TKR One Year Out

[benne68]

My main concern is that after all this, my ROM still isn't great and I have lots of stiffness.

Stiffness is normal at just two months post-op. In fact, many of us experience it well into the first year of recovery. And, while you don't see any swelling on the outside of your knee, it is very likely that it is still quite swollen inside -- which is probably why it feels hot. Your ROM will improve on its own when that internal swelling goes down.

Check out this article: Swollen and stiff knee: what causes it?

As others have said, it sounds like you are doing more than your knee is ready to handle and it is protesting. While I understand wanting to follow your PT's recommendation, this is you recovery and you need to do what is right for you.

It's hard to be patient, but this recovery takes time and you are still very early days.

 

[mendogal]

OMG! Just read your comment on another person's thread about your "smart" knee implant and how it monitors for both you and your OS!!!
If you're in the mood to repeat (or copy and paste) here on your own thread I bet there'd be lots of interest!

 

[Jamie]

Thanks so much for the details of your exercises. Many of them are primarily stretching exercises, which is good. We always recommend that BoneSmarties do gentle bends and stretches throughout the day and night once you are in recovery. Those bends and stretches are what should help with the stiffness - if not right now, at least later as time goes by. Your soft tissues all must readjust to their new normal for body balance and alignment. Just be sure you’re only bending and stretching to the point of slight discomfort and not any real pain. You want to challenge your tissues but not irritate them.

I wouldn’t recommend adding weights to your hanging extension exercise. At this early stage, the pressure from gravity should be enough to help your leg stretch out straight. You don’t want to hurry this process. Slow and steady is best. Extension is frequently the last thing to normalize. With this too, you want to evaluate how your leg feels during and after the exercise. Watch for pain beyond the mild stage during the stretch or that lasts after you stop the exercise.

If you do all these exercises plus walk 2 miles (even split up) a day, you may want to try doing one or the other. Walking (plus those stretches) is good exercise, so you could do your walks on one day and the quad and hamstring exercises on other days. As time goes by, you can slowly add more walking or pedaling to your activity providing there is no increase in your pain or stiffness.

In the end, you are the only one who can judge the impact of your activity and exercise levels on your body at this point in your recovery. Everyone heals at a different pace. Some people can do a lot more and do it more aggressively than others. Our guide is to listen to your body and pay attention to how you feel in the hours after the exercise or activity. When you say you feel “achy” afterwards, it’s pretty difficult for me to tell what that means. If you are in pain or sore for more than an hour or so, then it may be a sign to scale things back a bit. It’s good you don’t see any obvious swelling, but it is also possible that swelling (which can cause the stiffness you describe) can be internal and not visible at all. The knee capsule is very compact and it doesn’t take much fluid to cause discomfort.

There is nothing wrong at all with doing some experimenting with the number, frequency, and type of exercises you do to see what works best for you. The only thing that is very critical are the frequent bends and stretches.

 

[MSuki]

You are a good bit further along than me but looking at your list, that is a lot of leg lifts (long arc and short arc quads). At physical therapy I am doing 20 of each and I’m pretty sure that this is what makes me sore along with when I’ve done too much walking. I don’t think I ever did more than 30 total in a day of any leg lifts with my other knee.

 

[skiforever]

@marmarmish
I think you are doing too much. These exercises would be fine 3x/day every other day. Too much will slow healing.

ROM comes back very slowly for many people. Your numbers sound ok, albeit disappointing for you.

The lack of retaining the ROM you get each time you work at it is normal. It takes repeated work over a long time to become permanent. Each time we work at it we irritate the tissues so we start over next time.

The aches you get, for example when dining with friends, are due to the earlier work. When you find the right amount of exercise to do the discomfort should be greatly reduced.

You are so right about the lack of wisdom shared with us after the first 2 weeks. The PT people do not seem to be good judges of what is best for us. I could send emails to my surgeon, but still I felt a lack of guidance - when I had my first knee done. They should send us to BoneSmart!

