TKR Pain 2 years after TKR

[kneeper]

You lie on the bed with your leg straight and just tighten your thigh muscle. Not sure why they call it a quad "set."
If you do a leg lift, tighten the thigh muscle first before you try to lift the leg. Much less stressful on the knee.

 

[Mollymax]

That's one of the exercises I have been doing but didn't know what b they were called. I was doing the leg lift by just lifting my leg but physio said that's why my leg still was weak and she got me to pull my toes up, push my knee down then lift my leg. I couldn't do it. Thigh got the shakes. Eventually managed it but my knee hurt and today it's more swollen. I need to get past the weakness in it before I go back to work in 4 weeks.

 

[kneeper]

My PT said at first if I couldn't get the leg up, just the quad sets were fine to start.

Gradually you can get to an actual lift. IMHO, you shouldn't do anything where it is such a strain.
I don't quite get the "push my knee down" part--does she mean try to get your leg flat instead of trying to lift a slightly bent leg?

Slow and steady wins the race with tkr. Your knee doesn't know your work time table. Overdoing the exercise--as you've seen--doesn't speed your recovery, you just get more swelling and pain.

 

[lovetocookandsew]

I'm assuming you weren't actually pushing on your knee with your hands, but were straightening it or whatever it's called when you stretch it a little for extension. Anyway, I haven't done any exercises at all, but decided to try one time what I think she had you do; I could do it, but it wasn't easy. I also tried it with my good knee and it was a breeze, so it's something my right knee isn't ready to handle. I think it's something that your knee isn't ready for quite yet either since it was such a difficult thing to manage, and I'll not be doing it again. I'm not agreeing that your leg is weak due to a lack of that exercise, IMHO it's more likely that it's weak because it's still recovering from all the abuse it had to go through during surgery. You may be one who takes longer to recover, or maybe you're right on "schedule" for an average recovery; whichever it is, you're still in the early days, and your knee is letting you know that. I'm still limping quite a bit as my extension is not all the way to straight yet. My knee bends better than it straightens, but my understanding is that extension generally comes later than flex. Hopefully the next four weeks are good for your knee, but I also hope you don't get impatient, or nervous, about the time frame, and overdo things.

 

[Spex10]

The first thing the PT made me do post operative was push my knee down into the bed and flex my foot. Leg raises came next. He was particularly keen on the first two as he said it showed my quads were 'awake' which they obviously were.
Prior to the op he suggested I do leg raises and even count to 10 with my leg drawing the numbers in the air. I found that quite interesting and I could do it easily. My quads were pretty strong which I think has helped.

 

[Katkins]

I used to set my alarm to go off every 2 or 4 hours, or whatever the life of the pain med was at the time. That way I was medicated before the pain got so bad I was in agony thus was able to stay ahead of it (not including the reactions I had to the meds). My insurance even has a pain med app for that purpose.

This works!! I put myself on a schedule every 3.5 hours and managed to stay ahead of the pain. The only time I really hurt was when I tried to wean myself off the meds too soon. The meds are your friend!

 

[Spex10]

@Mollymax your situation is so complicated by having your other knee in such a bad state and so painful itself and your lymphoedema. It's surprising that you managed any exercises at all! Keep on keeping on. This time next year...

 

[Mollymax]

Yes I mean that I had to try flatten my knee down on the bed to get leg straight then lift it. She never touched my knee apart from sliding her hand underneath to see how flat it was on the bed. @lovetocookandsew I do feel my leg still weak and that exercise showed it. As you say my knee obviously isn't ready for that exercise yet. I don't know if I am on schedule for recovery or not but no doubt I will find out next week when I see surgeon.
@Spex10 I think you are right that my lymphodema and bad right knee is maybe making things a bit harder. I well keep striving on and hopefully see improvements soon.
Today I did a longer walk. Thoroughly enjoyed it. Was slow and painful in other leg but that is a pain I just get through after all its not like I need to take care of it like in my healing knee. It's not like it's ever going to get better so I get b up and get on with it. I may turn the air blue when it hurts but hey ho that's life....

 

[lovetocookandsew]

@Mollymax I put the word "schedule" in quotations as there is no real schedule for a knee recovery, just average time frames. But some of us recover faster than average, and some more slowly. And we also may recover quickly in one area, and slowly in another. If your surgeon isn't happy with your recovery pace, don't be discouraged, your knee not only has other issues, it will recover in its own time frame. And if your surgeon is happy with your progress, then that's great, but your knee will still recover at its own pace.

