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PKR PoorlyKnees’ road to recovery

March 29th. Four Weeks Post-op

Physio Session #2
I had my second physio appointment today. I was nervous. He had tasked me with doing an infinite number of leg lifts and improving my range of motion and achieving 90 degrees. He seemed unimpressed by my flashy show of leg lifts, but was delighted by my ability to achieve 105 degrees of bend. Huge relief.

A Lesson in Physiology
After a bit more knee bending and leg lifting and a lot of sharing of injury history (on my part) my physio confirmed his prognosis. Apparently my IT (iliotibial) band is very tight and this has been preventing my quads from engaging.

What Does That All Mean?
My knee has been sensing any heavy demands on it as trauma resulting in sharp jabs of pain. This has been a problem for literally years. He set about manipulating my IT band and within a few minutes I was able to flex my knee more easily and (thankfully) with no pain. This could explain the muscle wastage on my left quads and the disproportionate tightness on my left side when I used to practice yoga

So, What Next?
Now I have a programme of exercises using a resistance band. Small movements aimed at activating and loosening my IT band permanently and allowing my quads to engage. This is really exciting as I feel it may deliver some huge improvements to the strength and resilience of my left side, above and beyond the corrections to my arthritic knee.
 
March 31st. A Funny Thing Happened the Day After Physio
At the end of my session the physio gave my IT band a hefty deep tissue massage. It was very nice and provided some immediate relief in terms of increased range of motion, however….

What Happened After Physio?
The muscles in my groin and buttock started to twitch involuntarily. Not violently or painfully, but enough to stop me getting to sleep., however…..

Oh No, There’s More
I also woke up with a nasty headache and a pretty unpleasant upset stomach. This is not a massive shock, I have previously had chiropractic sessions that have resulted in similar symptoms but not quite as uncomfortable as this.

Gotta Fix This Thing
The physio suggested I get regular massages to my IT Band, so I’ve ordered a hand held massager to accompany my new exercise regime.
It may seem unrelated to my knee surgery, but following a series of tests I can see how an over-tight IT Band is causing me problems and has contributed to discomfort and muscle wastage for many years. Fingers crossed.
 
That doggone IT band can be a common problem. It's also hard to get rid of. It is amazing how much it can affect other areas of our body, including our knees. I hope your routine continues to help yours. We can all learn from it.
 
PoorlyKnees said:
At the end of my session the physio gave my IT band a hefty deep tissue massage
Click to expand...
Have you tried more gentle massage along the IT band with a spiky small pilates ball?
My pilates teacher does this sometimes at the the end of our sessions to release the IT band. I haven’t had any IT band issues but she says it is good to release it after exercises.
 
That darn IT band!! I went to see my OS about the tightness on the outer side of my knee. I have no other pain or problem except this tightness which just won't improve.

He thinks my problem is Trochanteric Bursitus which is an inflamed hip bursa. That is causing irritation in my IT band, which is in turn causing the tightness in my knee. I am going back to physical therapy on Monday to work on it. I also scheduled an injection in my hip in the hopes of settling that as well.

Good luck with your IT Band issues. I'll be watching your thread to learn more about that tricky IT Band.
 
EalingGran said:
PoorlyKnees said:
At the end of my session the physio gave my IT band a hefty deep tissue massage
Click to expand...
Have you tried more gentle massage along the IT band with a spiky small pilates ball?
My pilates teacher does this sometimes at the the end of our sessions to release the IT band. I haven’t had any IT band issues but she says it is good to release it after exercises.
Click to expand...
The massage itself was really helpful and wasn’t unpleasant (In fact it was really nice). Interestingly, the advice I was given was that the massaging should be done BEFORE exercising to endure any adhesion is released and the target muscles are correctly utilised.
 
April 2nd. Turning a Corner
Like all things, knowledge and understanding is the key. The more I learn about my new knee, the more I understand how to progress my recovery.

Scarring, Swelling and Numbness
I’m really pleased with the way the wound has healed. The puckering along the incision has nearly gone and there is no redness. All signs indicate the scar will be barely visible.
The swelling on the medial side of the joint has gone, but I still have a bit of swelling above the patella and on the lateral side; this is subsiding.
The area of numbness continues to recede. It’s now only a couple of inches in diameter.

