TKR Joe’s Recovery Jourknee

[Hey Joe]

11 days Post Op today and everything seems to be going well so far
I’m getting more comfortable hobbling around the house and even “forgot” my cane a couple times when going room to room walking unaided for a few steps. I can walk unaided for about 20 steps without feeling like I’m pushing myself too hard. The overall pain levels are down and I have gone 6 hours between pain meds a few times. I’ve been able to fully catch up on sleep finally as I have finally the strength and/or technique to use the comfy recliner. No digestive issues thanks to prune juice and Miralax.
The only stress I’m having is that my flexion numbers aren’t good. My home PT thinks I’m due for a slow recovery because I have so much pain when trying to due flexion exercises. I feel like I have an Ace bandage wrapped tightly around my knee preventing me from flexing even 90 degrees. I can feel my quad muscles and they seem very tight. PT wants me to inquire about a muscle relaxer. I hope that will help. Anyone have any experience with those? I’m afraid of forcibly manipulating greater flexion both because because the pain is otherworldly and because it feels like I’m going to tear the quad muscle. The latter is probably unlikely but it’s something I want to hear straight from my OS mouth.

Tomorrow is my 11 day post op visit with the OS so we’ll get the staples out and see what he says. I feel everything is going really well except the numbers. With the help of you all I’ve decided I’m not going to stress about those at least for today.

 

[Jaycey]

@Hey Joe Please do not let anyone force your knee. It is totally counterproductive and as you are seeing, only causes pain and increased swelling. You are only 11 days out of surgery. Don't worry about your range of motion now. Far too early. There is no timeframe for gaining ROM.

 

[Hey Joe]

@Hey Joe Please do not let anyone force your knee. It is totally counterproductive and as you are seeing, only causes pain and increased swelling. You are only 11 days out of surgery. Don't worry about your range of motion now. Far too early. There is no timeframe for gaining ROM.

Thanks so much Jaycey. I’m kind of old school and hard headed and really needed to hear that. Again.

Sorry about the double post.

 

[sistersinhim]

PT wants me to inquire about a muscle relaxer. I hope that will help. Anyone have any experience with those? I’m afraid of forcibly manipulating greater flexion both because the pain is otherworldly and because it feels like I’m going to tear the quad muscle.

I think it's too early to think about muscle relaxers. Your muscles aren't out of shape, they are injured and and need to heal. Forcing them before they are healed enough will only delay your healing, and increase your pain and swelling.

 

[mendogal]

I agree with @sistersinhim re no need for forcing or relaxants. In my experience, some PTs come up with weird explanations for our pain and stiffness, when it's obviously that injury and swelling is the cause. Also, a traumatized muscle that can't even fire efficiently yet can't be "too tight"!

 

[Hey Joe]

I agree with @sistersinhim re no need for forcing or relaxants. In my experience, some PTs come up with weird explanations for our pain and stiffness, when it's obviously that injury and swelling is the cause. Also, a traumatized muscle that can't even fire efficiently yet can't be "too tight"!

I appreciate this response. It’s almost like they have no idea sometimes.

 

[Hey Joe]

16 days Post Op and doing well. Still have pain and swelling especially after pt. Was able to attain 90 degrees flexion yesterday for the 1st time and I’m thrilled.
I’ve discovered that if I allow enough time for healing between PT sessions I can make small gains.
Not too worried about lack of ROM thanks to you all and Bones Smart even though my progress seems slow. Getting around and simple movements like getting in and out of chairs and getting up and down stairs continue to improve nicely.

 

[Hey Joe]

Btw when doing pt yesterday one of the exercises was doing a standing leg curl and as weak my hamstrings are I could hardly get my foot up off the ground a few inches. This seems like a good exercise but I’m just amazed at how week my hamstrings are.

 

[sistersinhim]

Was able to attain 90 degrees flexion yesterday

Not too worried about lack of ROM thanks to you all and Bones Smart even though my progress seems slow.

How can you say you're having slow progress? At 16 days out you achieved 90 degrees bend! Most OSs don't expect this until 6 weeks out and here you are at a little over two weeks out! Celebrate your success!

