TKR It's The HoneyB's Knees

[Jockette]

Well, you know what Josephine says about using gym machines.

They may not be making you do anything, but they are encouraging aggressive rehab activities that are not in your knee’s best interest.

 

[Celle]

They push me, but they don't over-push me. For example, yesterday they put me in one of the various knee machines (one where I'd sit in the chair/bench with a bar across the front of my ankles and raise the bar by straightening my legs to lift weights) and asked me to give it a try. When I couldn't even budge it, they held up the bar for me and asked me to try just straightening my right leg to the point where it didn't cause pain. Keep in mind that the chair/bench for this machine is tilted back. When I could only raise my leg a couple of inches in that position without pain, they simply said, "Ok, you're not ready for this exercise. We'll give it a try again next week and see if you're ready." No berating, no “try harder.” We simply moved to a different machine that I COULD do which was a kind of "opposite" machine. The bar was behind my ankle/calves and I pushed down (bent my knees) to raise the weights.

Today I was able to pedal their exercise bike forward (which seems harder to me than pedaling my exercise bike forward), and do a leg press machine using only my right leg, where I’d been using both legs. Granted, with both legs I was lifting 40 pounds for 30 reps relatively easily, and with just my right leg I was lifting only 10 pounds for 20 reps, but I could do it.

All these are far, far too much for your knee, which is still less than a month old.
For the first month, your knee needs rest more than anything, so it can start to heal. It only needs just a little, gentle exercise. Just because you can do more doesn't mean that you should.

While the people at your exercise group don't berate you for not being able to do the above exercises, they shouldn't be asking you to do them, now or even later. Using weights with a replaced knee is always a risk and any weights you do choose to use should not be tried until at least 3-4 months post-op.

 

[HoneyB]

@Joeckette - I know it seems so contrary to the Bonesmart way. I told myself when I first looked into going to this place that, if I didn't like it or felt that it was bad for my knee, I could always go back to the rehab clinic I used with knee #1. I am really enjoying it - well, as much as rehab can be enjoyed. This physical therapist has had a great reputation for 30+ years and was highly recommended by several people. I'm interested to see how it goes. I like the explanations that go with each exercise, I like the deep massages, and so far I like using the machines. I can always back out of it if it ever starts to feel "wrong."

 

[HoneyB]

@Celle - I'll be watchful and careful. My OS said that, mechanically, the use of weight machines would not damage my new knee. He said that the knee itself was as set/strong (as in the glue, etc. would hold) a couple of hours after surgery as it would ever be. He said I would not damage the knee itself using the machines; the effect, if any, would be sore muscles. So far my muscle soreness has been no more than it was with knee #1. In my "always the engineer" way, I evaluate this all the time. I appreciate the reminders to watch out for what I'm doing, though.

 

[Celle]

The potential problem with using weights is not damage to the implant itself but tearing of muscles and tendons, should your knee twist at all while you are using the weights.

Apart from that, using weights too soon just puts too heavy a load on your healing soft tissues. It keeps them inflamed and increases the potential for both swelling and developing adhesions. Why? Inflamed soft tissues become hot, and hot tissues become drier than normal tissues, which increases their likelihood of sticking together and forming adhesions.
That's why it's better to wait for several months.

 

[HoneyB]

Since it’s hot, sunny summertime here on the Gulf Coast of Alabama, I thought I’d pass along a warning I received from my surgeon, his physician’s assistant, and my physical therapist. I was told to never go outside without sunscreen with a very high SPF on my TKR scars. I was told that if my scars got sunburned even once, it could cause extreme keloid scarring that could only be remedied via plastic surgery. Slather on the sunscreen. I plan to buy an SPF 70 sunblock stick.

 

[pacosmom]

Did not know that about sunscreen & the scars, thank you!

 

[Katlyw]

Do you have access to a great massage therapist?? I went to mine at 3 1/2 weeks. She stayed away from the scar but massaged all the muscles around it. And then did my hamstring and glutes! She's in the same room as my therapist so they discuss my progress, care etc.

 

[Jockette]

The chiropractor I had when I lived in Ohio would have done that for me. She would have massaged my operated leg just right.

And she had a gentle, nurturing touch, but got your body to do what she wanted. She would also massage bio freeze into my neck and back. She’d kinesio tape my back as needed. (She even made house calls if you lived within 5 miles of her office!)

I moved 3 years ago to Delaware and I miss her so much. My current chiropractor doesn’t do massages, she doesn’t tape me or use bio freeze. Sad, sad.

I was in Ohio last December for my daughter’s wedding and my neck and back were so bad that I made an appointment with her. She was so happy to see me she didn’t even charge me for the visit! How awesome is she!

I don’t think I’ll find another chiropractor like her.

 

[MSgirl]

@HoneyB, way to go on your forward rotation! You are doing great! All my doctor told me not to do was squat or jog. He also told me not to walk the Biloxi Bay Bridge, one of my goals, because of the incline. I'm going to try it soon but it is just too hot right now. Meanwhile, I'm working on doing inclines at one of the local casinos in their air conditioning. At around five months, I am loving my new knees and forget about them most of the time. I bet you will do it even sooner! You go, girl!

