TKR Need better ROM, please advise.

[DragonHeart]

What did I say Al????? I told ya you were crazy for going back to work full time. What I do before work is ice my knees, do some gentle stretching and put mineral ice on from the tight band area above my knees down to my ankles. At work I get up and walk whenever my knees start talking mean to me. I've notice that with every hour that goes by I can't sit as long. My first hour I can make it about 40 minutes the next about 30 and by the third hour I can only make it about 20 minutes before needing to get up. When I do get up, I'm up for at least 10 minutes. I walk and to some stretches against the wall. I also take something like roll on Icy Hot or Ben Gay to apply to the tight band area above my knees to help relax the muscles and relieve the swelling and to my knees. It also helps to apply it just below your scar and behind your knee. I know you will smell minty fresh but what's more important - comfort or smell? Also, at home I found that hot wash clothes or heating pads on the tight bands and a gentle message helps relax the muscle and ease the tightness above the knee. Once you relax the muscles and reduce the swelling the heavy feeling in your knees should ease up. I'm right there with ya Al. I know your discomfort and frustration. I feel it when I over do it too. Like you keep telling me - we'll get through this. Even if we take two steps forwards and once step backwards (or vice versa) sometimes. We'll get there partner!

 

[hurtin_unit]

Thanks Maryo for your ROM idea. Your stretching idea will help, I will get my son to assist me to get this rolling. I believe the swelling I created caused me to go from 92 ROM back to 85. I noticed that at the top of the knee and mostly on the right side, when pressing with my thumb, it kind of sinks then it fills in again slowly. I feel fluid and wonder where the fluid is coming from. most likely from overworking the knee.

Chris, you asked me if I was sure I wanted to go back to work full time and you suggested I do what you did, starting with three hrs a day, three days a week but I didn't listen. My knee was happy with all the gentle care i was giving it. I also learned the easy does it, less pain & more gain method and my knee rewarded me with good ROM but I made a mistake by going full time from the start and now the swelling is going down very slowly. There was no method to my madness. Thanks Chris for the ideas you're passing along. I've been icing but haven't used any heating pads as suggested by both you and Ewhrn - I have a heating pad in a box in the garage so I will retrieve it tonight and put it to use. Chris our surgeries are four days appart so you also understand the cost of overdoing it. I have learned through this experience and I will make sure I post my ideas before I implement them as the folks here have the experience and can tell us what's best.
Take care of your knees...
Al

 

[DragonHeart]

Chris our surgeries are four days appart so you also understand the cost of overdoing it. I have learned through this experience and I will make sure I post my ideas before I implement them as the folks here have the experience and can tell us what's best.
Take care of your knees...
Al

And next time you'll listen to me right...

 

[hurtin_unit]

I sure will, partner. There were two days last week when I was walking then all of a sudden my leg felt so light that I thought I might fall. This happened shortly after getting up from my desk, on my third or fourth step. Im sure this must have something to do with abusing my knee the last two weeks.

Im going to ask my OS for a note requesting I work four hrs a day, not eight. If this happens them I will be able to car pool to work and I wouldnt have to drive for 35 minutes each way. This would help the swelling.

Regards,
Al

 

[Roy Gardiner]

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

You wrote all your own answers in your post. Less is more, no pain more gain etc etc.

Not sure what advice on how to achieve this; can you get a ride to work? Can you cut down hours? Can you have breaks for ice etc. during the day? Every bit will help. Good luck.

Yes the swelling is causing your reduction in ROM, yes the swelling is a result of stress and is slowing your recovery.

 

[maryo52]

I just posted on someone else's thread about swelling. What you have is pitting edema. You push on it and it fills in slowly. This is different than an effusion which is excessive joint fluid. Pitting edema signals the need for more precaution with swelling. Swelling is fluid in between cells. When this happens, cells get squished, so to speak, and circulation to and from those cells gets impaired. Circulation is primary to healing. So you see how important it is to control swelling?

 

[hurtin_unit]

Roy, Maryo, thanks for your inputs. I now have a much better idea of what causes swelling and the importance of circulation tp promote healing. In checking my previous posts I was doing great then i went back to work and things went south. I was under the impression that since I was doing so good then I should be alright to go back to work full time versus doing it gradually. My knee responded to the abuse with swelling and rolling back my ROM from 92 to 85.

I will be working 4 hrs now instead of eight, with a 10 min break per hr to move around. I will also be carpooling so I won't be driving. Working 8 hrs has drained me and the 35 to 45 min drive each way has caused most of the swelling. All this was caused by poor judgement on my part. I didn't follow the "easy does it" rule. Today is my first day of 4 hrs and it was good. I'm home already icing and elevating.

The last three days I've been feeling some discomfort on my bad leg but right at the hip. Is it because of the long drive i was doing until today? Could it be because I'm always elevating my right knee? I go to bed with two pillows under my knee too. At what point do you stop elevating? Maybe it will go away now that I don't drive. We'll soon find out.

Al

 

[maryo52]

Al, I'm glad you've modified your day. Way to go.

Re: left hip, there's no doubt that having our knee done causes stress in other places. I know we're not perfectly symetrical, but we become very lopsided during the knee recovery and this plays havoc with hips and backs and whatnot. I think you can go on the assumption it will clear up in time.

