TKR Now post-op, surgery on Feb 25, 2020 USA

That was my go-to option I did on my own too in my early pain-from-any-movement days! It was one of the few things I could manage. We have to find things that are doable, without too much fan-fare.
I used to lie on my back and bring my hip up and let my leg dangle. You could also support your leg draping it over pillows or the side of the bed as you are doing.
 
It's ok to put a heating pad on low on your muscles, just not near the knee. I found gentle heel slides ok, but squats (baby or otherwise) just too strenuous for a healing knee.
I did zero squats with my second knee and it healed as well (with far less pain) than my first knee where I let the PT persuade me into trying squats.
 
Today I celebrate 4 weeks post op! I can do many things: Walk with a proper gait for a short distance, walk for a few blocks in the neighborhood with a walker or crutches. I've started regaining moving my surgical leg pretty well, with more to go. I'm doing some puttering aorund the house with no crutches or cane. I am doing my exercises, but I have learned to do less and be gentle. My rom is 90 degrees and 5 degrees. But, can I just say this is so so so hard? I'm having a cry fest of a day, and this virus does not help.

I am in pain a lot, even with tylenol xs, ibuprofen, topical lidocaine, and tramadol at bedtime. I dread doing my exercises and PT cuz it hurts, and then comes icing, which hurts at first and then gets better. It seems that the pain continues, in diminishing amounts, for months! That aching and stiffness will continue for a long time. I have been crying off and on all day--when will it get better? and the Covid 19 doesn't help matters at all.
 
am doing my exercises, but I have learned to do less and be gentle.
I dread doing my exercises and PT cuz it hurts,
If you dread doing the exercises because they hurt then you are not being gentle enough. Recovery from this brutal surgical assault is painful enough without adding exercises that hurt. They not helping your knee heal, they keep your knee inflamed and upset. Back off what is painful and just do very gentle stretches and walks.


Regaining our ROM is more about Time than repetitions of a list of exercises.

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. Normal activity is the key to success.
 
I’m sorry for your pain & for crying. This is a long hard recovery & I came at it expecting the worst so each positive thing is a surprise for me. I haven’t made it outside yet - looking forward to that day! Today I celebrated letting my dogs out & in by myself . I have border collies & have worked on them lying down, waiting for me to release them so as not to be run over- one dog I knew would be perfect as she is for everything, but I worried over my wildchild
 
It sounds as though you are not managing your pain well. You should not be in a lot of pain. Perhaps you should consider using the Tramadol during the day. What is your schedule for the Extra Strength Tylenol? It would be possible to slip in some Tramadol that might help you lower your pain levels. Hurting a good bit of the time slows your recovery. It is not good for your knee to stay inflamed like that.
 
I was told that I should not expect to be absolutely pain free after my femoral nerve block wore off post surgery, regardless of what meds I was taking. I stayed ahead of the pain with a 7.5 mg Percocet every four hours or so for the first four days then I started to wean off the Percocet and go with two 200 mg ibuprofen every four hours or so. It worked for me.
 
Hi everyone--these are such crazy times, I hope all of you are holding up well. I have started binge watching "Nashville"--gives me lots of time to rest! Ok, true confessions: there is such a big part of me that believes in the Bone Smart point of view that healing takes time, time to rest, time to heal, time to recover. And then, I begin to doubt--my PT folks, who are relatively gentle, but it still hurts, stress the importance of working on extension and flexion. My friends who have had this say it is important to push forward and work on extension and flexion. I am 5 weeks PO on Tuesday, and I am taking 1 Tramadol, 1 oxy, 2400 ibuprofen, and 3000 tylenol a day, and it is still difficult and painful. This is with my trying to be gentle, but everything always aches and hurts. So my question is, and my need for reassurance is, really, will my range of motion come back all on its own? Is this generally people's experience, or is there research on this? I drape my leg over the arm of a cushy chair, and let it drape, but it hurts at a level 5. The tone and spirit of this site are so lovely--thank you for all you do, and your warm and gentle tone.
 
