TKR April rainbows
- Thread starter Peterfox
- Start date
Welcome to BoneSmart, @Peterfox. Please give us the exact date of your surgery and whether it was the left or right knee so we can create a signature for you. Having this information helps us better help you.
Swelling continues for many weeks -- even months for some of us. It's normal -- the body's way of protecting the new knee.
You are very early days in this year-long recovery -- much too early to worry about your range of motion. Right now, the best thing you can do is rest, ice and elevate so your knee recovers from the surgical trauma.
I will leave you BoneSmart's recommended recovery guidelines below.
Swelling continues for many weeks -- even months for some of us. It's normal -- the body's way of protecting the new knee.
You are very early days in this year-long recovery -- much too early to worry about your range of motion. Right now, the best thing you can do is rest, ice and elevate so your knee recovers from the surgical trauma.
I will leave you BoneSmart's recommended recovery guidelines below.
I hope you will take some time to read through our Recovery Guidelines. Each article is short but very informative -- and, at only one week out -- will help you have a less painful recovery.
Just keep in mind we are all different, as are the approaches to this recovery and rehab. The key is, “Find what works for you.“ Your doctors, PTs and BoneSmart are available to help, but you are the final judge as to the recovery approach you choose.
KNEE RECOVERY GUIDELINES
1. Don’t worry: Your body will heal all by itself. Relax, let it, don't try and hurry it, don’t worry about any symptoms now, they are almost certainly temporary.
If you want to use something to assist with healing and scar management, BoneSmart recommends hypochlorous solution. Members in the US can purchase ACTIVE Antimicrobial Hydrogel through BoneSmart at a discount. Similar products should be available in the UK and other countries.
2. Control discomfort:
rest
elevate
ice
take your pain meds by prescription schedule (not when pain starts!)
don't overwork.
3. Do what you want to do BUT
a. If it hurts, don't do it and don't allow anyone - especially a physical therapist - to do it to you
b. If your leg swells more or gets stiffer in the 24 hours after doing it, don't do it again.
4. PT or exercise can be useful BUT take note of these
the BoneSmart view on exercise
BoneSmart philosophy for sensible post op therapy
5. At week 4 and after you should follow this
Activity progression for TKRs
The Recovery articles:
The importance of managing pain after a TKR and the pain chart
Swollen and stiff knee: what causes it?
Energy drain for TKRs
Elevation is the key
Ice to control pain and swelling
Heel slides and how to do them properly
Chart representation of TKR recovery
Healing: how long does it take?
Post op blues is a reality - be prepared for it
Sleep deprivation is pretty much inevitable - but what causes it?
There are also some cautionary articles here
Myth busting: no pain, no gain
Myth busting: the "window of opportunity" in TKR
Myth busting: on getting addicted to pain meds
Good nutrition is very important during recovery:
Dietary Tips for Recovery
Nutrition Basics
We try to keep the forum a positive and safe place for our members to talk about their questions or concerns and to report successes with their joint replacement surgery. While members may create as many threads as they like in a majority of BoneSmart's forums, we ask that each member have only one recovery thread. This policy makes it easier to go back and review history before providing advice.
Just keep in mind we are all different, as are the approaches to this recovery and rehab. The key is, “Find what works for you.“ Your doctors, PTs and BoneSmart are available to help, but you are the final judge as to the recovery approach you choose.
KNEE RECOVERY GUIDELINES
1. Don’t worry: Your body will heal all by itself. Relax, let it, don't try and hurry it, don’t worry about any symptoms now, they are almost certainly temporary.
If you want to use something to assist with healing and scar management, BoneSmart recommends hypochlorous solution. Members in the US can purchase ACTIVE Antimicrobial Hydrogel through BoneSmart at a discount. Similar products should be available in the UK and other countries.
2. Control discomfort:
rest
elevate
ice
take your pain meds by prescription schedule (not when pain starts!)
don't overwork.
3. Do what you want to do BUT
a. If it hurts, don't do it and don't allow anyone - especially a physical therapist - to do it to you
b. If your leg swells more or gets stiffer in the 24 hours after doing it, don't do it again.
