TKR I'm back again

[Jamie]

Please schedule the dog walk for another day just to be sure you do not overtax your knee. That trip to therapy is enough exercise for the day plus your heel slides.

If you don’t have stairs and want to try the lunge stretch, you can also place your operated foot on a low stool or any sturdy object that is 7-10 inches off the floor.

Don’t do more heel slide sessions. More is not better in this case. Four is enough and, as your surgeon said, at some point you can probably reduce that to 2 sessions a day. You don’t need to increase the hold time either. Fifteen seconds is fine. Keep in mind this is training for your body to perform differently. So the time is not as big a factor as just doing the movements consistently throughout the day. You’re reminding your knee how to work properly. Do push to the mild discomfort stage, though, when you do the hold. That is the “challenge” you need to increase your ROM.

Thanks for posting the details about your visit with the surgeon. I’m glad he’s basically echoing what we’ve been telling you here. Keep that in mind when you deal with the therapist and stay with the program supported by your surgeon.

 

[EalingGran]

My knee is still slightly warm to the touch and I still occasionally get stabbing pains in the knee so it's still healing.

My knee stayed warm for the best part of a year. It worried me but I have read research that shows that implant knees stay more active on scans for up to 2 years. My knee would be warmer if I overdid things- like the time I went into Central London at around 7 months and an escalator was out of action and I had to walk up several flights of stairs.

 

[Dolphin5]

Thank you for your comments. Jamie it's good to hear that 4 sessions a day, holding for 15 seconds is enough. And 10 reps is enough? I can manage that indefinitely.

I thought the warm knee meant it's still healing? Hoping some of the stiffness will go by itself?

I'm still tempted to take the dogs out though I could do a slightly shorter walk. Especially as it's forecast rain here tomorrow. Stooopid British weather.

I'll let you know how I get on with the physio. I'm wondering what he'll measure the knee at.......

 

[Jamie]

Yes, 10 reps is enough.

Tell the therapist your surgeon directed you not to have these measurements done and just do the session without them. You are in charge of your treatment and it’s perfectly okay to do this even if the therapist complains about it. Do that and you’ll be following the surgeon’s guidance (as you should be doing; not the therapist’s ideas) and you won’t be worrying about numbers.

 

[Dolphin5]

Hi all. I did have the knee measured and it was 80o. Measured twice but in the same position. Not sure if this means the ROM has improved during the 2 weeks since the last physio or there's discrepancy in how they measure.

I told him about the previous physio getting me to do so many sit/stands and he said he'd never have got me doing so many. However, he wants me to start doing them again, to strengthen the knee. Twice a day, 4 each time. Increasing gradually if I'm able. I will do half that! See how I get on.

My next physio is in two weeks with the guy I saw two weeks ago. I'll certainly be curious to see what he measures but will be totally relaxed about it. I DID walk the dogs yesterday prior to my appt but 25 minutes instead of 35 minutes. I then iced when I got home and mostly relaxed before leaving 3 hours later. Unfortunately I got off the bus a bit earlier (driver gave me the wrong place to get off) so walked a bit extra. Aching and very tired this morning but it's fine.

Trying driving later and will let you know how I get on. Still getting the 2 inch increase when I do th

 

[Dolphin5]

Hi all. Just realised that having written the above I never actually posted it . I wrote it Friday pm.

Well......I'm driving again! Woohoo. In a car park yesterday to start with and then driving back home (10 minutes).. 90% comfortable and I'm happy with that. It's opened up all sorts of possibilities for me now and it's still sinking in. Still a bit of an effort to get into the car. Bum first, and I then have to bodily lift my bum into the air to move back enough to get my long legs in but that's ok.

Last night I'm was wondering about going back to table tennis, going back to bowls...then of course common sense kicked in. Just because I'm driving again doesn't alter the fact of where my knee's healing is at!!! My heel slides are going well. 10 reps 4 times a day (yesterday only 3 times). After about the 2/3 rep my foot goes back 2 inches, sometimes a fraction more.

I'll only drive short distances for now being conscious that driving is working the knee. My biggest temptation will be to walk too far with the dogs!

Two questions: are the sit/stand exercises necessary to gain strength in the knee? Or is daily living/dog walking enough? How long after the ops I've had do you think I'll get my energy levels back? I'm conscious that I'm no spring chicken so wonder sometimes how much my tiredness is due to my age. I also have very low blood pressure. Not sure if I've mentioned that before. My normal blood pressure is 95/90 over 65/60. This of course can make me tired.

Thank you for your continued support.

 

[Layla]

Still a bit of an effort to get into the car. Bum first, and I then have to bodily lift my bum into the air to move back enough to get my long legs in but that's ok.

Hi Dolphin,
Try a plastic trash bag on the seat, it should help remove any friction and hopefully help you position yourself with greater ease.
Hope you're having a good day!

 

[sistersinhim]

I personally did no sit to stand exercises. Just doing it once in a while was painful and my knee rebelled, so I listened and didn't do them. You might be fine doing them, just let your knee be your guide.

 

[EalingGran]

Two questions: are the sit/stand exercises necessary to gain strength in the knee? Or is daily living/dog walking enough

They are quite tough- especially early on.
I did a side lying glute strengthening 15- 20 minute pilates class with no squats as my main exercise ( Google Katja pilates and my teacher's free YouTube videos come up). I added weights or a resistance band after about 6 months to really improve strength.

 

[EalingGran]

Last night I'm was wondering about going back to table tennis, going back to bowls...then of course common sense kicked in. Just because I'm driving again doesn't alter the fact of where my knee's healing is at!