Everyone perceives pain differently. It's possible you are a bit more sensitive to it than others. A "5" for you might be a "2" for someone else.

The truth is that you are very early in this recovery process...just a little over 4 weeks out from surgery. For many people it takes patience - and lots of it. Please do try to have patience with your body as it heals itself.

What you don't want to do, though, is spend all day lying down or sitting. You need to be up walking around for about 5-10 minutes each hour or so. During those times up, although you don't need to do a lot of fancy exercises, you do need to do gentle bends and stretches of your knee for maybe 5 minutes where you are pushing the bend or stretch just to the point of beginning discomfort. Over several weeks of doing this (plus your normal elevation and icing), you should begin to see some improvement in your ROM as a result of the reduced swelling.

It isn't really good to be draping your leg over a chair arm if you have the arm under your knee joint. It can put you at greater risk for a blood clot. And it's a passive exercise. You want to be moving your leg, not just letting it hang. Depending on how long you leave it draped there, it could be causing some of your pain.

Do you see any improvements in your range of motion since your surgery? If so, I'd say....just relax and give yourself some time. Your medications are pretty light. You could up the Tramadol if you are experiencing pain....within the limits of your prescription, of course.
 
I pretty much just forgot about doing any kind of PT or exercises and just used my knee taking care of myself, yard, house and cats. It was really slow going at first, but as the swelling went down some I was able to do a little bit more. Having gone through 11 knee surgeries before my TKR, I knew my knee would come back all on its own without doing anything special movements. I did the natural things.
 
Good morning! Today is my 6 week knee-versary. I somehow feel that this is a turning point, not sure why, but there you have it. I am so grateful to this forum and support group, though I have not posted in a while.**** Today I will have a phone call follow up with a nurse practioner from the OS office. I sent her a photo of my incision, which looks pretty good, I think--except for one thing. @Layla @Jamie @sistersinhim I have a tiny bit of thread coming up from the very end of my incision. I will discuss this with the nurse today, but will this mean no baths???!!! I have been so looking forward to a bath with my leg immersed instead of showers. Will it clear itself up? ****** Progress report: I am now able to slowly do both forward and backward rotations on my stationary bike, and I also have been going on walks in the park with hiking poles, maybe 1/2 mile. My ROM is not progressin well, I am at 95 degrees and 5 degrees, but I have decided to not worry about it. It will come along, per the Bone Smart way. And, I wouldn't be able to get an appointment for a MUA right now anyway, and I don't want one yet....never say never. I am at the aching and stiff stage, with some pain. I am icing 2-3 times a day for 40 minutes, taking OTC meds and 2 tramadol at bedtime, and getting around the house with some cooking, puttering, etc. I hope all my fellow knee warriors are sheltering as well as we can...hugs to all of you!
 
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I have a tiny bit of thread coming up from the very end of my incision.
will this mean no baths?
That is a stitch working its way out. True, no baths until there are no open places at all. That includes what you are experiencing with your stitch.

You are doing great for only 6 weeks out! A 95/5 at your stage of recovery is very good. Most OSs look for 90 at 6 weeks and you are already 5 above that.
 
@sisterin
I have a tiny bit of thread coming up from the very end of my incision.
will this mean no baths?
That is a stitch working its way out. True, no baths until there are no open places at all. That includes what you are experiencing with your stitch.

You are doing great for only 6 weeks out! A 95/5 at your stage of recovery is very good. Most OSs look for 90 at 6 weeks and you are already 5 above that.

so, how does the stitch and the opening resolve themselves? It must not be a dissolveable stitch, as it is still there.
 
If you can see a thread, you can contact your GP or surgeon's office and go in to have it removed. I would contact the surgeon first.

In the article link sistersinhim left you, read down to the paragraph on Emerging Stitches. This is what is happening with your incision. It's fairly common and nothing to be worried about. But you do need to get the thread taken care of so that you don't end up with a surface infection.
 
