TKR Left TKR 9/23/19 My Journey

[LindaO]

Sounds like you are making progress! Keep going and stay positive!! Things slowly get better! Hang in there!
Sammy is a good name!

 

[Thatbpguy]

Ok, back from pt. It was painful, but fair. We did have a discussion about hurting me as opposed to pt.

One issue is my ROM. It's at 65. I do the exercises and stretches but I am stuck here. All I can do is keep pushing. I'm hoping I'm not headed for a MUA or some such thing. Anyone ever have that done?

 

[Jockette]

I do the exercises and stretches but I am stuck here. All I can do is keep pushing.

You are less than 2 weeks out of surgery. You are not stuck. You are very early in recovery.

Do not worry about your ROM. It will come. Put away any thoughts about MUA. it’s way too early to have any discussion or thoughts about that. And if your PT has already mentioned it, get a new PT, this one is worrying you unnecessarily.

You can push if you want to, but we know from experience that it will only create more swelling which will further reduce your ROM.

You need to take a deep breath, accept that this is a very slooooow recovery, relax and watch TV and let your knee heal. It’s going to take as long as it wants to, and you can’t speed it up. But, you can slow it down by pushing your poor surgically injured knee to do more than it is able.

I’ll ask @Roy Gardiner to come chat with you. He did bilateral and didn’t push anything and had a very successful outcome.

And yes, many members have had MUA. Here is a list if you like to check out some members’ experiences. As with every aspect of this recovery, there are many opinions about it.

Knee Surgery Recovery Area

For post-operative knee patients, on the "other side"

bonesmart.org

 

[Roy Gardiner]

It was painful, but fair

One or the other, can't be both...

my ROM. It's at 65. I do the exercises and stretches but I am stuck here. All I can do is keep pushing

You are, I'm afraid, trying much too hard and expecting too much too early, as everyone has been saying.

You don't need hard work. Imagine 'working hard' to recover a broken leg or a sprained muscle; you can't, and walking on a broken leg or exercising a sprained muscle are counter-productive, obviously. It's much the same with TKR, you have damage needing healing, not unfitness needing training.

All you need is to help retain mobility (not fitness or strength) until healing is complete. This is done with gentle stretching exercises, without pain.

And, most important of all, time; recovery is a long process. Relax, take it easy. It will happen.

 

[Thatbpguy]

One or the other, can't be both...
You are, I'm afraid, trying much too hard and expecting too much too early, as everyone has been saying.

You don't need hard work. Imagine 'working hard' to recover a broken leg or a sprained muscle; you can't, and walking on a broken leg or exercising a sprained muscle are counter-productive, obviously. It's much the same with TKR, you have damage needing healing, not unfitness needing training.

All you need is to help retain mobility (not fitness or strength) until healing is complete. This is done with gentle stretching exercises, without pain.

And, most important of all, time; recovery is a long process. Relax, take it easy. It will happen.

Roy, thank you so much. My pt has me scared half to death.

 

[Jaycey]

My pt has me scared half to death.

Please don't let PT bully you! Unfortunately they have a "checklist" that they want to tick off quickly. In most cases it doesn't work that way. Pushing will only set you back. Here's an article that might help: Saying no to therapy - am I allowed to?

 

[Jockette]

My pt has me scared half to death.

Get another PT or go without one. Recovery from a knee replacement is not rocket science. Though we are led to believe it’s so complicated that we can’t manage without a PT.

We CAN manage without a PT, especially if they cause us pain and emotional strife.

I think you should seriously consider canceling your PT appointments for a while. You are in too much pain to deal with the stress of outside PT. Give your self several weeks at home, resting and just walking around your house. When you feel better, and you WILL feel better, you can go to PT later if YOU feel you need any specific help.

I had my surgery mid day Monday, discharged from the hospital Tuesday evening, and had to go to an out patient PT appointment at 1:00 on Wednesday, 48 hours after surgery. What were they thinking making that appointment so soon after surgery. I could barely maneuver anywhere. Of course I went to that appointment, and all the others that first month, because I was supposed to. It was awful. They were nice people, did not verbally abuse me, but they hurt me by force bending my knee, they put me on the bike and I forced the rotation because at that point I thought I had to work really hard. I cried the whole time because it hurt so bad, I didn’t feel secure on the bike. Of course I had a set back for my efforts. I had other set backs from PT also, even though they were nice people.

Then I found Bonesmart and learned about a “radical” gentle approach to this recovery, which made so much sense.

I will not go to PT next time around. They didn’t do anything there that I couldn’t do at home. They caused me pain, stress and set backs. I’ll be fine on my own next time.

You’ll be fine also. Take care of yourself. Wait on the PT. Like I said, you can always go later if you choose to, after you’ve healed a bit and things settle down.

If your wife disagrees, ask her to read all these posts. If she would like to post, also, we would love to help support her also.

There is so much controversy about this recovery, and it’s all only opinions. So, you are entitled to your opinion about it. It’s your knee and you have the final say about it’s recovery.

