TKR Looking for reassurance - or company for my misery...

[ElanorG]

Sue, I would say you need to get off your butt and start using your knee more. I weigh a heck of a lot more than you do probably, and walking is very hard for me and I have to work at it, but I do a lot of the exercise that I can do, the bike, the pool and weights, and just keep working at the walking in baby steps. If I let myself, I would go up the stairs one at a time, but I make me go up normal, same with down. I really believe in the "use it or lose it" philosophy. I think if you carry any extra weight going into this surgery, it makes it that much more harder to recover and regain strength because one is already carrying more weight to begin with. If I do not exercise and stretch almost daily, my knee gets stiffer and the tissues feel a "tearing" sensation. But if I do some exercise each day, everything works better in the knee and I am able to use it better and better all the time. But if I did not exercise I think it would be a mess.

You might be having a slower recovery than others, but that is not a reason to not exercise the knee. My recovery is slower than others, I can't walk much due to the other knee and some hip issues, but I do make small gains, and my other exercise stuff is almost back to pre-surgery. Personally, I believe that if you keep babying the knee it will become a permanent habit and you will keep on babying it. Many PTs and doctors and athletic specialists believe this and I do too, also from personal experience with other injuries. I am sure there are many other people on the forum who will disagree. But the question I would pose to you is, what you are doing now is not working that well for you, based upon what you have posted and you aren't particularly happy with where you are it, are you? Then to me that says you need to try something different for awhile and see if things change. I don't know what kind of motivation will help you exercise, getting a trainer, joining a group, writing down an exercise regime, getting some more PT and I don't know what your options are, you will have to identify those things for yourself, especially since you are in France and I have no idea what is available.

Hope that was not too much of a boot camp kick-in-the-pants post! FWIW, support is key when doing something that is hard for you or you don't like doing. Find an exercise buddy if you can or a group of women to go for a walk with and complain about your husband(s)/kid(s) with. I know it is not easy, but I think you knee will love you for it.

 

[skigirl]

Sue, I agree with Mary that I would have the OS look at the knee. If he feels it is doing just fine, then maybe find a physic therapist to work with you for one or two viists to extablish a reasonable exercise program for your knee.

 

[Roy Gardiner]

First, let's assume that you see the OS and you don't need MUA or anything similar.

I'd then suggest

(a) stretching exercises every day, I have several listed from the thread in my sig. In particular I'd recommend the one with the kiddie's bike on a stand, which exercise is effort free but great for ROM.

(b) some massage on the muscles and tendons around the knee, this is both pleasant and good for flexibility.

There. An exercise programme for one who doesn't exercise

 

[Jacky48]

Hi Sue! "Still not a whole lot of bend on my knee, perhaps 95 - 100 degrees flexion, although every (French) nurse, physio and doctor says "it will come..."" Well my dear, being a full blooded (French) woman myself I must say, believe the nurse, physio and doctor, because we french wouldn't lie to you, you will get better!

"I still know the knee is 'there' and I am often stiff and have some discomfort (although not pain) over my kneecap. The muscles around and at the top of my calf are often uncomfortable and tight." This statement says that you still have swelling, therefore it's effecting your bend, my friend! I am 9 months out and I still have discomfort around my kneecap too! Remember, full recovery for this surgery is 1 to 1 1/2 year, and also remember that you don't have that god awful bone on bone pain the you had prior to surgery, and that you are NOT using crutches like you were prior to surgery! Remember also to "Accentuate The Positive, Eliminate The Negative, And Latch On To The Affirmative"! You'll get there kiddo! You lost a lot of muscle mass when you used crutches for 5 months prior to your replacement and it's going to take time to get it back, "Rome wasn't built in a day".

