TKR PCL release post TKR<<

[Celle]

Here are a couple of examples from people who gained ROM slowly, but still achieved it:
This is what one of our members wrote about the slow development of her ROM. (Thank you, Campervan). As you can see, her flexion continued to improve for a long time.

"I had a slow recovery. Here's my flex measurements at various points:
92 - 8 weeks post op
105 - 10 weeks
107 - 5 months
110 - 6 months
112 - 7 months
116 - 9 months
119 - 11 months
118 - 1 yr
120 - 1yr 2 months
125 - 1 yr 8 months
128 – 6 years "

And here's what bertschb posted:
"I'm 12 months out from my surgery and have some advice based on my experience:
1- Stop going to PT (all it will do is make your knee swell and reduce ROM)
2- Don't worry about your ROM
3- Be patient - VERY patient!!!

Here is my ROM history (more or less):
1 month - 60 degrees
2 months - 80 degrees
3 months - 85 degrees
4 months - 90 degrees
5 months - 90 degrees
6 months - 110 degrees
7 months - 120 degrees
8 months - 125 degrees
9 months - 130 degrees
10 months - 135 degrees
11 months - 140 degrees
12 months - 140 degrees

I spent waaaaay too much time worrying about ROM. I thought I'd be riding my bike a couple months after surgery but it took SIX months! Looking back on my surgery, if I knew then what I know now, I wouldn't have wasted my time with PT and I wouldn't have worried about ROM."

 

[IronGirl6]

Thank you so much for this info. I feel like after such a prolonged level of injury and 3 scopes, this may just take longer. I don’t want any more anesthesia, pills, force on my poor leg, etc.

That being said, after several near pain free days, I’m back to uber painful on the inside of my knee - the side that had been mostly pain free prior to TKR. Like, I’m limping again. I’ve taken more than my two halves of Percocet, and added 2 celebrex, massage, estim, extra ice, and my favorite arnica gel. Praying I feel better in the am... have some rather important stuff tomorrow. I at least need to be able to fake it well.

Here’s to hoping it’s not another insomniac style night.

 

[sistersinhim]

How do you feel today? I hope much better after a good night's sleep!

 

[Josephine]

Show me where this pain is

 

[IronGirl6]

I’m better after getting active again. I don’t know how to use that diagram on my phone, but my one pain spot is left tkr knee, inside / medial, toward bottom of patella an inch or so to the inside. It comes and goes, it’s also the source of most of my “zingers” middle of the night, when it feels like a hot sword is being shoved in there.

Wound is closed again finally, back in PT at a different place - went there for my neck. They decided I’m strong enough and just need to stretch / be massaged / etc, and that at 95 degrees on my own at 10 weeks I’m fine. Think I’m in the right place.

This week I’ve discovered I can get up and down off the floor - which thrills me so I can really get back into my stretching / pseudo yoga routine. I just keep the left leg straight and maneuver around it! Nearly gave my PTA a heart attack when I tried this in clinic, but it felt so good. I love sitting on the floor.

I can also take a half lunge with my new knee, and am working on going down stairs more. It’s amazing - the new knee feels more stable than my mostly good natural right knee! This is really amazing after suffering for SO LONG.

Guess I’m in the “happy I did this” phase now, as my abilities start to return and I feel like an able bodied human again!

I also managed 30m on elliptical, carefully, finally got a good sweat. But that bike... still my nemesis!

 

[IronGirl6]

Now that I’m actually awake (insomnia post above),@Josephine my leg has pain - only place - LF3, lower D and a bit to E when touched. Front to inside only. Thankfully it’s not constant, but when it’s there -

New therapist uses the Graston technique - this was done post neck surgery for me with terrific results. I think somehow the way the surgeon moved the muscles (which are large and dense from years of weightlifting) and tendons on the medial side made everything super mad. So I’m looking forward to this soft tissue practice.

In the event this might help someone else, here’s a good article on the technique. It’s a good way to break up scar tissue without being aggressive in any manner. Your skin is a little irritated after, but seems like a small price to pay if I can get this leg moving the rest of the way. I love the elliptical most, but I do miss my bike. And, ROM = back in the saddle!


https://breakingmuscle.com/fitness/what-is-graston-technique-new-tools-for-healing

 

[Josephine]

You mean about here?

