TKR Joe’s Recovery Jourknee

Hey Joe

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Surgery day finally arrived. Had LTKR yesterday. I’m handling the pain pretty well at least until I had my 1st PT session. BRUTAL. Omg. i get that you got to get that knee bending ASAP and I am an eager student. Guess I just wasn’t prepared for that.
Anyway I’m sure things will get better in due time. But that 1st PT session was something.

Edit: Forgot to mention that my Flexion was 75 and Extention -5
 
Welcome to recovery and I love your play on words with your title!

First of all, no PT session should be brutal, at any time, but especially not the day off or the day after surgery. Tell that PT no and don’t let him/her touch you. This person has not been trained appropriately and will do you literal harm.

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.

Just keep in mind all people are different, as are the approaches to this recovery and rehab. The key is, “Find what works for you.“ Your doctors, PTs and BoneSmart are available to help, but you are the final judge as to the recovery approach you choose.

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
ice
take your pain meds by prescription schedule (not when pain starts!)​
If you want to use something to help heal the incision,
BoneSmart recommends hypochlorous solution. Members in the US can purchase ACTIVE Antimicrobial Hydrogel through BoneSmart at a discount. Similar products should be available in the UK and other countries.​

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.
 
You do not have to “get that knee moving ASAP”. What is good for your brand new knee is very gentle bends, to give the joint mobility. Right now it has been through the mill and needs gentle treatment so it can heal.

Window of Opportunity

Regaining our ROM does not require forceful bending or painful exercises. That is counterproductive.

Regaining our ROM is more about Time than repetitions of a list of exercises.

Time to recover.
Time for pain and swelling to settle.
Time to heal.

Our range of motion is right there all along just waiting for that to happen so it can show itself.

In the general run of things, it doesn't need to be fought for, worked hard for or worried about. It will happen. Normal activity is the key to success.
 
Hi there Joe :wave:Welcome to recovery and thanks for joining us on the healing side to share your journey.

I am sorry you had such a rough first post op experience with PT. You really can be an eager and willing participant in physical therapy without allowing them to forcefully manipulate your leg or have you in misery by the end of your session. For your own comfort, please refrain from movement that causes discomfort or pain. Your range of motion is currently limited, but once the swelling subsides and the pain eases it will naturally increase. It takes time and patience, but you can get there without any brutal therapy sessions. Keep that in mind and give it time, chillin with some rest and ice. :ice: I look forward to following your recovery. A peaceful day to you!
@Hey Joe
 
Soft tissue healing (muscles) from much lesser "injury" takes 6-8 weeks; the other structures take longer. What we learn in athletics is that if it's manhandled, whether by training too soon or by aggressive PTs (who are *supposed to* understand the physiology involved), you can basically reset to injury or postop day 1....
All you need now, besides rest, pain meds, elevation, and ice, is to get up and take short walksin the house, do your ankle movements to promote circulation, do some quad sets to wake up your quads, and very very gentle range of motion within your current comfort level.
As my surgeon and his team reinforced: in the initial postop period "Less is Better."
 
i get that you got to get that knee bending ASAP
Not so. What about all of us who were put into braces and not allowed to bend for weeks but recovered our bends just fine? There is no time frame for achieving ROM. That's old, out-of-date thinking.

Just walking around doing your daily activities is all you need to do to loosen up that knee. To get the bend better, you have to get rid of the swelling in there. Rest, ice and elevation are the best ways to do that.
 
I have had an amazing recovery from both TKRs. The latest is 6 weeks old. I have not done PT for either knee. I did get back to daily activities quickly, but never pushed any bend or range of motion. I ran a little bit yesterday- not bad for 6 weeks. Listen to your knee and dont let PT force anything. Your knee is recovering from trauma- don't add to it.
 
Thanks so much y’all for the replies, Really appreciate the the strong advice. I haven’t felt much like posting here the last couple days as my pain level have been pretty high overall my mind mush from taking so many narcotics mostly prevented me from saying much of anything rational or coherent in any case. Dr finally let me go home Saturday so I’ve been home3days now. I think I’m making good strides as I can tell that it’s easier getting up from the couch into my walker and back down again. My dear sweet loving wife has bee tremendous catering to my many needs. I’m using a CPM machine and ramping things up slowly with that - current setting is -5 and 65. Pt has been here only once so far and will be coming 5 time/week for 2 weeks then outpatient 5 times a week for 2 weeks.
the biggest negative is that my other arthritic knee blew up while doin my 1st in hospital PT. So when this one is good enough it’ll be time for round 2 with the right knee.
The worst part of being in the hospital for 3 days is the inability to get comfortable or get any sleep. The mattress was made of rubber or plastic apparently and didn’t breathe so I was constantly feeling sweaty and chilled at the same time. The staff was short staffed and seemed overwhelmed most of the time. I guess that’s how things are these days or so I’m told.

1st home PT was rough as expected. I’m willing to push through some pain but I’m comforted by knowing that it’s okay to just say sorry not his time sorry that’s all I have right now.
 
Pt has been here only once so far and will be coming 5 time/week for 2 weeks then outpatient 5 times a week for 2 weeks.
Oh my goodness, this is WAY too much PT! Your knee isn't out of shape, it's injured from a very traumatic surgery. All your knee needs to get moving in these early days is gentle walks to take care of your daily needs. That is all.
1st home PT was rough as expected. I’m willing to push through some pain but I’m comforted by knowing that it’s okay to just say sorry not his time sorry that’s all I have right now.
PT should never be painful. If it is, then your knee is telling you that it is not ready for what you are doing and it will react with increased pain and swelling. This is a setback. Saying no to these exercises will do much more good, than doing them will do!
 