 

[Jockette]

This surgery also wreaks havoc with our emotions, here an article about it. It was in the Recovery Guidelines;

Post op blues is a reality - be prepared for it

Post op blues is feeling depressed, weepy, nervy, shaky, fearful of the future, anxious, overwhelmed by what is happening to you, convinced it's never going to get any better and finally, uttering that most intense of all cries "I wish I never had this done!" It arises out of a variety of...

bonesmart.org

Reread these articles, too:
There are also some cautionary articles here
Myth busting: no pain, no gain
Myth busting: the "window of opportunity" in TKR

 

[Jockette]

And one more thing,

It’s not exercising that gets our range of motion back, it’s Time:

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. 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.

 

[Thatbpguy]

I have followed the advice you all have given me and will be cancelling my pt. I will find another, but will screen very carefully.

Thank you, all!

 

[sistersinhim]

Be careful to not overdo. Sometimes PT can get carried away and end up causing a set back. You need to stay in control and not let them push or pull your knee. My PT at the hospital was sneaky and tried to push my foot with her foot and I strongly told her, "No!", and she stopped. You have that right, too. You can't force your knee to heal any faster by exercising, but you can sure set it back. If you follow the BoneSmart guidelines you'll have a much less painful recovery! Trust all of us who have been through what you are going through! Experience knows!

Your knee is damaged requiring healing not unfit needing training. Bending to the point of pain is not helping your recovery but compounding the damage done by the surgery. Your knee needs GENTLE stretches only, without pain. Taking painkillers before PT allows more harm to be done. You need to feel what is happening to your knee at the time, not hours later when it's too late!

 

[Thatbpguy]

Well, dear friends, day 13. My goal for today was to be able to walk, unaided by the walker, to take steps. Sadly, I will not meet this one. In fact, there's no discernible improvement in the last 2 days. So I continue to rest. Only getting 3 to 4 hours of sleep every 24. I feel good about cancelling my pt. I haven't needed an oxy since pt last Friday. Controlling with Tylenol. Enjoy your Sunday.

 

[Macknit]

I am glad you made your PT decision, I have had great PT, but I noticed set backs even when there was no pain during my exercises. So, I play hooky with some of my appointments and that really shows improvement!
I was reading somewhere in this forum that the sleep will get better after about 7 weeks. I have 2 sleep sessions, one from 9 PM to 2:30 AM (I literally wake up every day at 2:30-2:45) do my little food, TV, tylenol routine for about 2-3 hours then I go back to sleep from 5 AM-8:30 AM. I hit 5 weeks on Tuesday so I'm hoping I can adjust that wake up when I return to work part time in about 2 weeks! It really helps to be patient and kind with yourself!

 

[Thatbpguy]

I am glad you made your PT decision, I have had great PT, but I noticed set backs even when there was no pain during my exercises. So, I play hooky with some of my appointments and that really shows improvement!
I was reading somewhere in this forum that the sleep will get better after about 7 weeks. I have 2 sleep sessions, one from 9 PM to 2:30 AM (I literally wake up every day at 2:30-2:45) do my little food, TV, tylenol routine for about 2-3 hours then I go back to sleep from 5 AM-8:30 AM. I hit 5 weeks on Tuesday so I'm hoping I can adjust that wake up when I return to work part time in about 2 weeks! It really helps to be patient and kind with yourself!

Thank you for the sleep information. I've been wondering when sleep would return. So far the advice I have been getting has been spot on- like yours. As soon as I can sleep on a side, it will improve. I think my return to work schedule will be similar to yours as well. Nice to have your example.

 

[Thatbpguy]

So here's my question of the day. I have always had stiff joints. Even as a kid. I have never been able to just bend my knees and cut my toenails. So what if I don't get back more than, say, 115 degrees? All I want to do is put shoes on and walk. Nothing else. Is there any leeway in how much rom I eventually have?

 

[Jaycey]

You will continue to increase ROM for many months - if not years. Just give that knee time to heal and don't force it.

 

[Celle]

Well, dear friends, day 13. My goal for today was to be able to walk, unaided by the walker, to take steps. Sadly, I will not meet this one. In fact, there's no discernible improvement in the last 2 days.

THat goal was over-optimistic. There are no prizes for giving up walking aids early. They're just a tool, so use them as long as you need them. Some people need them for months.
Some people even use a walker until they can walk without a limp. That;s a proper use of a walker - to use it until you can walk with a good gait.

Your knee is in charge of its recovery, not you, I'm afraid, and it knows what it's doing. It's going to recover on its own schedule, not on yours, so try to stop setting goals for it.

I have always had stiff joints. Even as a kid. I have never been able to just bend my knees and cut my toenails. So what if I don't get back more than, say, 115 degrees? All I want to do is put shoes on and walk. Nothing else. Is there any leeway in how much rom I eventually have?