I expect that would be something like this Pes Anserine and MPFL pain

 

[IronGirl6]

That is exactly it! Thanks so much! Thankfully I don’t have much radiating pain, it’s like a sharp painful target at the knee, just at Pes Anserine, and perhaps 3” around up and down. Learned some new anatomy today! (Been a long time since university lol).

I started out with very tight adductors (which I stretch daily, but years of heavy lifting and riding horses is hard to combat), as well as IT band syndrome in both legs... grateful to not be bothered laterally, and looking forward to the new therapist and her amazing massage and Graston therapy.

I have one of those kinesthetic balls to work the wrist, I think it could double as a massager too. I’ve been using my tens unit with ice, which seems to help temporarily. When I finally get this resolved, perhaps I’ll be able to sleep through the night again!!!!

One other question @Josephine - for 15 + years, my left calf gets very tight - especially on the elliptical, regardless of angle. (Last several years I’ve used low settings to go easier on my knees - and I monitor my foot placement carefully). I’ve never been sure if it was because muscle was all I had gluing my knee together, or if it’s another imbalance of some kind. Ankle? I roll my calves out elevated on a bolster with the foam roller on top (which I highly recommend to folks esp post surgery - feels amazing and good for circulation). Wondering if there’s a reason for this as well? My left leg has been a war zone for sooo long.

Truly appreciate your time and these articles. Gratitude abounds!

You mean about here?

I expect that would be something like this Pes Anserine and MPFL pain

 

[beachy]

I've had that same pain since I had meniscus repair 2 years ago! I knew it was muscular and just keep stretching and massaging.

 

[Josephine]

for 15 + years, my left calf gets very tight - especially on the elliptical, regardless of angle.

You know, it never ceases to amaze me how people will say "I have had this pain since I did xyz but don't know what is causing it!" It seems pretty obvious to me that it's the elliptical that will be causing it! So stop using the elliptical!

I’ve never been sure if it was because muscle was all I had gluing my knee together

I don't understand this. Can you explain it more for me?

 

[IronGirl6]

No, I’m not going to stop using an elliptical, it’s a safe way to get a non impact “run” in. I’ll never not be an athlete. It’s tight walking uphill as well, and our ranch is nothing but hills. It only affects one side, so it’s an imbalance issue, not an activity issue. I’m NOT going to stop training (safely and intelligently) and keeping fit, I WILL figure out what ails my calf and address it. I had surgery to get my life back, not sit on the sidelines.

What I meant by the other is once my meniscus was removed (3 surgeries first was largest removal), it’s no longer in there to help create the stability for the bones and muscles. I had massive instability for over a decade. My leg would actually pop out of alignment from just walking on non paved surfaces & I’d learned to pop it back into alignment myself so I could continue my life.

While that problem is now solved, it has not instantly solved my very tight L calf. I stretch / roll / massage... in every activity it’s tighter, even walking on flat surfaces - on hills and elliptical, the continual stretch of the calf muscles brings it more into focus.

Happy to report that yesterday got thru the day sans Percocet - and I walked a large property (work) with hills and stairs galore. Going down the stairs feels like it loosened my knee up quite a bit to boot! Only walking downhill bothered me - a mild irritation though, not true pain. Additionally, being off the pain meds made my mind feel so sharp it was like I’d had 20 Starbucks lattes! I still have night pain, but now I know how to address that and make that a thing of the past too.

So now I’ve got the tight Pes Anserine and tight left calf to address. I get those feeling good and I think - drumroll please - I’ll finally have my dream of not even needing an aspirin 95% of the time!

 

[IronGirl6]

Happy update: today was my 11 week anniversary - we went to the gym, I got on the bike last to do my back and forth nothingness... suddenly I felt something - and I got it all the way around!!! In disbelief and fearing I was hallucinating, I continued to do this, forward and back, it’s real!!!


Thanks for all that ROM pep talk - I did NOT take the prednisone pack, did NOT stress it anymore... and I darn sure will NOT be having an MUA!!! Hallelujah!!!!!

The people in my gym probably thing I’m a giant nut case now, as I burst into happy tears and was celebrating all over the place!!

Happy Dance!!!!!

 

[donnag1108]

Yayyyy!! So awesome to see these wonderful victories. Congrats to you!!

 

[grandma chris]

Oh @IronGirl6 what a wonderful report! You are just two weeks ahead of me and this is very encouraging! I don't have great ROM yet, but it is getting better and your exuberant message is just what I need. Thanks and congratulations!!

