TKR low energy months past TKR

[hegel]

surgery straightened my right leg/knee, and as a result the muscles at the outside of my thigh, as well as my calf muscle, are stretched tighter than before. Also, when I saw a PT, she pointed out that my hamstrings in both legs are tight.

So a reflection: I'm warned that scar tissue will solidify and restrict motion in my knee if I don't stretch it out. Fair enough. But for me, in terms of extension, I wonder how much of my limitation is due to tight muscles, and not scar tissue. Further: I'm working on stretching those muscles, but in the end, will they actually grow longer to accommodate my new knee and leg stance? And how long will this take?

Or is my premise incorrect that tight muscles could be limiting extension in my leg?

 

[kmak81230]

Hi @hegel:

Don’t stress about extension-for many it is much slower to come and there is no magic window. With my first TKR it took me 6 months to get to 0. My extension was between 5 & 10 for years prior to surgery so it took a long time for those muscles and tendons to stretch out. It sounds like you are doing really well - don’t be pressured by the PTs and docs to overwork your new knee. I didn’t get to 110 flexion until four months and I also was still gaining flexion between 12 & 18 months. I was overdoing with my first TKR which I believe kept my leg swollen and less bendy. I am chilling with #2.

 

[traceys]

Hi @hegel
Same issue for me with the TKR lengthening and straightening my leg causing all of my previous issues and adhesions to come to light. The extension leaves me feeling like a piece of rebar is along the back lateral border or my knee and my rmt has been at it diligently.
It is improving but sooo slowly. Time will be your friend as it works it’s way out

 

[hegel]

The extension leaves me feeling like a piece of rebar is along the back lateral border or my knee and my rmt has been at it diligently.

Hi tracey: apologies for not getting back until now. What's 'rmt'? Yes, more and more I'm realizing that aches and pains in my leg and foot (!) are being caused by the new architecture of my stance and gait. However: I just now went out for a walk and feel that my stride motion is pretty good--but mostly, it's certainly better than it was pre-op, at least on concrete, because I'm not limping and hesitating from the bone on bone pain! I feel some slight soreness on the outside of the knee, but I'm sure that this is due to muscle atrophy from my previous stance and gait--so time should fix that.

I've been hitting the bike a few times (well. five to ten minutes) and upping stretching and other exercises. And those nights I've been in a good amount of pain. The kicker is that my surgeon took Thanksgiving day and Friday after off, and I'm out of oxycodone. I have some Hydrocodone left over from a hernia operation a half year ago. It's still not expired. Does anyone know the difference? The instructions allow more frequent use than Oxycodone and maybe that suggests that it's less potent?

At any rate, since I was told that I need better extension for my gait, and my gait seems good--why should I put myself in more pain prior to my pt appt. on Monday?

 

[Celle]

So a reflection: I'm warned that scar tissue will solidify and restrict motion in my knee if I don't stretch it out. Fair enough. But for me, in terms of extension, I wonder how much of my limitation is due to tight muscles, and not scar tissue. Further: I'm working on stretching those muscles, but in the end, will they actually grow longer to accommodate my new knee and leg stance? And how long will this take?

Or is my premise incorrect that tight muscles could be limiting extension in my leg?

You are correct.
Forget about the scar tissue. The sort they are talking about is actually quite rare and you're unlikely to have it.

It's the muscles and tendons at the back of your leg that will have contracted (shrunk/shortened) and they need to be stretched (and lengthened) gradually and gently. That will take time and patience.

It doesn't matter how long that takes, because there's no time limit.
There's no need to rush to get ROM (Range of Motion) because it can continue to improve for a year, or even much longer, after a knee replacement. There isn't any deadline you have to meet:
Myth busting: the "window of opportunity" in TKR

 

[Jockette]

I'm feeling a little discouraged and stuck at this point. Maybe I'll have progress pain wise soon.

Try not to compare and/or be discouraged because you haven’t been able to do what someone else can do. We are all different and what the surgeon had to do in each of our surgeries is different, as is their techniques, so we all have varying reasons for pain differences.

Yes, I ditched my narcotics early, but that was because I’d had a drastic vision change, overnight, with my surgery. We all thought it might be due to the Dilaudid I was taking, so I stopped it. I never felt it helped much anyway. My vision did not return to normal. 6 weeks post op I had an eye exam and got new glasses.

I had plenty of pain, but managed to get through it. There is a big difference between. managing and not needing.

 

[traceys]

@hegel
Do NOT fall in the trap of comparing to others. Pls don’t!

