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[TKR] Just a little support...

Discussion in 'Knee Replacement Recovery Area' started by lopat, Jun 4, 2019.

  1. lopat

    lopat junior member
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    so today is day 20 after LTKR. I found this site on day3 and have been lurking. I’ve read the articles suggested to others. I’m going through what everyone seems to go through, good days and bad. One day I think I’m making great progress and the next my knee is stiff and my calf and thigh muscles are so sore I can barely walk.

    I have what I call my golden hours. 10 am to 6 pm. This is when I get around best and feel almost normal. Came home the day after my surgery and have had 5 at home pt sessions. LOVED her. She encouraged and pushed but I always felt like it was my idea. Tomorrow I start real PT. I’m concerned about how that will go. I agree with the premise I’ve been reading here and have pushed myself to very uncomfortable but not quite OOWWW!. as of today, I am using a cane during my golden hours, even very short steps without anything. Walker at night in the dark when I’m sleepy and the leg has gone back to clumsy.

    My question and concern. Tomorrow, How do I figure out if therapist is helping or he/she is a masochist? My rom on day 15 was 94 and 5. That’s the last time it was measured.

    Thanks for all the helpful stories!
     
  2. Jockette

    Jockette FORUM ADVISOR Forum Advisor

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    Hi and Welcome to Bonesmart, we’re glad you joined us!
    You don’t have to figure this out, you have a talk with the PT right off before you start anything and tell them how you do and don’t want them to treat you. It’s all about consent and what you will consent to. We like to say you are the boss and they work for you, not the other way around. And if they don’t comply, walk out and look for another facility, there are many out there.

    And your ROM is coming along just fine, so don’t allow them to force anything.

    I know you’ve read the articles, but everyone gets their own copy, so, 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.

    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
    elevate
    ice
    take your pain meds by prescription schedule (not when pain starts!)
    don't overwork.
    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.
     
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  3. RAD

    RAD member

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    I’m on day 20 as well and had great home care. I had my first oUtside PT session yesterday and, fortunately, he seems really good. I told him my goals, the top one being that I’m fine with slow and steady progress and that my main concern is not being hurt and regressing. He seemed to understand and share that philosophy. My next PT session is tomorrow.

    Right now my ext is 0 and my flex is about 95. He said that was fine at this point and didn’t seem obsessed with it. I’m off the cane except for stairs, he says I’ll probably be totally off in a week or 2. Hope you have a good experience at PT!
     
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  4. KarriB

    KarriB FORUM ADVISOR Forum Advisor

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    My rule in PT was no one touches my leg. I was petrified someone would hurt me by dropping my leg, it never occurred to me that someone would push or press down on my leg. As Jockette said, you can have a conversation with the PT and set some ground rules. No touching is a good one to start with, that way you are in control.
     
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  5. lopat

    lopat junior member
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    Thank you so much. Rad, you and I seem about the same place. The thing I hate the most is not being able to see where I am comparatively speaking. I know everyone progresses differently but it’s nice to have a bookmark.

    I’m having a-LOT OF soreness in my calf. Almost bordering on pain. Normal?

    And, tried sleeping in my bed first night. Made it 2 hours and discovered my recliner was better. It goes almost totally flat so that’s OK. Have tried the bed twice since then. No matter what position, my knee wakes me up squealing. Have tried knee elevated, left side with pillow between knees, right side with pillow between knees and flat on my back. Nothing worked. And that’s really sad. The bed was really comfortable for about 1/2 hour.
     
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  6. maryo52

    maryo52 FORUM ADVISOR Forum Advisor

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    Well "very uncomfortable" is pain. "Uncomfortable" is also pain. I can tell you are a strong person!!

    The measure I used to know how far to go was "tightness." I stopped when something felt tight. And even though I would've wished to have better range of motion at the time, in the long run it works just fine, kind of like the turtle winning the race!

    My PT did touch me. First she massaged my knee for 20-25 minutes. She did bend my leg with me lying on the table but watched my face carefully and didn't push. She never never did anything that hurt me, and that trust is awfully nice to have.
     