As you know I am also struggling with ROM issues. My personal doc who has also had his knees done says ROM will come because there is nothing preventing it. But I am impatient, like most, and want to be sure I get the ROM. Not having it handicaps me in many ways, so I work at it, hoping to speed it up a bit. Currently that work is 5 minutes biking once a day and a seated leg out straight (not really straight) hamstring stretch 3x30 seconds once a day. It is marginally too much for me. ADL, walking, diving, etc. are fine - and much more fun!

 

[marmarmish]

I've been reading many people's stories of recovery, and taking note of the advice given. Can't tell you how much I appreciate the support and compassion provided by the kind folks on this website!

My first two months were pretty miserable. But I can't say enough how this website has taken such a weight of my shoulders! Just the change in perception has made a big difference. Before I found BoneSmart I was terribly anxious, now I realize patience and trust in the body's healing process is the key, and allowing myself that has been a huge relief! I have taken everyone's advice to heart, and have incorporated it to my own plan. Not being so desperate to accomplish everything at once and giving my body a little TLC, has given my body a chance to catch up and consequently reduce my pain and discomfort.

Anyway, I have continued with my exercises, tho I'm not doing all the sets. And am extremely mindful of not overdoing it, and backing off if I notice my knee complaining. And I ice and elevate after each round. Generally speaking, I am doing okay and seeing tiny increments of improvement. Haven't taken ROM measurements, but will do so next week.

Now, I did push a wee bit yesterday, cuz I was feeling so good. And sure enough, I felt it later, tho it's really not so bad. So today I am taking it easy. My "weak" spot is where the IT band ends on the outside of the knee. On the outer lower area next to my kneecap is the spot where I get some swelling, and pain. (It's also tender there when I massage the area.)

Exercises like heel slides really aggravate that area, and it's these types of exercises that usually get me. And why my flexion is limited. (I'm somewhere around 102 by last measurement.)
Any information and/or advice would be appreciated.

 

[marmarmish]

OMG! Just read your comment on another person's thread about your "smart" knee implant and how it monitors for both you and your OS!!!
If you're in the mood to repeat (or copy and paste) here on your own thread I bet there'd be lots of interest!

Sure! I had a Zimmer "Smart Knee" put in for my RTKR. There is an electronic component with a little antenna that is fitted into the tibia. This little device gathers all kinds of data that my surgeon can use to monitor how the artificial knee is doing. So if there are problems with it, he can see exactly what's going on. Even years down the road, if something goes out of whack, he just needs to log on. And! I have an app on my phone that lets me see a subset of this data, so I can track the following: Steps, Distance, Walking ROM, Walking Speed, Stride Length, and Cadence (steps/min.). I can see these figures daily, and then look at them on a weekly graph and compare them month to month. There is receiver near my bed, and every night this data is downloaded from my knee so I can see it on my phone. It's pretty incredible, and the added functionality they have for future models is amazing!

You can read more about it here:

Persona IQ® – Zimmer Biomet | Remote Patient Monitoring

Surgeons: Zimmer Biomet Persona IQ: Designed to provide objective, post-operative data about patient knee functionality following total knee surgery. Learn more

www.zimmerbiomet.com

 

[MSuki]

I so wish I had this….

 

[marmarmish]

I have a question for the northerns who've been recovering during the winter season.
I live in Sarasota, FL, so going about my business outside the home is not hampered by snow and frigid temps.
But we have plans to visit relatives in Canada for 9 days, departing next week. I will be just under 3 mos. post op and am not sure I can handle the cold and snow, let alone up to 4 hrs of car rides. Hubby is being persistent, but I'd love to hear from you before I put my foot down.

 

[Jamie]

@marmarmish … I’m a bit confused by your comment about “4 hrs of car rides.” If you’re driving to Canada, it’s MUCH farther than 4 hours. So were you planning on doing 4 hours a day each way? Depending on where in Canada you’re going, it could be around 20 hours of driving each way. Is flying an option for you?

If you can persuade your dear hubby to wait a bit on this trip, it would definitely be to your benefit. Whatever your pain and mobility levels are at takeoff time will most likely be what you’ll have during the trip - or they may get worse. A trip like this puts a lot of extra stress on your body and most likely will hinder your progress until you get back home and rested again. There are things you can do to make the trip a little more comfortable and we can talk about that if you really MUST go. But I sure wouldn’t recommend you doing it this early in your recovery.