Hello fellow knee warriors! I searched this forum yesterday for ideas for my new restless leg syndrome. I tried epson salts in my bath last night, as well as a glass of tonic water with quinine in it. Cured! I had no restless leg last night. @Jamie or others, shall I do this every day for a while? Or every few days? This is probably a trial and error situation...let me know if you have any ideas or thoughts. I am grateful to have found this forum.
 
The tonic water is something we recommend. A warm bath can help. You can also try a heating pad at the small of your back. Sometimes doing about 5 minutes on an exercise bike helps.

We have an article on Restless Legs after Surgery in our BoneSmart Library.

Restless legs following knee replacement surgery
 
@Jamie, thanks for your advice with the restless legs. I am getting some relief now with the epsom salts and the quinine. I am about to hit the 8 week mark, and I am doing well, I guess, as I have come to accept that this will take time, and to think of myself as recovering. I am up and about in the house, I have to focus on not limping, and do a bit outside off and on, given the covid situation. I walk in the park, ride my stationary bike with difficulty, so not too long, do my exercises, etc. My husband and I make an occasional foray into the world to get food and supplies. Most days I take a nap and rest, and I am still taking OTC tylenol and aleve, max dose every day. It is so odd to have seen no one since my surgery (doc or nurse) except for 2 phone calls. It feels very "lost in space" and ungrounded. I will see my surgeon at 12 weeks, unless we meet by phone, which I don't want. My ROM is stuck at degrees and 95 degrees--it has been there for a month, with PT and my own efforts, though I refuse to endure pain--only discomfort. I am trying to trust that it will come in time. Your words always comfort me! Thanks for being here for all of us.
 
Know that you can still have swelling in your knee that you cannot see. The knee compartment is very compact and it doesn't take much fluid there to create a problem with bending. Sometimes it just takes time for this to resolve. You're actually still very early in the recovery process and there is time yet for improvement. Hang in there......sometimes we have to wait for the "good stuff" in life. You'll get to the good stuff!!! You are doing things just right. It's hard to grasp sometimes just how long the recovery from joint replacement surgery can be.
 
I am 5 weeks PO on Tuesday, and I am taking 1 Tramadol, 1 oxy, 2400 ibuprofen, and 3000 tylenol a day, and it is still difficult and painful. This is with my trying to be gentle, but everything always aches and hurts. So my question is, and my need for reassurance is, really, will my range of motion come back all on its own? Is this generally people's experience, or is there research on this? I drape my leg over the arm of a cushy chair, and let it drape, but it hurts at a level 5.
You're only 5 weeks into a recovery that takes a full year. Your knee isn't healed enough yet to be doing the exercises you are asking of it. That's why it hurts - and the pain is your knee telling you to back off exercising, because it isn't ready yet.

There's no need to rush to get ROM (Range of Motion) because it can continue to improve for a year, or even much longer, after a knee replacement. There isn't any deadline you have to meet - in spite of what you may have been told:
Myth busting: the "window of opportunity" in TKR

In any case, 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 has the potential to achieve good ROM right from the start, but it's prevented from doing so by swelling and pain. As it heals and the swelling goes down, your ROM (both flexion and extension) will gradually increase, whether you do formal exercises, or just let your normal activities of daily living be your exercise.

There haven't been any formal studies, but we have had plenty of members here whose ROM increased naturally, just with being used in their daily living.

You don't have to work at making your knee bend and extend. Give it the right conditions, and ROM will increase naturally. The right conditions are:
No painful exercises - because they keep your knee irritated and swollen
  • Gentle treatment - just use your knee as you go about your daily tasks
  • Plenty of rest, ice and elevation, to help reduce swelling
  • Short, gentle walks that increase as your knee heals
If you want to do small amount of exercising, these are all you need - and you only need to do them once a day;
Heel slides and how to do them properly
Extension: how to estimate it and ways to improve it
 

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