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  7. Rockgirl4

    Rockgirl4 senior

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    I'm just 6 days behind you, but it's amazing the similarities. I have the Golden Hours of 9AM -9 PM. For some reason, my whole body aches late in the day,and there's no getting comfortable. Sleeping in bed stopped a few days ago. I was fine the first few nights, but I got tired of tossing/turning, ice on or off, switching out pillows....It was too anxiety-laden, knowing my husband had to work the next day. Now, the couch is my friend day and night. :)

    I feel your calf pain too. I've cursed this calf for over a week now.:censored: I've found a couple of ways to stretch that have helped, and I started using a heating pad a couple of times a day, keeping it well below the joint. My bruising is extensive behind my knee though, and most of the pain IS where the bruising and blood pooling is located. The colors have deepened/spread over the last 4 days, plus the skin doesn't like any scratching or pressure on it at all. My in-home PT thinks this is why it hurts so much, and it just needs time for the blood to be absorbed and surgical soreness to diminish. Standing up had been a challenge up until 2 days ago though. My calf wanted to cramp and simply not cooperate for 5-6 steps.

    You asked about PT. I was lucky this time around to be able to do my research ahead of time and find someone who is NOT aggressive. I think as long as you set some boundaries from the beginning, it will go more the way you want. I have had 2 PTs sneak their way into forcefully bending my knee when I wasn't looking (I was on my stomach), so there are no promises he/she won't hurt you. Just stay vigilant with self-advocating. It took 10 previous knee surgeries and many good/bad PT experiences over the years to find my backbone with medical professionals. Sometimes I do think they enjoy knowing your boundaries though...less confusion later hopefully. Best of luck to you.

    --Lisa
     
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    Last edited: Jun 5, 2019
  8. KarriB

    KarriB FORUM ADVISOR Forum Advisor

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    @lopat can you tell us the exact date of your LTKR so we can add it to your signature?
     
  9. RAD

    RAD member

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    I haven’t had much calf pain. I’ve been sleeping in bed, switching off between sleeping on my back with a pillow under the leg and sleeping on my side with the pillow between my legs. I do wake up a few times a night to change positions, but I’m sleeping a decent amount and it’s getting better. Went out for 2 walks yesterday which was nice. I live in a walk up apt so doing stairs with a cane, everything else without.
     
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  10. klinkmcbear

    klinkmcbear junior member

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    @lopat and @Rockgirl4 - I've had the severe calf pain as well, laterally from just below my knee down to slightly above my ankle. This has been some of my worst pain. I definitely find that changing the position of my leg helps with this - mostly flat on the couch - even a small elevation at this point makes the throbbing awful. I try to keep elevated as much as possible, but can't when this pain comes around. A compression sleeve seems to have helped with this throbbing pain too. Like you Lisa, My PT thinks that this is due to the bruising in that area. It's definitely less than is has been, so I'm hoping as the bruising decreases, so will the pain. It's also in the one area that is still numb to the touch. Are you able to describe the stretches that helped you out?

    kathleen
     
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  11. Rockgirl4

    Rockgirl4 senior

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    @klinkmcbear I've been doing a standing calf stretch while holding on to my walker. Honestly, it's not even the full stretch because the muscle is just too tight. As simple as it sounds, I have me good foot/leg in front, with the operated leg just a few inches back, and trying to straighten the operated leg--then hold it for 20-30 seconds, or shorter if it's early in the day and SUPER tight. Over the last 2 days, I've been able to move my operated leg back a few inches, but not much. I'm also doing a seated calf stretch on the couch, using a towel to pull the ball of my foot and toes toward my chest. That helped a lot last night when I couldn't sleep. I had to do so much stretching of the OTHER ankle this past Spring due to a minor injury at New Years. Who knew I'd be applying so much now. :) By the way, like you, I've also found that my leg being flat on the couch is the most comfortable position. I just about can't take anything firm being under my ankle/calf yet. That increases the pain immediately. Luckily I can still elevate easily.

    I spent part of last night with my gait belt, trying to stretch my IT Band, my glutes, hip...then sitting on the kitchen table trying to do a hip flexor stretch. I'm not doing it for exercise or because someone is telling me too. My BODY is begging me, even after only 2 wks of this recovery. This too will pass though. I know there will come a point at which I can drive myself to the massage therapist---just hanging on a few more weeks.

    @lopat I hope last night was more productive with sleeping. Did you try the bed again? My couch is getting old, but at least I sleep some. Better than laying in my bed, staring at the ceiling. :)
     
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  12. lopat

    lopat junior member
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    First off, @KarriB my TKR was May 15, 2019. Exactly 3 weeks ago today.

    Had my first Therapy today. It went ok. I have a feeling I’ll have to put my foot down (i’m Funny) with the therapist. She says a little pain is fine. I told her no. So today was ok. I think we’ll have to have the conversation again, though. I am thrilled and surprised my ROM was 100%. Who knew? I’ve been hobbling around the past 2 days “woe is me” because I was worried it wasn’t progressing. Down side, EXT was back to 7%.PT said back side of knee was swollen.

