TKR I'm desperate after my total knee replacement^

mmeyering

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I am 7 weeks post op and still in a lot of pain!! I have been back for xrays and the Drs comment is that it must be from my 11 degrees of knock knees before the surgery but the joint itself looks great. The pain is so great behind the bend of my knee I have difficulty walking. The physical therapist says it is where my hamstring attaches. Narcotics no longer touch the pain so I am trying CBD oil from the hemp plant. Is there something I can do to help with stretching the ligaments and tendons and hamstring that would speed up this healing process? Your help is appreciated!!
 
Hi and Welcome to Bonesmart!
Is there something I can do to help with stretching the ligaments and tendons and hamstring that would speed up this healing process? Your help is appreciated!!
I just posted about this very issue this morning. Here is what I told another member:

Here’s something @Mojo333 posted a while ago:

“I was given some great advice by another staff member as I struggled with the PT question and it helped me tremendously as I recovered from bilateral THR. It went something like this:

Many members think PT is needed to alleviate tightness. 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 is healing...and full healing takes a full year or more.

It seems that many PTs don’t take healing into account when they treat us. They seem to focus on ROM exercises and exercises to strengthen the knee/leg, but at 7 weeks post op it is too early for that.

And unfortunately, there is nothing you can do to speed up your healing.
 
I will leave you our Recovery Guidelines. Each article is short but very informative. Following these guidelines will help you have a less painful recovery.

Knee Recovery: The Guidelines
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
5. At week 4 and after you should follow this
6. Access to these pages on the website

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 the 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 the member’s history before providing advice, so please post any updates or questions you have right here in this thread.
 
I too am dealing with the pain associated with TKR of a valgus knee. My surgeon said it is soft tissue or tendon ligament issue and time is the only healer. When they straighten a valgus knee, so many areas are readjusted, even the lower leg bones take a twist so that means everything that attaches has to relearn after years of being misaligned.
While this answer brings no quick fix I hope it helps to know you are not alone. My pt currently wants me to avoid triggering the pain as much as possible to allow healing, my OS agreed. Keep moving but learn to pull back if you trigger the pain.
 
Hello @mmeyering - and :welome:

Please will you tell us the full date of your knee replacement and which knee it is, so we can make a signature for you? Thank you.:flwrysmile:

While you are still in so much pain, I think it would be a good idea to cut back on your PT therapy. Your knee isn't lazy or unfit - it's wounded from major surgery and it needs time and gentle treatment, so it can heal.
Remember this:
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.​

Your soft tissues had a hard time during the surgery and they're probably still upset and inflamed. Give them a few weeks' rest from the stress of doing exercises, and spend more time resting, icing and elevating your knee. Also, don't forget to take your pain medication on a regular schedule.

Don't worry about gaining ROM numbers.
It's not exercising that gets you your ROM - it's time. Time to recover, time for swelling and pain to settle, and time to heal. Your ROM is there right from the start, just waiting for all that to happen, so it can show itself.

And, just in case your PT therapists have told you that you have a limited time in which to gain ROM, ha isn't true.
There's no need to rush to get ROM (Range of Motion) because it can continue to improve for a year, or even much longer, after a knee replacement. There isn't any deadline you have to meet:
Myth busting: the "window of opportunity" in TKR

I'm going to ask @Josephine , our Nurse Director, to advise you. She has many years of experience in orthopaedics.
She'll probably ask you a lot of questions. Do try to answer them as fully as possible, so she has all the information she needs, to advise you appropriately.
 
I'd really like to offer you some structured advice but in order to do that, I also need to ask you some questions. Are you willing for me to do that?
 
Wow, Josephine, Celle, and Jockette. Thank you so much for your advice and quick response. In answer to the questions I saw I can tell you my TKR was on my left knee March 19. Also if you are interested I am 67 years old and had been bike riding a little most days before surgery .

Also maybe you have some advice for me about the pain. For the first week I took 5 mg oxycodone about every 4 hours. Weeks 2, 3, 4 and 5 I started with 4 mg Dilauded about every 6 to 8 hours and by week 5, I was taking 6mg Dilauded 3 times a day at which point that amount had stopped working. I was afraid to increase the dosage of Dilauded. So I have not had any narcotics for 2 weeks and I have hardly been able to sleep at all.
 
Also maybe you have some advice for me about the pain
Josephine is the best one to address that for you. Did you agree to let her post her questions to you? That wasn’t clear in your other post.
 
. . . another thing to do in the meantime, read the article on ice and elevation. The more pain you have, the more icing and elevation will help you. If it hurts behind your knee, make sure you ice that area.
 
I had a similiar problem after tkr (and slight valgus correction) my fantastic , gentle, encouraging physiotherapist told me how to gently massage the back of my knee and thigh to soften the hamstring. It has really helped, I still do it from time to time as it's so soothing.
 
I have valgus knees too. I used a lambswool paint roller to massage my hamstring and it seemed to help. Others have used a sponge roller, but Josephine will be able to advise you.
 
Here y'go then!

It would be very helpful if you would answer each one individually - numbered as I have done - in as much detail as you can then I'll come back as see where you are ....

1. what are your pain levels right now? (remember the 1-10 scale: 1 = no pain and 10 = the worst you can imagine. And don't forget to factor in other forms of pain such as soreness, burning, stabbing, throbbing, aching, swelling and stiffness).

2. what pain medications have you been prescribed, how much are you taking (in mg please) and how often?

3. how swollen is your leg compared to these?
ai63.tinypic.com_eta39s.jpg


4. what is your ROM - that's flexion (bend) and extension (straightness)

5. are you icing your knee at all? If so, how often and for how long?

6. are you elevating your leg. If so how often and for how long?

7. what is your activity level? What do you do in the way of housework, cooking, cleaning, shopping, etc., and

8. are you doing any exercises at home? If so what and how often?
This is the most crucial question so please help me by using the format I have left as an example
(which means please make a list and not an essay!)

Exercises done at home
- how many sessions you do each day
- enter exercise by name then number of repetitions of each
etc., etc.

Anything done at PT
- how many times a week
- enter exercise by name then number of repetitions of each
etc., etc.
 

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