 

[mendogal]

I also had a terrible time with a standing leg curl and... stopped doing them.
Part of the problem is weakness from the muscle not yet firing optimally, but in my opinion it's the swelling behind the knee that was the larger problem and I felt it would be counterproductive to force it.
Pushing feet down into the floor to rise up off of bed, chairs, toilet, etc naturally helps activate the hamstrings without formal exercises. At not even 6 weeks out it's way too early to worry about strength; your muscles need to be healing and waking up!

 

[Hey Joe]

Was able to attain 90 degrees flexion yesterday

Not too worried about lack of ROM thanks to you all and Bones Smart even though my progress seems slow.

How can you say you're having slow progress? At 16 days out you achieved 90 degrees bend! Most OSs don't expect this until 6 weeks out and here you are at a little over two weeks out! Celebrate your success!

Thanks for the question. My PT told me as much. He said you seem to be slow to progress and proceeded to tell me about another patient of his that achieved 120 at 2 weeks and she is older than I. I don‘t know if he’s clueless or just trying to motivate me. But it really bothered me. Made my worry needlessly while insinuating that it was somehow my fault. phrases like ”Does it really hurt that much?”
Reading here has really kept me from aa lot of negative thinking.

 

[Hey Joe]

I also had a terrible time with a standing leg curl and... stopped doing them.
Part of the problem is weakness from the muscle not yet firing optimally, but in my opinion it's the swelling behind the knee that was the larger problem and I felt it would be counterproductive to force it.
Pushing feet down into the floor to rise up off of bed, chairs, toilet, etc naturally helps activate the hamstrings without formal exercises. At not even 6 weeks out it's way too early to worry about strength; your muscles need to be healing and waking up!

Makes perfect sense. Thanks mendogal

 

[sistersinhim]

. He said you seem to be slow to progress and proceeded to tell me about another patient of his that achieved 120 at 2 weeks and she is older than I. I don‘t know if he’s clueless or just trying to motivate me. But it really bothered me.

If I were you I'd fire that PT. Being shamed for your accomplishments is not the way to go. You should be admired and congratulated. Put-downs are not encouraging. Comparing you to someone else is also wrong. If that older patient achieved 120 at 2 weeks then she's one in thousands or it could be that she did little PT or exercises so her knee wasn't as swollen as yours. But, to me, it sounds like a fish tale.

 

[benne68]

He said you seem to be slow to progress and proceeded to tell me about another patient of his that achieved 120 at 2 weeks and she is older than I. I don‘t know if he’s clueless

I would say he's clueless. Disparaging someone's progress is NEVER motivational. And I suspect he was not properly trained in how to help someone recover from joint replacement surgery.

Your flexion is excellent for just 2 weeks out! I agree with Sister, fire him and find a new therapist who knows what he's doing.

 

[Layla]

I am sorry for the negative PT experience, Joe. Hopefully you're able to find a better fit in a therapist.
I also found engaging here helps in recovery since you're dealing with people that understand through personal experience. Stick with us. We're happy you're here!
@Hey Joe

 

[Hey Joe]

Thankfully I’m done with him. His was the last of the home therapy sessions. Next week I move to OP part. 3/week for 4 weeks. And yes I think he’s clueless too.

 

[Jaycey]

3/week for 4 weeks.

Too much! PT 3X/week is just overkill. You are not in training, you are healing from major surgery. Please push back.

 

[sistersinhim]

I agree that 3X a week is way too much for that baby knee. All of this will only cause more inflammation, swelling, and pain in your knee. Once a week would be fine and then on your off days just walking around the house and taking care of your daily activities is enough PT.

 

[kneeper]

I would have loved to have 90 at 2 weeks. Don't listen to the PT who says your recovery is slow. The only reason I'd consider muscle relaxers is if you are having muscle pain, not so that you can meet his unrealistic demands.

 

[Hey Joe]

17 days Post Op

I used the CPM last night and after a slow build up was able to do 110 for 1 rep then backed it down and did 10 more at 100. I suspect the numbers on the machine aren’t true degrees but it‘s still major progress. I found a gentle flexion exercise that I like. In a rocking chair I put both feet on the floor and rock back until my left foot is just dangling a bit off the floor then let gravity do the work.
Interested to start outpatient PT tomorrow.