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[TKR] Kakalele’s recovery

Discussion in 'Knee Replacement Recovery Area' started by kalakeke, Apr 3, 2019.

  1. lovetocookandsew

    lovetocookandsew FORUM ADVISOR Forum Advisor

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    I'm sure you've heard this many times, but every knee is different, therefore will heal at different rates. Even two knees on the same person done at the same time heal at differing rates. For a doctor or PT to say you're behind is not true. Your knee is exactly where it should be. How do I know this? Because your knee is going to heal at it's own pace and nothing you do to push it will make it heal any faster; although doing too much PT can set it back somewhat. As long as you aren't overdoing PT and causing it to swell and be more painful, and are doing the activities of daily living, you are fine.

    Celle left you a reading list, and I hope you read them all. I actually read the activity progression one daily to remind me not to do too much, or too little, at any given point. If you continue with PT, (and, personally, I wouldn't) you need to take charge and tell the PT no more discouraging talk, only positive reinforcement will be allowed! No one can make you feel bad without your permission, and I would stop that PT in his/her tracks when they try. I am almost at a year post-revision and don't know my ROM as I never had PT this time, nor did I let anyone measure my ROM. Rom is just a number to me; my goal was to get to a place where I could walk, sit, stand, bend, straighten and flex enough to swim, ride a bike, and so on, but I never set a time frame as I knew it would take time and I allowed my knee as much time as it needed to heal. Knowing numbers wouldn't make a difference to me anyway-only actual ability to do said activities, so I've never worried about any of them.

    Take charge of your recovery and set your own limits and goals; allowing others to decide limits and goals for you is a recipe for continuous letdowns and discouragement. Tell your PT, and doctor as needed, that your knee is healing at it's own rate and not along any pre-determined rates for everyone! Good luck and keep us posted!
     
  2. Celle

    Celle FORUM ADVISOR Forum Advisor

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    I'm sorry you're feeling this way.

    Quite honestly, I think you should quit going to PT. Your therapist is not encouraging you as she should be doing. Instead, she's instilling worry and doubt into your mind.
    Your knee's recovery is unique and it's wrong for her to be setting artificial limits on what you "should" be doing.

    You've gone back to work very early and doing that is giving your knee all the exercise it needs. PT on top of that is overkill on the exercise.

    It's not exercising that gets you your ROM - it's time. Time to recover, time for swelling and pain to settle, and time to heal. Your ROM is there right from the start, just waiting for all that to happen, so it can show itself.

    Instead of going to PT, come home from work and spend as much time as you can resting, icing and elevating your knee, to try and reduce the swelling that is limiting your ROM.

    Most doctors don't expect 90 degrees of flexion until about 6 weeks. At 85 degrees, you're so close that it's not worth worrying about.

    Every knee is different, so there's no standard progress you "should" have attained by 6 weeks. As long as you're making progress, no matter how little, you are doing all right. Since complete recovery takes a full year, there's no need to worry about making progress quickly. You have all the time in the world.

    In spite of what your surgeon and your PT therapist have no doubt told you, there's no need to rush to get ROM (Range of Motion) because it can continue to improve for a year, or even much longer, after a knee replacement. There isn't any deadline you have to meet:
    Myth busting: the "window of opportunity" in TKR
     
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  3. Jockette

    Jockette FORUM ADVISOR Forum Advisor

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    My ROM has improved in my second year post op and has relaxed more as well. Dont worry about your ROM, it will come as you heal more. Mine sure did!
     
  4. kneeper

    kneeper FORUM ADVISOR Forum Advisor

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    It's not unusual to plateau for a while--I didn't make 90 until week 6 and didn't crack 100 for another couple of weeks. It was the swelling holding me back. Once that went down my ROM jumped.
     
  5. kalakeke

    kalakeke new member
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    Thank you all so much for all that advice. It actually puts me to tears...along with everything else that I’m so emotional about. I’m going to OS today and I’m feeling more confident now. Yes, my knee, whom I call Melonknee (totally a large Melon on my knee) will heal on its own. I can take a deep breath and carry one. Thank you all and best wishes to all the Melonknee’s out there in the bonesmart world.
     
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  6. sistersinhim

    sistersinhim FORUM ADVISOR Forum Advisor

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    You are exactly where you are supposed to be. Swelling is keeping that bend less. Even if you don't see a lot outside, the inside of the knee is swollen. That is a small space in there and it inhibits range. You are getting plenty of exercise just going to work and taking care of your daily needs. I'd quit PT and let your knee calm down the best it can without adding that extra stress to it and to you!
     
  7. Jockette

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  8. kalakeke

    kalakeke new member
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    I will read the articles ASAP. I went to see my OS today and he said if I don’t get my extension where it needs to be soon that I’ll never get it back. Any thoughts on extension. I have pressure to bend and pressure to extend. My goodness. Thanks to all.
     
