TKR Larry’s LTKR Recovery

[Larryhg3]

Today at PT I had a new therapist while mine is on vacation. She refused to try to measure me until she did some mobilization massage. She worked my knee gently for around 5 minutes I could bend to 105 she worked a few more minutes I got to 107. She actually called another therapist over and got another opinion. Apparently my knee cap doesn’t move very well. They showed me some gentle knee cap mobilization exercises and suggested I do them multiple times a day. Have to say these don’t hurt in any way and my knee bends much better after I have done them.

 

[Celle]

Apparently my knee cap doesn’t move very well. They showed me some gentle knee cap mobilization exercises and suggested I do them multiple times a day. Have to say these don’t hurt in any way and my knee bends much better after I have done them.

As long as the exercises don't hurt, I guess they're OK, but really they are unnecessary. Your kneecap will mobilise all by itself, without any encouragement or massage, as your recovery progresses.

 

[SusieShoes]

Massage is okay. I massage around my kneecap/incision regularly to keep things loose (I develop a thicker scar than most people). I'd be careful about moving the kneecap around too much, though. Keep in mind that as you walk and exercise more, you will be strengthening the muscles that support the knee joint and keep the patella tracking in a normal manner. So your kneecap movement should get better just from that alone.

 

[sistersinhim]

Your kneecap will move around on its own as you heal. Some PT think they have to force it to move before it's ready. At least it doesn't hurt. If it starts to, then stop.

 

[kneeper]

I had kneecap mobilization in my protocol-(It was on the standard sheet from the OS office)-I was to do it myself. It was gentle and it didn't hurt-- IIRC they had me do it once a day for a week or two. May not have been necessary, but didn't cause any harm.

 

[Larryhg3]

That is what they are asking me to do as well kneeper. Again it is very easy and gentle may not help but can’t see how it could hurt. I have been told by everyone who has experience or expertise that it will be a good year before I am 100%. I have too many things going against me going into this journey to expect to be on the low end of estimates. From that perspective I am feeling good about how it is going. I set myself small obtainable goals, listen to my knee and am paying attention to how far I have come over how far I have to go. I think there are many things from the BoneSmart way that help people like me who are going to follow what the doctors and PT say, to set ground rules that work.

 

[kneeper]

listen to my knee and am paying attention to how far I have come over how far I have to go.

 

[Larryhg3]

Good afternoon all. I just came from my 3 month (14 week but who’s counting) checkup with my surgeon. He gave me an A overall for where I am at at this stage. ROM is currently at 112 flexion and 4 extension he is happy with those numbers particularly based on where I started but would like the flexion @ 120 and extension @2 optimally. But “those numbers will gradually improve over a year” his exact quote. Commended me on the gains that I have made functionally and advised to keep trying new thing “ your knee will tell you if it is up to it or not”. Did tell me no golf just yet he doesn’t advise it until after 6 months. He did say that he thinks I could benefit from continued PT for strength and stamina but that if I am disciplined enough in daily activity could get the same results at home leaving that up to me and PT. As I was leaving he said that I should be proud of how far I have come in a very short amount of time and that we could do the other knee when I feel I am ready to take it on. I was dreading this visit because I am overly critical of myself (as anyone who reads my posts knows) but came away actually feeling really good about where I am at right now. Thank you all for propping me up during the tough times it really did help.

 

[Jockette]

What a reasonable surgeon you have. I like what he said to you.

My surgeon wasn’t very encouraging. All he seemed to care about post op was X-rays and ROM.

 

[Larryhg3]

@Jokette that is exactly what I expected when I went in. I was very pleasantly surprised at the supportive way he interacted with me. He pointed out areas where I still need to work but focused on the positive. Very cool visit for me.

 

[SusieShoes]

What a great visit! It’s rewarding when your surgeon tells you you’ve done a great job and says to keep up the good work.

 

[Larryhg3]

Hello all. At my last checkup I told my doctor that I still have stalling, he calls it starting pain, basically if I have been sitting (elevated or not) my knee wants a second or two before it gets going. He said that this is completely normal and will slowly subside over a year. He also said my little pop up pain, just comes up and goes away, will subside gradually over the year. I am not doing badly just curious about the experience with these phenomenon and how long it took to go away? I am a mere 15 weeks post op and have an equally bad other knee left to fix so I know I have to be patient.

 

[Celle]

At my last checkup I told my doctor that I still have stalling, he calls it starting pain, basically if I have been sitting (elevated or not) my knee wants a second or two before it gets going. He said that this is completely normal and will slowly subside over a year. He also said my little pop up pain, just comes up and goes away, will subside gradually over the year. I am not doing badly just curious about the experience with these phenomenon and how long it took to go away?

