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[TKR] New Here Looking for Positivity

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LooLoo

LooLoo

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Hello all.
I’m on week 6. Is it normal to still feel a lot of pain? I’m getting so frustrated and I feel like I’m not progressing as much as I should be. I’m looking for some reassurance. I really am not happy about this at all right now. I’m having a lot of struggle with patience.
 

Ladyala

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Yes, totally normal in my experience! I struggled a lot at that point in recovery too. Got depressed frequently, wished I hadn't done it, why do I have to deal with this etc etc.

This is hard both mentally & physically. It's a long drawn out process that seems to take forever. I will hit the magic 12 week mark on Monday, 1 quarter of the way healed - yippee!! But do I feel good about it? Nope.

I'm having a rough day mentally. Even though I'm doing well its still such a s l o w recovery & it's hard to accept my limitations. I think being 'younger' is a drawback in this case. (I'm 49) We feel like we should bounce back faster but that's not at all the case. For me I'm pretty sure my fabulous peri menopause hormonal state is a factor as well.

I do feel better overall than I did at 6 weeks. Most days are good & I do feel better. The knee stiffness & calf/thigh tightness are, while annoying, far less painful than my knee pain ever was.

Anyway...
I hope you have a good day. Be kind to yourself, this is a huge undertaking & there truly is light at the end of the tunnel. We just didn't realize how long the tunnel really was!!
:console2:
 
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Thank you for your support @Ladyala It sounds like we are experiencing very similar things. I also think the emotions are part of my hormones as well. I’m sorry you are having a rough go today. I hope you can feel better too. :console2:
 

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I remember Josephine stating that the 6 week mark can be the most difficult for some people. Just when you're thinking you're over the worse! It's all part of the rollercoaster ride that is TKR recovery. I've had a rough 3 weeks but today I'm on the level part of the ride...could go up or down but I know I'm not quite 6 months out so only halfway through. Celebrate the small successes - mine today was walking around the supermarket without a trolley/cart!
 
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Good job today @Glosnana ! I’m glad you are feeling better! I spent the day icing and elevating and I’m feeling much better now too.
Oh the roller coaster! :thud:
 
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LooLoo

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Hello.
I just got out of my 6 week post op. My doctor wants me to do MUA because he said I have excessive scar tissue built up which is causing a lot of pain when bending and limiting my walk.
I am afraid to go. After reading things here I told him I did NOT want to do the surgery.
He said he will give me a month to try to push through and heal with more PT and stretching. He said he believes it will be painful and difficult but if I work hard I can get there. After a month if there is not improvement he would like me to reconsider the MUA.
Can I get some opinions or suggestions from you all on what to do? I’m frustrated, sad, and scared.
Thank you for listening. I appreciate you all very much.
 

Jockette

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6 weeks is a drop in the bucket in this 52, week (one year) recovery. I’m sorry your surgeon feels the need to rush you. There is NO window of opportunity, ROM can continue well past a year and even past 2 years, mine has!

MUA is not a guarantee that you will get better bend. It’s only good if you have a true adhesion, and it’s really early to have a true adhesion.

At 6 weeks you are still healing and have swelling and that’s why you can’t bend your knee. I did not have perfect ROM at. 6 weeks, I had a lot of pain and swelling, just like you.

Good for you for declining his offer of an MUA. Give yourself time to heal and time for the swelling to go down.
He said he will give me a month to try to push through and heal with more PT and stretching. He said he believes it will be painful and difficult but if I work hard I can get there
Pushing through pain will prevent, or at the very least, slow recovery, as pushing the knee to do more than it’s healed to do just upsets the knee.

Reduce your activity, ice and elevate, take your pain medication the way it is prescribed, whether it’s prescription or over the counter, and try very hard to be patient.

It’s not exercising that gets our range of motion back, it’s Time:

Time to recover.
Time for pain and swelling to settle.
Time to heal.

Our range of motion is right there all
along just waiting for that to happen so it can show itself.

In the general run of things, it doesn't need to be fought for, worked hard for or worried about. It will happen. Exercise as in strength training is counter-productive and in the early weeks does more harm than good. Normal activity is the key to success.
 

Jockette

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One of our members, Bertschb, kept a record of his ROM process. He agreed for us to post it for those of you that are afraid you're stuck. The key is to have patience! Bertschb says:

“I'm 12 months out from my surgery and have some advice based on my experience:
1- Stop going to PT (all it will do is make your knee swell and reduce ROM)
2- Don't worry about your ROM
3- Be patient - VERY patient!!!

