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TKR Increase of stiffness and back of knee pain<

@flsungirl
Yes I hear you on the working! When I get really bad pain times (thankfully it’s not as often anymore) but I’ve only worked three days so far! I take my 500mg naproxen along with two extra strength Tylenol. And I take them right away when I feel it getting worse! Then right on time for next dose. I’ve been using melatonin to help sleep. Seems to work a bit.
Roboknee
 
I found that when I went back to work, support hose helped my keep the swelling in check, I got some online---discount surgical stockings. Got the mild ones with no feet, so I could still wear regular socks. I think I had thigh high and tights. I wore them for about 4 months after i started working and I did think they helped.
 
1. my pain ranges from 0-3 most of the time. except when I’m over tired trying to sleep or when that back of knee gets to me then it can to about a 5-6.
5-6 is not good for 10 weeks out.
2. I generally don’t take anything in the am. I have a prescription of Naproxen 500mg taken at bed time. Unless like two days ago at work I had to take another dose. I do supplement with two extra strength Tylenol if it is bad especially at night.
Not good. If you are experience pain levels of 5-6 then you need meds on a regular basis. I would suggest that in addition to the Naproxen, you take Tylenol 1,000mg 4 times a day at 6hrly intervals.
3. I’m moderate. Right in the middle
Okay. And you factored this in to your overall pain score, yes?
4. my ROM is 115 before stretching, 122 after stretching. My extension is 0
Don't want to hear stretching. ROM should only be measured with you doing it on your own with no pressure or stretching. Having delivered my little speech, 115/0 is excellent!
5. I only ice if I’m having more pain I have an ice machine maybe 2-4 times a week.
I would suggest you ice more often, at least every day for about an hour. After all, you just got through earlier telling me you had a pain score of 5-6.
6. I elevate while I ice and still at night my leg is up on a pillow. Not as much as I probably should I bet.
Well if you're only icing 2-4 times a week, then no, you're not elevating enough. Did you say you had moderate swelling? Don't ignore that. Swelling = pain, remember?
7. My activity level I do shop and cook some I light clean. I’m back at work so while I’m at a desk and try to get up every hour. But I’ve been on my feet mostly directing employees for the last few days as we are busy. Yes I over did it and I realized that I can’t stand for an 8 hour day! I’m trying for shorter days but it’s a flower shop and busy this time of year.
10 weeks is early to be back at work. And flower shops are not an easy place to work it right now!

done once a day - sometimes I do part in am, part in pm except PT days.
I do my home exercises once a day
Heel slides x10 hold bent position for count of 10
ankle on rolled towel knee hanging for 15-20 minutes
knee lifts x3 sets of x10 sitting
chair slides x10 with 5 sec hold.
towel around my thigh, lift it and let my bent knee hang until I feel slight pain x3.
Listen to me robo - you have excessive pain scores, moderate swelling, you're taking inadequate pain meds and not icing or elevating enough! BUT your ROM is superb - so you don't need all these exercises! If you stop them all, completely, you might have half a chance of getting the pain levels down and the swelling reduced. Then you won't NEED pain meds, or icing or elevating!
PT twice a week
trying lazer therapy
ride bike for 5 minute warm up
massage then lifts leg and does gentle stretches then uses rolling stick on quads.
hamstring stretch 30 second x3
up on toes, calf stretch 2 sets x10
sitting knee lifts with 4lb weight 3 sets x10
standing knee lifts to back with 4lb 3 sets x10
step up 2 sets x10
side steps with band 2 15 ft passes
knee stretches on chair hold 30 seconds one x10
wall squats with ball 2 sets x10
single leg balancing on foam x5 for 15 seconds
knee hip external 3 set x10
3 sets of 10 on quad machine. I think that’s what it is (Lay down push with feet on board)
And for all the same reasons, should stop going to PT as well. You don't need it. If you stopped all this, again, the pain and swelling would reduce and even go away completely.

If you are concerned about refusing to do therapy, you need to read this Saying no to therapy - am I allowed to?
 
