TKR Need better ROM, please advise.

[DragonHeart]

I am so uncomfortable and achey at this time of night. I used to love bed time, but not anymore. I really hope this bedtime dread isn't a very long stage. Here's hoping tomorrow is a better day!

Yes, it does get better. I'm the same way, I used to love bedtime but now dread it. Just in the last few weeks it has gotten better for me. The muscle spasms and restless muscles are calming down and I can finally get about 3 hours of sleep at a time instead of sleeping for an hour and awake for 40 minutes or so. When I do wake up, I can fall back to sleep faster and I feel like I'm sleeping deeper. So hang in there, eventually the sleep will get better. Mineral Ice helps the achey muscles and knees.

 

[hurtin_unit]

Thanks Liz for your mesg of encouragement, we are learning more and more here as we all share our ideas.
Chris, I was also sleeping about two hours then wake up for an hour and just take cat naps as my knee would wake me up. My OS prescribed muscle relaxants to take before I go to bed and I have been seeping thru the night. I always sleep no more than five hrs but now I average eight. Thats too much sleep for me but I will take it for now. I know once I go ack to work i will go back to 5 hrs.

 

[Nyland]

Hi Chris,
Thanks for sharing. It helps to know that I'm not alone. I opted to sleep in the recliner last night. I did because I feel so bad that my husband hasn't been getting any sleep. I think it was a good choice for me. I cat napped and was able to go online and read this website, and watch some of the olympic events. No stressing about bed dread helped so much.

 

[Celle]

Hi Chris,
Thanks for sharing. It helps to know that I'm not alone. I opted to sleep in the recliner last night. I did because I feel so bad that my husband hasn't been getting any sleep. I think it was a good choice for me. I cat napped and was able to go online and read this website, and watch some of the olympic events. No stressing about bed dread helped so much.

I read about sleeplessness being expected after a TKR, so I moved into the spare bedroom for about 3 months. I was also worried about hubby accidentally kicking my sore leg in his sleep, so decided to avoid that risk, too.

I set the spare room up as a sort of den for me. I asked my husband to put some bricks under the foot of the bed, so that the foot end of the bed was elevated. I put in there all sorts of activities for me to do if I could not sleep - TV, books, knitting.
I had all my medications in there, as well as water, drinks, snacks and ice packs.

Whenever was not pottering around the house, I retired to my den. With the door shut at night, I never had to worry about disturbing anyone. I found that helped me to relax as well, and gradually I started to sleep for longer periods at night.

 

[kneesrus]

Hi everyone, here are a couple of observations I have made over the years and with my own knee. One big reason, ROM is sometimes is slow in returning, is the swelling in the joint space. Some TKR patients are swellers and some not so much. If I have someone that tends to hold fluid in the joint, I stress to be gentle and don't let them be aggressive on pushing their flexion. As the swelling decreases, the ROM returns.
Another item that helps many, is to try walking around several times a day. In other words re-engage into life. I have found that too much inactivity does not help to decrease the swelling. Moderate activity helps keep all your systems regulated and lets the body know everything is all right so get rid of the swelling. Once the patient knows they are not going to damage the surgery and it is alright to walk and to be more active, the swelling goes down and the ROM improves. They are all amazed when this happens. They can walk with a walker or cane. The only rule is, they have to take a near normal step with each foot. Equal stride length.
I have worked with all ages, sizes, components, males, females, and numerous OS. The less active the patient is, the longer it takes to achieve normal functions. I never physically push on any of my TKR population. From day one, they are told, the motion will come back without me pushing on their knee. We will take only what it gives us, and it works.
Just a little FYI,
David

 

[Jamie]

I couldn't agree more, David!!! When we talk about resting as part of the BoneSmart mantra, it never means total inactivity. It is critical to do some walking around the house....even short trips outside (good for the body AND soul). When I couldn't sleep at night, I'd go out and get on my exercise bike for 5 minutes of VERY slow turning. It always worked.

 

[hurtin_unit]

David, are so right. My OS has been expecting a lot from me even though my knee has been swollen from the beginning. My PT was working it hard and so was I at home until I joined Bonesmart and learned that you cant get good ROM from a swollen knee. I shockedmy knee with all the hard work. Once I started icing, elevating & resting my knee more the swelling started going down. my PT has concentrated more on stretching the last 6 visits. Yesterday I went to my PT and was happy to find out I went from a ROM of 72 to 85 in two weeks. That made my day. Today I went to my OS and he said Im doing much better and wants to see me in a month, he's also expecting me to be at 110. Thats my challenge. Im feeling a lot better now that the swelling is going down. I had to give my poor knee a break!!

