TKR looking for help

[referee54]

Have you read this yet?
Where are you in recovery?? (tkr)

It may be of some help to you.

 

[referee54]

@sirj ---how is everything going for you?

 

[sirj]

@sirj ---how is everything going for you?

Good morning how are you doing? As far as me, I guess you could say I'm doing pretty good. On the 14th of this month will make exactly two months that I had my right knee surgery. I'm still dealing with certain issues about returning back to some sort of normal living. Issues like: I still walk with a limp, I'm still using a cane, I can't walk down the stairs, I still have night pains, etc, etc.. Yes these things play a part in my day to day thoughts and yes I do understand PATIENCE, GRASSHOPPER, PATIENCE ( thank you for that and the picture, being a martial artist you have no idea how that helped me out in fact that's what I keep telling myself try to maintain some sort of sanity). What I started to do was focusing on my bending exercises especially in the gym on the days I don't have PT.. I just started and it's going pretty well but I noticed I my night pains have increased. I can say that today I was taken back because as I was writing this letter the thought suddenly hit me that my right knee, the one I had the surgery on, was bent over the bed with the foot touching the floor !!!!!!! I was taken back because I wasn't able to do that before.....so I guess I'm trying to do good.... How are you doing?

 

[referee54]

I still walk with a limp, I'm still using a cane, I can't walk down the stairs,

I can certainly commiserate with you! Those were the very last steps to normalcy for me, too!

I can say that today I was taken back because as I was writing this letter the thought suddenly hit me that my right knee, the one I had the surgery on, was bent over the bed with the foot touching the floor !!!!!!! I was taken back because I wasn't able to do that before.....so I guess I'm trying to do good....

These little moment of epiphany actually are parts of the little victories that lead to winning the war of rehab.

Down the road, normalcy---simply doing what the knee is expected to do---will be easy-peasy and the norm. Normal is boring, and normal is good!

 

[sirj]

Feeling kind of depressed today.. I've stepped up my exercises to increase my ROM and it seems as if the only thing rhat has increased was my pain, especially the "night time" pain. At night it REALLY hurts and I'm up for HOURS.... I've applied more ice in which it doesn't seem to help. It's funny cause in the day time the pain is not as intense. Anybody know why is that? Also when can expect my ROM to increase. On the 14th of this month made my 2 MONTHS anniversary and even when doing my exercises it doesn't feel like my ROM will increase. I think I might need MUA cause it doesn't feel like anything I'd happening. I know I should be patient but it hard.. Any suggestions out there?

 

[Celle]

PATIENCE GRASSHOPPER!

Your knee has just given you a very strong message - that you did too much.

Remember these, from the BoneSmart mantras?
- if it hurts, don't do it and don't allow anyone - especially a physiotherapist - to do it to you
- if your leg swells more or gets stiffer in the 24 hours after doing it, don't do it again

You did too much when you ramped up the exercises and your knee is telling you so - maybe not during the daytime, but it sometimes seems as if the knee vows to pay you back by hurting at night, as yours does.

Please remember that you can't make your knee heal faster, or increase your ROM, by working hard at it. I know that's very hard for an athlete, but I'm afraid that you're going to have to ease off and be patient.

Two months seems like an eternity, but it's really still early in this recovery.

Your ROM will continue to improve - slowly and surely - as long as you don't overwork the knee.
This is what one member (Campervan) wrote about her ROM:
I had a slow recovery. Here's my flex measurements at various points:
92 - 8 weeks post op
105 - 10 weeks
107 - 5 months
110 - 6 months
112 - 7 months
116 - 9 months
119 - 11 months
118 - 1 yr
120 - 1yr 2 months
125 - 1 yr 8 months

As you can see, ROM can continue to improve for even more than a year after surgery.

 

[sirj]

PATIENCE GRASSHOPPER!

Your knee has just given you a very strong message - that you did too much.

Remember these, from the BoneSmart mantras?
- if it hurts, don't do it and don't allow anyone - especially a physiotherapist - to do it to you
- if your leg swells more or gets stiffer in the 24 hours after doing it, don't do it again

You did too much when you ramped up the exercises and your knee is telling you so - maybe not during the daytime, but it sometimes seems as if the knee vows to pay you back by hurting at night, as yours does.

Please remember that you can't make your knee heal faster, or increase your ROM, by working hard at it. I know that's very hard for an athlete, but I'm afraid that you're going to have to ease off and be patient.

Two months seems like an eternity, but it's really still early in this recovery.

Your ROM will continue to improve - slowly and surely - as long as you don't overwork the knee.
This is what one member (Campervan) wrote about her ROM:
I had a slow recovery. Here's my flex measurements at various points:
92 - 8 weeks post op
105 - 10 weeks
107 - 5 months
110 - 6 months
112 - 7 months
116 - 9 months
119 - 11 months
118 - 1 yr
120 - 1yr 2 months
125 - 1 yr 8 months

As you can see, ROM can continue to improve for even more than a year after surgery.

@ Celle... So for 2 months post op only hitting 90○ ROM is normal? I was at 90○ for the last 2-3 weeks prior along with my exercises shouldn't it have increased?

 

[Celle]

90 is probably OK and it should improve. Very few surgeons will consider a MUA once you have achieved 90.

I was at 90○ for the last 2-3 weeks prior along with my exercises shouldn't it have increased?

I'm thinking that those exercises could be the reason why it hasn't improved. Remember how you said only a few days ago that you discovered your ROM had increased without your being aware of it?

I can say that today I was taken back because as I was writing this letter the thought suddenly hit me that my right knee, the one I had the surgery on, was bent over the bed with the foot touching the floor !!!!!!! I was taken back because I wasn't able to do that before.....

