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Bilateral TKR New member - Bilateral TKR February 2021

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MerlinWizard

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The pool is a double edge sword. It's so easy to exercise because of the weight distribution but my brain forgets I am 53 and thinks it's 16 at times! Which is how I got myself into this mess in the first place.

I am always sore after I get out of the pool. It's very good exercise, but as usual - know your limitations.

My legs feel pretty good today but then again I haven't gone in the pool either. I did some other exercising with the bike, some weight distributing stuff as well. If I go in the pool I have to tell myself it's to get out of the heat and relax - not pretend I am 16!
 
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MerlinWizard

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Something rather unusual happened or at least to me something worthy of more exploration:

When I was doing exercises in the pool, my legs would stiffen up after being out of the pool about 30 minutes later. The next day, everything felt fantastic.

Yesterday, I did some ROM exercises and rode the exercise bike. Now, I didn't "over do it", I simply did about 40 minutes worth all together, less than I would have a PT and less than I think I should be doing now. I didn't extend that regiment, I have been adding 5 minutes a week to it but I hadn't done it for at least a week because of the pool.

Today, I am stiff as a board!

Starting week 16 and I am still trying to figure this all out!
 

MARYCOOL

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We are both February kneebies.. I am actually at week 15, and older than you, but I think the stiffness, at this point, is worth working through. I played 9 holes of golf yesterday on a very hilly course. I iced last night, but am so stiff this morning! I am going to do an easy 5 miles on the bike(indoor)... see if that helps.
 
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MerlinWizard

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Thanks for that!

I always work through it, being too stubborn and all. The only thing I don't do again for a few days is kneel. I did that this past weekend for about 30 minutes so I won't do that again until well, today!

While I have knee pads for all the DIY stuff I do, I bought new ones because of the surgery and that's really the only way I can kneel other than on my bed. I've tried without with varying degrees of success/failure - never on a hard surface, only on grass or the bed.

Other than that, I will work through the stiffness.

I guess I was just surprised because I know I exercised a lot harder in the pool two days ago than I did yesterday and I didn't expect to be so stiff waking up today.

I think the weather might be playing into it as well. It went from 60's to 90's and when it gets that hot here, doing any work outside like yard work can be exhausting.
 

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This is weird! I’ve been through a carbon copy of that this week. Lots of exercise, no ill effects. Normal exercise, ouch big time today. Interesting how others cope.
I am considering myself lucky that our pool has not warmed up enough for me yet (just don’t do water below 80 without a wetsuit). I would most certainly have put myself back on the bed for a few days if let loose in a pool. You are testing the waters for me!
 
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MerlinWizard

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With the weather we have had here, the pool is above 90 degrees. We keep it 87 degrees otherwise until the snow flies and then of course we close it.

My first experience in the pool wasn't a good one, so much so that I avoided going in the pool. But as things get better, I find I am able to do a lot more in the water than I could otherwise.
 

Ghostpipe

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Grateful for that. I know what to expect now. Renewed membership of the ODIC club!
 
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MerlinWizard

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I wish it was easy to know when you over do it.

If while I am doing something I knew it was ODIC, that would be helpful. Sadly most times I don't figure it out until well after!
 

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Hi, Merlin
How are you doing? I was reading your entry about working out in the pool with your new knees. You said the first time wasn’t good. Do you mind telling me what happened? I was an avid lap swimmer before my new knee. Hoping to get back to it, as soon as I can. My surgeon won’t allow me in the water until June 17 . (4 weeks out) .It helped me a lot to get back into shape after my hip replacement surgery 3 years ago. Any tips on the types of exercises you do with your knee? Keep cool this week.
Tricia
 
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MerlinWizard

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Hi Tricia,

I am doing good! I was so excited to get into the pool. I was done with PT because my insurance wouldn't cover any more and I figured I had just opened the pool and turned on the heater and it was nice 87 degree water, less weight on the joints, etc. and it would be awesome!