 

[Dmgkag]

Glad to hear you are making progress...Have you gone in the pool yet?

 

[kneesrus]

I would suggest not to be focus on the number of degrees but can you do better functionally. Putting your socks on, dry your feet, get out of car without hitting your foot on the door and able to go down stairs, (that's a tough one). Try to increase your function and the motion will take care of its self.
David

 

[maryo52]

The fact that I&E + stretching-focused PT has gained you almost 15 degrees is proof that your problem is not adhesions but swelling. I think it's incredible how quickly you accepted the advice of this forum and got mobilized on a new program. So I know while you like your OS's hope for 110 at next visit, you know that your knee doesn't give a rat's a-- about medical numbers. You and your knee are working well together and you WILL see 110 and beyond in your own good time.

 

[hurtin_unit]

David, I agree with you. Increasing function is the best way to monitor your progress. My OS only worries about ROM. He never asked me last thursday if i could do any functions. I have found that as of last week I can put on my underwears, my socks and barely go in and out of the car without hitting my foot. This is major progress for me. I noticed that icing every two hrs, and elevating my knee, with my PT being more gentle really helped bring down the swelling. Now that she sees my progress she's not working me hard as my OS requested. I don't mind going to PT anymore. If it hadnt been for all I've learned here and not allowing any more aggressive PT, this knee would be twice as swollen. I'm impressed with this site. I thought that a week after my post I wouldn't get any more advise. I see that people still read my post even after several people already gave advise. I welcome each and every advise given because I have followed the examples and because of that I'm doing so much better.

Thanks Maryo for your comments, you hit the nail in the head, my knee and I are a team now. It didn't care about my OS demands to be at 90 by last Thursday. I was at 85 instead. My OS said he would lower the bar for me. I told him that my knee will dictate when it will bend better without getting a gorilla to bend it. I also told him I was happy wih 85 ROM. I'm sure I will achieve 110, maybe more. It's up to my knee, the real boss.

II remember a month ago my knee was being abused by both my OS and my PT. Whenever I had to see either one i would be left in a little corner licking my wounds then I came to Bonesmart and I was filled with hope from my new family here. I want to thank everyone for being so nice, understanding and helpful.

Al

 

[bottomshollow]

Al. What a wonderful testament to the forum, its members, and the BoneSmart way to recovery. I'm so glad you found us and that we were able to be of real help to you. You are doing great---so just keep up the good work. Take care of yourself and your knee and keep us posted. We care.

 

[maryo52]

H.U., if your OS "lowers the bar," does that mean you get a drink sitting down??!!

So glad we have been at help. Eventually we all learn to "channel" our knee because that works.

 

[bottomshollow]

Maryo52 said, "H.U., if your OS "lowers the bar," does that mean you get a drink sitting down??!!"

Too funny Mary! I love this---great sense of humor---and it helps in this journey we're all on.

 

[kneeper]

So glad you're doing better hurtin unit.

 

[hurtin_unit]

Thanks Kneeper,
This site is unique, everyone has a genuine desire to help others. Your message as short as it was carries a lot of weight. This message makes my day. Because of folks like you Im proud to be a bonesmarty. Its a long road to recovery but its a lot easier when you know help is just a post away. I will have a three month update soon to post. I wonder if I should post here or start a new post.

AL

 

[bottomshollow]

Al, this is your recovery thread---so you should post your update here. If you'd like a title change for your thread---let me know and I will be happy to change it for you. You can tag me by putting a @ in front of my user name bottomshollow---just be sure to get the spelling right. Then I'll change to whatever you'd like.

 

[hurtin_unit]

Alrighty, thanks for the info.
I see many people have their surgery info like TKR and date.
Do I as a new member have that option? I went to my profile but didnt see that option.

 

[bottomshollow]

Al, if you go to the top of the page and hover your mouse over your user name, you'll get a drop down box that offers you lots of options---one is Signature. Select that and in the message box type in the surgery info using font size 2 or 3. If you look on the gray bar at the top on the extreme right hand side, you will see "Office" --if you select this, there will be a selection on "how to use the forum" that has lots of good info.

 

[hurtin_unit]

I just went and found a world of options!
Thanks!