@skigirl
Oh my great advice!! I didn’t think about getting the thigh highs. That’s going to work great! Thank you. I’m pretty lucky at my work as I’m still doing part time through next week..so far it’s been manageable.
Robo
 
@Josephine
I’m doing a more routine pain Med control and it’s working great. Thank you.
I have two more physical therapy visits this next week along with two more laser therapy treatments of which I have already paid cash for so I will be done with PT by next Thursday. My doctor has only released me back to desk work only so I’m trying to do that. My disability will run out Dec 11 so I’m phasing back into full time. This next week I’m planing on three longer days this week with a full 8 hour day Friday. After that I’ll be on full time. I will have help so that’s good. I keep thinking my ROM isn’t that good since it really hasn’t improved much in the last month. I’m really having trouble sleeping these last few days maybe it’s been a week, is that normal?
Robo
 
You can decline to do things at PT if you want to. Once I found Bonesmart at 4 weeks post op I started saying no to things and they never gave me a hard time about it.
 
@roboknee, my first opportunity to catch up on your recovery thread. It sounds like you have a reasonable PT who listens and is concerned about how your knee is progressing. While I didn’t have the same problem you’ve described, I did have a period where I was experiencing some unusual pain while still going to PT. He adjusted my treatment routine and was able to improve the situation. As long as they listen and don’t try to push exercise just to achieve certain numbers, I’ve found them to be beneficial.

The key to going back to work is to pace yourself. It’s so easy to get caught up in the routine you forget about your knee until it’s too late.
 
Seems like you’re surgery was a day after mine :console2: I too have started back at work, this week will be my first full week with 3 eleven hour shifts and a half day on Thursday . I struggled with insomnia from week 2-6 but have been sleeping fairly well since. Although if I think about it...not as soundly as before I went back to work. I have been taking Advil PM to help sleep and I get a few solid hours. Melatonin gives me weird dreams!

My ROM is staying pretty much the same. I know it’s swelling still because of the 11hour shifts! I did get nails done today and did some Christmas shopping. When I got home the knee was tired so I’m icing and elevating...feels really nice! Who thought I’d have a thing for icing?:heehee:

Cheers to week 11 :cheers2:
 
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I keep thinking my ROM isn’t that good since it really hasn’t improved much in the last month. I’m really having trouble sleeping these last few days maybe it’s been a week, is that normal?
Your ROM is pretty good. Don't worry about it, because you're still early in this year-long recovery.
There's no need to rush to get ROM 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

As for not sleeping, I'm afraid that is a normal part of recovery - and sometimes it can take months before your sleep pattern returns to normal:
Sleep deprivation is pretty much inevitable - but what causes it?
 
You are 3 days ahead of me. I have stiffness everyday, some days more than others. My pain is mostly ok now,but I have learned that stiffness is pain, interesting. While I have been religious about stretching I have not pushed past a point, I have had tightness but not pain from stretching, if that makes sense. The beginning home OT really pushed me. My outpatient PT was aggressive but different. I hope your pain has calmed.
 
This is what one of our members wrote about the slow development of her ROM. (Thank you, @Campervan ) As you can see, her flexion continued to improve for a long time.

"I had a slow recovery. Here's my flex measurements at various points:
92 - 8 weeks post op
105 - 10 weeks
107 - 5 months
110 - 6 months
112 - 7 months
116 - 9 months
119 - 11 months
118 - 1 yr
120 - 1yr 2 months
125 - 1 yr 8 months
128 – 6 years "

Here's another one of our members, Bertschb, who kept a record of his ROM process. He agreed for us to post it for those of you that are afraid you're stuck. The key is to have patience! Bertschb says:

I'm 12 months out from my surgery and have some advice based on my experience:
1- Stop going to PT (all it will do is make your knee swell and reduce ROM)
2- Don't worry about your ROM
3- Be patient - VERY patient!!!