You're most likely to regain good Range of Motion, but it's going to happen slowly. That's OK, because ROM can continue to increase for a yer or more after this surgery. Even if you only regain 115, you'll be able to do most things.
These are the degrees of flexion required to do the most common activities:

• 65° to walk
• 70° pick an object off the ground
• 85° to climb up stairs
• 95° to stand from a sitting position
• 105° to tie shoelaces
• 115° (or greater) to half squat or sit cross-legged
• 125°+ covers most activities. However, full squatting or sitting on your heel may always prove challenging.

 

[Softtail]

Been a few days since I replied last but I see the pain level has decreased considerably and now you are considering your overall approach to PT.

In my recovery I learned for the most part it wasn’t measured in days but weeks. In other words each day didn’t bring a monumental increase in either pain reduction or flexibility or swelling . It was more or less weekly or biweekly that I had any big improvements, so that in itself can be a bit disheartening . Point is when Ilast visited your blog you were in a great deal of pain and today you are handling it with Tylenol.

Patience is by far and away the most important virtue in dealing with your recovery . Also each knee even on same person takes completely different paths to recovery. If you were to read my two recovery Threads you would see how different mine were. Left leg started at 70° flex 4 or5 degrees straight , and I could lift my leg up pretty much right from the get go. Right leg started at 100° and couldn’t lift my leg for two weeks. One year later on left leg my flex is 140 and straight and at five months my right leg is 140 and straight .

You can have pains in completely different spots, but your knee will eventually end up ok. Now as for PT I am a big believer in it but it needs to be done correctly with your therapist on the same page. I liken it to stretching. A good stretch takes you right to that point beyond which you know you are hurting yourself. Pt is the same or that’s how I approached it pushing it to the pain point then backing off. Now that doesn’t mean there is no pain to start, but at the possibility of sounding stupid there is manageable pain and pain that is caused by pushing beyond that threshold where good becomes bad. I know this probably sounds odd, but I am not sure how to explain it better, I just knew where that point was for me. That’s where I took charge and no therapist on earth could push me past it. All in all my knees couldn’t be better, and I believe in PT. ,but you can find just as many here that took a more time let’s it heal approach and came out great.

Hang in there it already sounds like you are progressing nicely

 

[Thatbpguy]

Been a few days since I replied last but I see the pain level has decreased considerably and now you are considering your overall approach to PT.

In my recovery I learned for the most part it wasn’t measured in days but weeks. In other words each day didn’t bring a monumental increase in either pain reduction or flexibility or swelling . It was more or less weekly or biweekly that I had any big improvements, so that in itself can be a bit disheartening . Point is when Ilast visited your blog you were in a great deal of pain and today you are handling it with Tylenol.

Patience is by far and away the most important virtue in dealing with your recovery . Also each knee even on same person takes completely different paths to recovery. If you were to read my two recovery Threads you would see how different mine were. Left leg started at 70° flex 4 or5 degrees straight , and I could lift my leg up pretty much right from the get go. Right leg started at 100° and couldn’t lift my leg for two weeks. One year later on left leg my flex is 140 and straight and at five months my right leg is 140 and straight .

You can have pains in completely different spots, but your knee will eventually end up ok. Now as for PT I am a big believer in it but it needs to be done correctly with your therapist on the same page. I liken it to stretching. A good stretch takes you right to that point beyond which you know you are hurting yourself. Pt is the same or that’s how I approached it pushing it to the pain point then backing off. Now that doesn’t mean there is no pain to start, but at the possibility of sounding stupid there is manageable pain and pain that is caused by pushing beyond that threshold where good becomes bad. I know this probably sounds odd, but I am not sure how to explain it better, I just knew where that point was for me. That’s where I took charge and no therapist on earth could push me past it. All in all my knees couldn’t be better, and I believe in PT. ,but you can find just as many here that took a more time let’s it heal approach and came out great.

Hang in there it already sounds like you are progressing nicely

Spot on.

I spoke to my new pt today and told them I will give a 110% effort, but don't physically hurt me- just work with me.

And patience is something I need to work on.

Thank you!

 

[Ceegee]

So here's my question of the day. I have always had stiff joints. Even as a kid. I have never been able to just bend my knees and cut my toenails. So what if I don't get back more than, say, 115 degrees? All I want to do is put shoes on and walk. Nothing else. Is there any leeway in how much rom I eventually have?

IMHO there's far too much emphasis on numbers and not enough on functionality. I, too, have never been a very flexible person. I'm now 20 months post-operation and have about 120 degrees of range. However, I'm fully functional: can walk and run, can compete in agility with my dog, can hike on very rough terrain and on moderate hills for long distances (10 miles), can run upstairs two steps at a time, can do all exterior maintenance on my house, including jobs requiring ladders, etc. Putting on shoes and cutting toenails is a breeze. If you search for my recovery thread ("Ceegee's recovery", https://bonesmart.org/forum/threads/ceegees-recovery.47021/), I've posted videos. You will see that I'm very mobile.

If I look at the numbers, my recovery is disappointing. But if I look at functionality, it's amazing. Life is much better now than I expected it would be, and I can do far more than I expected. My ROM is still improving and I expect to get another few degrees over time. But I don't need them to function well. If this is all I get, I'll be very happy indeed.