" But I did think I would be as good as I was before the knee failed. And I'm not yet..." Wow, I don't know how long ago your knee failed, but both of mine failed about 14 years ago (I was 50) and if I thought just for one minute that after my BTKR I would be as good as I was before my knees failed, they would have to put me in the "cuckoo bin" by now! That's a lot to ask for, isn't it?, a little too much pressure on ones self, I think! If I wanted to feel 50 at 64, heck I'd be in the dumps all the time! I'm so happy I don't have excruciating pain 24/7 day or night, that whatever happens after that is cake, so to speak! Enjoy what you have at the moment and the rest WILL come my friend!
Stay well and try and stay positive kiddo!

 

[soSuesew]

Thank you, everyone, once again for your support and advice. I also spent some time trawling through threads and discovered that I'm not alone in recovering at what seems to be glacial speed, which is sort-of encouraging.

So, new plan of action. 1) GP appointment on Monday to discuss my concerns in my post. He is a no-nonsense chap and will pull no punches. But he will also have a view on whether I should see the surgeon sooner than June. 2) Massage booked to see if muscles can be seduced into behaving (unfortunately not until 19 March but my 'preferred supplier' isn't available until then. 3) Talking-to delivered to self to up exercise level. Truthfully, the exercise thing will always be problematical. I'm not deliberately lazy but my thoughts go to sewing, reading, cooking, knitting - none of which do much for my knee. And winters in Northern France are not condusive to external activity...so much easier (and nicer) to curl up with a book and some quilting in front of the fire.

I think I am only just beginning to realise how bad my knee was - it failed overnight and catastrophically. I spent five months barely mobile. The surgeon did a LOT of work - my scar isn't a neat short line but 10 inches-plus long to allow for a good rummage around. His colleague in the surgery commented that it was the worst knee they had worked on in a long time (and that's in a region of gnarly old farmers).

This is probably the fourth time that this forum has stopped me throwing myself under a passing tractor when it's all seemed just too hard, too painful, too slow...(joking really but only just!).

Sue in chilly and wet Aix en Issart

 

[Roy Gardiner]

Just to re-emphasise, you don't need to do training-type exercise to gain ROM, you need to do stretching, which isn't really exercise at all.

 

[soSuesew]

Jacky, would you like to explain this non-fibbing French theory to our refrigerator repair man? He has an elastic view of time and, when I got cross, shrugged his shoulders and asked why I was worried as it's February and cold outside and I didn't need a fridge...

i think I'm still getting over the speed of the loss of my mobility and, for a while, independence. My knee failed, overnight and completely unexpectedly. I went from a busy, active person in her middle 50s with a business to run to an...invalid, for the want of a better word. It's the one year anniversary of that on 9 April, which is looming, and I truly thought I would be back to normal by then.

You're right. Even if I don't get any better than I am now, I am better off than the shambling person with crutches, unable to drive, close to housebound and emotionally devastated. But that's hard to accept when I want to be the person before. And hard to accept a level of blame if I have contributed to a less than successful outcome by not doing enough (which is a strong possibility with the exercise thing...).

Il va venir...

Sue

 

[Roy Gardiner]

No guilt, Sue. You don't need to beat yourself up as well as everything else now do you? Doing very little is in fact the key to good recovery in the early days, only when healing is complete should real exercise start.

 

[soSuesew]

Just to re-emphasise, you don't need to do training-type exercise to gain ROM, you need to do stretching, which isn't really exercise at all.

Roy, I'm assuming that I need quad exercises/stretches most of all. So, given limited attention span, those are the ones to concentrate on?

Sue

 

[Roy Gardiner]

Given that you said in the first post on this thread that you have good extension, I'd say yes, flexion stretches are the idea.

You also said

Can't use an exercise bike as can't make a revolution.

If you have an exercise bike, just rocking the pedals back and forth is excellent and very well controlled ROM exercise. No resistance needed on the bike, of course.

And 'limited attention span' is OK, you do the stretches for a couple of minutes each time, as often as possible. Many times a day.

 

[soSuesew]

No guilt, Sue. You don't need to beat yourself up as well as everything else now do you? Doing very little is in fact the key to good recovery in the early days, only when healing is complete should real exercise start.