    Oh, and when I mentioned my calf pain, one of the asst.’s brought out a handy dandy rolling pen and rolled it gently while I was laying on my stomach (didn’t even know I could lay on my stomach). That felt great. They also introduced a calf stretch that is supposed to help. All in all, I may be a worrier but I’m thinking I just might live through this.

    Thank you everyone. Just being able to chat is a great help.
     
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  13. klinkmcbear

    klinkmcbear junior member

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    Thanks for the stretches @Rockgirl4 - I'll give them a try. I hope you're able to get to the massage therapist soon. I've gone 3 times to my chiropractor for Active Release Techniques (ART - similar to massage in that he hits the trigger points until you scream, but it hurts so good, and brings tremendous relief). This has been a huge help in my whole body feeling better. I hope you have similar results soon.

    @lopat - 100 on flexion is awesome - good for you!! I had forgotten about using a rolling pin, but might give it a shot on the calf pain.
     
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  14. KarriB

    KarriB FORUM ADVISOR Forum Advisor

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    I never thought of icing the back of my knee with my TKR, but you might try that to get the swelling down behind your knee. Another trick is to spend a few minutes with your leg stretched out between a chair you’re sitting on and an ottoman or other chair.

    You’re right, I think you will live through this and learn a whole lot in the process, I know I did!
     
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  15. winemama

    winemama senior

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    I have the same pain in calf and ankle, it is brutal. My Dr said anywhere from 1-8 weeks, I’m at 6 weeks now, and about 85% pain free in that area. It is because they straightened my leg. Hang in there
     
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  16. Atlas_aus

    Atlas_aus member

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    Hi,

    Hope you are feeling better. To date I am cramp free, but know what it is like over the years.

    Even though I am icing as required I have been using heat on some parts, my quads, lower back etc.. Perhaps there maybe some relief in some heat and gentle massage in the area.

    Good luck.
     
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  17. fenway09

    fenway09 junior member

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    @lopat we have twin TKR dates.....5/15/19.....I had my PT out patient EVAL yesterday and I was at 120 ROM but negative 8 for my extension. Tomorrow I return to PT at 8 AM ( ugh) it takes me so long to get going in the am. I used to be able to jump out of bed.....not so much since my TPF surgery a year ago and now the TKR. I will look forward to following your recovery progress. Cheers.:flwrysmile:
     
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  18. RAD

    RAD member

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    I’m 5/15/19 too! I’m the opposite of you, 0 extension 95 flex. My energy level is good though, actually going back to work on Monday. I have a desk job, I can ice at work and I’m going to do a bit of an abbreviated day. I’ve been lucky that I haven’t had any cramping, I’ve been able to drive for an hour plus and haven’t cramped up. Still up and down a bit during the night but it’s getting better. Good luck to you!
     
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  19. fenway09

    fenway09 junior member

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    @RAD that's awesome your extension is at 0 and you have the energy to go back to work on Monday. I know its a day by day recovery but for some reason I feel as though today someone pulled the plug on my energy drain. I have been so sleepy and weak all day. I managed to get out to get a haircut this am and that did me in. That was my first outing so to speak. Out for 2 hours and then came home and slept. How is your pain level? Are you still taking pain meds? My OS has me on a combo of anti inflammatories, VITA C, laxative, Asprin, gabapentin, Tylenol and dilaudid for the pain med. I am still taking them during the day but am managing to sleep without the middle of the night pain med. I will be watching your recovery too....its neat to see others that have the same Surgery date and to be able to follow their recovery. Take care.:tada:
     
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  20. RAD

    RAD member

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    I’ve been off pain meds since Day 6. It hasn’t been easy but it’s been manageable with just Tylenol and lots of icing and elevation. I just hated the feeling of being on the pain meds, they made me feel so sick. I’ve been pretty lucky with energy. I live in NYC, took the bus for the first time Uptown for a dermatology appointment, came home, drove (I need a car, my office is outside NYC) to my PT which is by my office about 45 mins away, did PT, went to Lab Corp since I’m on Coumadin (I had a PE 4 years ago) for 5 weeks and the test my blood twice a week. Then drove home. Now I’m elevating and icing. Hopefully I’ll sleep well tonight with all this running around! I’m sure your energy will improve soon. Have you had a hard time sleeping at night?
     

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