Pt has been here only once so far and will be coming 5 time/week for 2 weeks then outpatient 5 times a week for 2 weeks.

1st home PT was rough as expected.
I’m willing to push through some pain but I’m comforted by knowing that it’s okay to just say sorry not his time sorry that’s all I have right now.

All this PT is unnecessary and will cause increased pain and swelling which will require more medication to get your pain under control. Very few people go to PT 5 times a week. In fact, some don’t go to PT at all, and they have less pain and swelling and have a great outcome.
Saying no to therapy - am I allowed to?

Regaining our ROM does not require forceful bending or painful exercises. That is counterproductive.

Regaining our ROM is more about Time than repetitions of a list of exercises.

Time to recover.
Time for pain and swelling to settle.
Time to heal.

Our range of motion is right there all along just waiting for that to happen so it can show itself.

In the general run of things, it doesn't need to be fought for, worked hard for or worried about. It will happen. Normal activity is the key to success.
 
Can you tell me what you’re taking for your pain? The name(s) of any pain medications, including over-the-counter meds, strength, and when you take them may help us make some suggestions to help with your pain levels.

The posts above are correct in that you may be pushing a bit too hard this early in your recovery. Some therapists still practice this aggressive therapy, but the latest studies show it’s not needed and actually can be counterproductive. In the early days and weeks, all that’s needed are gentle bends and stretches throughout the day and night and getting up for 5-10 minutes of walking about the house with your walker every hour or so. If the therapist tells you there is a “window of opportunity” to obtain your ROM, please don’t let that scare you. It’s not true and ROM can be improved for an extended period of time. Don’t force things. Let your body heal itself….it’s on its own schedule….not yours, your surgeon’s or your therapist’s.
 
@Hey Joe
I had 2 PT session at home mainly for home safety and mild stretches. 6 Outpatient PT over 3 weeks. Should have stopped after session three. My ROM return to preop range, and so did strength. I did gentle stretches, walking around my house.
At 7 weeks I have full ROM, no difficulties walking or reciprocal stairs.
Rough PT, forcing the knee is not necessary. All that is necessary is time to heal.
 
Yep, I knew being my main support after my first TKR was going to push my other knee right into mine needing a TKR. You have lots of company here for that!!!!!
 
I think I was in a narco fueled cloud earlier but my Outpatient PT program is set up to run 3X week for 4 weeks. How I got 5x5 eludes me now.

For pain I am taking oxycodone and hydrocodone with acetaminophen 5/325. I’d been taking tramadol 25mgs 3x/daily for about 8 years and can go back to them when the other stuff runs out.

I had a different PT today and the guy was better that the last one. I told him I’d do whatever he asked as long as he respected my stop signs. Yeah he still pushed me to perform the basic exercises but when I protested he didn’t push it. He showed me the best techniques for navigating the stairs and I was able to go up and down a flight of stairs with one crutch. That felt great. He adjusted my gait with the walker and I was able walk semi normally for a few minutes. Baby steps baby! What I liked best though is that when he measured my flexion and it came up worse than yesterday when the Marine Sargeant was pummeling me, he said that maybe yesterday sessions was too much. Yathink?

Ive never been the fastest learner but usually catch on eventually. And it’s starting to sink in that when comes to PT, too much is probably worse than not enough Especially early on. It’s a tough adjustment for me as I’ve been pretty disciplined to push hard for whatever I want to achieve. And in most physical pursuits, more IS better.

Lastly I, did a search on “constipation issues” pre op and a big thank you for those recommending combinations of stool softeners, prunes, prune juice and miralax.
 
Ive never been the fastest learner but usually catch on eventually. And it’s starting to sink in that when comes to PT, too much is probably worse than not enough Especially early on. It’s a tough adjustment for me as I’ve been pretty disciplined to push hard for whatever I want to achieve. And in most physical pursuits, more IS better.


 
it’s starting to sink in that when comes to PT, too much is probably worse than not enough
:yes:

He adjusted my gait with the walker and I was able walk semi normally for a few minutes
Heel-toe walking also helps with gait.
This involves striking the ground with your heel first, then rolling through your heel to your toe, and pushing out of the step with your toe. It takes a concentrated effort, but I believe you'll notice a difference. Give it a try.
Here is a visual
1690558304760-png.88336
\
Best Wishes, Joe!
 
it’s starting to sink in that when comes to PT, too much is probably worse than not enough
:yes:

Thanks @Layla. People you trust and medical professionals tell you for a long time that ‘A‘ is true. It’s not easy to break out of that indoctrination. It feels like leaving a religion or a cult.
 
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Thank you !!
 
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Post Op Day 6 and things seem to be progressing well. Small improvements in little things like getting up and around more independently and taking care of personal hygiene type stuff all getting easier as I get more stable being on my feet. Wife is wonderful helping me with everything. And I’m both fortunate and grateful.

Still have considerable pain when 1st standing up or if I fall asleep and wake up in an uncomfortable position but went about 6 hours last night between doses so that seems encouraging. From here the emphasis will be on getting up and around more frequently and doing a couple laps around the downstairs.

Thanks so much for all the support and ideas. Still struggling a bit with editing posts and such.
 
Feeling good POD 6, that's great news! Sounds like you have a loving caregiver in your wife...and a grateful heart.
You're blessed, Joe!

The pain will ease, keep up with the icing and meds for as long as you feel the need.
Your posts look fine, but if you need assistance in any area, we're here, ready, willing and able to help.
Happy Wednesday! I hope it's a good one for you. :)
@Hey Joe
 

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