4. PT or exercise can be useful BUT take note of these
the BoneSmart view on exercise
BoneSmart philosophy for sensible post op therapy
5. At week 4 and after you should follow this
Activity progression for TKRs
The Recovery articles:
The importance of managing pain after a TKR and the pain chart
Swollen and stiff knee: what causes it?
Energy drain for TKRs
Elevation is the key
Ice to control pain and swelling
Heel slides and how to do them properly
Chart representation of TKR recovery
Healing: how long does it take?
Post op blues is a reality - be prepared for it
Sleep deprivation is pretty much inevitable - but what causes it?
There are also some cautionary articles here
Myth busting: no pain, no gain
Myth busting: the "window of opportunity" in TKR
Myth busting: on getting addicted to pain meds
Good nutrition is very important during recovery:
Dietary Tips for Recovery
Nutrition Basics
We try to keep the forum a positive and safe place for our members to talk about their questions or concerns and to report successes with their joint replacement surgery. While members may create as many threads as they like in a majority of BoneSmart's forums, we ask that each member have only one recovery thread. This policy makes it easier to go back and review history before providing advice.
lrj
member
Swelling can last quite awhile. First month or so, it's just swollen. Then I started seeing fluctuation with active. There was one day, my knee was so big, and I had to make myself ret for 2 days to get it back down to better level.
Swelling was causing my patella to lift away from the groove in the femur, which caused it to move out of place when I bent, and pop back in place when I straightened. Took 4 months before the swelling decreased enough for a substantially dropped my knee popping. Still occasionally occurs.
This actually helped me judge what my activity level should be. If it started happening too much, I knew to stop and rest. And then I also learned what I could work up to and stop before overdoing. Learn to use those signals your body gives you on what you're able to do.
Swelling was causing my patella to lift away from the groove in the femur, which caused it to move out of place when I bent, and pop back in place when I straightened. Took 4 months before the swelling decreased enough for a substantially dropped my knee popping. Still occasionally occurs.
This actually helped me judge what my activity level should be. If it started happening too much, I knew to stop and rest. And then I also learned what I could work up to and stop before overdoing. Learn to use those signals your body gives you on what you're able to do.
Peterfox
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tKR left knee
April 1
2 weeks out
Swollen on the side of my knee tremendously. ITL band all the way down.
Is the motion machine worth it.
I do like the ice machine.
Doing PT at home
Still on pain medicine.
April 1
2 weeks out
Swollen on the side of my knee tremendously. ITL band all the way down.
Is the motion machine worth it.
I do like the ice machine.
Doing PT at home
Still on pain medicine.
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To be honest, all the peer-reviewed research says the CPM machines make no significant difference. But your surgeon may be aware of a specific reason for you to have it, so check in with him.
The ice machines are great!!!! Can't imagine how I would have coped without mine.
Are you icing and elevating at least 45 minutes at a time? Many of us ice nearly continuously the first weeks, just stopping to do our hourly walk and attend to other needs.
The ice machines are great!!!! Can't imagine how I would have coped without mine.
Are you icing and elevating at least 45 minutes at a time? Many of us ice nearly continuously the first weeks, just stopping to do our hourly walk and attend to other needs.
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A Iow-grade fever (less than 101.5°F) during the first week after your surgery is common but you are a bit beyond this...
This is a normal response by your body to the stress of surgery.
Interesting that you note that it is on the days you have PT.
On average, body temperature can rise by about 1 to 2 degrees Fahrenheit during moderate exercise and even more during vigorous exercise.
Take it slow...and let your PT know about it and to take it easy.
I would monitor it and if other symptoms arise or it gets higher, do call your doctor.
This is a normal response by your body to the stress of surgery.
Interesting that you note that it is on the days you have PT.
On average, body temperature can rise by about 1 to 2 degrees Fahrenheit during moderate exercise and even more during vigorous exercise.
Take it slow...and let your PT know about it and to take it easy.
I would monitor it and if other symptoms arise or it gets higher, do call your doctor.
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Your new knee is three weeks old. That's an absurdly onerous burden to place on it. Even a minor athletic sprain or strain needs 6-8 weeks to heal; a rigorous or repeated routine prevents it from healing and leads to chronic problems. A knee replacement is not at all like a sprain or strain; it's more like the trauma of a car wreck! I can't imagine how your PT doesn't know this.
