TKR It's The HoneyB's Knees

[sistersinhim]

Please be very careful on your babysitting days. Your knee is much to young to be watching 2 1/2 year old child. Is there anyway you can keep from doing this for the next 2 or 3 months? Doing too much too soon will delay your healing.

 

[HoneyB]

Yes, I nap when she naps. We also do blocks, Legos, puzzles, etc. that let me sit or lie on the floor with my leg stretched out, and cuddle on the couch for movies. As it turns out, I had recovered ok by time for PT this morning. My flex was a couple of degrees less than usual, but step ups, pedaling, and all other exercises are still getting easier every PT visit.

 

[HoneyB]

This may sound crazy, but here goes. For my entire life, my left shoulder has been slightly lower than my right shoulder. As a teenager, I was told it was due to scoliosis, but instead the problem turned out to be that my left leg was slightly shorter than my right leg. My left hip bone was always slightly lower than my right hip bone. My left leg was slightly bowed. Since my left TKR, my shoulders and hip bones are level and my left leg is straight (no longer bowed). My left hamstring is really bothering me. I know hamstring problems are common after a TKR. I’ve never had hamstring problems. I’ve always been able to easily touch my toes, etc. Even the week of surgery, I could bend over and touch my toes and sit on the floor, bend over, and touch my toes. I’m doing hamstring stretches as part of physical therapy, but it actually feels like my hamstrings are being stretched ALL THE TIME. Is it possible that the straightening of my leg and “leveling” of my left side is causing my left hamstring to be temporarily over stretched? Is it possible that I’m doing stretching exercises on a muscle that has already been stretched to the max?

 

[SusieShoes]

Replacing your knee could have resulted in the hamstring feeling stretched. Those tendons were probably shorter due to the leg being shorter. The knee was replaced and the leg made longer (it sounds like), so... the tendons weren't replaced, and neither was the muscle. Both are the same length they were before surgery, so they have to stretch to accommodate the new length.

The good news is both the tendons and the muscle can do this. They can stretch and grow to become the length they need to be. Once that happens, you will be more comfortable. But these tissues, and the tendons especially, require time to stretch. It might take a few months or maybe more. They can't be rushed, but will stretch with use.

Are you doing stretching exercises on a muscle (and tendons) that are already stretched to the max? Possibly. I'd be careful about how you stretch those tissues. Don't push on them, for example, or do anything that might over-stretch them. You don't want to risk damaging them. Have you talked to your OS about his or her thoughts? Some exercises are inherently gentle, such as walking. Walking is a great way to gradually stretch and strengthen the muscles of the legs and knee.

Can I say I'm happy you have your legs/hips balanced now? It's better for your joints in the long run, though you (body and mind) will have to get used to the new normal.

 

[HoneyB]

Replacing your knee could have resulted in the hamstring feeling stretched. Those tendons were probably shorter due to the leg being shorter. The knee was replaced and the leg made longer (it sounds like), so... the tendons weren't replaced, and neither was the muscle. Both are the same length they were before surgery, so they have to stretch to accommodate the new length.

The good news is both the tendons and the muscle can do this. They can stretch and grow to become the length they need to be. Once that happens, you will be more comfortable. But these tissues, and the tendons especially, require time to stretch. It might take a few months or maybe more. They can't be rushed, but will stretch with use.

Are you doing stretching exercises on a muscle (and tendons) that are already stretched to the max? Possibly. I'd be careful about how you stretch those tissues. Don't push on them, for example, or do anything that might over-stretch them. You don't want to risk damaging them. Have you talked to your OS about his or her thoughts? Some exercises are inherently gentle, such as walking. Walking is a great way to gradually stretch and strengthen the muscles of the legs and knee.

Can I say I'm happy you have your legs/hips balanced now? It's better for your joints in the long run, though you (body and mind) will have to get used to the new normal.

My physical therapist said pretty much the same thing today. We skipped my hamstring stretch exercises today.

