TKR Keith’s Recovery<

[Kperform]

7. I have done very little with housework, cooking, cleaning, etc. I live at home with my family and they have been doing the chores etc.

8. I did include a list of my home exercises. Please see above list. I do them 2 sessions per day. 3 sets of 10 repetitions for all of the listed exercises.

For physical therapy I was doing heel slides 3 sets of 10 repetitions. They only have been manually working on my flexion. I go to physical therapy 2x per week.

This Tuesday I will be at 3 weeks post op. I hope this helps

 

[Kperform]

Hi @HoneyB! Thank you for your feedback. You make some excellent points. I do find it difficult not to compare myself with others especially when I have a set back. I have that Type A personality as well. Right now my knee swells up very easily. Last weeks PT session seemed to trigger it and I just can’t seem to keep the swelling down. Because of this my progress with my ROM is probably going slower. I did order one of those ice machines so I am hoping that will help out and I do have a tens unit.

I do have difficulty recognizing the difference between discomfort and pain with a knee replacement. I have had acl reconstructions in the past and it seems like knee replacement is a totally different animal. I am trying to educate myself the best I can and learn from my experience. Tomorrow starts week number 3 post op and I see my OS ON Thursday. Thanks again!

 

[dmichael21]

You and I have a lot in common, same age same surgery date same amount of past knee surgeries and I also had both rotator cuffs repaired and I train year round for my sport ( I was competing in vet class events as recent as last November) so I only know how to train. I weigh the same as I did in my senior year in high school . Just like you I deal with stiffness and swelling cause I let the PT folks push me and then I do the recommended PT on my own and I don’t take any short cuts. I’m driving my wife nuts because like you I pout and moan for hours and I have a big enough home where I hide so I’m not depressing my amazing wife.

 

[Kperform]

Hi @dmichael21! I appreciate you reaching out to me.

Congratulations on making it to week number 3. It definitely sounds like we have a bunch in common including not trying to burden anyone else in the household. I have found my hiding places in my home too. Lol!

I was checking your recovery thread and I think your sport was motor cross. I know that is a sport where your body can take a pounding. My primary sport was basketball and I was playing up to December 2017. Overall I have active with many other recreational activities. Psychologically it's tough being away from something that you love and for me my identity has always been tied into my sports activities, working out, and being active.

When checking out your recovery thread it does seem like you have been pushing yourself pretty hard and that's why your knee has been getting cranky. Like yourself pushing hard through the training is the only why I know but what I have learned over the years is that at times less is more.

After reading many posts on BoneSmart, knee replacement can be tricky rehab in more that we do in physical therapy the more swollen, stiffness, and pain we can have. As a type A personality I have struggled with this over the years and has gotten me in trouble from more often that what I want to admit.

Last week I had a substitute physical therapist and she was fixated strictly on beating the previous range of motion at my last PT session. The previous session was very tough and we should have backed off a bit in that session. After my last session I have been struggling more with swelling, stiffness, and pain. Over the last few days I have to talk myself down in not over doing it. I am going to physical therapy tonight and seeing my OS on Thursday.

By the way I do like going to physical therapy. As crazy as that sounds. Please keep me posted about your recovery.

 

[Josephine]

1.Right now around a 5

Not bad for three weeks out!

2.
Oxycodone 5mg 1-2 tab 4-6 hrs
Tramadol 50 mg 1-2 tab 4-6 hours
Skelaxin 800mg 1 tab every 8 hours
Gabapentin 100mg 1-2 capsules every 12 hours

Skelaxin is a muscle relaxant that is commonly used for depression as well. I suggest you don't take this as it's a) addictive and b) unnecessary if you're taking it for pain.
Gabapentin is likewise. It's a nerve pain drug. Also addictive and also unnecessary as a straightforward pain killer.
You should also NOT really need both oxycodone AND Tramadol.
I suggest you stick with Tramadol but take Tylenol 1,000mg with each dose. Here's a routine I worked out for my knees. Why don't you try it and see how it works? It would be better for you if you dropped those other two meds.

3. swelling: Moderate

Okay

4. Flexion is around 70. Not sure about extension. My knee is fairly straight

That's usual for 3 weeks out. It will improve in time. Extension is the most difficult one to get going!

5. icing: Yes. Several times a day
6. elevating: Yes. Usually when I ice

You didn't answer the question properly and I missed it out in my further post! I really wanted to know how often and for how long? So I shall assume it's for around 20-30 minutes at a time. (sorry if I'm wrong!)
However, you accomplish little or nothing in 20-30 minutes. Ice for at least 40-60mins and more than 4 times a day.

