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TKR LTKR recovery going smoothly

Had my second post-op appointment today. I came very close to cancelling it, but I did have a painful bump behind my knee that I wanted to ask about (its was much smaller today, he said it was probably a Baker's cyst that has drained). So I went, and luckily it was with the friendly PA rather than the surgeon who is fairly cold and unfeeling. The PA is one of the only reasons I keep going to this office! I did get a little lecture about not continuing PT. My extension was good (zero) but my flexion was only about 75. I explained that I didn't want an aggressive PT, that previous visits set me back for days with swelling and pain and that I'd rather be able to do the stuff I want to do, like go for walks, garden, etc.

The PA gave me a recommendation for a PT that he said agreed with gentle approach. So I'll give it a try but am very prepared to stop going yet again. I think the only reason I'm willing to try again is I've reached my out of pocket maximum for my insurance, so what the heck, it's free now! Maybe I'll at least get some leg massages :heehee:.

I also got a steroid injection in my left knee, which is also in bad shape, and I'll be having TKR in the fall. It's been really angry at having to do all the hard work since the RTKR. Hopefully the steroid will help and last a few weeks. In the past, some injections have helped, sometimes they did nothing :shrug:

Aside from that, I'm doing pretty well. I'm walking around the neighborhood, slowly, but it gives my dog plenty of time for sniffing! I've been driving a bit, and I've been into the office a few times. I'm still mainly working from home, but my coworkers are starting to trickle back in after covid restrictions are being lifted, and it was nice to see everyone!
 
I’m glad you had a good appointment. You have a very common sense approach to your recovery, you’ll do fine.
 
Don’t concern yourself with the numbers. Sounds like you are accomplishing quite a bit and that’s really the end goal. See what the new PT is like. We’ll be anxious to hear!
 
Hi @GiantFinnegan

I know how you’re feeling. My ROM feels like it’s at a plateau for the moment. I’ve decided to forego formal PT so I’m relying on ADLs and a bit of “home PT” at this point.

On a positive note, I just spent my 60th birthday kayaking, paddleboarding and being dragged behind a motorboat on a giant inner tube—-and my knee seemed to be ok. I didn‘t go crazy but had a great time for being almost 7 weeks post op!!!

Take care!!
 
ihavetwins said:
On a positive note, I just spent my 60th birthday kayaking, paddleboarding and being dragged behind a motorboat on a giant inner tube—-and my knee seemed to be ok. I didn‘t go crazy but had a great time for being almost 7 weeks post op!!!
Click to expand...

@ihavetwins Wow, I'm impressed, and jealous! I don't know if I could go kayaking or paddleboarding anytime soon! I don't think I could get out of a kayak right now. I'm really hoping to go on a camping trip later in the summer where I'd have to get in and out of small boats, though. Fingers crossed!
 
Well, I'm almost 2 months out from TKR, and my ROM is just a little over 95 if I push it a bit. I've had a relatively pain-free recovery so far, but I am getting a nagging feeling about my lack of ROM. I do my stretching exercises (gently!) occasionally throughout the day when I need a little break from work, peddle on the recumbent bike (still can't do a full rotation...) for 5 mins maybe once or twice a day and walk about 30 mins a day. I ice when it feels like it needs it. Other than that I'm just taking care of myself and the pets, which isn't much, so I don't feel too much like I'm overdoing it.

I know ROM can improve over the next year or so, but I'd like it to hurry up a bit already! I know, I know, patience, grasshopper....

My concern is mainly for 2 reasons. One, I'm tired of this stiff knee; and two, I'm supposed to have my left knee done this fall and I'm getting worried that my surgeon won't schedule it if I haven't improved enough on this knee. He hasn't mentioned the dreaded MUA yet, but I bet that's coming next visit (in 2 weeks) unless I have drastic improvement.

My PT mentioned that over his 20+ years of seeing TKR patients, some people get ROM back so easily, and some people it takes a long time, and he hasn't seen any rhyme or reason. I asked my him when the surgeon would likely start threatening the MUA and he said yes, probably soon. I'm pretty sure I will refuse an MUA if they suggest it (I don't want to go back to square 2 and I'd rather just give it time), but then they probably won't do the second knee for me this fall. I really want to do my left knee because it hurts worse than the TKR knee right now! I have better ROM in the left knee, but it is really angry from taking the brunt of the recovery. Although my TKR knee is stiff, in general, unless I'm stretching my TKR knee, it feels better than my left knee.

Sorry for the long ROM rant for today! Just wanted to say it here because my partner is probably as tired of hearing about my knee as I am with it's lack of progress! :gaah:
 
You mention your knee being stiff, a lot. The walking 30 minutes is obviously good for your strength, balance, leg extension and gait, but I wonder if you should walk twice a day , starting out at 15 min. each time. Maybe challenge yourself a little more with the stretching (without much pain of course) and adding more time on your bike , adding more minutes a week building up from 5 to 10 ,15, etc. as long as you don’t have a lot of pain the next day. I believe if you want your ROM to improve a little more quickly, you might want to challenge yourself a little bit. My PT has me doing wall slides and that has increased my ROM by quite a bit over the last month. I am 8 weeks out. Again, this is just my opinion and my experience. Best of luck !
 