Roy, it struck me that you said 'early days.' I guess I've been thinking that six months isn't early days - in fact, rather later days and that's why I've been worrying at my slow progress.

Sue

 

[Roy Gardiner]

Sue, poor expression on my part; I meant that your non-pressurised approach was correct when it was early days, which I'd class as the first three months. Now is mid-term, perhaps. But if you haven't done anything to regain ROM by way of stretching, it's no surprise that you haven't regained it. You should now be able to do stretches to the point of pain (you back off as soon as it starts to hurt) without causing reaction or swelling. They should work!

 

[skigirl]

Sue, I agree with Roy that rocking on the bike is a good way to begin your stretching. So, Rock to the point that you can go with a good stretch and then back the other way. I did that at first and one day, I just went around. It is easier to go around backwards at first too.

While you are knitting, etc sit in a rocking chair and put that knee down and that will also stretch it. You can put the foot farther and farther behind eventually. Some folks put a skateboard on the floor (a child's one) and rock the foot back and forth while sitting. I used a rocking chair quite successfully. Begin easy, don't try to run a marathon next week---start slowly stretching and then begin slowly---maybe 10 leg lifts in the am and pm before and after sleeping. Incorporate exercise into your life a little. Kelly

 

[Roy Gardiner]

Some folks put a skateboard on the floor (a child's one) and rock the foot back and forth while sitting.

Pix of this in the exercise link from my sig.

 

[Jacky48]

"Jacky, would you like to explain this non-fibbing French theory to our refrigerator repair man? He has an elastic view of time and, when I got cross, shrugged his shoulders and asked why I was worried as it's February and cold outside and I didn't need a fridge..."
Sue, I think he was a tad lazy and fresh my friend! And obviously he hasn't learned the "The customer is always right!", silly man!

"You're right." Sue can I please have you put this in writting so I can show my husband?

"I am better off than the shambling person with crutches, unable to drive, close to housebound and emotionally devastated." Yes madam, you are and it will get better! And as you said "Il va venir..." it will come!
As stated above by Roy "just rocking the pedals back and forth is excellent and very well controlled ROM exercise." is a great way to get started!

Stay well and stay positive kiddo!

 

[soSuesew]

In my defence, I am not just lazing around the house...I do all the household stuff (cleaning, cooking, laundry, shopping...), run my patchwork workshops etc. The surgeon, at my three month check up, said 'just live your life' and that I didn't need more physio. Generally speaking, it's probably the right advice...except I took it that I didn't need to specially exercise and my everyday life is pretty sedentary, and I was not in a good starting position. I can work all day but if it's sitting at a sewing table designing and sewing, then writing up the design on the computer and the commute is 60 seconds each way, it's not a lot of movement...

Jacky, as well as fibbing, could you explain customer service to people in our little corner of France? The average American would have a conniption fit (as my Southern sister-in-law would say) at French notions of customer service.

Sue, in Aix en Issart, getting ready for more snow.

 

[Roy Gardiner]

Sue, I don't think anyone is actually attacking you . Just recommending some easy stretching routines.

 

[soSuesew]

O

Sue, I don't think anyone is actually attacking you . Just recommending some easy stretching routines.

Oh, Roy, no need for that - I truly didn't feel attacked. Or think that it was anyone's intention. Just thought, on reflection, that I made it sound as if I laid around eating peeled grapes...(I wish!).

Sue

 

[skigirl]

 

[nmscienceteacher]

Sue, I too would rather cozy up with a good book in front of the fire rather than exercise...have taken to wearing a pedometer to keep track of where I really am with walking. I teach middle school and sometimes at the end of the day it doesn't reflect much movement...I am trying to use that to motivate myself to do more. I also joined a gym and have a personal trainer once a week who works with me to push myself a bit more than I really want to and I find that it seems to help me push myself when I am not with him. Finding an exercise buddy or someone to be accountable to is a great help too. Get rid of the idea that exercise has to be massive chunks of time and find little ways to increase your movement a little bit each week.