7. I have done very little with housework, cooking, cleaning, etc. I live at home with my family and they have been doing the chores etc.

Good!

Home PT exercises 2-3x sessions per day - I suggest you do one session a day and none at all at the weekends
Ankle pumps x10 reps 2-3 set - these are only required for the first few days when you are not getting around much. Once you are, they are unnecessary thereafter.
Heel slides x10 reps 2-3 set - worst way to do heel slides! Read this (which was given in in the Guidelines) Heel slides and how to do them properly.
Standing active knee flexion x10 reps 2-3 set - not quite sure what these are but you are already doing heel slides so any additional flexion exercise is unnecessary and likely to cause you pain and swelling
Terminal knee extension over roller x10 reps 2-3 set - same with this one. You said you knee was "fairly straight" which is plenty good enough. Don't do these any more.
Straight leg raises x10 reps 2-3 set - a tip: once you can do SLRs, you don't need to do them any more!
Leg lift laying on side x10 reps 2-3 set - these are also known as adduction exercises which are more appropriate for hips than knees. Unnecessary for knees!
Standing calve raises x10 reps 2-3 set - I'd say these are unnecessary too!

For physical therapy I was doing heel slides 3 sets of 10 repetitions. They only have been manually working on my flexion. I go to physical therapy 2x per week.

Don't let them make you do heel slide or 'work on your flexion. It will worsen your swelling and pain.

Remember this: it's not the exercising that gets you your ROM, it's time. Time to recover, time for swelling and pain to settle and time to heal. One thing that seems to be missing from all the PT's protocols is that all your ROM is there right from the start, just waiting for all 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. Exercise as in strength training is counter-productive and in the early weeks does more harm than good. Normal activity is the key to success.

You may think I'm mad or OTT in crossing out all your exercises but I'm really not. There are plenty of members in this forum who, like me, never did any exercises (which includes PT) at all during their recoveries and yet had excellent outcomes. It's a fact that knees to as well and even better being left to their own devices and we never had the problems with excessive pain and swelling either. I suggest you try it!

If you are concerned about refusing to do therapy, you need to read this Saying no to therapy - am I allowed to?

 

[HoneyB]

@Kperform and @dmichael21 - It's way too soon for you to be worrying about ROM. With knee #1, the PT clinic I went to measured ROM at every visit. That made me stress over ROM. With knee #2, the PT clinic I went to rarely measured my ROM. That also kind of made me stress over ROM. Sometimes after about 3 weeks with no measurements, I'd ask them to measure my ROM. They would groan and measure it. I think my ROM got to 120 (and beyond) with #1 quicker than it did with #2, but I'm not sure. Regardless, they both got there via two completely different methods of physical therapy. I know some people in this forum recovered nicely without PT, but I liked going to PT. I did learn to watch out for myself and speak up at PT even though I had very good therapists at both clinics.

Now I'm 10.5 months post op with #1 and 7 months post op with #2. This evening after work, I went to the gym and did strengthening exercises using the leg press machine, leg curl machine, and leg abductor and adductor machine. When I got home, I went for a 1.5-mile walk on the sidewalk and followed that up with a 4-mile ride on my exercise bike. Now I’m about to continue packing away Christmas. I’m still almost constantly reminded that I have two new knees, especially when I'm working and get up from my desk after sitting for too long, but these knees sure are BIG improvements over the old knees they replaced. Happy New Year, Y’all! Don't worry about ROM! It'll happen. I'm still dealing with a little bit of stiffness and soreness (mostly due to IT Band issues), but I'm looking forward to the new year with my new knees. You'll get there!

 

[sistersinhim]

Not everyone can do this much exercise on a 7 month old knee. Let your knee be your guide. If you do something new and your knee swells and/or hurts afterwards, then your knee isn't ready for that. Wait a few more weeks and try it again. Remember it takes a year or more for complete healing of a tkr.

 

[Josephine]

You should also really need both oxycodone AND Tramadol.

@Kperform I made a rather serious typo in my answers.
It should have read "You should also NOT need both oxycodone AND Tramadol."
I do apologise.

 

[SteveMinSD]

Hi @Kperform, I hope you are well! I am in a similar situation (ACL reconstruction in the early 80s, unwillingness to give up basketball) and wonder how you are doing now? Are you out of pain? Have you been able to return to the court? Would you do it again? Any other wisdom you care to share?

Thanks!