Here is my ROM history (more or less):

1 month - 60 degrees
2 months - 80 degrees
3 months - 85 degrees
4 months - 90 degrees
5 months - 90 degrees
6 months - 110 degrees
7 months - 120 degrees
8 months - 125 degrees
9 months - 130 degrees
10 months - 135 degrees
11 months - 140 degrees
12 months - 140 degrees

I spent waaaaay too much time worrying about ROM. I thought I'd be riding my bike a couple months after surgery but it took SIX months! Looking back on my surgery, if I knew then what I know now, I wouldn't have wasted my time with PT and I wouldn't have worried about ROM.”
 

sistersinhim

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I just got out of my 6 week post op. My doctor wants me to do MUA because he said I have excessive scar tissue built up which is causing a lot of pain when bending and limiting my walk.
I am afraid to go. After reading things here I told him I did NOT want to do the surgery.
He said he will give me a month to try to push through and heal with more PT and stretching. He said he believes it will be painful and difficult but if I work hard I can get there. After a month if there is not improvement he would like me to reconsider the MUA.
Can I get some opinions or suggestions from you all on what to do? I’m frustrated, sad, and scared.
Thank you for listening. I appreciate you all very much.
I'll gladly give you my opinion! You are the owner of your knee. Your doctor works for you. If you don't want a MUA, don't do it. You can not force your knee to bend more by aggressive PT, but you can sure slow it down and set it back by painful PT. Your doctor is being very impatient and doesn't understand that your knee needs to heal and is not out of shape.

Many of us never took formal PT or did exercises. I am one of them. I had 11 knee surgeries, 2 of them kneecap removals and 1 tkr. Even after those I never took PT. But, I didn't just sit around and do nothing. I took care of myself, my house and yard as my knee allowed me to do. As I healed, I did more. But, my knee was always in control. This was enough therapy for me and would be for any tkr patient. All the awful pain of PT is so unnecessary.

All you have to do is use it in your daily living. Your knee knows how to rehab itself and doesn't need anyone telling it how. Just use it and it will come back like new. You have to be patient, though, it doesn't happen quickly. ADL,(activities of daily living), going to the bathroom, brushing your teeth and bathing, fixing a light meal, getting something to drink and or a snack, those kinds of things will be all the exercise your knee needs. If you just use it daily in your living, you can have a less painful recovery. We know what works, we've been there:yes:.
 
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LooLoo

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Thank you all so much for your positivity and suggestions. I am going to take my time and get through this without surgery. I am going to continue to work on my attitude and allow myself to be at peace with where I am at right now. I appreciate this forum so much. :thankyou:
 

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I have just read your whole thread and sympathise entirely. I had my right knee done in January and it was an up hill, painful battle. I could never get the swelling under control despite days of icing and never managed to hit the famous 90. At 13 weeks, I felt I was making no further progress and had a MUA and have not looked back. My bend is now 115 or so and things improved so quickly that I decided to do my left one to get the whole ordeal behind me. The left one, done 3 weeks ago now, is going so much better - proof that no two knees are the same. In fact with this recovery, I have done less icing / rest / elevating, because I haven’t need to. When I was at your stage with my first one, I swore I would never ever do it again. Proof that things do change!,,


Sent from my iPad using Tapatalk
 
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LooLoo

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Hello. Looking for advice again.
At week 7. Started work yesterday. PT in the morning then work following for about 5-6 hours mostly desk work and some walking. ROM is still at 108 and not really changing. In more pain than usual and very stiff. Am I overdoing it? I’m very concerned because of the threat of MUA in 4 weeks so I’m trying to do what they’re telling me. PT consists of several types of stretches, bike for 8 minutes and a machine similar to elliptical that just you just push legs up and down but doesn’t go all the way around for 8 minutes.
I feel very conflicted with doctor and PT advice vs Bonesmart.
My gut tells me Bonesmart is the right direction but doctors keep telling me otherwise. How can I find a doctor who practices this method?
 

Jockette

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Why are they talking about an MUA with your ROM at 108? That’s great for 7 weeks!

You have lots of time for in this recovery that takes a full year, for your ROM to improve. Mine improved after the one year mark AND after the 2 year mark.

My surgeon did not have the Bonesmart mindset. I did it anyway, because it was my knee and my recovery.

If you are in more pain than usual then you are overdoing it.
https://bonesmart.org/forum/threads/bonesmart-philosophy-for-sensible-post-op-therapy.37103/
 
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LooLoo

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Thanks @Jockette I should know better. I keep asking the same questions out of fear that I won’t improve. I appreciate your reassurance. I have to remember to be patient and follow my gut feeling which is belief in the Bonesmart way of healing.
 

Jockette

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I know just how you feel. I had a tough recovery, and I had a partial so it was way tougher than I expected (I was so ignorant and thought a partial would be easy.)

Anyway, my ROM numbers were great, but they were always forced, even by my surgeon at check ups, so I never had the function those numbers implied. My bend was not good in reality, it took me months to sit with my feet on the floor comfortably, I was embarrassed by my lack of abilities and felt peer pressured by everyone that I should be better. You name it, I worried about it.

Though I adopted the Bonesmart approach as soon as I learned about it, I feared I would be the exception and it wouldn’t work for me.

And now, 2,5 years later, my ROM truly is fine and my leg more relaxed than ever. :happydance: I do still have some issues, but ROM isn’t one of them.

