Bilateral TKR No progress ROM

[sistersinhim]

If you aren't in much pain, you can stop the Tylenol at any time. Your knee should be your guide. It's wonderful if you don't need it anymore. You can always take it again if you need it.

 

[Butterfly22]

THanks. I just think its giving me an upset stomach that's far worse than any knee stiffness!

 

[sistersinhim]

I'd say it's time to stop it then. It's bad with the pain pill is causing more discomfort than the knee is. It sounds like your knees are doing really well!

 

[Butterfly22]

Thanks. My recovery has been super easy. I was in lots of pain pre surgery, so this is nothing. My ROM isn't good though, only 100 and 105 at 6 weeks, but I'm trusting they'll get better in time and trying to keep rest, ice, elevate priorities a few weeks longer.

 

[Jockette]

Your ROM is fine. Who says it isn’t?

 

[Butterfly22]

My surgeon says 120 by end of 6 weeks and I’ve been the same for 3 weeks. My therapist says I’m on a plateau and not to worry but I cut my activity in half and am icing more again. I’m told I’m extremely functional for this stage in recovery but usually people get rom and then become functional. I seem to be doing it backwards but have things I want to do, so I figure out a way to do them. Haven’t mastered standing from the couch, but I keep trying.

 

[Jockette]

ROM returns at different rates for each of us. It is only one measure of recovery, and as I said, your ROM is fine. What difference does it make in which order you achieve “milestones“ and regain abilities, the important thing is that you do regain these things, and you are.

Stop stressing about what your surgeon wants, that‘s all it is, a want. You are doing very well in your recovery. Don’t let him take that from you.

 

[AussieRodney]

Wow. 6 weeks out and you go for a long bike ride (long for me at least). As others have said, I think you need to slow down a bit. Perhaps take some time to study the ceiling while you lay on the couch elevating your legs.

If you're not in pain, you don't need Tylenol to reduce it! And if you do need something, how about something you can rub on?

 

[sistersinhim]

Your ROM at 6 weeks is quite good and better than average. We have found that most surgeons want 90 degrees at 6 weeks. I don't understand why yours wants that much more. That is added stress that you and your knee don't need! Many surgeons don't measure ROM, just want to know what you can do. Mine was that way. He gave me a prescription for PT, which I threw away, and just did my ADL at home. He never said a word about it and was happy with my function at each appointment.

I believe that way too much emphasis is put on numbers when it's the function of our knees that really matters. We have this surgery to get back to doing the things we need and love to do, not to measure how much we can bend!

 

[kneeper]

Hi--I've been reading your last few posts and have a couple of thoughts.

--you say you don't really have pain, but that it's more like tightness or stiffness. A lot of my pain was that achy stiffness. It's ok to take tylenol or something else for that. You may find that if you're like me, that tight/stiff feeling is making you unconsciously tense your muscles, which keeps you in that cycle. I know I did that.

--if your stomach doesn't like the tylenol you might experiment with reducing the amount you're taking and see if that helps. You'll also be able to see if the tylenol is doing anything for that tight feeling.

 

[Butterfly22]

Thanks. I guess I dont call that tight/achy stuff "pain". I cut my tylenol in 1/2 so still taking it before exercises and I seem less nauseous at night. Big plus. Dont think I'm getting more bend but trying to rest, ice, and trust this is a phase that will help in the end.

 

[Butterfly22]

So any thoughts on when the tight, achy feeling gets better? I'm hoping my rom improves when the tightness is gone.

 

[Algarve46]

I am now into week 11 since surgery and at week 5/6 the tight feeling across the front of my knee started and pretty much stopped any real progress with ROM as it was impossible to get past the pain of the stiffness when bending beyond a certain point.
It was only in week 9/10 that I noticed any change and now in week 11 I can definitely say that the stiffness is subsiding quite substantially. However, that stiffness at the front of the knee, which was ever present, has been replaced by a similar feeling at the back of the knee but only when trying to bend beyond a certain point.
Nevertheless I measure this as an improvement, which is a welcome change, as I feel I had been stuck for a few weeks without any real gains and feeling somewhat frustrated.
Hang on in there it seems that your body will let you know when it is ready to move on.