There is NO such arbitrary timeline on either extension or flexion. Most surgeons seem to be happy if we are at 90 degrees at 6 weeks, and plenty of our members have totally successful recoveries gaining flexion more slowly. Extension for most of us takes significantly longer.
At your stage, walking, gentle stretching, and slowly increasing activities of daily living is all you need. It's unsafe to try formal strengthening exercises yet; folks are more prone to tendonitis and adhesions when they damage or overheat unhealed tissue.
I agree with @mendogal that the PT protocol you mentioned in her quote above is not a good one, and with her reasons why.
I’m glad that you are doing what works best for you!
Peterfox
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3 months I will be moving about 10 hours away where I would like to enjoy hiking and biking. I am having anxiety attacks about possible manipulation if I dont get to a certain degree
I was very active before tennis. Golf. Ect
I think I am very fit but this recovery time has taken a toll on me
Do I need to worry ?
BonevSmart is very relaxed about healing which I like
What’s with all the PT pushing
I see the Doctors in two days and I have lots of questions
I was very active before tennis. Golf. Ect
I think I am very fit but this recovery time has taken a toll on me
Do I need to worry ?
BonevSmart is very relaxed about healing which I like
What’s with all the PT pushing
I see the Doctors in two days and I have lots of questions
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You really need not worry about a manipulation (MUA). It's very rare to need one.
The "window of opportunity" is a myth. Here's why.
Some of our members have shared charts of their progress regaining flexion. As you can see, for each, it returned slowly but surely.
Campervan’s ROM history
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
Bertschb’s ROM history
2 months - 80 degrees
3 months - 85 degrees
4 months - 90 degrees
5 months - 90 degrees
6 months - 110 degrees
7 months - 120 degrees
8 months - 125 degrees
9 months - 130 degrees
10 months - 135 degrees
11 months - 140 degrees
12 months - 140 degrees
The "window of opportunity" is a myth. Here's why.
Some of our members have shared charts of their progress regaining flexion. As you can see, for each, it returned slowly but surely.
Campervan’s ROM history
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
Bertschb’s ROM history
2 months - 80 degrees
3 months - 85 degrees
4 months - 90 degrees
5 months - 90 degrees
6 months - 110 degrees
7 months - 120 degrees
8 months - 125 degrees
9 months - 130 degrees
10 months - 135 degrees
11 months - 140 degrees
12 months - 140 degrees
You will enjoy these things again, in the future. You need to heal first. You are still very early in a recovery that takes a year, on average. That doesn’t mean you will be limited and in pain with “poor ROM” the whole year. We all recover at different timelines. At 3 weeks post op, it’s way too early to worry about almost anything. Your body is still figuring out how to heal!
Try not to worry about this. There is no date by which you must be at a certain number. Even if your surgeon recommends a manipulation, you don’t have to agree. It is your decision. They can’t do it without your signed consent. And again, it’s way too early to think about that.
That is the 60 million dollar question. They all need to take a course on the Bonesmart Recovery Guidelines!
This is what one of our members, TortiTabby, experienced:
(Just so you know, ADL means Activities of Daily Living.)
(Just so you know, ADL means Activities of Daily Living.)
“At my six week appointment this is what my OS wrote in my visit summary: "She reads an online website called Bone Smart which states to not push through pain following knee replacement. If she were to follow this direction, she will have to learn to live with a knee that only reaches to 85 degrees of flexion. I believe this website is very misleading."
It has now been 20 weeks and all I do is ADL and this is what my ROM has done:
3.5 wks: 75
6 wks: 85
7 wks: 90
10.5 wks: 95
14 wks: 100
17 wks: 105
20 weeks (where I am today): 110
I am so thrilled it keeps improving and improving and I know now that I will get to my goal of 120 (or even better, dare I say!)
And,
“Just an update for those who are apprehensive about gaining ROM:
It has now been 26 weeks and all I do is ADL and this is what my ROM has done:
3.5 wks: 75
6 wks: 85
7 wks: 90
10.5 wks: 95
14 wks: 100
17 wks: 105
20 weeks: 110
26 weeks (where I am today): 120!!!
I did it! My goal of 120! No "pushing through pain", no PT after the first 3 visits, and most importantly to me: No MUA! My surgeon who said I would never get beyond 85 ROM without pushing through pain was wrong, wrong, wrong. I'm excited to see if it gets even better.“
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Here are a couple more accounts from members in regard to ROM.
