TKR Mariposa's Journey

[Mariposa]

Thanks Layla, yes, I did some research on the net and my OS explained it to me too.

In my case I think that the cause has been overcompensation for my TKR, as well as "naivety/ignorance/pressure" of my part as plenty of people (PTs included) kept saying leave the crutch behind..

We live and learn!

I trust my OS, he seems rather sensible and experienced.. I'll follow his advice and put everything from my part and see how it goes..

I'm sooooo looking forward to gaining full mobility and a "normal life"..

Thank you for your interest!

And to the ones who will post if they like;-)

Mariposa

 

[Layla]

You’re welcome, Mariposa!
Stay in touch, I will follow with interest. This will be a learning experience for us all.
I hope you have a lovely weekend!
@Mariposa

 

[Mariposa]

Same to you, have a lovely weekend!

 

[Mariposa]

Hi again,
I forgot to ask something please:

My arthroscopy (smoothing of the cartilage with radiofrequency/troclear grade 4) was a month ago..

Is it normal to still have stiffness and internal swelling?

Thanks again

 

[Layla]

Everyone responds to surgery differently and while your procedure was minimally invasive with an anticipated recovery shorter than that of an open surgery, I don’t think it’s abnormal that you’d still have some residual discomfort or swelling at only one month post op. Try elevation and icing for relief and don’t hesitate to contact your surgeon or his care team for reassurance if you feel the need. There’s nothing like peace of mind.
A great week to you, Mariposa!
@Mariposa

 

[Mariposa]

Thanks for your feedback, Layla.

Yes, I'm hoping is that and I'm trying to work on the bending with gentle exercises at the pool.

I admit that I feel sometimes a bit anxious about the outcome of this surgery .. I'm aware that my troclear is level 4 (bone one bone on that part)..

The OS seemed certain about not needing a PKR in "many years"..

I'll try to strengthen gradually over the next few weeks and months.. with adapted exercises (I'm just "working" a bit at the pool for now).. and see how it goes.

Ill give myself a few months. If I don't get enough improvement to lead a "normally mobile" life, I'll look for other opinions/surgeons.

but I'll try to concentrate on the present.

have a good week you too

 

[Mariposa]

Hi bonesmarters,
I have got a little update and a question about strengthening methods, if I may.

Thank you very much in advance

I'm on my 7th week after my arthroscopy on my left knee and I'm feeling much better.. and I'm still being treated for the tendinitis on my tkr leg (right one).

I'm walking still on crutches due to lack of muscles in my legs though and I'm thinking about either :

1) Joining a gym and work on strengthening with machines (with some guiding during the 1st and 2nd sessions) as I'm not a gym person.

OR

2) Joining a Pilates studio (with a machine called reformer, I think) and work the strengthening there.

Does anyone have experience with both or one of them, please?

What would you recommend?

I have been swimming 5 times a week over the last 2 weeks (with a better kick) for about 30/40 minutes session, with some pool walking.. and some floor exercices for strengthening in the evening (20/30 minutes) about 4 times a week

I still have atrophy on both my legs and my aim it's to get rid of the crutches in a few weeks if possible (!)

I'd appreciate all the suggestions/advice you can give.

Thank you all. I hope everybody is recovering well.

Greetings from
Mariposa

 

[mendogal]

I understand your frustration. Your current regimen sounds sane for being postop!
My experience and understanding of soft tissue healing and muscle rebuilding (after various athletic injuries and surgeries, plus I really enjoy doing weight training on machines when it's safe to) is this: soft tissue healing takes 6-8 weeks so in your situation I personally wouldn't consider going near any machines for strength training yet, and would definitely clear it with my surgeon first.
Doing Pilates *without the machines* and with a focus on core isn't going to directly address your leg atrophy but is still helpful and @EalingGran has some good info on that!
Building muscle...from everything I read about current research, as we age it's really difficult without increased protein (at each meal, not just a big serving at the main meal). I realize you're not a senior citizen yet, but being post op also increases the need for protein. This is something you can try that may make your current regimen more effective.

 

[sistersinhim]

I would think that your swimming should be the best thing for building up your muscles. Your knee is still a baby and strength training isn't suggested until around 4 months out. Walking against the water is adding resistance and is a form of strength training. Be very careful or your knee may throw a fit!

 

[Mariposa]

@mendogal Hi and thank you for your feedback!

Yep, sorry, I forgot to add that I'm intending to start some strengthening exercises in September, so 8 weeks after the artroscopy.

My surgeon gave me the green light for that last month, going slowly and listening to my body, as he knows that muscle atrophy has been my weakness all along..

(I arrived late at my RTKR and I see that it has complicated and prolonged everything) but I'm determined to fully heal.

About protein: yes, thanks again for the tip. I'm taking some protein powder with my breakfast every morning and I eat healthily (with protein in every lunch).. as it's very hot in here (Spanish summer), I skip dinner.

I'll see how I go about it .. if I hit the gym I'd do it first with a couple of sessions (I have got 2 left) with a PT, so that she can supervise the exercises and/or machines..

She's rather cautious so I trust her.

If Pilates it's not the best way for working out the legs, I'll opt for the gym..

(I'm more naturally attracted to pilates though).

Thanks again. Enjoy your weekend

 

[mendogal]

Oh! I wanted to add...
Before my knee replacements, I had been off of the leg strengthening machines for years because they aggravated my arthritis terribly! So I don't know what your arthroscopy was a treatment for, but if there's still arthritis in that knee, you definitely should check not only with your surgeon but specifically ask a PT for knee-sparing exercises!