 

[marmarmish]

@Jamie We will be flying up to Detroit, and renting a car. Then we will be driving to various locations, they are each about a 4 hour drive. (Airports alone are exhausting!)

Yeah, my gut tells me this is not a trip I should be taking right now. So I told hubby I decided not to go - he is pretty unhappy with me right now. This is a hard recovery, wish he could be more understanding. But unless you've been thru it, I guess it's hard to understand.

 

[CatieViv]

If you are headed to the Niagara area and beyond, I would recommend waiting until spring! Although we are getting rain down here in Kingston, it can quickly change and get much colder. Your 4 hour drives into Ontario put you in the middle of the snowbelt and it can be cold! I find it cold on my new knee and I live here! Your baby knee will definitely not like it not to mention the traveling!

 

[Jockette]

So I told hubby I decided not to go - he is pretty unhappy with me right now.

I’m sorry that he is disappointed but you made the right decision. You are not in any condition to travel, especially heading north in the winter, for all the reasons CatieViv said. I hope he will realize this and you’ll have a nice Christmas locally.

 

[marmarmish]

@CatieViv Our trip takes us from Detroit to London, to Toronto, to Owen Sound, back to London, and then Detroit again. Yup, the middle of the snowbelt! How is your revision going? Your surgery was 3 days after mine, so you too are still in the early stages of healing. I hope that it is going well for you!

I feel better now about my decision, thank you all for your support!

 

[benne68]

But unless you've been thru it, I guess it's hard to understand

Yes, it can be hard for others who haven't been through this recovery to understand that it really does take many, many months to recovery. I doubt he would want you to suffer a setback because you pushed beyond what your body is ready to handle.

You made the best decision for your recovery.

 

[Jamie]

I'm glad to hear you are following what your body is telling you. This surgery is too important to risk a setback or even worse (like a fall on the snow and ice!) for a trip that can be rescheduled. Hopefully your hubby will recover from his disappointment. Wish him well if he would like to go alone. Hopefully if he feels he needs to be there, he will do that and have a good time. You will not be disappointed to have chosen the long term benefit of a steady recovery over pushing things on a trip you are not ready for.

 

[CatieViv]

Things are going well for me. I make sure I elevate every afternoon because I still have a lot of swelling. My friend was very concerned about my walking. She talked me out of using the scooter at Costco. My the time we left, I was pretty stiff and swollen. Hence the peg leg. She doesn't think I am doing enough and that I have adhesions. I reminded her I am only 2 months in. The pain is so much better. Pretty much minimal as long as I stay out of the ODIC! Planning a 2 hour driving trip late January. I hope to have a friend join me in case the driving is too much. Especially once we get to Ottawa.

 

[marmarmish]

@CatieViv I'm glad your pain is under control - such a relief! Me too. But it's still tough being so limited with what you can do. Just making dinner can tire you out and leave you with a sore leg. I've cut back on my exercises, I'd do good for a day or two, and then get sore and need to take a day off. The BoneSmart folks must get tired of saying ,"We told you so!"

Question for the forum: Is it typical thru the course of healing, to have new and different pains appear?

P.S. I feel such relief knowing I'm not travelling, and hubby has come around. All is good!

 

[WFD]

Question for the forum: Is it typical thru the course of healing, to have new and different pains appear?

Yes. Atrophied muscles and connective tissue get sore as you work them, other muscles and connective tissue gets sore as your posture and gait change, and old maladies can get resurrected. In my hip on the surgical side, old arthritis, bursitis, and sciatic issues have come back, though thankfully at a low level.

 

[mendogal]

Oh I'm glad domestic harmony is restored!!!!

Re new and different pains... Oh heck yeah, in my experience!!!
Some are long lasting. Some last a while, then completely go away. Some come out of nowhere, hang around like party crashers, and stagger off.
Same with knots and odd areas of kinking or catching... A new one appears, I massage it or do range of motion to work it out; after days or a couple of weeks, it's gone.