PKR JusticeRider’s rehab adventure

[Jockette]

Done!

 

[JusticeRider]

Thank you! The adventure continues…!

 

[JusticeRider]

Since this is a new thread now, I guess I should recap. I had a partial (patellofemoral) knee replacement on August 10th. Previously had an FAI left hip repair in 2015 and again in 2021. I had an arthroscopic on this knee in January 2022. I’m 44 and never thought I’d have 4 surgeries before age 45! I realized the other day that my femur has been cut into on both ends. Yikes!

Anyway, the partial replacement is going really well overall. The last couple of days I’ve been walking around about half the time with a cane and the other half walking independently. That’s pretty exciting for me! Just building up strength in the quad. When it starts to feel tired and shaky, I grab the cane for a bit. Pain levels have been really low, which is a blessing since the narcotic pain pills made me violently ill. I am getting outside more for little walks which has been good for mental health! Overall, just starting to feel more like myself!

The first few days were pretty awful because I was so sick from the Tramadol and Oxy, couldn’t keep anything down, not even water. Which meant no pain relief in my system at all, not even Tylenol. I was vomiting and hallucinating and in pain. I called the nurse on call the night after surgery and I was so incoherent she had my husband call 911 because she thought I might be having a stroke! The medics were very sweet and said I was dehydrated and my BP was a little low and I needed try to get some water and food to stay down (haha). They also said the Tramadol might be making me hallucinate and the Oxy was probably making me sick to my stomach, so I needed to ask for some different drugs. Well, the new drugs unfortunately made me sick too, so I decided to just bare knuckle it with Tylenol and ice after that. I finally got all the drugs out of my system by about day 5 and things started looking better after that! My husband took 10 days off work to care for me and I am so glad I had help!

I feel like I am seeing a light at the end of the tunnel. The only worry I have had is the surgeon and my pt said my flexion was behind where it should be at this point and I needed to push through the pain or risk facing manipulation under anesthesia. Thank god for this group and all the great information, support, and personal stories! I had pt today and I said I didn’t want to measure my ROM for a while, and I wasn’t going to push through the pain anymore. I said I believed it would get there in it’s own time…and they totally respected that! They said it is my journey and they are here to help me and would honor my boundaries. Yay! I have known these guys since my hip surgery in 2015, and they are great. But if I hadn’t been given the affirmation at Bonesmart, I wouldn’t have known to even set that boundary. Thanks guys!

 

[Jockette]

Since this is a new thread now,

This is not a new thread, just the title has changed. All your information is here in this thread. It might seem like a new thread since the title change coincided with the posts going to page 2.

 

[JusticeRider]

Oh! I see that now, Jockette, thank you!

 

[JusticeRider]

Ok, my turn to join the ODIC. ):

Since I haven’t been able to ride my horse, I’ve had a wonderful woman I met through a friend riding him. She rides him on our local trails when I am unable to trailer him out somewhere, but they are pretty limited so when I’m able, I trailer him up to different trail systems for her to ride. She came here and brought him in, got him ready and packed up the stuff, and helped me get the trailer hitched up.

I didn’t have to do any of it, but I still stood around (shuffled around because I can’t stand still) and talked to her while she was doing everything (and maybe packed a couple things too). Then I drove them about 40 minutes away to a trailhead and stood (shuffled) around again for a few minutes while she was saddling up. Then I drove to the nearest town, about 10 minutes away and got gas and then wanted to grab something to eat.

Of course, I’m driving my truck and towing the big trailer, so parking options are limited. I ended up having to walk almost a block to the cafe up a slight incline and then back down to my truck. There were a lot of people around, so I think my pride unconsciously kicked in and I was trying to walk ‘normally’. So too fast and too big a stride than what my knee currently likes. Unfortunately, when I got back to my truck, I realized that the restaurant hadn’t given me my credit card back. Nooooo! That meant I had to walk back a block up the incline, get my card, and then back down to my truck.

By this time, my knee was hurting a LOT. Every stride when it would bend I would get a sharp, squeezing pain. I could feel it throbbing. I took two Ibuprofen and two Tylenol, which I fortunately had with me. But I still had to drive 10 minutes back to the trail to pick up my horse and friend, then drive 40 minutes back home and unpack/unhitch. I realized it had been almost 7 hours since I had iced and elevated. And this was the first day without the compression hose. The swelling and pain were the price I paid for all of it.

