I don’t have extensive knowledge of these things, but do have enormous respect for how our muscles and joints work as units. I had a frozen shoulder years ago and worked with a wonderful PT to get function back. I couldn’t lift my arm above my chest in any direction, could not reach behind my back... it was getting worse, too. Anyway, what happened in a nutshell, according to her and my shoulder doctor, was that a few of the muscles were atrophied and because of that the joint was out of alignment and not moving properly. A few months of exercises to strengthen these muscles pulled the bones back to where they needed to be and, wellah! I have full ROM in that shoulder.
Knees don’t get out of alignment the way shoulders can, but there is a certain balance to our muscles that is optimal for knee function. It’s important they are all strong and working together. I’ve noticed this on the stairs most of all: from the beginning it was easier for me to go down the stairs foot over foot than up. It took a few months of doing stairs very deliberately (no hauling myself up by the handrail, making sure my back was straight and my thighs and butt were doing all the work) to build up the muscles that made ascending stairs easy. Doing so also benefitted my knees for rolling over in bed and getting up and down from low seats.
This is all a long way of saying it sounds like you’re headed in a good direction with your exercise!
It's been almost a month since I last posted. I still have the inflammation discomfort/pain. I'm still taking the Gabapentin 3 x a day. I take Tumeric for my inflammation as I would like to stay away from the anti-inflammatories (they don't seem to work on this inflammation). My OS put me on the 5 mg. of Prednisone for a month and that definitely helped. He said too, there was less swelling in the joint. I did more too. I told him I wanted to be off it to make sure I could still do what I was doing. I can. But... I can tell the inflammation is back to how it was. My next plan this summer is to ease off the Gabapentin so I will be able to measure my true pain/discomfort.
This is the time for my annual blood work. In addition to the normal stuff, my dr. is adding 4 tests for checking my bodies inflammation. I didn't ask her for the allergy blood testing yet, as she didn't feel I'm having any allergic reaction (neither did my OS or my allergist). "Just a slow healer". We'll see where all this leads when I get the blood draw next week (I wanted to make sure the Prednisone was out of my system).
Otherwise, I've added a day of hiking these last several weeks. I use my trekking poles (not sure my natural knee would make it without). It's only 2 miles, but there are some hills and I can tell it's a great workout and my knee is not angry or upset at all. I've also added a day of swimming - I do the freestyle stroke and swim non stop for about 30 min (it's about 3/4 of a mile). My knee felt good all day after the swimming. Note to self - add more of that. I continue to use the foam roller on my IT band and hamstrings (all sides of the hamstring) as the roller seems to help the most! So... yes, I still have discomfort/some pain that I truly hope goes away, but I am definitely doing more. I can tell when I exercise or do some activity, the inflammation seems to get "worked out" or at least the heat is less and the joint feels better for a bit. A little thing, like vacuuming yesterday, didn't create a lot of discomfort like it used to. I'm not pain-free enough to use my OS for my next TKR though! That's still up in the air.
And... whatever happened to "April showers, bring May flowers"? We had a pretty hard frost this morning. Those of you in the U.S. north and northeast... I'm sure you're more than ready for spring.
Ready for spring doesn’t begin to describe it! It’s really annoying to attempt a morning walk and have to watch out for icy patches in mid-April. On the plus side, the magnolias and flowering shrubs are blooming, so things are looking more like spring.
I’m impressed with how much you’re doing and with such good results! Your knee in itself appears to be doing well. It’s just that odd inflammation you have that won’t go away. And yet your knee works without pain and sounds like it’s recovered nicely. It’s all rather mysterious. I wonder what your blood tests will show.
I'm sorry the discomfort has returned after getting off the Prednisone @jaschembra. hope it will subside in time. Your activity level is great though. I suspect I need to get on that foam roller for my hamstrings also - they are so tight and I have this burning sensation a lot of times - not bad, but just enough to tell me they are there. I still have a swollen spot on the back of the knee - not painful but noticeably bigger than the other leg. I hope your blood work comes out ok. I am also noticing that my new knee recovers really well the day after a lot of activity - unlike my old one that remains sore. Sounds like your new one is really strong also.
i am impressed with the variety of activities you're able to do and interesting that you notice the activities seem to help "work out" the inflammation and the joint feels better. obviously your new knee loves to be active. i'm sorry about the residual pain you're still having; hope time will help reduce it.
we're hoping for spring to arrive here also. the snow is starting to melt and the sun is shining and feeling warmer; still need winter coat though. enjoy all your activities and more as the weather cooperates.
Thanks ladies. And just to say... yes, the inflammation comes on, there is some pain... but, if I do less, I hurt more. I told my OS - even though I’m walking with discomfort, an 8,000 step day feels better than a 3-4,000 step day! He agreed and said the joint likes movement
I completely agree that these new knees want to be used! I have no pain at all doing over 10,000 steps in a day or riding my bike 5 + miles daily! I couldn't even ride it 1/4 of a mile without pain before the tkr! It's great to be able to do the things we enjoy again!