Range of Motion
The range of motion is improving, but progress is slow and a bit frustrating. I’ve found that releasing the IT Band prior to exercising reduces any discomfort I feel and really gives me confidence. This helps me to commit to the physiotherapy.

Pulsio Air Massage Gun
I took delivery of a Pulsio Air massage gun yesterday. It is a game-changer. I now use this to release my IT Band prior to exercising and the positive impact has been remarkable. It feels like it can flex my knee further with a significant reduction in the feeling of tightness.

Strength and Endurance
I’ve been carrying an injury to my knee for 37 years. It has always been weaker and muscle wastage has been a problem. The recovery from surgery has both added to this and suffered due to it. I feel like I can walk and exercise as I did prior to the operation (within the limitations of the range of motion), but I’m conscious that I’m probably using all the wrong muscles due to the IT Band issues. I’m hoping the massaging will help me correct this.

Mobility and Normality
As the range of motion improves, my mobility increases and the journey to normality progresses. I’m still having problems getting in and out of cars and simply sitting in the car continues to be uncomfortable.
The single most exciting thing about my recovery is that there is absolutely no pain from the medial side of the knee. I cannot express how exciting that is as the thought of walking without each and every step being accompanied by stabbing pain is wonderful.
 
trinket said:
That darn IT band!! I went to see my OS about the tightness on the outer side of my knee. I have no other pain or problem except this tightness which just won't improve.

He thinks my problem is Trochanteric Bursitus which is an inflamed hip bursa. That is causing irritation in my IT band, which is in turn causing the tightness in my knee. I am going back to physical therapy on Monday to work on it. I also scheduled an injection in my hip in the hopes of settling that as well.

Good luck with your IT Band issues. I'll be watching your thread to learn more about that tricky IT Band.
Click to expand...
I’ve got a Pulsio Air Massage Gun now. It’s brilliant. It releases my ITBand and I’m convinced this will help me escape the vicious circle.
 
April 4th. Busy with the Physio
37 years ago today, Living Doll by Cliff Richard and The Young Ones ft Hank Marvin was number 1 in the UK charts. Rock me Amadeus by Falco was number 1 in the US. Wayne Gretzky sets NHL record with 213th point of season…..and I crashed my motorcycle. Badly breaking my left leg (amongst other things). That’s how this all started.

Strength and Endurance
My new knee is doing OK, but the leg itself is so weak. The muscle atrophy resulting from all the years of “protecting” the knee have taken their toll. I’m working hard on the quads and flutes on the left side but it’s dreadfully slow progress.

Range of Motion
I’m still struggling to increase the range of motion in my knee. Even though the swelling has reduced, the fluid around the joint is compromising the flexibility. I’ve packing is the only way to reduce the swelling.

Time and Patience
I know that I need to be patient, but it’s really frustrating when progress is do slow that it is almost imperceptible.
 
@PoorlyKnees Reading your last post you mention the UK charts and Rod Stewart came on my Spotify and, I don't know I just thought I had to chime in. I am rooting for you and your full recovery sooner rather than later. Healing vibes sent your way OH BTW this is what I really wanted to say - because I JUST did it to myself when reading your post and it made me feel better as I just had surgery too. I placed my hands on my operated knee and gently made contact and the slight pressure FELT GOOD! I just wanted to throw that out there - I had never thought of that slight good feeling and it was like a major victory in my recovery and may help you too. When I placed my hands on my knee it was as if I was soothing an angry Tasmanian devil.
Hope that helps and if you like Sir Rod Stewart put on "Do Ya Think I'm Sexy?" LOL that song always puts a smile on my face.
 
Mettleinside said:
I placed my hands on my operated knee and gently made contact and the slight pressure FELT GOOD! I just wanted to throw that out there - I had never thought of that slight good feeling and it was like a major victory in my recovery and may help you too. When I placed my hands on my knee it was as if I was soothing an angry Tasmanian devil.
Click to expand...
I totally empathise with you here. I think we look at the wound with its staples and puffiness and see it as something to fix. I’m 5 weeks post op today and I love my new knee. I give it a gentle massage at the end of every physio session. It feels different, it feels strange, but it’s MY knee and we can only fix this by working together. Love your knee and your knee will love you back. ;-)
 