 

[Mutti3]

My hamstring is still a bother. I stretch it everyday. Cautioned to be careful while stretching. I take walks, practice yoga poses that emphasizes the area, such as triangle, bending over with straight legs touching the toes. I even threw in a few planks, and downward dog!

 

[Oomworthy]

This may sound crazy, but here goes. For my entire life, my left shoulder has been slightly lower than my right shoulder. As a teenager, I was told it was due to scoliosis, but instead the problem turned out to be that my left leg was slightly shorter than my right leg. My left hip bone was always slightly lower than my right hip bone. My left leg was slightly bowed. Since my left TKR, my shoulders and hip bones are level and my left leg is straight (no longer bowed). My left hamstring is really bothering me. I know hamstring problems are common after a TKR. I’ve never had hamstring problems. I’ve always been able to easily touch my toes, etc. Even the week of surgery, I could bend over and touch my toes and sit on the floor, bend over, and touch my toes. I’m doing hamstring stretches as part of physical therapy, but it actually feels like my hamstrings are being stretched ALL THE TIME. Is it possible that the straightening of my leg and “leveling” of my left side is causing my left hamstring to be temporarily over stretched? Is it possible that I’m doing stretching exercises on a muscle that has already been stretched to the max?

Well I can't speak as to the effects of the operation (not having had mine yet), but I can tell you that after a couple of years of compensating for the damage to my left knee I went to see a guy who had been recommended for stretching treatments (he was an anaesthetic nurse prior to retraining so knew a bit of anatomy). He had glowing reviews from several friends, all of whom had been personally referred. Anyway, he uses a technique called 'Active Isolated Stretching', which builds on the principles of kinesthesiology (sp?).

After my first session he got me to stand up straight and tell him how I felt: The answer was "about 3" taller and leaning to the right". He then got me to look in the full sized mirror and I could see that far from being leaned over to the right, I was actually straight upright for the first time in several years. I hadn't even noticed how much I was hunched forward, let alone how much I was leaning to my left - all to compensate for my knee.

Even now I can feel my left side sorer to stretch (when I all to rarely go through the routine) because my tendency is to compensate. The muscles down my left side are all that little bit shorter. If you had that all of your life then you will definitely notice it, but muscles/tendons are flexible enough to adjust over time.

Now I'm wondering if my trousers will no longer be too long on one leg once the surgeon has done his thing to my knee.

 

[HoneyB]

I will be six weeks post-op from a left TKR 2 April 2018, and my flex has been stuck at about 105-108 for the past two weeks. Everything else seems to be progressing well. I think my biggest hinderances to increasing my flex are my IT band and hamstring. I’ve had IT band issues for years. I’ve never had hamstring issues in the past and think my hamstring issue stems from the stretching of my hamstring caused by the straightening and slight lengthening of my leg from the TKR. When I practice heel slides, I feel a pop in the hamstring area behind and slightly above my knee. It feels like something pops and then shifts to the left (toward the outside behind my left knee). The therapist can also feel this happen by placing her hand on the back of my leg just slightly above my knee. After the pop sensation, I get a pain and tightness near my hip/top-outer edge of my thigh, and on the outer edge of my shin about 3 – 4 inches below my knee. These two spots continue to hurt and feel tight as I straighten my leg from the heel slide. After straightening my leg, the pain goes away until I feel the pop during the next heel slide. The pop doesn’t happen at the top of my ROM. It happens at different angles between about 70 degrees and 95 degrees. I’ve been working on hamstring and IT band stretches for weeks, but so far it doesn’t seem to have had any effect. This is frustrating. Any tips or ideas would be appreciated.


One of the therapists said this pop could be caused by my new knee tracking differently from my old knee and causing a shift (pop) in the location of one of the hamstring muscles, and that this should self-adjust over time.

 

[sistersinhim]

You are only 105-108 at six weeks!? Why are you concerned? Most OSs expect only 90* at six weeks. You are way above that! Enjoy your successes and don't worry. Your ROM will fluctuate all the time in this journey. It's also normal to have a stalemate for a while, then all of a sudden, it improves again. Here's an example of one of our members:

One of our members, Bertschb, 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.

