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Revision TKR My left knee story, revision complete 8/14/12, hopeful

It rather depends how much 'slightly bent' they are. A little is okay but it's difficult to say how much is too much. You could probably do with making sure you stretch your legs often during the night when ever you happen to wake up. That's what I used to do.

But the night time's inactivity is bound to have repercussions in the morning. It should ease off as time goes on.
 
I agree with Jo. I think a bit of stiffness is just a fact of life for a while, though. As long as it stretches out okay I wouldn't worry about it.
 
Day 5 post MUA: Started the day yesterday feeling pretty good, still had good extension and motion. Got to PT, and with minimal movement got fairly flat and reasonably good flexion. THen the PT started in with some harder pushing and twisting my leg. It seems the hip/leg is somewhat out of position or doesn't line up right, which has been a long term problem, but never impeded me from doing anything. She decided to spend some time on it, then got heavy into the pushing for extension. By the time we were done, I was plenty sore. They put me on 15 minutes of electrical stimulation but forgot to ice it, and I didn't even think about it until I went to put my shoes on and it was painful to move from the table to the chair. I got back to work and had to get straight into a sitting position, so this all added up to one painful evening. I did elevate and ice for about an hour after supper and then got into the CPM for an hour. I have PT again this morning and will make sure I tell her we are taking it easy today, not going for broke. If there is one thing I have learned from this site, it is that you can't get extension or flexion with swollen joints. Since I am paying for this, I will be a little more firm so that I don't walk away today with a similar situation. I also need to remember that focusing on the numbers for extension and flexion can be a real downer. I can't remember who it was that posted about focusing on function, but that is great advice.

Thanks for helping me to become empowered with knowledge and affirmation that what I am experiencing is real and "normal". I don't know how I would be doing without the reassurance of this pool of experienced knee survivors.

Thanks and here's wishing everyone a great day!

Dawn
 
jerseychick said:
Dawn...welcome to our family here at BoneSmart. My muscles were also contracted, I walked with a limp for about 15 years or more and could not bend my knee more than 30 degrees. I found that deep tissue massage helped me tremendously. I started going about 1 1/2 months after my TKR and I still go every week on a regular basis. My extension was good, but because I couldn't bend my knee, my muscles were so tight and contracted. It took lots of work but now my flexion is about 105-110 degrees. My therapist works my hamstrings. quad, it-band and calf muscles. It has really loosened up those tight muscles. It may be worth a try.
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KKM said:
I have found that massage therapy works much better on me than any other kind of therapy. ... A lot of traditional bending and straightening seems to make my knee swollen and angry, whereas massage is soothing, gentle and gives me better gains.
Click to expand...
Absolutely!!

Tightness is something I know a little about, as it's endemic amongst competition cyclists -- the position on the bike is most unnatural, fairly obviously. Cyclists develop weird posture and an odd DA walk (stands for 'duck's ****', can I say that on here?? (Edit: preview shows me that 'no I can't', but I expect you know what I meant. I'm not going to workaround the rude word checker either, I might get banned.)).

Massage is BRILLIANT at fixing this and helping to ease tightened muscles (and ITB too, although doing that right hurts). I am certainly going to experiment* with it during my own recovery (roll on the day) and would WHOLEHEARTEDLY recommend trying it. It feels very nice too.

*the experimentation will be just for the TKR recovery, I've worked with the same masseur for about 12 years for therapy from cycling-induced stiffness.
 
Day 6 post MUA: had pt at 8am, and I let her know that we would not be pushing and pulling hard today, that I wanted to focus on massage for my calf, hamstring and quad. She complied and ended with estim and ice, which was better than yesterday. I am still really swollen and stiff, extension is not as good as a couple of days ago but I really think it has to do with the puffy joint. I think looking into massage will be next for me once PT is done. I feel a little down about where I'm at having lost some extension but it's to be expected. I came home, got supper and went straight to the ice and elevate. Now I am in the CPM for another 20 minutes, then call it a night.

Hoping for a better day tomorrow!

Dawn
 
Good idea to take it slow, Dawn, until you get that swelling under control. You're doing a great job of staying in control of your therapy! It will pay off for you. After all, YOU are the only one who really knows what is working and what isn't with your body.
 
It's been one week since the MUA and I am feeling a little frustrated. I have had quite a bit of swelling and it's been painful, stiff and not nearly as freely moving as a few days ago. My calf has been cramping quite a bit today for some reason, so tonight I have done a good bit of massage on it. Helps but not a lot. Have had ice on it for the last hour, now on to the CPM. I hope the extension and flexion come back once I get the swelling down. Fingers crossed! Trying to keep the faith....Dawn
 
Day 10 Post MUA: knee is still puffy and stiff. I cannot get the foot flat on the floor like it was for the first 4 days after the MUA, very frustrated!!! I had PT yesterday and discussed with her my situation, she advised not to get impatient. It's very challenging at this stage. Was really hoping that the MUA would work and the results achieved would be kept. Not so sure anymore. I am back to using one crutch, had to give up the cane. With Winter already here, snow and ice part of the daily grind, my spirits are pretty low. I am fearful of falling but can't just hibernate either. Perhaps I overdid it with all the Thanksgiving dinner preparations, was on my feet for a very long time, maybe why the pain yesterday was pretty bad. Just looking for perspective, hoping this will be a bad memory in a few months.