We have a lift to get into the pool for my wife and I figured if I needed it, it was there. The steps into the pool are larger than normal steps but silly me did it anyway. Second step in I was like "ouch". That got me rattled right away. I was doing fine I guess until I went to actually swim and kick my legs. It was pretty painful at first, got a little better but after I got out I was so disappointed. I was sore, defeated and depressed.

I avoided the pool thinking that this awesome idea I had turned out to be too much for me.

I was stupid to think that. I should have gone right back in the next day. Instead I didn't for a couple of weeks. The next time I got in, same thing but I knew what to expect from the steps. Kicking my legs got better and from there it's just a "time" thing. The more I do it the better it gets.

In fact my wife gets mad because I purposely kick my legs very hard to find out how far I can push them. I am like - it's a pool, you are going to get your hair wet!

Anyway, don't let it scare you like I did to myself. It gets better each time, just like everything else we do.

Unfortunately I have one of those bodies where I can exercise all I want to, diet and whatever and I can lose inches but I never seem to lose what I want to lose. At my age I have taken the attitude that this is just the way God made me and I try to stay as healthy as I am able to given my size. I fluctuate between 280-300# and I can probably get to 250 and that's my goal when I can do more but I won't be discouraged if I don't reach it exactly.

My new knees should help me attain my goals because being as bad as they were, they certainly helped me get to the size I am now. Now they can return the favor!

They thought I was healthy enough to have both knees done at the same time, I have slightly high BP but nothing earth shattering and other than that, I am a healthy "fat guy" as my GP puts it. Have to watch sugars and all of that but you know what? My mom is a rail and she has diabetes and she was a registered dietitian for her career. So apparently it doesn't really matter what size you are, we should all watch our sugar!
 
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MerlinWizard

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Here I sit on another Friday contemplating an attempt to go the weekend without compression socks and compression sleeves for my knees. A lot of the things I do I handle just fine but I know the compression makes everything just a bit easier, particularly the knee compression selves because inevitably I will end up on my knees doing one thing or another at least a few times today.

Today I am clobbering ants that were kind enough to enter my ground entry home. I guess I didn't get the chalk and cinnamon down quick enough this year. Ants won't cross either of those and I usually do it by every entry.

I only have three pairs of compression socks, two of which are in dark colors. They get washed on a rotating basis so I have a clean pair if I need them at all times. With the heat, one pair a day. It's been in the mid to upper 90's all week and although I have white calves and tanning thighs, I think I can safely say that dark knee high socks in the blistering sun isn't all that pleasant! I don't want to buy anymore, I can't really see their use much past this summer.

So, off they come. Something tells me I will have them back on later today - just a chicken I guess.

I know that swelling affects my ROM thus why I still use the compression. My strength is pretty good I think at this stage and stairs get easier by the day. I don't have as much pain anymore and if I could kneel more than 90 degrees that would be awesome but - I will take what I can get right now.

I am actively walking my 2.5 acres doing yard word, gardening, etc. I have a grass project right now that will take some labor, but nothing I shouldn't be able to handle. It's a small section we are trying to grow grass in that has been more stubborn than I if that's possible.

Anyway, does anyone have any non-standard exercises to increase ROM? I know I am pushing probably too hard being at week 16 and my ROM is around 125 on a good day in each knee although the right one still lags at times. My goal is to be in the 130's by August but nothing I am doing is working. I don't think I was ever over 140 at least the past several years. But the way my knees feel I think I can stretch and eventually exceed that over time.

Or maybe I am just pushing and wishing too hard only being 16 weeks out.
 

Ghostpipe

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You’re pushing too hard. I have just had two really quiet days, having been tempted to do too much with my legs in the gym and suffering for it. Did next to nothing yesterday, had a fit on the miseries at my progress, and when I woke up this morning, my ROM was better than it’s ever been, my better leg about 4 inches from my backside.
Needless to say, it didn’t last once I started doing chores, but I know it’s there!
 

