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TKR Need better ROM, please advise.

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Well folks, today is Sunday and I'm getting myself ready for my second full time week at work. I will be working a different schedule - 6:30am to 3pm - which will allow me to go home earlier and attend PT again. All of last week I drove 45 min each way to work, walked from parking lot to the building, walked around for 15 min every hour, to losen up and kept leg somewhat elevated. Once I got home I was too exhausted to do anything so all I did was elevate, ice and massage my knee, then took meds, went to bed and was comatose within 5 minutes.

One thing I've noticed is that I'm still lifting my hip a bit when walking. I also feel I'm not bending my knee all the way as I walk. When I walk I bend my knee and feel like I have a rubber band on both sides of the knee with a lot of tension, which cause my knee to snap back into place hard so I walk with caution. Does that make sense? Let me say it in a different way, it's like my knee has too much tension and it needs to losen up. I wish I had a hidden nut on the side of my knee to adjust the tension in order to walk smooth and quiet as a cat.


At three months since my operation Im happy to be driving, the 45 min ride is a bit too much for me as my leg starts to call me names after 20 minutes go by. The rest of the way I keep moving my leg from left to right until I get to work. Once there I'm glad to stand up for a minute before starting to walk. Im getting better at some things and im slow doing other things. I can put on my socks, with a little stretching, and when putting on my pants, I lower the right leg pant to the ground as I can't lift my bad leg well enough. That will get better with time. I take the elevator to the second floor every day. I wonder if I should start walking up the stairs every other day. Please advise as I don't want to overdo it.

This Tuesday I go back to my PT and I will have her measure me to see how my ROM is coming along. My OS said I need to be at 110 by the 9th. I was at 85 when I saw him last. This man only cares about ROM. I'm not worried about it. I know ROM will come along now that I finally believe in "less pain, more gain". That is something I learned here at Bonesmart. I don't know what my ROM will be by then but it will have to do. My knee and I are a team and we decided no one is going to hurt us anymore.

Well friends, be kind to your knees and take care.
Al
 
hurtin_unit said:
This Tuesday I go back to my PT and I will have her measure me to see how my ROM is coming along. My OS said I need to be at 110 by the 9th. I was at 85 when I saw him last. This man only cares about ROM. I'm not worried about it. I know ROM will come along now that I finally believe in "less pain, more gain". That is something I learned here at Bonesmart. I don't know what my ROM will be by then but it will have to do. My knee and I are a team and we decided no one is going to hurt us anymore.
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You have a great attitude---and the right attitude---please keep in mind how long ROM can be gained and that you are still moving forward! You will indeed reach your destination!
 
Hi Al, i think it would be wise to continue taking the elevator instead of stairs til your swelling and all pain is gone. I have not had surgery yet, but from all i have read here, is your getting enough exercise already with daily living and going to work, i would think that once you are not still swollen and have your full energy, that then you will be able to resume stairs at work again. i know others will be around with their thoughts. Keep up the good work, and sharing your story with us, it really does help us on the pre-op side get a good glimpse of what to expect. Thanks...:flwrysmile:
 
Al, glad you are making progress, and even better, feeling more comfortable with how your activities are going.

ROM does not need to be measured. You really can eyeball the angle. I think that's another component we can take back ownership of. I even drew angles on paper and cut them out, bent my knee, and asked my husband to point out which angle it seemed to be. Do you think you've passed 90?
 
hurtin_unit said:
All of last week I drove 45 min each way to work, walked from parking lot to the building, walked around for 15 min every hour, to losen up and kept leg somewhat elevated. Once I got home I was too exhausted to do anything so all I did was elevate, ice and massage my knee, then took meds, went to bed and was comatose within 5 minutes.
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|I'm not at all surprised! You are still in the throes of your energy drain not to mention recovery. Expect to keep up that schedule for several more weeks yet.
hurtin_unit said:
One thing I've noticed is that I'm still lifting my hip a bit when walking. I also feel I'm not bending my knee all the way as I walk. When I walk I bend my knee and feel like I have a rubber band on both sides of the knee with a lot of tension, which cause my knee to snap back into place hard so I walk with caution. Does that make sense?
At three months since my operation I'm happy to be driving, the 45 min ride is a bit too much for me as my leg starts to call me names after 20 minutes go by.
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Perfect sense! That rubber band is swelling. Read here "Tight band" feeling across the front of my knee. Usually the names my knee called me at that time weren't very lady like so I tended to take note of the message!
hurtin_unit said:
I wonder if I should start walking up the stairs every other day. Please advise as I don't want to overdo it.
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I think your knees are being overworked already. Leave the stairs until about 6 months out unless you want the names to get even worse!
hurtin_unit said:
My knee and I are a team and we decided no one is going to hurt us any more.
Click to expand...
I love that! Brilliant approach!
 
Tim, Sheryl, Maryo, Josephine - thanks for your inputs and words of encouragement. I will follow all of your advise as usual, this is how I've been making progress. As far as ROM I was at 85 on 08/09/12 and I know I'm past 90 but will have my PT measure me tomorrow .
Josephine, I've been taking my meds and doing exercises and with everything else going plus work I'm feeling drained but am I supposed to be on any type of high protein diet? I'm surprised my OS didn't mention anything about that. Any special diet? I read the info on the "tight band". There's certainly no end to how much you can learn here.

