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TKR Just curious

Photogoddess

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Hi. I am new to bonesmart. I had my TKR on my left knee on 9/17/2024. I had 2 weeks of in home PT, it wasn't aggressive, and started outpatient PT on Oct. 7th 2024. I go 2 times a week and do my own PT they gave me to do every day at home. I am making slow progress and still haven't made my 90 degree bend yet. I am at 82. Ever since surgery I have had this burning on the inner side of the knee, it really intense when doing extention exercises, which I am not hitting the completely straight degree yet. I had my right knee replaced 15ys ago and just remember that it took a long time for it as well. I am still not sleeping very well at night. Just wanted to ask how nice it is to have found Bonesmart where I don't feel alone. Just feeling like I could be doing more but don't know if I really should. This is a pic of my knee from 2 days ago. Thanks for listening and best to all that are healing.
 

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:welome:@Photogoddess !

If anything, at one month post op you're probably doing TOO MUCH for your new knee with a daily PT regimen!

I'll explain why in a second post.

Meanwhile
I will leave you our Recovery Articles that have helped tens of thousands of other knee replacements. We are here to help you through this journey the best we can. The very best thing for your knee right now is to rest, ice, and elevate. Exercises can come later. There is no rush to achieve ROM because it will come naturally as your swelling decreases. Your OS was able to bend your knee while checking for movements during your surgery, so it will be fine. It just takes time.

Each person is different as is their recovery. Most find that the Bonesmart approach works best for them, but others find that a more aggressive therapy helps them more. It's your recovery and your choice on how you recover. As you read more on other members' recovery threads, you’ll get a better perspective of what to expect. The following are our basic guidelines and should help get you started.

KNEE RECOVERY 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.

If you want to use something to assist with healing and scar management, 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.

2. Control discomfort:
rest
ice
take your pain meds by prescription schedule (not when pain starts!)​

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

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 a 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 history before providing advice.
 
@Photogoddess

Knee looks great!!!!

My entire ortho team united behind telling me, knowing I was active, that in the initial weeks Less is Better. They were right!

The main thing that causes poor flexion, poor extension, and pain is swelling. Overworking a completely traumatized knee joint increases inflammation, swelling, pain, and is counterproductive to achieving better range of motion.

I should add that my orthopedists' goal, as seems common here, is 90 degrees at 6 weeks. It seems the majority of our members don't meet that, yet have excellent recoveries.

My initial regimen was rest, ice, elevate. Walk once an hour. Do ankle pumps and quad sets.
If I wasn't taking my walk or addressing hygiene and food needs, my knee was continually iced and elevated to reduce pain and swelling.

When I could sit up in a chair for a few minutes I added heel slides (much easier and less inflammatory than doing them lying down).

I hope you're not doing much more than that.

Some PTs act as if we're athletes who had a bad sprain, not people who have had bones drilled, implants hammered in, muscles, tendons, ligaments, connective tissue and nerves traumatized.

Muscles take 6 weeks to heal; tendons and ligaments up to 12 weeks. It's inappropriate to push or pull on the knee or work on repetitive strength exercises (other than walking and light daily life at home as tolerated) until the danger of injury has passed.
 
Welcome @Photogoddess! So glad you found us!

I've added a signature to your posts with the dates of your surgeries. Please confirm that your right knee was done in 2009 (15 years ago).

Just feeling like I could be doing more but don't know if I really should.
I agree with mendogal that you are probably doing more than your poor knee is ready to handle. You likely still have quite a bit of internal swelling at this early stage of recovery, and when your knee is swollen, it can't bend.
Overdoing exercises in the early days can actually increase internal swelling, making it even harder to bend.

Please read through the articles shared above. Even though you've had a TKR before, things have changed in the past 15 years and I think you will find the information very helpful. I've had both knees done in the past 3 years and can truthfully say that BoneSmart made me recoveries easier.

Stick with us. We are here to help!
:flwrysmile:
 
Thank you for both replies. I will slow down and let my knee heal more before doing any major pushing. As for my right knee, yes I confirm that it was done 15 years ago.

Take care and thank you so much again!
 
Please do come back and give us status reports. I found that journaling my recovery here really helped me see my progress.
 