Roy Gardiner

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My mom is a rail and she has diabetes
I am 183cm 78.4kg (6' 1/2" 172lb) and am diabetic. So correct, not all thin people are free of diabetes, not all fat people have it. But there is an extremely strong correlation. Michael Pollan 'In defence of food' opens with 'Eat food. Not too much. Mainly plants'. Good way to lose weight, IMO.
Anyway, does anyone have any non-standard exercises to increase ROM?
My own ROM, Extension and Quad exercises and using a static bike

Using a bike to gain ROM is pretty simple:
  • Set the bike to zero resistance
  • Set the saddle low enough so that a single rotation is a challenge; difficult but not painful. When a rotation becomes easy right from the start, lower the saddle a max of 1cm.
  • Gently turn the pedals, through discomfort but without pain.
  • Continue until the knee is 'warmed up' and the rotation is now easy, or for 2 minutes, whichever is the shorter time.
  • Repeat several/many times a day, but don't go mad. Diminishing returns will apply; my guess is that half a dozen reps would be enough
  • Do not pedal fast or for more than 2 minutes, this is a stretching exercise, not training.
  • And if you get any pain or swelling in the 24 hours after doing this, cut it down until you don't
Here is a bit more chat and some pix and how 'healing' and 'training' are different
 
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MerlinWizard

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Thanks Roy.

I am on the bike every other day seemingly. That depends on how much I've done during the day or plan to do.

The seat is set at my wife's height so it's plenty low =). I add about 5 minutes every few weeks to the exercise. I am at 20 minutes right now and I was at 10 minutes in PT 4 weeks ago. I warm up for 10 minutes with my the middle of my foot positioned right in the middle of the pedal and I can get around without much effort, the first few are stiff but then after that it's pretty normal and I can pedal pretty fast if I am honest.

Then I move my foot position to increase the ROM over the next 10 minutes very slowly taking 10 rotations in eat position until my toes are what I am pushing the pedals with. On my toes my hips still lift but I figure over time that will stop.

That exercise doesn't seem to affect the rest of my day much like the "normal" stuff I have been doing.

I've also been in the pool several times in the last few days and I work on frog hops and walking on my knees and knee bends. I don't do a ton of any of them, but I do spend about 10-15 minutes in the pool doing that stuff. My ROM in the pool is way better than it is on dry land. However, I am shot after being in the pool. So I try to do that towards the evening.

I know I am pushing pretty hard and it's good to know that at least some of what I am doing is helpful.

Yesterday I tweaked my right knee getting off the ATV. I felt that the rest of the night. It's hard to explain but we have a but water tank on the back of the ATV to water plants in part of the yard where the hose can't reach. I have been riding "side saddle" most of the time but Ol' Smarty Pants thought he would be "cool" and try to ride normally. Getting on, no problem. It was the pulling my right leg past the water tank where I tweaked it. Needless to say, I was done after that.

I did get the grass all taken care of and I was really pleased with myself and how it went with my knees. I was tired afterwards and a little stiff but overall I was happy I was able to do it without paying much of a price.

We have a wedding this up coming weekend so my week is full of a lot of activity including hosting two rather large parties Friday and Sunday as well as putting up and taking down tables and chairs and what have you. I do have some dollies and carts that will help and nothing is terribly heavy. I have some cooking to do but the reality is, it isn't hard. Mostly load up the smoker and wait =).
 

Roy Gardiner

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I am on the bike every other day seemingly. That depends on how much I've done during the day or plan to do.

The seat is set at my wife's height so it's plenty low =). I add about 5 minutes every few weeks to the exercise. I am at 20 minutes right now and I was at 10 minutes in PT 4 weeks ago. I warm up for 10 minutes with my the middle of my foot positioned right in the middle of the pedal and I can get around without much effort, the first few are stiff but then after that it's pretty normal and I can pedal pretty fast if I am honest.

Then I move my foot position to increase the ROM over the next 10 minutes very slowly taking 10 rotations in eat position until my toes are what I am pushing the pedals with. On my toes my hips still lift but I figure over time that will stop.