I'm thinking this: ease off the exercises, increase the rest, ice, and elevation. Tale a knee vacation for a week (or two), just do heel slides, and see if there's any improvement. If not, then consult your surgeon.
Heel slides and how to do them

Have you seen this article?
Knee recovery - Lose the Work Ethic!!

 

[referee54]

I agree with Caryl. Whenever you have this urge to do more---do less. This is not a case where hard work solves all of the issues with ROM. I believe that you are doing too much and your knee is inflamed, which can bring about internal swelling and stiffness,.

It is also important to note that these plateaus are normal and that you will see these in recovery from time to time.

I would also agree with taking a vacation from all of the exercises---let the knee rest a little bit---and, if you do not see improvement in a few weeks, then call the OS.

Please remember that you can't make your knee heal faster, or increase your ROM, by working hard at it. I know that's very hard for an athlete, but I'm afraid that you're going to have to ease off and be patient.

:iagree:

 

[referee54]

Grasshopper---do not fall into the "vicious cycle"trap---where you want more ROM and work hard to achieve it---and then, when you do not see the success that you want---you work even harder to achieve that ROM.

Think about it---what is the definition of insanity---you know, doing the same thing over and over again and expecting the same results.

If you are working hard and that is not getting the job done(of course it isn't!) why not fight the urge, and let the knee rest and calm down?

It is contrary to everything that we have been taught, but that is the way this recovery goes. Do not work harder---work smarter and recognize that less is more.

 

[kneeper]

It is not unusual to "pay" for increased activity later in the day or at night rather than right away.
Listen to the knee boss.

 

[jenng2003]

@sirj how are you doing?


LTKR. October 27th 2014

Sent from my iPhone using BoneSmart Forum

 

[sirj]

@jenng2003 Hello and Happy New Year to you. So far I'm doing ok. Still dealing with the night pain and sporadic pain here and there. I have a doctors appointment on the 7th and I'm kind of concerned, I know the last time I visited my doctor he was concerned with me not being able to straighten out my leg completely. I think I've gotten better be not totally there yet. Also going down stairs is still such a major task that in still doing the "one leg at a time thing". This is a process... How about you we both had TKR around the same time, you on the 27th and me on the 14th. How are you doing with your recovery?

 

[jenng2003]

Good that you are making progress. Both my os and pt said that as long as I was making progress, they were happy. lol.

I am doing well. I had my first day back after the holidays. I am sore today, but not as bad as two weeks ago thankfully! It still swells by the end of the day and it is achy. I am not taking meds, unless the pain gets unmanageable. Then I use a tramadol. They don't make me sleepy or tired. I've been using benadryl to sleep through the night. So far it is working. Sitting for long periods is still awful. My husband wanted to see a movie. I sent him alone and said bring me back some popcorn. Haha. It's just not worth going.

Good luck with your appointment Wednesday! I don't go back until March.


LTKR. October 27th 2014

Sent from my iPhone using BoneSmart Forum

 

[sirj]

I have a question, tomorrow is my follow up from my October 14th TKR. My ROM is 90-95○ when sitting in a chair, done by a home therapist, and sliding my leg back and 85○ when lying on my stomach and having the PT push my leg forward. IS THIS A NORMAL ROM OR SHOULD IT BE MORE. I attend physical therapy and I have good days along with bad. I must admit my leg "bends" alot more than before but shouldn't I be able to bend it more or have less pain when trying to do certain activities (walking down stair, riding the stationary bike, etc, etc)

 

[jenng2003]

It takes time. Swelling prevents bending. Try heel slides while lying on your back. I have hip flexor tightness which caused my knee not to cooperate while bending in a chair.

I was stuck at 75 for a month. Once I started doing normal things (shopping, walking, etc), my knee naturally gained ROM. Today, my rom is probably only about 95-100 due to the weather and work. I spend time in the shower bending my knee. I sit on the couch with my knee bent over the arm. I heel slide lying on my back with my leg on the wall.

If your knee is still swollen, it won't bend. Ice as much as you can. Don't get discouraged. It will take time. It can take over a year. If you didn't have much rom before surgery, it may take time to retrain the other muscles. My hamstrings are also tight which caused some bending issues


LTKR. October 27th 2014

Sent from my iPhone using BoneSmart Forum

 

[jenng2003]

@sirj how did the dr go?


LTKR. October 27th 2014

Sent from my iPhone using BoneSmart Forum

 

[sirj]

@jenng2003... the Dr. Said I my ROM is way below normal and wants to do MUA as soon as possible... can't say that I'm not nervous.. still doing my research of MUA.. getting just ad much good feed back as bad.. I'M CONFUSED!....lol

 

[jenng2003]

I am sorry. Some people have excellent results from MUA. You need to keep it moving afterwards though. I know my OS will not do one after 90 degrees is achieved, nor will he do one after four months. He says he finds it is more successful if done early in the recovery process, and if I can get to 90 degrees, he considers that functional (and ROM continues to improve for up to a year). Search the forum for others who have had it done.


LTKR. October 27th 2014

Sent from my iPhone using BoneSmart Forum

 

[Clipless]

@sirj , my TKR happened the same week as yours. My flexion is about like @jenng2003 these past couple weeks and sort of stalled. Edema and bend improve when I do less- then of course I get the urge to do more and I fall back to square one. Slow recoveries are incredibly frustrating, especially at nearly 3 months out. I don't know about you, but I pictured myself being almost back to normal by now.

MUA (as I'm sure you've heard) brings some additional soreness and time off work, but it's a super quick procedure that might help you progress. Honestly there are days I wish I could have one. Best Wishes on your decision. We support you either way!