I think fretting about it won’t do anything positive. Relax. Time is your friend. You have several months before Fall. Be gentle, don’t overdo. Forcing will increase swelling which will decrease bend. Keep icing and elevating. My OS was just happy I was at 90 or better. I am nowhere near 120 after these months. I’m confident it will come.
 
Giant, I had a lot of frustration around eight weeks, things had seemed to plateau for ages. It sounds as though you are accumulating quite a bit of activity for each day, maybe back off a bit with the structured exercise.
I have had two major leaps forward with ROM. Once was when I got so dispirited that I “gave up” for a few days and stopped fighting, just lazed around with my legs in the air feeling sorry for myself. And guess what? My ROM improved beyond my wildest dreams.
The second was fairly recently when I was hospitalised for a couple of days, after having done little for a couple days beforehand. Knees loved it, came out of there nice and bendy, with one leg only a couple of inches from my backside.
Therein lies a lesson. I am soooo keen to regain strength that I constantly cause swelling. I just can’t stop myself. Had an active day yesterday, have just spent over an hour on my feet grooming a couple of my dogs, and can hardly bend either leg at all now. ROM gone from about 155 to zero in four days.
 
Thanks everyone. Yes, it seems like there is such a fine line for my knees between doing nothing and doing too much. Last week I decided to get a bit more obsessive about doing my exercises regularly in an attempt to "loosen up" my knee. So I set an hourly timer during the day, and at each hour I did at least one of the exercises or peddled on the bike. Never to the point of pain, just stretching or moving the joint. The result? By Friday I was really sore, tight band feeling was back for the first time in weeks, my ROM at PT was 60 and Saturday I couldn't walk my dog and sat on the couch icing all day :(

So my knee just does not want to move yet! Perhaps I need a spa vacation where I sit and do nothing and people wait on me. Alas, my partner is out of town for work so I have to keep feeding myself and the pets and vacuuming occasionally because otherwise it feels like I'm living in a barn with dirt floors! :loll:
 
It sounds like you've learned that exercising hourly, particularly if you're doing a lot of ADLs is too much. Sometimes we learn the hard way.
If you're vacuuming (which is surprisingly stressful on a new knee) and cooking, think of that as one of your PT exercises. Another good way to approach things is to pace yourself. For example, don't do all your household tasks in one day. Maybe vacuum one day and dust on another.
Time on your feet is notorious for adding to swelling and stiffening up in these early days.
 
I would add that the swelling and stiffness persists even after early days. BUT, look another big butt =), what you can do improves along the way.

As a frequent member of the "over did it club" myself, swelling and stiffness can last for days even at 21 weeks out where I am. Sometimes it doesn't manifest for a couple of days at this point. Just enough to remind me that I had surgery 5 short months ago and that I should take it a bit easier.

Which has been difficult for me this summer, it's been a pretty busy one.

Pacing yourself is key and only you know how your body is going to react. It's like going to school and learning a new subject, you never quite know what your grade will be until after the final which is typically at 1 year!
 
@ihavetwins you were kayaking and paddleboarding 7 weeks post op?!? How in the world did you get your knee to bend so you could get in the kayak and other things??? I'm 5 weeks post OP and I cant bend mine without pain and bands of stiffness and barely over 90 ROM!!
 
5 weeks is very early stage in your recovery. Try not to worry. The bend will come.
 
Just had 10 week post-op appointment with the surgeon and luckily he was OK with my slow but steady progress. I was worried he would want to do an MUA, but he said as long as my ROM keeps improving then it's fine. I will see him again in 4 weeks and if I'm continuing to improve on my right leg, then we'll schedule my left knee.

Also saw my PT right after the surgeon and my flexion is now at 105 and my extension is 0. So ROM finally improving! Mods can you change my title to "ROM slowly but steadily improving"?
 
@Jobiwan I took my ice machine with me and was very good about keeping the swelling under control. As of today my knee feels pretty tight and I can pedal slowly for about 30 minutes, which I’m sure is great but, honestly, I was hoping my knee would be feeling much better by now…

Hang in there. It’s a long journey but the support here is fantastic!
 
@GiantFinnegan ;

While your best opportunity to gain quick ROM is in the first 12-16 weeks, that doesn't mean you won't progress after that.

My PT had an eloquent explanation and I wish I had written it down. You can always gain ROM, even years after surgery.

Right now, I "think" I am really close to where I was before surgery, I can almost wrap my feet around my office chair now. How many degrees that is? I don't know but it's about the only benchmark I remember other than squatting which I am where I should be with that.

I am going to make a real push to work on kneeling and getting ROM while I a am kneeling here in about a month. I have plenty of range for everything I do except when I kneel, then it seems 90 degrees is all I get. It's probably in my head (at least my wife says so).

While I have been working on kneeling since basically the beginning, it's still uncomfortable when I don't use knee pads and for what I paid for this surgery, if I had to carry them around with me, I will!
 
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