That exercise doesn't seem to affect the rest of my day much like the "normal" stuff I have been doing.
That all seems pretty spot on to me. If you don't want to alter the saddle position moving your foot's the next best thing. I'm not surprised it doesn't affect other things, it's pretty low impact.

Once your hips no longer lift you might want to think of changing the saddle position, if it suits you and you want more ROM.
 
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MerlinWizard

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My goal is to ride an actual bike when I can get my hip to stop moving. I think I could do that now but the risks of balance and falling are still there. If I can be back on the bike trails next Spring I will be really happy.

I spoke to a long time friend and he asked me how the physical fitness part was going. I have a goal to lose at least another 50# to get myself under in the low 200's. I've lost 30 already but that's been that way since 4 weeks out. Losing weight was part of the decision to do both at the same time. I had to tell him that I am not there yet when it comes to hard core exercise. I am able to do a lot more now than I was doing the last year or so before surgery but none of it really amounts to a lot other than moving the right direction with my knees.

If had a crystal ball as I told him, come and talk to me in 2023 and I think I will be where I want to be weight wise.
 

Roy Gardiner

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My goal is to ride an actual bike when I can get my hip to stop moving.
:thumb:

The static bike can be used for ROM, where all this saddle movement and just doing 2 minutes comes in. On a road bike you'll be training and (hopefully) losing some weight. I've read recently that the latest idea is that a man should aim for the same weight he was at 21. Sheesh.
 
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MerlinWizard

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21?!?!?!?!?!?!?!

As my knees deteriorated, on came the pounds. Even when I was doing CrossFit for 5 years, I didn't lose a lot of weight, I lost fat and inches but I gained a lot of muscle. Sadly, it's gone now =(.

I will say this much, I feel a whole lot younger as this recovery goes and I am very hopeful that if nothing else I will get healthier in the process. Mentally I am doing very well and the frustrating times are few and far between now, although I know I will have them for the next 8 months, I know the hurdles will be smaller and smaller.
 

NightQuilter

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I am appreciating your story @MerlinWizard . Well I know the weight gain saga as the knees (and in my case, hips and back) deteriorated. You asked about unusual exercises to gain ROM. Given your propensity to overdo :swim:, I considered not responding, but.... One I developed and still do frequently 9 years later is to stand at the bottom of the stairs and put one foot on the third step. Then very gently I lean into it (ultra gently for you Merlin! :no-fin:) and hold. By shifting positions slightly, I can bend the knee, then stretch the calf, stretch the hammies, and also open up the hip flexor. All without a penny spent on some equipment.
 
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MerlinWizard

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Thanks NightQuilter!

I didn't even think of that! I am all for "free" exercise equipment =). Sometimes we can't see the forest between the trees when it comes to certain things.

That tweak on the ATV on Sunday is still bothering me a bit. Also, I went and picked up all the drinks for the parties this weekend. It went much easier this go around than the last time I had to pick up cases of something. But, my right knee is sore.

My surgeon said both my knees were pretty bad but in the months leading up to the surgery it was the left one giving me so much trouble. However, in the years previously it was my right one that had the worst of it. I think by favoring my left one it eventually deteriorated. So I think my right one in all actuality was the "worst" if that's possible and it's the one being a darn.

Right out of surgery it was the one that had a lot of burning pain. Not intolerable but irritating. Early on it lead the way in ROM. My left one had a lower hamstring pain that prevented it from bending as much as it should. Around week 6 the left one surpassed the right one and while the right one didn't burn anymore, it had the stiffer patella. It all balanced out in week 8 when I fell =). But the right one still lags at times.

Scar tissue-wise, I had some in the left to begin with but it went away by that week 6. PT never indicated that there was anything like that in the right and I don't feel anything like that in either of them anymore.

I know it's a long process and this week, because of everything I have to do, I won't be doing any extra exercises. It is the largest gathering we will have been a part of since Covid started so as you can imagine everyone is coming that can come vs. 80% of people cancelling like it was last year.
 

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