I canceled pt today, but unfortunately I have another appointment scheduled somewhere that has an iron clad policy of no cancellations within 24 hrs. Omg, I do NOT want to get back in and drive another 40 minutes each way. And then sit in a chair with no place to put my leg up for an hour. This lady made it VERY clear that she wouldn’t accept same day cancellations under any circumstances. Grr. Thank god I have massage therapy scheduled tomorrow!

 

[benne68]

So sorry you ended up in pain, @JusticeRider.

That was an awful lot of activity for barely a month into recovery. We've all done it, because it's hard to figure out where the line is between doing enough and doing too much -- until you cross it.


Enjoy your massage tomorrow!

 

[JusticeRider]

Thank you, benne68! It didn’t seem like it was going to be that much but it added up to be way too much. I am walking slowly and carefully today. Using my cane even around the house. I survived the trip and appointment today. Luckily she had a footstool I was able to put my leg up on. And I brought an ice pack with me and put it on my knee while I was driving home. Now icing and elevating. I was hoping to help my husband mix up the horses’ grain rations tonight, but I think it will have to wait for another day. It’s not very nice on the ODIC bench. But at least I’m not alone here I bet! (;

 

[FCBayern]

FCBayern, how did you do it? Get the ROM over time I mean? Wondering what I can do, besides letting PT wrench on it or forcing it myself? I cannot wait to hike again, it is one of my favorite things!

I only had one thing that I did besides just going about my daily activities. I was working an office job at the time of my recovery and two or three times a day I would roll my chair back a little bit, put my foot flat on the floor and then roll the chair forward until I could feel the stretch in my knee, not even to the point of discomfort, just enough to feel the pull. I would stay that way until it was uncomfortable. Seemed to help the stretch without causing any pain or swelling.

 

[JusticeRider]

Ok, thanks FCBayern! I can use all the good tips I can get through all of this! Still hanging out at the old ODIC from my activities on Wednesday…

 

[JusticeRider]

And speaking of the ODIC. Some questions have come up that I’m hoping for some advice about.

Before I overdid it, when I would walk, there would be an annoying feeling of tightness in my knee just at the point where my operated knee was behind me and bending. It was a little uncomfortable, but nothing unbearable. Since I was naughty a couple days ago, at that same point in my stride now I am often getting a sharp/pinching/squeezing pain. It makes me give a little ‘ah!’ when it happens because it feels really awful. It has made me compensate by walking very slowly and sort of hitching that leg around without bending it much at all. This seems bad for the rest of my body, but it keeps that nasty little pain away.

1) First question, is it ok to favor it like this for a couple days until it gets better? Or should I try to walk more normally and just take the pain? Or should I try not walk more than absolutely necessary? I know movement is important but I don’t know the best way to deal with this. I have dialed my activity way back and am icing and elevating as much as I can, as well as taking Tylenol again after not needing it for several days.

2) The day I overdid it also happened to be the first day I was allowed to take the thigh high compression stockings off. Do you think it still needs some compression? Would it help to put a compression sleeve on my knee? I know there’s a lot of swelling happening. What are your opinions on the use of compression sleeves in general?

Thanks so much, guys! It’s so nice to be able to ask questions and not feel you either have to call and bother nurses, PA, etc to ask about every little thing, or just try to blindly figure it out and worry you’re doing the wrong thing!

 

[Jockette]

First question, is it ok to favor it like this for a couple days until it gets better?

I’m sure the technical answer is, walk heel to toe. However, that can be hard to do when it hurts. I know that I did favor my leg when I was tired, and hurting, and as I healed, I had to favor it less and less.

What are your opinions on the use of compression sleeves in general?

Many members here do find wearing compression sleeves helpful. My personal opinion is, the minute I was told I didn’t have to wear the ones right after surgery, I didn’t wear anything like it again. The thought of something the least bit snug on my sore leg just didn‘t appeal to me.

So, do what you think is good for you. Trust your own judgement. Give the knee mobility at times, let it rest and recover at times. There really isn’t any right and wrong in this recovery. We all do different things, at different times.

 

[Roy Gardiner]

My problem is everyone else is telling me I have 3 more weeks or else!

And everyone here has said the opposite.

FCBayern, how did you do it? Get the ROM over time I mean? Wondering what I can do, besides letting PT wrench on it or forcing it myself? I cannot wait to hike again, it is one of my favorite things!

No forcing, please.