I think what you're experiencing is pretty common. Many of us find that our knee takes a little while to get going properly. For me, usually a couple of steps was all it took for the knee to work properly again.

Your surgeon is right and this will improve gradually, but there's no set time when it will go away completely.
I'm not even sure when my knees stopped doing that - the problem just faded away. It could have been around 6 months, more or less.

 

[sistersinhim]

my knee wants a second or two before it gets going.

It's like the knee wants to get itself together before it takes those first steps! It's a perfectly normal reaction.

 

[Larryhg3]

Hello all I haven’t posted in a while. Lefty is still progressing nicely. He wants to get up and move as much as I can do. I walked 45 minutes the other day and Lefty wanted to do more. However, Righty who is bone on bone like Lefty was is very unhappy with the new exercise level. I have scheduled him to get replaced on Oct 10 th. In the meantime I am working to get him in better shape for that surgery. I am attending conditioning twice weekly doing preparation exercises to get me ready for knee replacement. I am hoping this will help the recovery process. I still get startup pain particularly once I have settled in for the evening (after 8 pm) but it is manageable. Again way more pain in Righty , stiffness and discomfort in Lefty. All in all doing well.

 

[HoneyB]

Hi @Larryhg3 - We had our LTKRs at about the same time, and I see you have your RTKR on the schedule. My left knee is also still a little stiff, but mostly feels pretty well and is behaving like a champ as the "work horse" knee as I'm rehabbing my RTKR. I like to give it a little "test" as I'm going through PT with my RTKR just for comparison. I use a leg press machine as part of PT. First I use both legs to lift 40 pounds for 30 reps. Then my therapist removes all of the weight and I use just my right leg to lift 10 pounds (the weight of the machine parts) for 30 reps. Using just the right leg is difficult and causes mild pain. When I finished those 30 reps at my last PT, I decided to give that setup a try with just my left leg. I was THRILLED to find that it was almost effortless and caused zero pain with my left leg. It was good confirmation that my left knee and muscles truly are coming along well with time. I switched PT groups for my right leg. My new therapist found that, while my muscle strength for front-to-back motions with my left leg is pretty good, my side-to-side muscle strength is a little lacking. He said we'll work on that for my left leg when I get to the point with my right knee of working on that with the weight machines. While my right knee still has pain, it sure is nice to go on my daily walks and not feel that bone-on-bone knee pain in either knee. I feel like I could walk forever, but I know better so right now I'm limiting myself to 7 minutes away from the house and 7 minutes back. Still, that 7 minutes takes me a little bit farther from the house every day or so. Good luck to you as you continue on this journey to two good knees!

 

[Celle]

@Larryho3 ,

HoneyB had previous experience with using weight machines before her surgery and she is using them now, but is listening to her knee. Hers is a rather unusual way of recovering, but it is her choice.

In general, BoneSmart recommends not using weight machines after a knee replacement. There is too much danger of causing tears to your soft tissues. If using weights, you should wait until at least 3-4 months post-op, to allow your knee to be well on the way towards healing.

 

[Larryhg3]

Celle thank you for your concern. My conditioning consist of body weight only exercises. I won’t list them. But they address, quad and hip strength issues. I use recumbent bike and walk a minimum of 40 minutes per day (@3 miles) not fast but steady. I also have begun performing quad and hamstring stretches. As you can see I am addressing areas that I neglected due to many years of pain the hope being I am better prepared for Righty by lessons learned from Lefty. I know that the knees will recover differently but going in with better strength and ROM surely can’t hurt.

 

[HoneyB]

@Celle and @Larryhg3 – Sorry if my comment made it sound as if I was encouraging the use of weight machines. I wasn’t. I was responding to his comment that his left knee has progressed to the point that his right knee is now complaining about his level of exercise and is now scheduled for replacement. Since he said that his left knee still has stiffness, and since our left knees are about the same age, I was just commenting that I also still have stiffness in my left knee, but my little “tests” at my RTKR rehab show how far along my left knee has actually come. Again, sorry. Also, I had never used weight machines before my RTKR rehab except for my visit to the physical therapist for my pre-surgery evaluation. Weight machines are new to me so I’ve approached them with caution and only use them under the watchful eye of my therapist.

 

[Larryhg3]

HoneyB no apology necessary whatsoever. I understood your post completely and took it as the encouragement it was intended to be. This journey is difficult and this forum is a safe place to share how we are getting through it. Not every journey is the same and not every knee responds to the pure BoneSmart way.