I went thru it and it crushed my spirit (I talked about it on my thread and got some great advice and support from very wise members).

Every knee has its own history. Every recovery is its own story. When I stopped wanting to be “like everyone else” the stress stopped and I started making more progress. Your a-hah moment for this will come and its very liberating! Trust me -

 

[hegel]

Thanks for your words of encouragement Tracey!

On another thread Jockette mentioned that rain bothered her new knee. It started raining for the first time since my surgery a few days ago and MAN! it's felt like I was back in week one or two. I thought that I'd just overdone PT. Maybe the rain in Spain fell mainly on my pain! or something...is this a common thing? It never even occurred to me. Today it's not raining and I feel much better, but I've taken it easy.

 

[Jockette]

Weather bothers some of us and not others, just like every other part of this recovery. And, it doesn’t bother me every time, and sometimes not until the day after.

 

[hegel]

Jockette, I really hope it wasn't rain that caused my pain. I can't control the rain. I'll let you know after tomorrow night when it starts raining again.

My Donjoy ice machine and cuff has stopped circulating cold water. The pump is making a lot of noise and water seems to be circulating but it's warm. I wonder if there's a blockage. Any tips?

edit: never mind, fixed it! whew. this cost me some pain last night.

 

[Jockette]

Rain is not the only thing we can’t control! And just because it bothers your knee now doesn’t mean it always will.

 

[sistersinhim]

Your knee without 'outgrow' the weather pain. Those soft tissues feel the difference in the barometric pressure. We had the remnants of Michael come through here and my 2 year old knee still felt it. It was only for about 5 or 10 minutes, then it settled down. The more healed your knee gets, the less it's affected by weather change.

 

[hegel]

The more healed your knee gets, the less it's affected by weather change.

Good, because it started to rain a few hours ago and I'm definitely feeling it!

Just to be clear, I'm really not a weenie! I deal with pain pretty well. I managed to get to our 4:30 daily office at Church today, which I've been missing.

But as a final rant--my ice machine went down for a few days without my fully realizing it. Painful! I got it fixed yesterday and was able to cut back on the pain meds--felt like I'd made a little leap. Best I'd felt since the surgery. Icing for even ten minutes worked great! And now the rain...

So it goes.
p.s. does icing help with the lower barometric pressure pain?

 

[sistersinhim]

does icing help with the lower barometric pressure pain?

I don't remember if it did or not. My pain during the last tropical storm was short-lived, thank God, and I didn't ice.

Isn't it amazing how much ice helps to reduce our pain! I could be fast asleep and when the ice in my machine ran out, the knee would wake me up. I'd replace it and go to back to sleep! Now, that doctors are hesitant to refill pain meds we have a good help with ice!

 

[hegel]

Isn't it amazing how much ice helps to reduce our pain! I could be fast asleep and when the ice in my machine ran out, the knee would wake me up. I'd replace it and go to back to sleep! Now, that doctors are hesitant to refill pain meds we have a good help with ice!

this is how I know that I'm making progress: ice alone is sufficient to help with pain during the day and I don't need the Oxycodone. Although I'm not completely off it yet...and my experience with the ice machine at night is just like yours--I can sleep longer into the morning because of that.

I used the ice machine while it rained last evening and seemed to get some relief.

 

[sistersinhim]

Good news that you've cut back on your pain meds and that the ice helped even in rain! Yay!

 

[kmak81230]

Glad to hear you are able to reduce the pain meds @hegel. I found that with a clearer head I seem to have more energy during the day and tend to feel a little more optimistic about the recovery. Glad you got your ice machine fixed - it's one of the MVPs of this recovery.

 

[hegel]

So I have another question: temps have dropped and I wonder if wearing a knee sleeve to provide warmth is a good idea. I suppose it would also provide compression. Or would warmth increase inflammation?

I keep thinking of that metal knee conducting cold! especially when icing.

 

[Celle]

My mother wore knee warmers, but only after her knees were well healed.
I think it's a bit too early for you to be using them.

The metal implants inside your knee are protected from the cold weather temperatures by the soft tissues that surround them. They won't get cold when winter temperatures drop, but will stay at the same temperature as the rest of your body. (It's the change in barometric pressure that sometimes has an effect on our knees, not how cold or wet the day is.)

 

[Softtail]

I jumped in our jacuzzi on week 6 , and loved it. Didn’t really see any increase in swelling ,but everyone is different. I know the heat felt great, and could bend and straighten leg easier I tub. Just gotta try it and see.