  9. lovetocookandsew

    lovetocookandsew FORUM ADVISOR Forum Advisor

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    Sorry, but I totally disagree. Extension often takes longer to achieve than flex, and you're still in the early days. Ignore the naysayers, do your normal daily activities and be patient. It will come, it just takes time. Doctors and PTs that have artificial timelines drive me nuts as each knee recovers at it's own rate, and your knee is no different in that aspect. Good luck and be patient as you have a ways to go before your year is past.
     
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    Last edited: May 16, 2019
  10. Jockette

    Jockette FORUM ADVISOR Forum Advisor

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    There is no rush to get bend or extension. It will come. Don’t believe their deadlines, it’s not true.
     
  11. Irish471

    Irish471 senior

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    @kalakeke , it sounds like you have a lot of swelling still in the knee. Could it be from your early return to work? I just went back to work at 7 weeks and I have a desk job. It definitely affects the amount of swelling in my knee. Also, I just started pedaling forward on the exercise bike this week (8 weeks post op). I started by going backwards. And I don't do it perfectly, either. I tend to point my toe down to help get that full revolution. As for extension, mine is always terrible when I wake up and I have to spend a good 10 minutes stretching to get it straightened out. I don't think I've gotten to 0 on extension yet and I am almost at 9 weeks. Is there an option to switch to a different physical therapist? It doesn't sound like yours has been especially helpful.
     
  12. Celle

    Celle FORUM ADVISOR Forum Advisor

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    Maybe that's what your OS was taught, but it's wrong.

    There's no need to rush to get ROM (Range of Motion) because it can continue to improve for a year, or even much longer, after a knee replacement. There isn't any deadline you have to meet:
    Myth busting: the "window of opportunity" in TKR

    Don't be frightened into exercising madly, in the hope that will increase your ROM. All that will do is upset your wounded tissues and make them hot and swollen.
    It's not exercising that gets you your ROM - it's time. Time to recover, time for swelling and pain to settle, and time to heal. Your ROM is there right from the start, just waiting for all that to happen, so it can show itself.

    And lovetocookandsew is correct - it's not at all unusual for extension to take longer to achieve than flexion. That's because the big muscles and tendons at the back of your leg have to be stretched slowly and gently. Try to do it too fast, and You could cause problems.
     
  13. kalakeke

    kalakeke new member
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    I did go back to work too early and the circumstances in my life don’t really allow for rest and relaxation after work. It’s unfortunate, but my life. I will continue to do what I can and not allow the medical providers to pressure me into what my gut tells me is wrong. Thank you all.
     
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  14. kneeper

    kneeper FORUM ADVISOR Forum Advisor

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    What kind of work do you do? Is there any chance to put your leg up at lunch time and ice?

    As far as the exercise bike, are they having you try just rocking back and forth as far as you can? I was rocking back and forth for quite a few weeks before I got that full rotation. Again, the swelling is part of the issue with that.
     
  15. kalakeke

    kalakeke new member
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    I have a question/concern. I still have a swollen knee and I thought it should be down by now. Could it because I’m not icing? It’s swollen whether I walk or not. The tightness in front is still there and I figure it will continue to be there, but swollen 24 hours a day. Should I be icing more? I also realized I have been elevating the wrong way. Ugh

    Thanks
     
  16. kneeper

    kneeper FORUM ADVISOR Forum Advisor

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    It can take a long time for the swelling to go down. Icing and elevating should help.
     
  17. Jockette

    Jockette FORUM ADVISOR Forum Advisor

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    Reducing your activities will also help. The leg swells easily when the knee is not able to handle the activity level.
     
  18. Celle

    Celle FORUM ADVISOR Forum Advisor

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    Ice when you can. In fact, ice all the time you're elevating your leg. It will help.

    It's not quite 8 weeks since you had this major surgery and it's still perfectly normal for your knee to still have some swelling. Most people find their knee still swells for as long as 6 months after surgery, if they overdo things.
    However, I think that the fact that you had to go back to work early has probably contributed to a lot of the swelling tightness.

    I know you have to work and your life is busy, but it really is important to rest, ice and elevate your leg when you get home from work. Technically, you shouldn't be back at work for another month, so ask for help after work if you can. It really is important.
    Nurturing mother: how to let go and accept help
     
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  19. kalakeke

    kalakeke new member
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    Hi everyone, so I will be 9 weeks post-op tomorrow and I’m flying 4 hours. I am not looking forward to it. I would have cancelled, but it’s my daughters graduation. I am still very much swollen and barely tinkering on 87 flex. I have no idea how I’m going to get through this. Someone told me that compression socks would help. Thought?
     
  20. kalakeke

    kalakeke new member
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    I posted twice and couldn’t delete it. Lol
     

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