 

[IronGirl6]

Oh @IronGirl6 what a wonderful report! You are just two weeks ahead of me and this is very encouraging! I don't have great ROM yet, but it is getting better and your exuberant message is just what I need. Thanks and congratulations!!

So happy my post brought you comfort! I honestly feel it was practicing going down stairs, straight gait, no hiking of hip, that started this breakthrough. Not a bunch - just about 1 flight worth, slowly, using handrail. I am so relieved - and can’t wait to go jump on the bike again!

 

[sistersinhim]

The people in my gym probably thing I’m a giant nut case now, as I burst into happy tears and was celebrating all over the place!!

No one but someone who has had a knee replacement understand how exciting a revolution of the bike pedals can be! Enjoy and celebrate with carefree joy! We're celebrating with you! My first revolution was at home by myself late at night. I was so excited I got off and called my best friend, crying. She probably thought I was crazy, but I just had to share the good news with someone who cared!

 

[SusieShoes]

Sometimes the little things mean the most. What a wonderful success and of course you feel on top of the world! Getting back an ability you deeply crave is awesome. The key is to find joy in small victories and pile up on those victories. A month or two more or less at the end of the journey isn't going to matter. Getting there is what matters. Go you!

 

[IronGirl6]

Almost a month later, two days ago I made more progress by being able to ride the bike **without hiking my hip**!!! Yahoo! Now I’ll have to keep working to get the seat back to my 6’1 setting rather than the Kobe Bryant setting...

Two weeks ago I measured at 105° on my own. I believe that was my week 13? (You know you’re getting better when you lose track of the weeks of post op!) Then I saw my surgeon, who was pleased - so was I, knowing I never took that awful prednisone, and I would not be needing any crazy MUA. He switched me from taking Celebrex to regular ol’ Aleve, which is good as that was always my “drug of choice”.

I am now a total believer in ATI physical therapy (I believe they’re nation wide) and their use of Graston and distraction techniques to break up scar tissue. My therapist does almost all bodywork with a touch of strengthening work... no force, no stress, and a focus on REST. She also confirmed my suspicion that people who have acute injuries then TKR usually gain their rom quicker than someone like me who got the age runaround for a decade.

In case this helps anyone, here’s a link to the technique. I like it so much I may get certified myself for training clients and to use with my horses!

https://www.grastontechnique.com/

Really feeling thrilled with my new knee!
Hope you’re all doing well!

 

[Beachinnc]

Great information given in this thread, I'm 5 weeks post-op from total knee replacement, right knee, and sleep in 2 hour blocks at night right now. I find it actually easier to sleep during the day for some reason. At night I can't seem to get comfortable and just toss and turn plus my knee aches at night . I just transitioned from my walker to a cane but can walk independently very slowly and try to concentrate on having a good gait. The only pain med I take is Tramadol, one every 6 hours plus Tylenol PM at night.Pretty much just do some stretches ice elevate, rest and repeat.

 

[IronGirl6]

Great information given in this thread, I'm 5 weeks post-op from total knee replacement, right knee, and sleep in 2 hour blocks at night right now. I find it actually easier to sleep during the day for some reason. At night I can't seem to get comfortable and just toss and turn plus my knee aches at night . I just transitioned from my walker to a cane but can walk independently very slowly and try to concentrate on having a good gait. The only pain med I take is Tramadol, one every 6 hours plus Tylenol PM at night.Pretty much just do some stretches ice elevate, rest and repeat.

I have found Tramadol to be a wonderful tool for pain, have used it off and on over the years as I struggled to stay active with all my issues!

I believe our cortisol levels raise at night and again early am, which is why we experience pain more then. I just started being able to sleep thru the night myself... well then we went and got a new kitten, so that didn’t last long!

Slowly walking on your own is a serious thrill, isn’t it? Are you having in home PT? My one recommendation is for them to watch your gait so you don’t get any bad hip hike or leg circle habits. Mine would put me back on the walker and encourage me to over emphasize walking heel-toe and ensuring that my body moved normally.

Congrats and blessings for your healing! I’m honestly at the point now where my other knee is almost jealous... my new one feels SO strong and stable! But I think I’ll go for another round of mesenchymal stem cells for the right knee and hip to make sure I won’t need anymore bionic parts. 3 artificial vetebral discs and a TKR is enough cyborg for me lol.