@PoorlyKnees I know you may not want to hear this, but you have at lest a couple of more weeks with your "Tasmanian Devil" but you are on the cusp. With my VAST (11 weeks) knowledge of TKR your slow progress will suddenly get fast. At least mine did. 6 weeks I was get a couple of hours of sleep then I was chilaxin with Netflix for a few hours and repeat till morning. At 7 weeks, and a couple of Tylenol PM's, I was gettin 6-7 hours of blissful sleep. After that stairs were even easy. I'm now riding a stationary bike and am thinking I may try the Stairmaster (we'll see). Finally, every day after my surgery, I massaged my knee with CBD oil (sometimes more than once). I am not sure what if any therapeutic value of the CBD oil but just the massage on my knee felt wonderful (try to always rub towards your heart to help the swelling find a new home. Hope you have a good day...
 
April 6th. Taking a break from Netflix
Why? Because it’s US Masters weekend. A total overload of TV golf.

Busy Day/Rest Day
I’m managing to get some jobs done at home which is making me happy. I can manage 2-3 hours of pottering about before I have to call it a day. Unfortunately our Spring seems to be late in arriving. It’s been very rainy for the last month, so it was back inside again today, crab walking around the house and scaling the stairs as best I can.

TOP SECRET: Escape Plan
I’ve formulated an escape plan. Now that I can comfortably bend my knee to 90 degrees and put my trousers on without having to sit down, I feel it’s time to make a break for it. To that end, I’ve managed to sit in my car and press the pedals (it’s a manual). I think that if I complete a couple more days of physio I may be able to drive. First stop, B&Q (that’s a UK version of The Home Depot). I need some power tool therapy.
 
April 8th. Freedom is Mine!
I have successfully managed to drive my car; independence has been restored.

Incremental Steps of Physio
As I get more confident with my new knee I’ve found that I can take on more ambitious physio activities. Counter-intuitively, the more I seem to do, the more the swelling around my knee decreases. It gets a bit uncomfortable but if I rest regularly, it soon recovers.

So What Next?
Now I am free I figure I can go to my gym. I can use their resistance bands, mats and steps to strengthen my knee and leg further. Still a long way to go until I can get on the recumbent bikes but I’m getting there.
 
Please be careful at the gym. It's awfully early to start strength training on your knee. We recommend holding off until at least 3 months. You can judge your knee's reaction and know if it's ready or not.
 
sistersinhim said:
Please be careful at the gym. It's awfully early to start strength training on your knee. We recommend holding off until at least 3 months. You can judge your knee's reaction and know if it's ready or not.
Click to expand...
Thankyou for your concern. I’m the sort of person that will “forget” to exercise if I plan to do it at home. The staff at my gym are really helpful, so I’m planning on taking my exercise bands and massager and using the space and facilities to make the most of my physio time. I can also do a bit of upper body and core work whilst I’m there.
 
April 10th. Everyday is a School Day
One thing that has become clear over the last few weeks is that this whole recovery thing is a lot more complex than I could’ve imagined.

Keeping Busy vs Taking it Easy
I am a fidget; I can’t sit still. I’ve been pottering about in my garden and my lawn is looking beautiful. In my mind this will help with my recovery in terms of both strength and range of motion.
We’ve had a record amount of rainfall in March so I’ve been forced to stay in the house for extended periods. I’ve been elevating and icing my knee between bouts of physio. Which of these approaches has had the most positive impact? I’d have to say that the gardening has helped keep me sane, but the knee recovery has benefited more from the RICE.

Massage and Stretching
For me, the epiphany has been the positive impact of massaging and stretching. I was not aware of the problems being caused by IT Band issues and the loss of strength in my Gluteus Medius. Massaging these areas and performing targeted stretches with resistance bands has brought almost instant relief and reduction in the swelling around my knee. I don’t understand it….but it works
 
April 12th. 6 Weeks Post Op
My wound has healed beautifully. The puckering from the staples has nearly gone and there is no redness.

Things I can do….
Walk without crutches
Bend my knee past 90 degrees (just)
Walk up stairs (slowly)
Put my socks on without sitting down
Mow the lawn
Drive my car
Sit on a normal chair
Play the guitar

Things I can’t do….
Sleep through the night
Kneel down
Dig the garden
Walk downstairs (or downhill, come to think of it)
Play golf!

I have a physio appointment tomorrow. I feel a certain amount of apprehension.
 
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