How long to elevate? Are you elevating at all at work? I elevated as much as possible for six months. I had a slow recovery. I can't say for you but any and all measures to minimize swelling is good.

Driving has been hard all along on my knee. It was quite unhappy the last month, and we had to go on a 6 hour drive, and two days later it's still unhappy. I think it puts a strain on the soft tissues.

Keep up the good work.

 

[Roy Gardiner]

Al, sounds like you've made perfect adjustment . I had loads of minor aches and pains drifting in and out as my body adjusted. Still happening (8 months) although much less. I'd not worry about it.

 

[hurtin_unit]

Thanks Maryo for your advise, yes I elevate at work all the time that Im there.
I also ice my knee for 30 min twice in the four hrs that Im there. I believe things will improve now that I wont be abusing my knee.
Maryo, you said your recovery has been slow. Driving is tough for me. My knee starts hurting after 15 min. You recently drove for 6 hrs...wow. I couldnt do it.

Roy, I guess the knee surgery upsets more than just the leg. It throws your body out of wack for a while. Now that Ive made work adjustments I will concentrate on the swelling and go easy on my knee.

Take care partners!
Al

 

[bottomshollow]

Good for you, Al! I always admire a man who can see the error of his ways and make the proper adjustments. And it will all benefit your knee and you. Keep up the good work.

 

[hurtin_unit]

Hello folks,

As you may remember I went back to work three weeks ago but went full time ( 8 hr days, 5 days a week) versus what Chris (Dragonheart) suggested I do, which was 3-hr days instead and go easy. Because of going full time, my knee retaliated by swelling and ROM went from 92 to 85. I realized that the knee is boss. Driving to work was also painful. I was doing real good prior to going back to work, so good that I thought I should be ok. Huge mistake on my part. After posting my dilemma everyone here agreed I abused my knee and suggested cutting down hrs, even carpooling if possible.

With my PT’s help I was able to cut down the hrs from full time to part-time until my knee decides when it’s ok. Last week I worked 4 hrs per day, car pooled to work and had 10 minutes each hour to get up and move around. Wow, what a difference. My knee rewarded me by regaining the ROM I lost during the first two weeks and even gave me a little increase so now I’m at 96 – I think my knee wants to be my friend again. By giving me an additional increase (from 92 to 96) it’s telling me that if I’m gentle and don’t abuse it again it may give me even more ROM. It’s a deal!

My son gave me a box of Ensure so I can gain back the 22 lbs I lost in the last three months. I want those pounds to go to my chest and arms so I can show off at the different beaches we have here in Arizona …
I had never tasted that drink before and it actually tastes good. I also has lots of vitamins. Is this a drink any of you recommend? I’m now eating balanced meals and I’m sure I’ll gain back those lbs but wondered about this Ensure drink.
Easy does it...
Al

 

[bottomshollow]

So glad you recognized the error of your ways and made the necessary corrections to work and recover at the same time and have a happy cooperative knee. Now you have the experience to encourage others here to follow the BoneSmart mantra. Keep up the great work, Al, and keep us posted. We care.

 

[Motorcycle Meemaw]

Hope I lose 20 pounds during recovery. I could use it!

 

[Josephine]

Sorry I've only just caught up with your thread. I am delighted to hear how you have managed your working day to the benefit of your knee. Sounds like you and your new knee will be good friends for a very long time!

 

[maryo52]

Wishing you continued progress and continued learned lessons. Funny how we have to re-realize our knee is boss. And re-re-realize, etc. etc., etc. I was underweight as a child but can't relate to that problem now. More snacks? Anyhow, I'm' sure you will soon become a veritable chick magnet. Attitude is everything!!

 

[hurtin_unit]

I know...lesson learned, we just go on making adjustments and fine tuning as needed. The knee has its days when it feels a little "under the weather" but I try not to feel like I'm not making any progress. My knee also surprises me when I do things I didn't think I could do yet. Reaching comfortably and putting my socks on is one thing I would like to achieve. I can reach but can hardly wait until I finally get it on so I can get back to my comfortable position. Now that Im working part-time the knee is feeling a lot better and it's not as swollen anymore. Carpooling to work is also another adjustment which benefits me.
We are on a long journey and we need to be patient and keep a positive attitude. "Life is 10% what happens to me and 90% how I react to it".

Yesterday I was walking slowly to my car when I felt like someone sprayed my leg with water, like a fine mist. I looked for my pants to be wet, near my knee area, but it was dry. That feeling lasted about 10 seconds but it left me wondering.
Has anyone experienced this?

Be gentle to your knees,

Al

 

[Jebsw]

Hi,
I've just read your thread. I'm waiting a while yet to go back to work, but I'm really scared of how my knees will react.
Anyway, yes, sometimes I do get that weird wet sensation. Not often. I just figure it's the nerves rejigging their connections.
Good luck. Be good to your knees

 

[maryo52]

When a strange sensation feels tingly or hot or cold, it's definitely a nerve thing. I think rejigging the connections captures the concept perfectly!

 

[Limpin'Lizzie]

Yes, Al, I've had that sensation. It's like water is dripping from my knee down my leg....strangest feeling!!
I'm so glad you're doing better!

"Sista Liz"