Here is my ROM history (more or less):
1 month - 60 degrees
2 months - 80 degrees
3 months - 85 degrees
4 months - 90 degrees
5 months - 90 degrees
6 months - 110 degrees
7 months - 120 degrees
8 months - 125 degrees
9 months - 130 degrees
10 months - 135 degrees
11 months - 140 degrees
12 months - 140 degrees

I spent waaaaay too much time worrying about ROM. I thought I'd be riding my bike a couple months after surgery but it took SIX months! Looking back on my surgery, if I knew then what I know now, I wouldn't have wasted my time with PT and I wouldn't have worried about ROM.
 
I’m really having trouble sleeping these last few days maybe it’s been a week, is that normal?
It depends upon what you are taking in the form of pain meds, how much activity you are engaged in and what your pain scores are. Mostly this kind of sleep disturbance is due to under-managed pain. And don't forget that even discomfort is a form of pain.
I’m doing a more routine pain Med control and it’s working great.
That's great! So what are you taking now, how much and at what times?
I keep thinking my ROM isn’t that good since it really hasn’t improved much in the last month.
So what is your ROM then? (and by ROM I mean flexion AND extension, not just flexion)
 
:wave:Hi @roboknee ! We are only 2 days apart and I too just went back to work at week 10. I loved reading your progression over the last few weeks and hope you’re seeing improved pain & swelling in the next few weeks. I really think mine has. But as I’ve learned from here, those darn awful naggy painful days just reappear out of nowhere! And hopefully they slowly just appear less and less. Looking forward to reading how your next work week goes ! :loveshwr:
 
@Jockette
My PT never pushes me. He’s great and doesn’t go with the theory of “you only have three months to get all of your range”. I have one more visit with the laser therapy. Then we will re access if I need more. Thank you Robo
 
@NavyGunns
The biggest problem I am worried about is just going back and messing something up or slowing my recovery. I do forget to think of my knee first! My job can be very physically demanding at times so I’m really trying to stick with the desk only my doc recommends for now.
 
@Josephine
I am an operations manager at a very large flower shop. To get a better idea of what I do I’ll try to explain a few of my jobs. So I buy and transport buckets, boxes and bundles of flowers. I think handling the big carts where I buy is part of my knee problem it’s the twisting and maneuvering. I process flowers which entails lifting and carrying buckets of water and flowers. They can be up to 5 gallon buckets loaded with flowers. I coordinate and help set the front of the store with flowers too. I also buy all the hard goods for the store cases of glass and ceramic. I also buy and transport most all of the plants we get in on a weekly bases. That’s flats of them.

Yes I’m having a hard time remembering my knee is healing and not ready for all of that for a while. I’m really trying to ease back into it a little at a time. Especially since I’m on desk duty only per doctor.
Robo


@flsungirl
Hi surgery buddy!! :flwrysmile:
Oh wow I do know how long those 11 hour days can be! I don’t think I could do that many right now. I’ve been doing part days until on Friday and I am gonna try to keep it to 8 hours. Next week I’m at full time I think. Normally I work 10-12 hour days. So far no weird dreams from the melatonin.
Robo


@JRS11
I totally understand the tightness without pain. My knee is better!I’m sure it’s because I’m managing my meds better than I was it does help. I do stretch and the tightness eases for a while. I keep trying to figure out just why I have bad days. I can’t really pin down one thing.
I’m so glad I found this forum I’ve learned so much from everyone.
Robo


@sistersinhim
Oh wow thanks for the examples. I’m learning from everyone that my ROM is pretty good for my time from surgery and this info really makes that hit home.. I am not under that time crunch I thought I was..
thank you.
 
That's great! So what are you taking now, how much and at what times?
I’m taking Tylenol 1000 mg in morning then my naproxen 500mg at breakfast (better for my stomach) then Tylenol again in afternoon and naproxen again just before bed. It’s been helping thank you for the advice!

Oh and as for ROM my flex is stuck at 120 and my extension is 0.
 
'stuck' at 120? You mean you're dissatisfied with that?

I'd also recommend that you take the Tylenol at least 3 or even 4 times a day as twice a day, you're not getting the full benefit from it.
 

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