 

[Mariposa]

I would think that your swimming should be the best thing for building up your muscles. Your knee is still a baby and strength training isn't suggested until around 4 months out. Walking against the water is adding resistance and is a form of strength training. Be very careful or your knee may throw a fit!

Thanks @sistersinhim !

I see your point.. I'm feeling quite ok after the arthroscopy now, after 7 weeks though.. a huge difference from recovering from my RTKR. Do you think I shouldnt be thinking of strengthening exercises?

 

[Mariposa]

Oh! I wanted to add...
Before my knee replacements, I had been off of the leg strengthening machines for years because they aggravated my arthritis terribly! So I don't know what your arthroscopy was a treatment for, but if there's still arthritis in that knee, you definitely should check not only with your surgeon but specifically ask a PT for knee-sparing exercises!

Thanks again. My arthroscopy on my left leg was for damage on the troclear cartilage. They used radiofrequency and most of the pain seems to have gone now, thankfully. BUT I'm aware that I need to go slowly with everything.

I'll be extra careful with that and I'll tell definitely my PT about it.

The last thing I want now it's going backwards ;-)

 

[sistersinhim]

Do you think I shouldnt be thinking of strengthening exercises?

I think you should let your knee be your guide. If you are OK doing those exercises, then continue on with them. That is the key for all of our members. Your bodies are all unique and what's good for one might not be good for another. Listen to your knees and learn from it and you'll have a less painful healing!

 

[JusticeRider]

Hi @Mariposa it’s good to hear from you! Please go easy at the gym. I’m not a doctor, but as I understand it, cartilage damage does not go away and cannot be reversed. The exception is cartilage grafting which can work for some people for some amount of time (it wasn’t a good option for me personally, sadly). Right now, the damaged cartilage in your knee is still damaged. It sounds like your surgery was meant to ease your symptoms and buy you some time before a PKR or TKA is unavoidable. Does that sound right?

I also had cartilage damage to my trochlea (groove of the femur that the patella slides along, for readers who may not be familiar), as well as my patella. My current PT told me absolutely do NOT use the leg extension machine at the gym. She said it puts tremendous strain on the patellofemoral joint. She also warned against the leg press and the hamstring curl machine for the same reason, though she said the leg extension machine is the worst. She said many PT’s do not realize how those machines can be dangerous for people with patellofemoral issues specially.

I hope you will go easy and slow, listen to your knee, and carefully preserve the cartilage you have left as you heal and begin to strengthen. You can do this! Wishing you all the best

 

[mendogal]

and @JusticeRider and @Mariposa ...
those are precisely the machine workouts used to rebuild quads and hamstrings. It's been years since I could use them (clamshells with resistance bands and straight leg raises with ankle weights were my knee-sparing exercises). My hope is to slowly resume leg press and hamstring curl, at very low weight, when my newest knee hits 9 - 12 months.

 

[JusticeRider]

@mendogal yes, exactly! And strengthening those muscles is what we all hope to do. It’s quite a conundrum…how to build strength without inflaming the knee.

I should clarify, my PT didn’t mean not to use the leg press or hamstring curl machines EVER, but to not use them if you have patellofemoral cartilage damage or before a replaced knee is ready. (She did say to never use the leg extension one ever though). Every knee is different and apparently PF issues are especially complicated.

I personally have to protect my non operated knee because it has PF damage of its own. So those are no-no’s for me! The hill work has made a world of difference though, and it works both the quads and hamstrings. But the trickiest question is what can be done early on when the knee is fragile

 

[mendogal]

@mendogal yes, exactly! And strengthening those muscles is what we all hope to do. It’s quite a conundrum…how to build strength without inflaming the knee.

...but the trickiest question is what can be done early on when the knee is fragile

agreed. I have been doing simple quad sets per OS instructions literally since I woke up from surgery, and still do them often throughout the day with no pain. Once sidelying is permitted and comfortable, I go back to doing clamshells, although without the therabands. Once I can raise my postop leg successfully and easily - and I can see from folks' postings that when that's possible is really variable! - I go back to trying a few slight straight leg raises because they never irritated my terribly arthritic knees.

 

[Mariposa]

@sistersinhim , @mendogal, @JusticeRider

Thanks to all of you for your wise recommendations! Great to hear from you too JusticeRider!

Yes, I'll not use the extension quadriceps machine at all. I'm still not sure whether to join the gym or not, to be honest.

The idea it's to start with a PT in the gym (as I have 2 sessions left) and she works just next door... But then I wonder if it's the right option?

As we know, the tricky bit it's to try to strengthen slowly without overdoing it and causing more damage.

I'm really listening to my knees these days.

Swimming it's one thing I can do better now without hardly any pain.. so I'm mainly doing that with pool walking (gently).

For the swimming: I do crawl and back strokes (without hitting the wall, doing the turning, as I used to do).

But I'm aware of the fact that I need more strength.

I'm going to take it slowly, think and see the best way to go about it and start really slowly.

@JusticeRider : did cycling hurt you?

Because I'm not too comfortable on it for now.

I'll keep you all posted. @mendogal : I wish you a good recovery!

Thank you again all for your support!

Mariposa

 

[EalingGran]

My pilates teacher has a really good side lying/no squats glutes strengthening 20 minute class on YouTube. Google Katja pilates glutes and it comes up.
I was able to do it before and 4 weeks after my PKR. My surgeon was impressed with how strong my upper leg was post surgery.
I use a medium resistance band now when doing it.