 

[Butterfly22]

Thank you so much! It helps to know someone has gone weeks, but it's now changing. I feel badly in that I havent been taking pain pills, and not been in pain. This has been nothing compared to the constant, daily pain I was in. Still, I have what I call this tightness, maybe that's "pain", and that's been there since day 1. Its improved with stretching and moving, getting better, not as bad after a nights rest. Hopefully that's keeping my rom held back and when it subsides I'll get more movement. I'm extremely functional, so I'm trying to dial back my activity to give more healing time. I just need to know theres an end in sight. Thanks.

 

[JojoFitness]

Guess I thought I had 6 weeks to get my bend and it just isn't going to happen

As @Jockette and other bonesmart admins will tell you there is no time frame for range of motion. It will come and decreasing swelling will help it along!

Here is my story which hopefully will make you feel better:
My progression
3days post op -4 & 30
2weeks -1 & 50
3weeks 0 & 68 (I called it 70!)
4weeks 0 & 75
5weeks 0& 82
6 weeks 0 & 90
7 weeks 0 & 97
7.5 weeks 0 &105
And then I stopped measuring because it stressed me out and sucked and destroyed me for 2 days after to get a “number” which I was told still wasn’t good enough. At the 7.5 week appt she told me- it only gets harder from here. I was threatened since week 3 every PT (3xweek) for 4 weeks with an MUA. The problem isn’t the knee. It is actually great- so smooth! Less pain than prior to surgery, no limp. I haven’t had full extension since my initial injury that lead me down this road when I was 17 (25 years ago) So I know flexion will come in time. Was told at 20 yearsold to stop being so active or I would need a knee replacement at 30 I continued a very active lifestyle with -2 to -3 degrees extension and made it to 35… suffered for the last 8 year at -4 &120 deteriorated to -10 & 100- also from my femur to my ankle was tilted laterally (off to the right 10 degrees from the line of my knee to hip)- My point is let’s not forget the function of our knee was so bad- it justified the risk to cut it out and replaced it!

Be patient. Our bodies are shifting a readjusting to our new joints. muscles have to heal from the surgery and then adapt to new alignments. Do not despair, or get discouraged for not achieving their goal. Focus on small victories and give yourself a break. Less is more sometimes. Look at this season of slowing down as not “missing out on things” but as a time to reset. Go easy on yourself. You will get the numbers when your knee is ready! You got this!!

Is there a way to measure our flexion ROM ourselves? Since i graduated from PT, I still continue to do heel slides and would love to know where I am. I was at 120, but know it takes gentle repetitions to keep it there. Thank you!

 

[InkedMarie]

Is there a way to measure our flexion ROM ourselves? Since i graduated from PT, I still continue to do heel slides and would love to know where I am. I was at 120, but know it takes gentle repetitions to keep it there. Thank you!

You can get a general idea here.

 

[Samsrf]

@JojoFitness I tend to “nerd out” on things so I have a goniometer (tool PT uses to measure angles) It Is pretty straightforward but I can’t use it on myself so (it’s hard to tell if it’s lined up for right) I judge ROM by are my feet parallel when I sit in a chair (surgical leg not kicked out but equal to normal leg), Is my bike seat where is was prior to surgery (somewhere between 110 and 120 degrees of flexion) can I bend my leg while standing and putting a sock or shoe on, am I using both legs when rising from a seated position (not favoring surgical leg- strength) can I walk DOWN stairs (getting better- also use this for a quad stretch as that seems to be primary thing keeping flexion from happening) I am super goal oriented and love “numbers” but It took a couple of months to realize I really don’t care what “the number” is - it is all about being able to move & do the things I want to. Everyday a millimeter closer.

 

[Butterfly22]

Thanks. Today I am finally able to stand up from the toilet and a chair without using my arms to pull myself up. Not consistent or easy and I do have my arms bent to help give me some stability but it’s progress. Sitting down is controlled until the very end, then I “flop”, but I’m getting there!

 

[Samsrf]

@Butterfly22 it’s these things that are victories. In a week or two of consistency you will be like “hey, I didn’t flop today!” WIN!

 

[JojoFitness]

Is there a way to measure our flexion ROM ourselves? Since i graduated from PT, I still continue to do heel slides and would love to know where I am. I was at 120, but know it takes gentle repetitions to keep it there. Thank you!

You can get a general idea here.

Thank you, @InkedMarie! That does help. I'm guessing I'm at 130, which makes me feel super!