So please try to relax. Don’t force anything, try not to overdo, it really isn’t necessary.
 

sistersinhim

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I feel very conflicted with doctor and PT advice vs Bonesmart.
My gut tells me Bonesmart is the right direction but doctors keep telling me otherwise.
Bonesmart has had thousands of joint replacement patients for around 15 years. All this experience from all these people has led to what we know works and what doesn't work. I practiced the Bonesmart way before there was a Bonesmart. I started in 1983, after my first knee surgery, with doing my own gentle recovery by just using my knee as it permitted without extra pain. This is my personal experience through 11 knee surgeries with no formal PT.
 

kneeper

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I'd say just do what you're doing and see how things are by your doctor's "deadline."
 

Celle

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At week 7. Started work yesterday. PT in the morning then work following for about 5-6 hours mostly desk work and some walking. ROM is still at 108 and not really changing. In more pain than usual and very stiff. Am I overdoing it?
Yes, you are overdoing it.
How can your knee bend further when it's got swelling (water) inside it, making it stiff? It can't, of course.

Work on top of PT is too much for such a new knee and will increase the swelling that's stopping your flexion from improving. Going back to work at only 7 weeks was too early, although I do understand it was probably an economic necessity.

The thing to remember about going back to work is that so often when you think of going back to work you just think of the work.
You forget it also includes these:
  • having to get up earlier in the morning
  • getting washed/showered, putting on the 'face',
  • getting dressed
  • getting a fast breakfast and eating it in about 5 mins instead of casually
  • getting out the car
  • driving to work
  • walking from car to office
  • actually being up and about and unable to take intermittent proper rests during the day
  • walking from office back to car
  • driving home
  • putting the car away
  • making an evening meal
  • probably feeding pets and/or others
  • washing up and then finding it's almost time for bed.
That's a whole lot of additional exercise, so you don't need to add PT as well.
(Yes, I copied those examples from this article: Phased return to work )

Stop trying to make your knee bend more by doing more exercise. Instead, decrease the exercises and spend more time resting, icing and elevating your leg, to try and decrease its internal and external swelling.

I’m very concerned because of the threat of MUA in 4 weeks so I’m trying to do what they’re telling me. PT consists of several types of stretches, bike for 8 minutes and a machine similar to elliptical that just you just push legs up and down but doesn’t go all the way around for 8 minutes.
I feel very conflicted with doctor and PT advice vs Bonesmart.
My gut tells me Bonesmart is the right direction but doctors keep telling me otherwise. How can I find a doctor who practices this method?
It's only 7 weeks since your surgery and a flexion of 108 is pretty good. Most surgeons won't even consider doing an MUA once your flexion is beyond 90 degrees and you're well past that. Your PT and surgeon are trying to scare you into working harder by threatening you with the possibility of an MUA.

Your PT therapist wants your knee to continue to increase ROM according to a theoretical protocol she/he has that takes no account of individual recoveries. An increasing ROM makes her/him look good when it's reported, but trying to make your knee conform to that set pattern isn't good for your knee, and it's worrying you.

But it's not exercising that gets you your ROM - it's time. Time to recover, time for swelling and pain to settle, and time to heal. Your knee is capable of achieving good ROM right from the start. Its ROM will gradually increase as your knee heals and the internal and external swelling decrease.

As for your surgeon, don't waste time discussing what you want to do. You won't change his mind and you wont find a surgeon to take you on so soon after surgery. Simply say that you don't want an MUA and you'd rather wait a while, to give your knee the chance to increase flexion when it is ready.

Stick to that, and don't be frightened into having an MUA.
No one can do an MUA without your consent. You are the only one with the right to say what happens to your knee.

I know it's difficult when you get conflicting advice, but you have the right to choose whether or not to accept the advice that is offered. You don't have to get your surgeon's or your PT's approval for what you decide.

Talking about PT: It's far too early to be using the machine where you push your legs up and down. There's a danger of causing damage to your knee by twisting it when you use that machine. Please don't use it any more. (Just say "No, that doesn't feel right for my knee." )
 

Celle

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I'd like to let you know that not all surgeons and PTs believe the same as yours do.

My surgeon doesn't allow any formal PT at all for the first month after a knee replacement. He says your knee needs that time, to start on its journey of healing. For that month, we rest, ice and elevate our leg, and walk around the house. The walking is our exercise and we increase it a little each week.

After that month, we just go to PT once every 2 weeks, where we are shown a few new exercises to do at home each day.

His patients all do well and achieve good ROM, as I did. Nobody's knee has set like concrete with a poor ROM and he hasn't had to do an MUA for the past 4 years. I think that speaks for itself.
 

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Let's get to the practicalities, rather than numbers on a form which somebody else wants to put a tick against.
Question: Why is ROM important?
Answer: because it allows us to do what activities we want to

What can't you do with 108deg?

I had a dog who loved to chase bicycles. Once he caught one, but didn't know what to do with it.

107 Deg in 7 weeks is already great

Be confident, and take excellent advice.

Here in the UK, almost nobody has a physiotherapist, and I've never seen anyone walking about with a stiff leg.
 

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