Al
 
A special diet of time and patience maybe. I found that root beer floats helped a lot! lol
 
^ha. I think just a good well balanced diet is all you need.
 
LL: I had a scare. For the first 3 weeks post-op, chocolate actually made me sick to my stomach! Fortunately, that didn't last past Week 3, otherwise I would have been a bear! Can't go thru recovery without chocolate!

HU: When you feel the tight band from morning to night, it hard to imagine that the feeling would ever go away. Six-months post-op ... and the tight band feeling is intermittent. Yes, there will come a time when you won't feel it.
 
Pooshay .. LOVE the scar decorations!.. Are they henna tattoos? If so, how long do they last?
 
maryo52 said:
Al, glad you are making progress, and even better, feeling more comfortable with how your activities are going.

ROM does not need to be measured. You really can eyeball the angle. I think that's another component we can take back ownership of. I even drew angles on paper and cut them out, bent my knee, and asked my husband to point out which angle it seemed to be. Do you think you've passed 90?
Click to expand...
Sounds like you're doing great - I have a dumb question though - I STILL do not understand ROM. My pt tries to explain it to me, but I just don't get it. He uses what looks like a protractor to measure something - is that for ROM? Last week I was at 70 something, yesterday, I was at 90. Is this why being sure to do exercises both at home and at PT is so important? Sorry for the questions - hope someone can answer! Thanks.
 
ROM (range of motion) information Wants to Walk, check this link out and you will get a good explanation of ROM. And there are no dumb questions---if you don't know or understand you need to ask. However, I can attest to the fact that there are a lot of dumb answers.
 
Thanks everyone for your comments on my diet question. I'm glad to hear some of you feast on chocolate, actually I'm a chocolate lover myself but need to follow a well balanced diet.
Thanks Pooshay for the info on my tight band, I feel better knowing that time will heal this.
Be gentle to your knees and keep up the good work.
Al
 
PooShay said:
Yes, henna. They last until their next encounter with water. I have a henna pen, so I keep on retouching. And embellishing.
Click to expand...

Oh what a relief PooShay to hear that your tatts are henna. I realize I might be an old fuddy duddy when it comes to tatts, but they are so permanent (the real ones) and I would worry that you would be sorry for having them. Now the henna ones would be fun. I would like to make my legs look like a fur coat. I have the fur from not shaving, just need the outlines and buttons to make it complete. Here my doc told me I didn't have to wear my teds, compression stockings anymore, but I still am to cover up my hairy legs until I am off the coumadin so I can shave. Actually I don't mind the teds.
 
Hi Folks,

I completed two weeks of full time work - it has been tough though. I went from little activity to a busy bee. From little walking to triple the walking. From no driving to 35 to 45 minutes of daily driving each way to work.
My knee would start hurting after the first 15 minutes of driving and I would take the pain the rest of the way.
I went from no stress to some stress related to my tech support position. I had said my knee and I are a team but it seems I abused my partner for the last two weeks and it may be a little upset with me because it decided to swell up some and I'm getting the message.

My first week my knee felt heavy, I went home drained, exhausted and all I did for the week was rest, ice, elevate and massage it. My friends had set I was crazy by going back to work full time versus 4 hrs a day, three days a week. I was doing so good and my ROM was at 92 that I felt I was a big boy and I could do it. I didn't go to the PT all of the first week since I was so tired.

My second week was a little easier, not by much, but my knee started feeling heavy, especially the right side, near the band. I think this may be because I have long legs and the knee sticks out of the seat and it's balancing from a staright position to leaning to the right, looking for some support. Sometimes I hold it with one hand to give it support until I get to work but that's not enough.

I have realized that I made a mistake by going full time and shocking my knee. Now that I started work with the OS orders to have a break every 15 minutes it's too late to go back and say that I really should have started working half a day. I go to my OS on the 20th (I re-scheduled my previous appt which was the 9th) due to this. I will explain but he wont be doing any MUA otherwise my knee will be calling me names that we can't print here.

I went to my PT last Thursday and was measured for ROM - I went from 92 to 85. (what the heck!) I guess my knee is really mad at me now. Hopefully my ROM will come back soon. I remember my OS is expecting me to be at 110 by my next appointment. Well, we'll see how it goes. I believe the swelling is causing this but my knee cap feels heavy and a little sore.

Your advise, please. It's OK to call me anything, I deserve it.

Al (hurtin' for certain)
 
try heat prior to any PT exercise, and ice when you are done. 15 mins of heat and 15 min ice should help by decreasing pain and increasing flexablity.
 
I had a PT friend come to my house when my ROM was stuck. She showed me a way of stretching based on this principle: the more you contract a muscle, the more it stretches. So you sit in a chair with your TKR foot on the floor and get someone to provide resistance to your shin while you try to straighten your leg. Push hard against resistance for a few seconds. Once you've contracted your quad with this effort, then you quickly bend your knee as much as possible (thus stretching your quad). Your helper can gently assist this stretch. Then with your leg still bent, you push against resistance and bend again. We'd do that several times. It didn't solve my problem but it might help you although, again, it's hard to rush a knee especially with the strain of your workday.

I guess it's possible that your bend is limited entirely by swelling, or perhaps a combination of swelling and adhesions. Only time will tell. Don't give up the "less is more" approach.
 
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