Wow, how time flies. Didn't know it had been this long since I last updated my thread. I've come back on to research some dates that I need to put down on the "Authorization for Release of Information". I decided during water class today that I am tired of the discomfort, it's not normal and if it is truly normal and just the way my body has recovered, then I need to here a 2nd OS tell me that. I do pray they tell me the same thing my OS says.
So here is what's gone on since my last update:
All of my blood work for inflammatory issues came back negative. No RA, no auto immune, inflammatory measures were normal. That was good.
I weaned off the Gabapentin in time for my OS appointment and yes, I could feel the difference :( I had to start taking my Meloxicam and Tylenol Arthritis to get there...
My last OS appointment (2 mos. since the last one I had with him) was on June 7, 2 weeks ago. The pain on the medial side of my knee - I have decided and my OS agrees is due to scar tissue and it's only an issue when flexing to a point. OS told me not to try and flex further (beyond the point of pain). The pain on the lateral side (IT band area) was the other major issue - he gave me a cortisone shot into the IT band. He said I would not like him for a couple of days and boy was he right! It felt like my tendon was tied in a knot - painful for a couple of days. That particular pain has left. But - the whole knee still has it's pain going on when I'm standing or walking longer than maybe 15 minutes. (Standing, probably only 5 min.) Sometimes, the grip across the back of the knee is like a vice grip... What's still crazy is that "both" of my knees feel the same way - the same discomfort, with the exception of additional bone on bone pain and popping of the right knee. I just don't feel that I'm aligned properly - my whole body, from my lower back to my calves and that puts a strain on my legs. I do try and stand upright and I try to relax my knee - it's hard to explain.
So... I have a plan. I'll keep you posted. Now to go look for the dates of x-rays, etc. that I came on the computer to get. lol.
My second opinion last week was disappointing. The dr rushed the appointment and didn’t look at my list of concerns.
Is it worth a second second opinion? I’m not sure. I’m glad he didn’t say I need a revision. He said not everyone gets a good outcome, and sometimes doing it over can make things worse. While I do believe that’s a possibility, do they also tell you that because they don’t want anything to do with your case? I don’t know.
Oh, I was so hoping that since you haven't been here, that you were doing well. I think it's worth it for you to get a second opinion. It sounds like something isn't right. And if your knee is OK, then you'll know it for sure.
So very sorry you are not getting the relief we all hope for. If it is scar tissue, I am just wondering if a massage therapist might be able to get in there to try and break it up a bit. Certainly cheaper than a revision. Would probably give a lot of discomfort the first couple of treatments, but that's what they Tylenol or Aleve are for! A second opinion can't hurt either. Good luck.
So... instead of sending my request for records back on Monday, I sent an email to my OS asking for the mayo fascia release PT - Graston Technique. Within 1 hour, he had the script sent to my local PT office. Had my first visit today and I really feel hopeful. She hit every single spot that has been sore on me... and that was without showing her! She was good. 2-3 visits for 4 weeks and my insurance pays 100%. I asked her if I was too late (I'm thinking I needed this a year ago!!) and she said no, not at all. Feeling "hopeful"!!
She used her tools and deeply massaged each spot that she was feeling tightness or stiffness. One time I told her it felt like she was "flicking" my tendon and she said she kinda was. Google that technique @Jockette and you'll see the tools and read what they do. The area that hurt the worst with her massage was "Gerdy's Tubercle" - it's where the IT band inserts into the knee - of course, that's been one of my sore areas since day #1.
I failed to say in my above post what PT measured me in a "cold" state. Remember how long I had an extension issue...... I am now ZERO!
I figured I was at zero around Nov. of last year. With so much soreness, I was glad to see it measured as such by a professional.
And my flex/bend was 126!!!!
I am familiar with the Graston technique, my son had it done to the incision on his forearm when he broke both bones in his arm at work and had to have surgery. His incision on the inside of his arm is quite long.
This was the first I’d heard of it, but he didn’t give it a name. After hearing about it a while back here on bonesmart I recognized it as what his therapist had done to him. It sounded very aggressive then as he said it was quite painful, but they “had to do it.” Now I wonder if indeed they had to do it. It was somewhat early in his recovery, though I don’t remember how early. He believes the “no pain, no gain” theory and accepted all the painful therapy with a “bring it on” attitude.
I now know knee replacement does not require that theory, but I can’t say if that’s also true in his case.
@Jockette Yes, I think that's why my OS told me about it in Jan. but said it tends to make you worse before it makes you better and he wanted to try the Gabapentin, etc..... I believe he also looked at it as being pretty aggressive and didn't really want to go that direction at that time. I'm not feeling any issues with it yet. However, at this point, any improvement in my pain/discomfort is better than what I have and everyone still says it seems to be soft tissues. I know one thing - it's the first time I've been to PT where I actually feel like I'm getting treatment the insurance is paying for lol - she was hands on for 50 minutes. That included my fancy taping (kinesio tape) she put on to help with any swelling or bruising - I have none right now.