 

[kneeper]

It's great that you're getting out for short walks. Good for the knee--and the mood, I found!

 

[KarriB]

Don’t worry about your leg being weak right now. It takes a while to build up that muscle strength again. Remember your knee didn’t get bad overnight, I’m sure you had years of pain while walking. It will take a while to build strength in your knee and that’s ok because your knee is still healing. Strengthening doesn’t happen until 4-5 months post op.

 

[Mollymax]

Reasonable sleep last night although awake by 7am. I had to go out to the bank this morning then drive my car back from garage as hubby was picking his up. I managed my first drive ok although knee felt a bit strange and thigh slightly shaky. I won't do any long drive yet.
It was the walking to the bank from where we parked the car that was the problem. Twice my thigh had a wobble. The second wobble actually scared me and the air was a teeny tiny bit blue. This just proves I am not ready to go back to work and my manager will be told at my meeting. I guess I should maybe try the exercises physio gave me. The wobbles today has made me scared to go out on my own.

 

[Spex10]

Gosh. Was that your thigh on your operated leg? I'd done lots of exercise for my quads prior to the op. Yesterday the PT said my quads were so strong that it's an extra stretch to bend the knee. Can't win : not enough strength and too much both a problem.
Good you managed the drive though. Its a start. I agree it's a funny feeling but not painful. Did you have difficulty bending it enough to get in the car door? I do have to move the drivers seat as far back as poss to get in and out then forward again so I can reach the pedals.

 

[Mollymax]

Yes its operated knee. The physio said I had been walking so badly for years the muscles had weakened. It wasn't a nice feeling when it wobbled. Without my stick I may have fallen.
There was no pain when driving just a funny feeling. I got into car ok but hubby had been driving and as he is 6'2" the seat was right back so once in I needed to pull it forward.

 

[lovetocookandsew]

I hesitate to suggest this, but maybe using your walker when out and needing to walk a ways might be a good idea for now. Once your other knee is replaced, and you begin to get strength back in your muscles, you can go back to the cane, (sticks) and finally graduate to walking unassisted. It's not a step back to realize you need some assistance walking, it's reality and common sense to keep you safe and mobile. Not only have you had knee problems in both knees "for years", you just had one replaced. But your other one is still giving you fits, and will do so until it's replaced. It's not a bad thing to use a walker while you need it; and you know you won't always need it.

 

[KarriB]

I used my cane for months because my leg felt was weak, but starting strength work now will on,y cause more swelling. What sort of exercises did the physio give you?

 

[Mollymax]

Knee very swollen and sore tonight. Think I may have overdone things today but needs must as I had no choice.
@KarriB She gave me leg raises and one where I was to try putting good leg in front of operated one and push it back and the one where you straighten leg. Another where you sit on sofa and stretch leg out with for on coffee table or similar to straighten leg. Oh and heel slides. My bend has gone down from 86 last night to 80 tonight so I know it is more swollen. Off to bed now but first night I can say I actually feel pain.

 

[Celle]

Knee very swollen and sore tonight. Think I may have overdone things today but needs must as I had no choice.

You do have a choice.
It's your knee and your life and you are in charge of both of them. You owe it to yourself to do what you need to, to help your knee recover.

She gave me leg raises and one where I was to try putting good leg in front of operated one and push it back and the one where you straighten leg. Another where you sit on sofa and stretch leg out with for on coffee table or similar to straighten leg. Oh and heel slides. My bend has gone down from 86 last night to 80 tonight so I know it is more swollen.

"She" may have suggested you do all these exercises, but you have the right to say "I'm not going to do them today." You're the boss, remember.

Molly, how many times do we have to suggest that you stop doing all these exercises?
We suggest that, and you keep doing the exercises and worrying about why your knee is still swollen.
Your knee is not going to get less swollen while you're doing the exercises, and they really aren't necessary. They are setting back your recovery.
Your knee gets all the exercise it needs, just from your activities of daily living.

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 ROM is there right from the start, just waiting for all that to happen, so it can show itself.

 

[Spex10]

Maybe to strengthen your quads its not actual PT exercises that would help but some more just plain walking. A question of judging how much though! Enough to help but not enough to hurt.

 

[Celle]

Molly, Spex10 is right. Your quads will strengthen gradually, as you use them in your daily life.

As a general guide, we suggest not doing any strengthening exercises until about 3 months post-surgery. Let your knee heal more first, then start the strengthening.