Hi All. Just curious how everyone is coping with the no sleeping? What do you use to get your leg comfortable at night? I am currently using a very thin body pillow under my leg to give it a little support but not too much of a bend. But I still have trouble getting comfortable. Also, I was able to bend my knee, assisted to 86, but still haven't hit 90 yet. Surgery was Sept. 17th. PT says I am making progress, but the knee is stiffer than they would like, but the knee is being stubborn. I get kind of emotional about it, but keep doing my best and following everything I am supposed to do. I just fear I am going to have to have the MUA and really do not want that. Thanks for listening and any feedback on what is helping folks sleep is truly appreciated! Warm healing wishes to all going through this.

Take care
Polly
 
I am only 2 days behind you and can only bend to 90. My surgeon was fine with that at my appointment Monday. I'm not even being made to go to PT, though some of his patients do. You have PLENTY of time and are normal at this point in recovery.

Others will jump in with the articles to read and recovery guidelines, but the big one is DO NOT FORCE te knee to bend, do not let anyone push it or cause you pain, it's a 12-month recovery, and there is no "3 month window of opportunity" to get your range of motion back.

As for sleep, some of the biggest and long-lasting complaints after a TKR are getting to sleep, being comfortable while sleeping, getting good quality sleep, and not being able to sleep all night in bed. I still need stronger pain medication at night too. My "pattern" is moving around between the bed and 2 couches all night, and not even trying to sleep until I'm falling over on the couch with exhaustion. I use a big pillow (lengthwise) under my leg in bed, as elevating it hurts too much for those 3-4 hours of sleeping in bed. I tend to get 4-5 hours at night between bed and a couch, then I take a couple of 2-hour naps during the day. For those 2-hr naps on the couch, I elevate with the Lounge Dr and use my ice machine. I'm not currently working though, so this isn't feasible for everybody.

For the record, this is my 2nd TKR but my 3rd arthrotomy (open knee surgery with a 7-inch incision). I can easily say my sleep is progressing the same with this one as the last 2. Hang in there. :friends: I promise it should be better soon. I've seen a drastic improvement in everything the last 4-5 days, and I would have told you that wasn't possible a week ago, or even last Saturday.
 
@Photogoddess I merged your newest thread with your original recovery thread, as we prefer that members in recovery have only one thread.

This benefits you because all your information is in one place, easy to find, and maintains a nice journal for you.

This also benefits our staff, as your information is all in one place, and we often go back through your thread for previous details, so we know what you‘ve been through which helps us advise you better.

So, please keep all your posts in this thread. If you’d like a new title, let us know what you want, and we’ll change it for you.

Many members bookmark their thread in their computer browser, so they can find it when they log on.
How can I find my threads and posts?


Best wishes on your continuing recovery! :flwrysmile:
 
I definitely agree with @Rockgirl4 that more elevation really helps with getting better sleep. I would ice for at least 45 minutes with either a three pillow stack or a Lounge Doctor, then keep the elevation for at least my initial period of sleep.

In addition, sleep whenever (and wherever it's safe and comfy!) - many of us sleep and/or nap in a recliner, or surround ouselves with soft pillows.

Icing, elevating, napping.... All help, but you might also consider some nonprescription remedies....

If you're lactose tolerant, a glass of warm milk! If you're not diabetic, a teeny bit of honey makes it even more comforting... plus milk is high in magnesium! Helps us relax!

If you aren't a milk drinker, or want an easier way to, an evening magnesium supplement has been very helpful for some members.

OTC diphenhydramine, an antihistamine also used as a sleep aid (Benadryl) because it makes you drowsy; it's also included in some cold, flu, etc "nighttime" combination meds.

Low dose melatonin, sustained release - not for long term use but I have used for a week at a time without ill effect. It should be taken an hour to hour and a half before going to bed, and during that time stay in a dimly lit area to allow this hormone to activate.

Valerian root - an herbal remedy, it can be taken in capsule form but that dose might be high compared to my preference, herbal "sleep" blends that include a smaller dose of valerian and make me pleasantly drowsy. Plus the other tea flavorings make it nice tasting! Celestial Seasonings and Traditional Medicinals sell teabags by the box. Their sleep blends without valerian have never ever made me sleepy.

What finally worked for me: a mug of sleep tea with valerian followed by a 3 mg sustained release melatonin, immediately going into a dimly lit room and relaxing. When I got sleepy, turning off the light and lying down with my legs up on the Lounge Doctor. After a few hours I would wake, move the Lounge Doctor away, and sleep more.