Hopefully it will help ease your mind.
@Peterfox
Message from member JusticeRider -
"I just want to add, for all those coming along, a note on ROM. I want to share this because nearly all of us have a tremendous amount pressure put on us to increase our ROM by certain deadlines, or else.
Mine has been extremely slow coming. First I had to wait out the swelling, which in my case took more than 5 months. Yes, months. At that point I began to see real progress. It has continued to this day. I have seen improvement in the last 2 weeks. It’s still going. A this point I think the limiting factor is tight muscles, ligaments, and tendons from 3 yrs of very limited ROM and actually about 25 yrs of somewhat limited ROM. Those tissues are slowly stretching.
I have had to be willing to let my flexion improve at a glacial pace, be very patient, and tune out the dire warnings of my surgeon, PA, previous PT, and some well meaning acquaintances. I refused painful PT and refused a MUA. I have absolutely no regrets. I know my body, and I believe those things would have caused a domino effect of swelling and pain that may have derailed my recovery long term and even possibly have torn soft tissue, etc. I now know I have the added challenges of hypermobility and an immune condition that causes an inflammatory reaction. I think a MUA would have been very harmful to me.
Instead of forcing it, I have relied on weekly massage and using my stationary bike as a stretching aid every single day. I have been very active, but I have ramped up really, really gradually. I have not measured my flexion, because honestly I feel almost a PTSD type of reaction around it. All I care about is function and what I can do. My knee is very functional now, and still improving. I love my new knee. I’m glad I let it heal on its own timeline even though it was so much longer than everyone (most of all me!) would have liked."
Hopefully it will help ease your mind.
@Peterfox
Message from member JusticeRider -
"I just want to add, for all those coming along, a note on ROM. I want to share this because nearly all of us have a tremendous amount pressure put on us to increase our ROM by certain deadlines, or else.
Mine has been extremely slow coming. First I had to wait out the swelling, which in my case took more than 5 months. Yes, months. At that point I began to see real progress. It has continued to this day. I have seen improvement in the last 2 weeks. It’s still going. A this point I think the limiting factor is tight muscles, ligaments, and tendons from 3 yrs of very limited ROM and actually about 25 yrs of somewhat limited ROM. Those tissues are slowly stretching.
I have had to be willing to let my flexion improve at a glacial pace, be very patient, and tune out the dire warnings of my surgeon, PA, previous PT, and some well meaning acquaintances. I refused painful PT and refused a MUA. I have absolutely no regrets. I know my body, and I believe those things would have caused a domino effect of swelling and pain that may have derailed my recovery long term and even possibly have torn soft tissue, etc. I now know I have the added challenges of hypermobility and an immune condition that causes an inflammatory reaction. I think a MUA would have been very harmful to me.
Instead of forcing it, I have relied on weekly massage and using my stationary bike as a stretching aid every single day. I have been very active, but I have ramped up really, really gradually. I have not measured my flexion, because honestly I feel almost a PTSD type of reaction around it. All I care about is function and what I can do. My knee is very functional now, and still improving. I love my new knee. I’m glad I let it heal on its own timeline even though it was so much longer than everyone (most of all me!) would have liked."
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Message from member VolLady -
"I want to tell everyone that has went though TKR that it is a long journey to heal. I am going this spring to have my other knee replaced.
Please do not get discouraged and I know you will because I did with my first one and cried more than I had in a life time. Scared mostly.... Surgeons will not tell you everything that you will experience during your healing. It took me 7 months actually to feel more normal but not 100%.
For the ROM I only got to 112 at 4 months and still cannot bend it all the way back to reach 130. But I can drive, sit at a table, put my shoes and clothes on great without a ROM of 130 or 120. There is no swelling at all at 8 months but I still have some stiffness at times but I deal with it and walk. I also still ride my bike with no trouble.
I am telling everyone this because your body will heal without PT and pushing your limit beyond to the point there is more swelling and pain. I have decided when I have my other knee fixed this spring, that I will do my own PT since I have all the equipment and items that they use anyway.