Dawn
 
Listen to your PT. It's much too early to start getting frustrated, especially if you've been on a cooking marathon! (naughty naughty :wink1:) but things will settle in time. You need to get really stuck into the icing and elevating to get on top of that swelling because that's what's holding you back.
 
Day 12 post MUA, swelling has come down considerably over the weekend. Lots of ice and elevating, rest and gentle stretching. I am standing straighter and flatter which is good. Bad news is, when I go to work and sit in my chair for those long stretches, the knee doesn't like it and is stiff/painful to get moving on. I try to get up often but admittedly it's not enough. PT today started Luton a sour note, measured at 14 for extension, exactly where I was pre MUA. With lots of massage and stretching, no hard pushing, got to 5, so we ended on that high note. Trying to keep the faith...on the CPM now and soon heading to bed. Take care out there!

Dawn
 
Dawn....you might want to get yourself some YakTrax to help keep you stable in the ice and snow. They really work.
 
Thanks Jamie, I will do that. There is an LLbean store nearby plus an Eastern Mountain Sports store, so one of them should have some. Not looking forward to slippery sidewalks and stairs!!
 
Hi Jo,

He got to 5 for extension and 118 for flexion. At PT on Monday, initially I measured at 14, then after quite a bit of massage I measured at 5 with a tiny bit of pushing, flexion at best was 105. She mentioned she might recommend a dyna splint or JAS device if I don't improve. I have the CPM until next Monday and i use it for an hour each day set at 120 to -10. I ride the recumbent bike each day for 25-30 minutes and other stretching each day as well. I see the OS on 12/21 for a follow up. I did read the article you suggested and it makes perfect sense, constriction changes blood flow which challenges the joint. I just need to get up more often or stretch out my leg while sitting. Tomorrow will be two weeks since the MUA and 3 1/2 months since the TKR. Hoping to see improvement that stays with me instead of being lost when I walk out the PT door. What are your thoughts?

By the way, I can't thank you and Jamie enough, plus all the members who provide counsel. This is something of an isolating situation and people who have never been through TKR just don't understand it the way this community does. Glad I found you all!

Dawn
 
Dawn, I'd say you're doing just fine. Some folks just come along a bit slower than others....especially where extension is concerned. If it was me, I'd skip the devices and just continue to work on exercises that stretch and bend your leg. You'll get there!!
 
Well, no-one was ever able to get to what the surgeon did while the patient was under anaesthetic. The patient is paralysed for one thing and not feeling pain for another. Once the MUA is done, there will always be a lot of reactive swelling which further inhibits it. So all in all, I'd say those numbers were pretty good. You just need to ice more and as the swelling goes down, things will improve.
 
Hello I was wondering about degrees and my extension issues and scrolled up saw this posting I guess it answered a lot I went to the library and saw a few things I have PT at noon today was going to ask her for some measurement’s I no its just 8 weeks I think last week I was at 105 degrees I bought a recumbent bike which is great I watch TV as I ride it about 10mins morning and 30 at night I also bought the for my boots as I’m afraid also slipping on the ice CozyWinters.com , I no Josephine we all heal different and listen to are body which is in control I just feel I’m not getting ahead I’m on one crutches ice and my meds vicodin 3 times every 3 hours which don’t agree with me but they help with the pain my big things I can’t get comfortable with is the elevation part I see it in the library but I’ve tried pillows but they slip away then my knee bends I would buy a pad or something as I’ve tried pillows but they slip away but I; v looked at different site to buy something as seen on the library site oh well I’m off to PT :blush:
 
Day 14 MUA: Thanks for the encouragement Jo. PT today was actually pretty good. Initial measurement was 9 and 105, pretty happy with that. The PT spent almost the whole 45 minutes in deep massage on my calf muscle, he calls it the gastroc. He used a couple of devices, one held in the palm of his hand and the other that looks like a rolling pin. it was painful but nothing like the pushing they had been doing. After all the massage he measured again and I had 6 for extension, very happy with that. At home now and notice that I have three fresh bruises on that same calf, maybe a small price to pay.

Just13, you are right, only 8 weeks out is really pretty early. I found myself focusing on the numbers way too much, and still doing it too. Extension has been a long term issue for me so I'm a little uptight about it. Just stick with the exercises, ride the bike which is awesome, and see if you can find some firm pillows to elevate on. I would check with your PT, they may have suggestions on where you could find something that would work. Hope PT went well for you today!

Dawn
 
Day 16 post MUA: went to PT yesterday morning, and boy was I sore. She spent a lot of time doing massage on the hamstrings, quads and calf. the joint itself seemed to just ache, and ache. We didn't take any measurements but it was clear that extension was still missing. We had a cold front move into the area overnight, maybe that played a part in it. By the time PT was done, all I really wanted to do was go home, take a pain pill and chill. Unfortunately, I had client meetings and had to go into work. After a short time, I was better, but man that depressing feeling hit me like a ton of bricks.

Just don't know where all this is leading. Soon I will be 4 months post op, and still using one crutch, still having pain that requires more than OTC meds, and in the morning, I couldn't imagine trying to get up and around without the crutch. I just want to know there is hope that I will be able to at least walk without any aid and be able to do the daily functional things, like getting up from my office chair and start walking without being so wicked stiff, and being able to go up and down stairs like a grown up. I'm not expecting to run a marathon, I just want daily function to return. Maybe its just still to early to expect given my history of adhesions, and issues with extension. If there is someone out there who has had a similar obstacle and has come through it, I would be interested in hearing how you did it and what the timeline was.

Dawn
 
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