Be aware: even benign herbals and supplements can interact with your routine or post op prescription meds, either making their effects weaker or stronger. If you're on meds you may want to check with your doctor or pharmacist, or even check online for interactions.
 
Hi all. I have finally got my 90 rom bend on 10/30. Still making slow progress, but happy I am heading in the right direction. I do not want to rush anything. One thing I am dealing with since surgery is the internet burning pain on the inner side of the knee. It doesn't happen constantly, but when I am doing pt, especially flexion and extention it's relentless. I have to stop for a moment and massage that area. I talked to my surgeon about it at my 6 week checkup on 10/31 and he said that area was a really bad area and he had to do a little more work there. He told me that I won't hurt anything, but not to kill myself if it gets too painful. So hopefully this will subside as time goes on. I do have one question, I am thinking it is OK to take a day off from pt I do at home? I don't it twice a day, along with day to day stuff. I ice frequently and elevate, but just feel I could use a day to just rest. Hope everyone is doing well and being kind to yourself.

Thank you
Polly
 
Congratulations on your flexion!

Our pain sometimes feels like burning when the little sensory nerves that were cut or damaged in surgery start waking up and regrowing and, yes, it should slowly subside.

I am a big fan of alternating higher activity and lower activity days throughout the long recovery period, so a wholehearted YES to doing formal exercises every other day.
 
is OK to take a day off from pt I do at home?

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.
 
Thank you so much Jockett and Mendogal for your encouraging words. I've been reading the posts here from time to time and see that rest is a good thing, but just needed to ease my over processing mind and worries. Thank you again! Take care!

Polly
 
Don’t look at slowing down the PT, or even stopping the formal exercises, as “doing nothing.” Look at it as giving your body the best opportunity in which to heal.

Truly, while you’re healing, every movement in your every day activities is a natural form of PT. There is plenty of time for more exercise/training, later on after
you have healed.
 
Hi there Photogoddess!
Welcome to BoneSmart and thanks for joining us! :)
Thankfully you're comfortable with allowing yourself the restorative rest you need and deserve. Overworking your healing knee through too much PT or aggressive PT can cause strain, slow down the healing process snd potentially stall your recovery and I know you wouldn't want that. The rest, icing and elevation you are engaging in will help control any swelling which will help with pain management and assist in the healing process.
Best Wishes for a great week! Keep in touch, we love updates.
@Photogoddess
 
Hi photogoddess, we are surgery sisters! Had my right TKR on the same day as you. I did develop a haematoma but that has dispersed. I will be 8 weeks tomorrow and I do sometimes miss an out PT session day if I have lots of pain and feel maybe I overdid it a bit. I’m still standing! I bend my knee really well as I feel the swelling has reduced a lot, but not gone. It doesn’t straighten completely yet but it will come. My PT sessions have been a mixed bag, some are great but some not so much. The group session last week was awful with a PT who I think was trying to train me for the SAS. She pushed down on my knee roughly saying No Pain No Gain, so I shan’t be seeing her anymore! My more difficult bit is walking as the left knee also needs replacing and is pretty painful. I’m still using a crutch most of the time. How are you doing with the walking?
 
Hi there ouchie! Thank you for reaching out. I am doing ok with the walking, still using a walker for now. I too cannot fully straighten my leg yet, we measured at pt last week and it is at 13, but my pt has said in the beginning I would have this big extension degree drop and then it would go slowly after that. So at least I am going in the right direction. I finally got my 90 bend on 10/30 and I think I may be a little more than that, but we haven't measured again yet. So far my PT is really good and gentle. She doesn't push if I am experiencing any discomfort. She comes up with different ways to move my knee. I believe I will move to a cane today at PT, but we will see. I also have been dealing with a burning pain since surgery on the inner side part of the knee, but we are working through it. How is your stiffness? And how are you sleeping?
 
Hi Photogoddess,
Happy Two Month Anniversary!
I hope you had a good week and you're finding it comfortable transitioning to a cane. I am, sorry about the burning pain you're dealing with. I hope it's easing for you.
Have a nice week!
@Photogoddess
 
Hi Layla, thank you! It's hard to believe I am at the 2 month mark. Still making good progress. Got a 97 flexion today at pt. Extention is going super slow though. I am at 12. My therapist gave me a different position I can try to help get that to 0. How are you doing? Thanks for reaching out and I hope you have a wonderful week!
:wave:
 
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