30 days to establish a new habit? Well, it takes even longer to retrain and stretch soft tissues to do a different job. They will always want to go back to the original function that they’ve been used to until you establish a new normal. As the months progress, you will need to continue some type of stretching and “challenging” exercise to “remind” you knee of how it’s supposed to work. The exercise could be heel slides. It could be the stair lunges I described to you. But you’re going to need to do something beyond walking in order to increase your ROM. Walking does not give you enough bending movement to reach the goal you are seeking.

 

[Dolphin5]

Hi. Well my appt with the consultant was a happy one . He disputed, several times, the measurements that the physio gave although he knows the physio measured in 3 different positions, and accepted that he wasn't using a measure but just gauging by looking. But he was adamant that in his opinion I'm am around the 90o range. He said to try and forget numbers (someone on here said the same) and just concentrate on the functionality of the knee.

He said to emphasise to the physio tomorrow about my other arthritic knee when it comes to exercises, but I told him that the stand/sit ones made my operated knee really bad. Although I stopped these 6 days ago I believe I'm still bearing the consequences. I feel a bit of a plonker now. The physio told me to do them hourly, 10 each time. I was doing them 11 sessions a day. This means I was doing 110 every day. So nothing one day and then 110 each day thereafter. The physio should've known better and told me to increase them slowly. I trusted the physio.

He said I may never get much more ROM. When I asked him whether the 2 inches I gain during the heel slides, but which went back to square one before the next session, would eventually stay at the 2 inches he said yes. He said I may eventually be able to cut from 4 sessions a day to 2 sessions but to keep going with them. He was slightly waffley when I asked whether I should increase the 15 seconds I'm holding each slide to longer. I felt very reassured when I left there. He asked me to let him know how I get on with the physio tomorrow and to let him know how I get on with driving on Saturday.

Now I'm having a tussle with myself. I need to leave here tomorrow at 12.20pm. 5 minutes to the bus stop, 50 minutes on the bus, 10 minutes walk to the clinic and 30 minutes physio before returning home. I'm tempted tomorrow take the dogs out before I go. Figuring if I give them their walk early, I could relax for 2 hours before leaving. I can hear you all now....nooooo, that's silly, it's too much. This is where I am my worst own enemy. But the dogs missed their walk today and we enjoy our walk. I can probably get a taxi back after the physio if needed. I suppose I'm reluctant to accept I have a physical mobility problem!!

My knee is still slightly warm to the touch and I still occasionally get stabbing pains in the knee so it's still healing. This helps me to believe that some of the stiffness will go and things improve with the ROM.

Sorry this is a bit long.

 

[Dolphin5]

Jamie I've just read your post. Thank you. Very useful information and advice. I don't have stairs here. Only a step from the kitchen door where people can view me from the pavement so I'm going to stick to the heel slides. I'm used to them (should be by now ). So I'm currently doing them 4 times a day. 10 reps. Holding each one 15 seconds. I'm not sure I can do more than 4 times a day. Should I increase the reps? Increase how long I hold each one?