My own ROM, Extension and Quad exercises just for example, there are loads

And you could use a static bike, if you have one:

• Set the bike to zero resistance
• Set the saddle low enough so that a single rotation is a challenge; difficult but not painful. When a rotation becomes easy right from the start, lower the saddle a max of 1cm.
• Gently turn the pedals, through discomfort but without pain.
• Continue until the knee is 'warmed up' and the rotation is now easy, or for 2 minutes, whichever is the shorter time.
• Repeat several/many times a day, but don't go mad. Diminishing returns will apply; my guess is that half a dozen reps would be enough
• Do not pedal fast or for more than 2 minutes, this is a stretching exercise, not training.
• And if you get any pain or swelling in the 24 hours after doing this, cut it down until you don't

Here is a bit more chat and some pix and how 'healing' and 'training' are different

 

[JusticeRider]

I have to confess, I do have a stationary bike, which I loved and relied on for rehab after other surgeries. I have not been using it this time. That is for the simple reason that, even with seat high enough that I can just barely reach the pedal on the bottom of the rotation, I can’t do a full rotation. I go back and try every so often and when once again, I’m not even close, I feel so devastated that I don’t even want to look at the bike again for a while. Until the next time I try, thinking ‘maybe this time!’ and am once again disappointed. I know this is silly and over-dramatic and it probably helps just to rock the pedals back and forth and I should just get on with it and at least do that. But when I do, it feels like it’s not doing anything and just frustrates me! Maybe this is that perfectionist athlete in me wanting to ‘achieve’ the goal of a full rotation and feeling anything less is pointless? Is it really helpful to sit there and rock the pedals back and forth? It doesn’t help that the bike is out in the wood shop and so I can just…not think about it and avoid the frustration

 

[Jockette]

Bikes can be very helpful in this recovery but many of us recovered our ROM fine without one. If riding yours causes you distress in any way, then don’t ride it. One month post op is early days. You might like riding it later in your recovery. Or not. It’s up to you.

 

[sistersinhim]

It was about 2 months before I could make a revolution and then it was backward for a few days at first. I had to hike up my hip to do it at first but soon was able to put it down some and also soon went forward. Just rocking back and forth is a great workout, so don't be disappointed. It all takes time.

 

[JusticeRider]

Thank you Jockette for the reminder to be gentle with myself. I’m walking as best I can manage while being careful and very slow. I think I will try wearing a compression sleeve when driving or doing a lot of walking and leave it off for adl’s and resting. And maybe I’ll try the bike again (or maybe I won’t!)

Roy, I read a lot of your content and enjoyed it very much! You’ve inspired me to go and make a cup of tea and do some gentle stretching while I sip it and read my book. Cheers!

 

[JusticeRider]

sistersinhim, I can’t tell you what a relief it is to hear that you weren’t able to get a full rotation on the bike for the first couple months! I’m just over 4 weeks and it’s nice to know that it’s ok if I’m not there yet

 

[JusticeRider]

Well, I had no idea I’d be sitting on the ODIC bench this long. As of today, it’s been a week since I did too much and caused a lot of pain and swelling. I thought I’d take it easy for a day or two and I’d bounce back. Well. At least I am finally heading in the right direction as of yesterday. Incrementally. I am trying to feel grateful that I see improvement. I am still nowhere near where I was before. It is really frustrating. My attitude has been better the last few days. But on Sunday I fully gave in and just let the post-op depression swallow me up. Spent most of the day in bed crying. To take such a huge step back when things were going so well is really hard. I’m not in much pain when I am resting comfortably or even standing, but walking is not good. I am extremely slow with an ugly limp. It hurts when my operated leg is behind me and I am starting to push off and bend it. It still feels like there is a LOT of pressure/swelling in the joint that is pinching sensitive tissue or something. I am using the cane STILL, and remembering sadly (angrily?) how a week ago, before I overdid, I was about 90% off the cane. I have been doing my adl’s and very gentle stretching. Walking in the house but in very short chunks spread between periods of icing and elevating. So much icing. And elevating. Using the compression sleeve seems to help some. I’m not sure what else I can do besides trying to keep the faith and wait it out. Any ideas?

 

[Jockette]

You are doing all the right things, so try hard to keep the faith and be patient.

I had a big setback at 4 months post op, which I thought was way past the time I’d have a setback, and it took me a month to improve.

Then, my son got married, which basically entailed a 3 day event, a 90 minute drive from my home. So, lots of driving back and forth, too much standing, not enough ice and elevation, and by the time I got home to stay, I could hardly walk. It took another month to begin to improve, but these two setbacks slowed my recovery for the rest of the first year.

Setbacks can take quite a while to recover from.