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TKR Moving forward.

Day 18 post-op:

- extension is still difficult, but with a good warm up, hamstring and calf stretching, I got to -1° today. To me it feels like pressure in the back of my leg, not stretching, or pain.

- flexion seems to be easier for me. I was able to get to 121° after all exercises at PT. As I'm going through my sessions my quad feels like it is stretching. Nothing like the feeling of trying to get gains in extension.

I am happy with my progress so far, but I am definitely nervous regarding extension. Realizing that it is still very early in the healing process helps, but I guess it is just ingrained in me to move forward. Doing my best to find a balance between patience in healing and working towards gains. It's tough.
 
Cycle-Path said:
am happy with my progress so far, but I am definitely nervous regarding extension.
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Great update. Your extension seems great for so early on- so I wouldn't worry. Just go easy- the bigger risk is pushing too hard and causing swelling which would set you back. You are doing really well- just go gently.
 
Three weeks post-op:

Things are going well. I'm at 123° flexion and still struggling with extension, but I can get -1° and sometimes 0° with some work. It still hurts, but I am down to taking only two percocet a day at this point. One every 12 hrs versus every 4hrs.

A new concern of mine is calf weakness. I injured my back in 1999 which required surgical intervention. The injury involved my sciatic nerve root which left me with right calf weakness. This procedure seems to have allowed my calf to get much weaker with less use. I hope with work that I'll be able to get it back or my gait will be pretty bad. As of now the calf is tight and weak.

One thing that keeps going through my head since surgery is my interaction with the nurse anesthetist right before the procedure. She came in the room and started asking pretty intrusive questions and she did so very rudely. She was unprofessional and was borderline accusational. She most certainly had some preconceived notions regarding veterans and/or law enforcement, maybe both. I've had six other procedures under anesthesia without any reactions and I have never been treated like a convicted violent criminal before. I've been debating on writing a letter or requesting a meeting with hospital staff since then. Right now my focus is recovery and moving forward, but I still may pursue it to a degree.

Back to my knee. I'm enjoying therapy much more now since my quad has started working. Therapy seems to be changing and is more about moving while still doing the ROM exercises: Straight leg raises while standing - forward, side, and back; high knee and butt kicks (very slowly with control); calf, hamstring, and lunge/stair stretches; heel to toe raises; baby squats in parallel bars; etc... We've also started to do both legs, so my left leg is not jealous. Then again, it may be about using my right leg functionally a little bit ;-) For the most part the exercises feel good. I do enjoy what I describe as a stretch type of feeling in my quad as I do them. The knee does swell quickly, but the session always ends with a wonderful compression/ice machine that relieves swelling greatly. I'm debating on trying to find someplace that does therapeutic massage to help.
 
Calf issues: check with your PT for gentle calf stretches to do at home (I stand on a tilted surface with heels lowered for a few minutes). They might also show you simple strengthening like facing and holding onto the kitchen counter and going onto tiptoe a few times.

The PT regimen sounds sane as long as you take days off after. And I strongly caution against adding weight or resistance bands for another couple of months to assure enough healing - some PTs simply don't understand the degree of physical trauma we go through.

YES to massage. You might ask about someone who can include hip and sacrum releases as they are often affected by the way our quads and thigh tendons are traumatized in surgery, and after my knee replacements it was a huge relief to have those done as part of therapeutic massage.
 
I got in my pool last night and did a little but of walking followed by a good bit of floating ;-) It felt great to be able to move around with confidence and no walker or cane.

Since I'm down to two percocet a day I got in touch with my Doc to discuss working in tylenol and motrin (yesterday). He gave me the recommended amounts and a green light to use them.

This morning there was a very noticeable reduction in swelling in my knee and thigh. It really is surprisingly better and I wonder if it's due to motrin or just progression of the normal healing process. Regardless, it sure feels better and I can get around/move the knee much more intentionally today.

I want to add that I really needed this boost. I've been fighting a negative mood/depression over the last week.
 