 

[Babushelen]

I never get tired of reading @Bertshb record of his ROM progress. @HoneyB, I think your ROM is excellent!!

 

[Celle]

I will be six weeks post-op from a left TKR 2 April 2018, and my flex has been stuck at about 105-108 for the past two weeks.

Don't think of that as stalling. I call it a period of consolidation before your knee moves forward again - which it will do, as long as you don't stress it by adding more exercise.

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.

Your ROM Is already very good for your stage of recovery, so try not to worry.

 

[HoneyB]

Thanks, @sistersinhim, @Babushelen, and @Celle! That ROM history was a good thing to save and share. I have a feeling that my PT wants to get me to 120 by my 8-week OS visit on 17 April. I reminded the PT that there's no rush; I plan to have my right TKR in May so I've got months of therapy visits ahead of me. My left knee can keep coming along while I work on my right knee. So far, they've only made me do one exercise at therapy that I felt was on the extreme side. They had me lie on my back with my left foot raised and pressed against a vertical surface (window) with my knee bent at about 90 degrees (so far so good - no pain). Then they put a weight on my ankle that caused my foot to slide down the window and bend my knee at increasing angles. My quick reaction was to place my right foot under my left foot to control the slide. When it got to the point of being pretty painful, I'd use my right foot to push my left foot back up to 90 degrees instead of letting it keep sliding down the window. It hurt, I told them it hurt, and so far I've not been told to do that again. I'll strongly consider refusing to do it again based on advice I've received on this forum. I'll try to be patient, but I sure hate feeling stuck at the same ROM. Sitting in church today caused some swelling so I've not done much more than ice and rest today.

 

[HoneyB]

Could one of the forum admins please add my implant type (ConforMIS iTotal) to my signature? Thanks!

 

[Celle]

I've done it.

 

[Oomworthy]

The location of the pain is the same as I get occasionally and is about the right locations for the peroneal nerve (which I damaged in my crash) but I can't imagine it popping. That sounds much more like tendon getting in (or out) of the way.

 

[jaschembra]

Just from my personal experience, I went through periods of the tendons moving or popping as you described. On my lateral lower side, when I would bend from a stretched out position and on the medial side when I would do slightly angled toe touches in the water. The lower lateral side went on for a few months (like it rolled over something) but then eventually quit, just disappeared. The medial side has also stopped, but I did do some moves with a foam roller lately which I know helped my hamstring back and inside. I can't say the tendons hurt, but felt really weird and nearly uncomfortable. I say all this because hopefully yours is too just a phase your healing is going through. I should look at this recovery as the most intriguing.... I tend to analyze....but it sure has it's little quirkiness about it. By the way, your flex is great! I was stuck at the 105 mark for nearly a month or more before I started moving again...

 

[sistersinhim]

Sitting in church today caused some swelling so I've not done much more than ice and rest today.

I sat on the back pew, that was usually empty and put my leg on it, plus an ice pack on it. That helped a lot. I did this for at least a couple of months until I was able to get back up into the choir loft. I even have a low stool in the choir where I can get my knee above my hip. That's always less painful, too. Any elevation while sitting is better than none!

 

[HoneyB]

Thanks, Oomworthy, jaschembra, sistersinhim! Once again, I feel reassured via this forum that what I'm going through is normal. That helps so much. Sometimes I want to shout out in therapy, "Hey - This is happening to me. Is this happening to anybody else?" Thanks to this forum, I don't have to do that. By the way, I got to 110 today at PT.

 

[Celle]

@HoneyB - I have edited your post, to remove the tags at the beginning.
Please only tag one person at the start of a post. We ask that because starting with multiple tags makes it hard for people reading on a small mobile device. All they see at first is the tags.

Here's an article that explains
How to tag another member; how to answer when someone tags you

Thank you.

 

[HoneyB]

Thank you, Celle! Also, I realize that sometimes when I reply from my phone, my reply contains a quote of the previous post. I'm not intentionally quoting the previous post. It sometimes just happens automatically when I'm using my phone.