It's great that you are able to drive and become independent again but be realistic.
I can walk miles ( max I have done is 20,000 steps on a Citybreak) and spend the day looking after a toddler but I would be wary of table tennis even after 2 years. I was advised never to jump after my PKR and only to run under necessity to avoid very heavy loads on my implant. I have run short distances ( for a bus) and done 10 flights of stairs when lift/ escalator out of action on a Tube line but I still treat my knee with a degree of respect and don't push it. I haven't tried bowls and that might well be fine for my knee but my spinal stenosis would probably struggle with the bending.
Message is- it is still very early for you and go easy and listen to your body.

 

[Jamie]

The stand to sit exercises are the best way to work on quad strength. If it bothers you to do them right now, find a straight sturdy chair (like a dining room chair) with arms and use the arms to help lift you up for now. If you have a raised toilet, you can also do them there (be sure and put the lid down and just sit on the edge of the toilet. You can use a walker to give you a little assistance for now. What you do don’t want to do with stand and sit is to strain to stand. Don’t lunge upwards to begin the standing motion. That will most certainly make your knees hurt.

While walking is good exercise, forward walking isn’t the best way to work on quad strength. If you want to use walking as a quad exercise, walking backwards is better. Just be careful that your balance is adequate to do this. You don’t want to risk a fall.

The sit to stand exercise is a movement you need for everyday living to rise from a seated position or lower yourself down without “plopping.” So, I feel this may be helpful, as your therapist says.

Real energy levels can take as long as 6 months to return. So patience is important with this.

 

[Dolphin5]

Hi all. As ever thank you for all your comments. Layla until recently I was using a silky sort of slider which hospitals give you to get you into the car. It's my long legs which hamper me, but it's ok. Not as hard as before the recent surgery., but of course it's a negative reminder that I've still a way to go.

Jamie it's now 6 months since the TKR but only 5 weeks since the MUA/Arthroscopy so I'm not sure how my energy levels should be right now......I will re start the sit/stand exercises after your comments. I will just do a few each day.

I know it's too early for me to go back to table tennis. Just wishful thinking. I'll ask both the physio and surgeon for their advice when I see them.

 

[Jamie]

Unfortunately you must start the time clock again for recovery when you have another procedure done. So, please use the MUA date as your starting point now. Thinking about it that way, you actually are doing well to be where you are right now.

 

[Layla]

Hey there It's been over a week with no progress report. Hopefully you're doing well and feeling stronger week by week. I'll bet you love being independent again. Are you driving to a local area to walk the dogs daily? If so, I hope you're enjoying your freedom. Let us know how its going when you have the time.
Take care!
@Dolphin5

 

[Dolphin5]

Hello Layla

Thank you for thinking of me. All was well until two mornings ago.......I stubbed my little toe and I'm sure it's broken. I was going out yesterday so needed to walk the dogs. A real struggle to give them 30 minutes and had to use my walking stick, purely because of the toe. I can't believe such a little thing can be so debilitating and painful. I've had to cancel my outing today. The internet says to rest, elevate and ice - deja vu with the knee . Incredibly frustrating and annoying. I've got physio again for the knee on Friday so was going to get in touch then. It's the same one as a month ago so will be interesting to see what he measures it at. I'll make it my last appointment probably.

Still doing 3-4 sets of heel slides daily. 10 reps. Holding each one for 15 seconds. At times I'd get the 2 inches back at the 3/4 rep, other times not until the 7/8 one. I now seem to reach the 2 inches more or less straightway which shows progress.

 

[sistersinhim]

Ouch! that poor toe. I have had a broken one and the only thing you can do is to tape it next to the other toe, and of course, ice and elevate. Maybe you'll get some more information about its recovery Friday.

 

[Layla]

Oh no! I'm so sorry, Dolphin. If it's not one thing, it's another. At least it feels that way when we have these setbacks after making some headway.
You're wise to frequently ice and elevate to reduce any swelling. You may want to avoid walking on it too much initially and hopefully OTC pain relievers help with the discomfort. Good luck with Physio on Friday, let us know how it goes. Nice to hear from you!
@Dolphin5

 

[Annekin]

I did something similar to my big toe in my 20s when I went clubbing in flip flops and someone in chunky heals stood on my toe!

I confess the alcohol I had consumed numbed the pain somewhat (not that I'm advocating this!) But it was the home made splint my boyfriend at the time fashioned for me (using his first aid skills) that helped me recover relatively quickly.

 

[Dolphin5]

Hi all. The physio I saw yesterday, who measured me at 70o a month ago, measured me yesterday at 82o. He's meticulous how he measures so I'm guessing he's fairly accurate despite this being contradictory to the surgeon estimating I've been at 90o since the recent op. All a bit puzzling.

I told him about me doing the sit/stand exercises as he'd directed with me doing 110 a day and he's saying well done etc until I said that by the fourth day both knees were hurting so much and were so stiff I could barely walk!!

He emphasised the need to get back to doing them saying they would strengthen the knee and help improve the ROM. But this time he said to start with about 10. Rest the next day and then try and do 12 the following day. Resting alternate days.

I'm seeing him again in five weeks.

He commented on my swollen foot, the one with the bad toe. The foot seems to have become swollen the last couple of days. Toe still hurting. I'll definitely ice pack the foot later. It's really annoying to have to deal with this just when I'm getting my mobility back

 

[Jamie]

@Dolphin If your foot stays swollen and painful more than 3 days, you should have it checked out by your GP. Although most toe stubs can heal on their own, there can be some more serious and long-lasting problems if the bones or ligaments are damaged. It’s possible for a broken bone to heal improperly and cause you permanent foot pain. Only your GP can make the determination regarding treatment.