Cycle-Path said:
I've been fighting a negative mood/depression over the last week.
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So normal....Cold comfort, I know, but you're not alone and it will pass. Glad you got the boost you needed, but don't be surprised, or get down, if swelling returns. It seems to be in relation to activity, or lack thereof early on. It's a lot about finding a perfect balance and you're still very early into the healing process. Resort to rest, icing and elevation on the days you feel the need. Thanks for sharing an update with us. I hope you have a nice Sunday and week! :wave:
 
Layla said:
It seems to be in relation to activity, or lack thereof early on. It's a lot about finding a perfect balance and you're still very early into the healing process.
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I believe you're right. My PT really changed things up this week and I think for the better. It was probably a natural progression, but I like it. In turn I reduced what I was doing at home, but still focus on stretching, icing, and elevation.

I got out for a little bit today on my tractor and used the loader to lift the pool steps out, so my son could clean under them. Then I filled the horse's water troughs using my country golf cart to get around (4x4, mud tires, radio, etc...). Lol. It didn't cause any swelling or pain, so I'm not feeling as limited in ability this evening.

Right now I'm cautiously looking forward to what next week brings at PT. Although my therapist made mention of stairs... I sure hope she means the really, really, short ones!

In hindsight this past 3rd week has been the best week since surgery (roughly day 15 to current). I have made a lot progress in the past 8 days.
 
Got to 130°, but extension was only -2°. I'm really trying to convince myself that extension will come, but it keeps making me nervous.
 
Your extension is FINE.
You're less than a month out.
It might take two to three months for zero.
Some folks stay at 1- 2 degrees and do just fine.
 
Day 28. Happy to report that I really don't need to use my cane anymore unless I'm swollen or pushing new walking distances.
 
As long as you're not aware of a limp, that's great!
I continued to use my walking stick on longer solo outdoor walks for 8 weeks because our sidewalks are notoriously battered and uneven.
 
mendogal said:
Your extension is FINE.
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Thank you for the positive reinforcement. I'm just very hopeful for the outcome of this procedure and have tended to be active in my recovery wherever comfortable. I am not pushing into pain thresholds at all and have been doing well. However, my level of activity was fairly good pre-op and I believe that has helped greatly.

One thing that I am noticing is that my hamstring, calf, and IT band are pretty tight on the operative side. When I stretch them I get more extension. I've got my handheld roller out have been working those musle groups lightly. It feels good, but I am not ready for my foam roller (one of the 6" tube's that are 3' long).

Also, I don't recommend using a handheld vibratory massager. I tried it and it was instantly a bad result. Lesson learned there. I have found a local theraputic massage business and will be scheduling a session soon.
 
Cycle-Path said:
found a local theraputic massage business and will be scheduling a session soon.
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That's a great idea. I found deep tissue massage very helpful in loosening up all those tight muscles. Just be sure to check with your surgical team before your schedule. My OS, who is a huge advocate of massage, asked me to wait until I was 2 months post-op and the incision was well healed before my first appointment.
 
Cycle-Path said:
Day 18 post-op:

- extension is still difficult, but with a good warm up, hamstring and calf stretching, I got to -1° today. To me it feels like pressure in the back of my leg, not stretching, or pain.
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There is absolutely nothing wrong with -1 on day 18. I am at 10 weeks and 2 and 127 flex, I am not one bit worried about it because I know it will get better. Even if it doesn't I am good because I can walk without a limp and have no problem putting on my socks and shoes. I still have tenderness in my knee when I walk but it is getting better all the time. I have no problem with steps now either.
Hang in there do not push it because that will set you back I had to tell my PT several times to stop the amount of reps they wanted me to do because of swelling and pain.
 
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Progress report at one month:

Took two of my puppers out for a short walk this morning. I decided to stack the deck and took my basset hound and dachshund - low speed but ferocious. Lol.

I'm way out in the country and 1,000' from the road, so I don't need to leash them. Between walking and stopping to enjoy the view and nature around me we went 1/4 mile in about 20 minutes. Of course the dogs probably covered a mile running circles around me. No issues at all with my new knee.

Have a great day everyone!
 
Love this! Sounds like a peaceful and successful walk with your fur buddies. I can only imagine the mileage they made, lol. Thanks for sharing an inspiring update. I loved reading posts like yours before my surgery, or in the early days of recovery when I'd wonder when I'd be able to do this...or that?
Happy 4th, Cycle-Path!
@Cycle-Path
 
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