 

[HoneyB]

@Katlyw - My physical therapist is also a massage therapist. His massages are magical. I also work with an exercise therapist at physical therapy.

 

[HoneyB]

Today I'm 3 weeks post-op on my RTKR and 18 weeks post-op on my LTKR. Is it over yet? Both knees are coming along well, but I have to say that for right now, I'm way beyond tired of this journey. I'm going to take 5 minutes to feel sorry for myself while I'm icing and elevating, and then I think I'll have some ice cream and head off to bed.

 

[Jockette]

Sounds like a great plan!

 

[pacosmom]

Ice cream is almost always the perfect cure!

 

[Katlyw]

@Katlyw - My physical therapist is also a massage therapist. His massages are magical. I also work with an exercise therapist at physical therapy.

Yes!! Mine is not a massage therapist but should be But my massage therapist is in there same room as him, so its awesome!

 

[SusieShoes]

That’s the problem (challenge?) of getting staged knees: the recoveries are back to back, so it seems like they go on forever.

You’re doing wonderfully so far. Hope the nap restores some of your energy!

 

[HoneyB]

Dear Fortune Cookie – Nope, I’m pretty sure it’s because I had physical therapy this morning.

Speaking of physical therapy, here is today’s "novel." At 23 days post-op on my RTKR, my ROM was 0 – 100 this morning. I asked the therapist to measure ROM for my LTKR (18 weeks post-op) just for peace of mind while it’s being a little bit ignored. It was 0 – 120. I enjoyed PT this morning. Everything was a little bit easier than it was Monday. Today’s exercises consisted of:

1. Quad sets while lying on a table with heat under and over my knee, and hooked up to the TENS machine (5 minutes).
2. Foot raises while lying on a table with a cylindrical bolster under my knee, still with the heat and TENS, 3-pound weight on my ankle (5 minutes).
3. Sitting on the edge of the table with my legs dangling over the side, and my feet on a big exercise ball while doing knee bends by using my feet to roll the ball toward the table (5 minutes).
4. Knee extensions - Sitting on the edge of the table with legs dangling, and raising my leg to the straight position. I did this first with no weight, then with a 1.5-pound weight on my ankle, and then with a 3-pound weight on my ankle (30 reps total). I have a mild pain on the inside edge of my knee when doing this. The pain level was exactly the same whether I had no weight, 1.5 pounds, or 3 pounds on my ankle.
5. Knee extension - Quad & hamstring work while sitting on a low table and pushing a “sled” hooked to resistance bands with my right leg (5 minutes).
6. Mini squats while holding onto a vertical pole (30 reps).
7. Leg press machine (quads/hamstrings/calves) – 40-pound weight while using both legs (30 reps) & 10-pound weight (just the machine parts – no added weight) while using just my right leg (30 reps).
8. Machine where I sit in a chair with a bar behind my ankles/calves, and push down with my ankles/calves (bend my knees) to raise the weights (30 reps).
9. Exercise bike – forward rotation, but with my heel (instead of the ball of my foot) on the pedal to make the forward rotation easier on my knee.
10. Heel slides while lying on my back – just a couple of these for ROM measurement.

I told my therapist that I’ve added a 1.5-pound weight to my ankle while doing straight leg raises in four different positions (30 reps in each position) at home. He said that even though I have no pain while doing this exercise with 1.5 pounds, I should not add more weight. He said to gradually increase the number of reps until I can comfortably do 50 reps in each position. At that point, I would move up to a 2-pound weight and drop the reps back down to 30. I would continue this process over a period of weeks until I’ve made it up to 50 reps with a 5-pound weight. I must admit, this has been my favorite exercise for my LTKR and my RTKR. Once my quads started working again a few days after surgery, it has been a painless, relaxing exercise.

I had been walking 6 minutes away from home and 6 minutes back. I was given the ok to increase this to 7 minutes each way.

I had an NFL football player doing rehab alongside me this morning. That was kind of fun to watch. I won’t mention his name for his privacy.

 

[Celle]

Just a word of caution for anyone reading this thread:
HoneyB is dong far more exercise at this early stage in her recovery than we recommend.
They are her knees and she has the right to choose.
As long as she's listening to them and not doing anything that makes them more painful, stiff or swollen, that may work for her knees. It would not work for everyone.

We always say that everyone's recovery is different, and this is one example of that difference.

 

[pacosmom]

@HoneyB - sounds like you are doing so well! How fun having the NFL player at therapy lol

My PT just added 1.5 lbs ankle weight to straight leg raises and it went very well. I think my non-functioning quad is one of my biggest issues thus far!

 

[sistersinhim]

Just because HoneyB's knee can do doesn't mean yours can do it. Always let your knee be your guide. Healing knees have inside stitches that have to knit together. No one wants to pull those stitches apart!