I had a MUA at almost 6 wks., and regretted it from day one. Simply because it did not help me anymore with my ROM but it did set me back on healing. The swelling was awful. I will not have another MUA even if my ROM was 95 at the time.
I will go in with open eyes on this other knee comparing on what I went though with the first one. So, with all that said, I wish everyone a happy healing and let your body decide with healing than someone trying to push you until you scream with pain. Also don't worry about the ROM, it will come -- it might take a year or more, but it will come. I am 67 years old and I don't expect to get past 120, but I do what I want to do at 67. Oh! and I can even bend down with the knee need to kneel on it..... Best wishes everyone!"
"I want to tell everyone that has went though TKR that it is a long journey to heal. I am going this spring to have my other knee replaced.
Please do not get discouraged and I know you will because I did with my first one and cried more than I had in a life time. Scared mostly.... Surgeons will not tell you everything that you will experience during your healing. It took me 7 months actually to feel more normal but not 100%.
For the ROM I only got to 112 at 4 months and still cannot bend it all the way back to reach 130. But I can drive, sit at a table, put my shoes and clothes on great without a ROM of 130 or 120. There is no swelling at all at 8 months but I still have some stiffness at times but I deal with it and walk. I also still ride my bike with no trouble.
I am telling everyone this because your body will heal without PT and pushing your limit beyond to the point there is more swelling and pain. I have decided when I have my other knee fixed this spring, that I will do my own PT since I have all the equipment and items that they use anyway.
I had a MUA at almost 6 wks., and regretted it from day one. Simply because it did not help me anymore with my ROM but it did set me back on healing. The swelling was awful. I will not have another MUA even if my ROM was 95 at the time.
I will go in with open eyes on this other knee comparing on what I went though with the first one. So, with all that said, I wish everyone a happy healing and let your body decide with healing than someone trying to push you until you scream with pain. Also don't worry about the ROM, it will come -- it might take a year or more, but it will come. I am 67 years old and I don't expect to get past 120, but I do what I want to do at 67. Oh! and I can even bend down with the knee need to kneel on it..... Best wishes everyone!"
Peterfox
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4 weeks out
Pain on meds fr 2 weeks
PT great
No scar tissue
Do my exercises three times a day
Ice, elevate ice, elevate ice, elevate
I have a brace at night.
On third day of prednisone to keep my swelling down.
Everything is going OK.
Pain on meds fr 2 weeks
PT great
No scar tissue
Do my exercises three times a day
Ice, elevate ice, elevate ice, elevate
I have a brace at night.
On third day of prednisone to keep my swelling down.
Everything is going OK.
It sounds like you are doing well.
What exercises are you doing?
Your swelling might be better if you only do your exercises once a day. You are very early in this recovery. Make sure you’re doing them gently.
By the way, I merged your newest thread with your original recovery thread, as we prefer that members in recovery have only one thread.
This benefits you because all your information is in one place, easy to find, and maintains a nice journal for you.
This also benefits our staff, as your information is all in one place, and we often go back through your thread for previous details, so we know what you‘ve been through which helps us advise you better.
So, please keep all your posts in this thread. If you’d like a new title, let us know what you want, and we’ll change it for you.
Many members bookmark their thread in their computer browser, so they can find it when they log on.
How can I find my threads and posts?
bonesmart.org
Best wishes on your continuing recovery!
What exercises are you doing?
Your swelling might be better if you only do your exercises once a day. You are very early in this recovery. Make sure you’re doing them gently.
By the way, I merged your newest thread with your original recovery thread, as we prefer that members in recovery have only one thread.
This benefits you because all your information is in one place, easy to find, and maintains a nice journal for you.
This also benefits our staff, as your information is all in one place, and we often go back through your thread for previous details, so we know what you‘ve been through which helps us advise you better.
So, please keep all your posts in this thread. If you’d like a new title, let us know what you want, and we’ll change it for you.
Many members bookmark their thread in their computer browser, so they can find it when they log on.
How can I find my threads and posts?
How can I find my threads and posts?
There are a couple of ways you can find categories of threads on the forum. You are able to use links in the main forum toolbars at the top of the screen to quickly access certain types of threads: your own threads, threads with your posts in them, and watched threads. You can also use links...
bonesmart.org
Best wishes on your continuing recovery!
Happy One Month Anniversary, Peterfox!
