TKR PT Failure

[Shea]

Here is a photo of the wonderful knee wrap in the above post.

 

[EalingGran]

really remarkable, I didn’t know knees went back that far.

don't know if this applies to you, but most of my body has joint laxity.
It's not to the degree you would call me "double jointed" nor have I ever

I am like @mendogal in that I had almost hypermobile joints. I could put my hands flat on the floor, not just touching my toes. And I could hold my ankle behind my bottom in a standing quad stretch. I can still do that on my unoperated side but I am a few degrees off on my PKR side.
This probably explains why my ROM is so good. One of the best predictors of ROM post-op is the pre-op level. But being so flexible can make you more prone to injury like mendogal says. I used to like sitting with my knees under my bottom- but I think that can be damaging to knees.
To be honest joint function is more than just ROM. Some people here have less ROM than me but stronger muscles and can ride, ski or surf- which I certainly couldn't do! It's more about doing the activities you want to do without significant pain rather than getting too tied up with numbers of flexion.

 

[mendogal]

@EalingGran Well said!

 

[Shea]

@EalingGran @mendogal this is all new to me and very interesting. Thanks. I do dream of getting in and out of my kayak again. That’s when I will have arrived.

 

[EalingGran]

I hope that with gentle exercise you will eventually get there!
I know you have other joint issues that might limit things but have a look at my teacher's free classes on YouTube. She has loads of excellent ones including a 20 minute side lying/ knee friendly/ glute strengthening one for post injury with no squats. That was my go to exercise regime between our private lessons.
Google Katja pilates and it comes up on YouTube.

 

[WFD]

I do dream of getting in and out of my kayak again.

You and me both. Between my knee and the pandemic, I haven’t been able to race since 2019.

 

[Shea]

@EalingGran Oh thank you, that’s exactly what I needed. I thought about Pilates after you mentioned it but my experience finding gentle practitioners in anything has been limited. I think the swelling has lessened enough that it’s time for some exercise. Thank you again.

 

[NeedaThneed]

Is anyone else having trouble finding their food underneath all the ice wraps?

Me! I have 4 extra large gel wraps. Having ice wrap around behind the knee has been very helpful for me.

Don’t give up on the pool. It took me several visits waiting a while in between before I didn’t react. It was a benchmark - I would notice things like how changing got easier, limping across pool deck got less. Honestly I think it was the drive, walk, changing that made me react most! I had to stick to very gentle flutter kick alternating front crawl vs just waving my arms around on my back - big sweeping gentle shoulder movement. Water walking was NOT good for me - I had to stick with limited range because of all the crackling in my kneecap. I find water (and a hot tub!!!) is the best place to relax the muscles and get more benefit from gentle stretches. I also have to take muscle relaxants often. Swimming helped my shoulder after an injury. And it loosens up my muscles a bit for a day or so before they stiffen again.

This surgery made me realize how much we need every other body part. You have extra challenges. Your medical people should help you feel encouraged, not worse! I guess I’m saying don’t beat yourself up - just go at your pace and pay attention to what helps and go with that. No one knows you better than yourself.

 

[Shea]

Thank you Needa, so much good stuff to unpack…

It had not occurred to me to try something else in the pool other than walking but I agree it makes sense. My shoulder PA said I could do the side stroke or a breaststroke ...as if on the breaststroke. I feel like I will try to mix it up in the pool now that I found a front zipper swimsuit; that was a game changer. And yes, all the showering and driving and walking and struggling into a swimsuit and only being able to exercise for a few minutes, it’s a lot.

I’m also getting a little concerned I’m bordering on lazy in terms of any exercise… I love that icing and elevating forces me to do my favorite thing, reading.

Also, a few days ago, I decided I was too busy to ice first thing in the morning and carried on for a couple of hours until my knee literally dropped me in my tracks. I felt a sharp pain, then another sharp pain on the next step and it’s been reoccurring pretty regularly. I’ve been treating that as a message to kick back and ice more. I’m the only one getting things done around here though, smile, despite some helpful friends.

I’ve been wondering about my hot tub and I’ve been in a couple of times. It feels beyond wonderful but I’m not sure about the next day…plus I am still swelling at the smallest encouragement. I’m trying to do without the Jets because I know they cause problems. I’ve just tried a muscle relaxer and those are definitely helpful, thank you for mentioning it.

Your encouragement to be my own self is also needed. To be honest, I’m staying away from the medical profession for the time being, unless I really, really need them,

 

[NeedaThneed]

I love the hot tub at the pool because I can move around and put the jets on the muscles avoiding the knee. I actually tried it on the knee on a day I wasn’t swollen and it loosened up without any consequences (surprisingly!). I just wish I could get there during the quiet times without the crowds of kids!

My knee can get hot in the bathtub. So I’ve found if I open the window for cool air then I can soak and bring knee out of water for evaporative cooling. And as I am getting out I run the cold water tap over my knee and feet. It seems to keep swelling down. Usually followed by ice and bedtime. I think I would struggle to get out of the tub if I didn’t have good arms and a good other leg though. So I’m grateful I can do this as my muscles get sooooo stiff and hot baths are the best thing for them.

Sometimes my shoulder still hurts with front crawl, so I flip over and float on my back using a gentle flutter kick and then reach my arms out and up as much as tolerated and then wave them back to my body….a bit like part of making a snow Angel. I use the lap lane and this is partly why I go during quiet times because I can’t see where I’m going otherwise! I have met a few people at the pool and some recovering from shoulder surgery too!

I bet you will exercise again when you are ready. You are not lazy! It takes so much extra energy right now to do everyday things and look after a home.

 

[Shea]

I love your encouragement, Needa. Thank You!

 

[Abbylayla]

Hi @Shea
I haven't been around in a while but just want to let you know that my personal experience is PT is not all it's cracked up to be. Not all the time. And a WHOLE lot depends on your therapist. There's a lot of lousy ones out there.
I had a right TKR in 2020. I came out of surgery with a 90 degree bend and was always able to lay my leg flat. Tried PT but only went 3 times. I was unable to complete because my hips were so bad. Arms too just like you. However, my knee is just as good as anyone & know who had PT for months AND actually better than some!!
I was never able to understand the purpose of forcing my knee back. Especially since I already had good flex & it made no sense to expect a swollen joint to get the same flex that a knee w no swelling would. But regardless, keep icing. It's your ace in the hole. And exercise only as much as your knee can handle. You know your body better than any physical therapist. Excruciating pain should never be tolerated.
Hope everything works out great for you! I know it's frustrating.

 

[Shea]

@Abbylayla thank you, that really sums up everything I need to know right now. Icing is my ace in the hole, That’s what I need to hear. I’m becoming a little ice averse. I am icing three body parts each time And it gets a little chilly

 

[Abbylayla]

@Shea Oh yeah! All that ice does make you chilly to say the least! Ha!

 

[Shea]

Something interesting happened yesterday on an outing. My PT doctor told me to take my cane when I’m around people so they are less likely to bump into me.

I took my cane yesterday because we were walking more than usual for me and boy did it change my life. People kind of basically ignored us until they looked down and saw my cane. They leaped out of my way, held doors and the manager came over to see if we needed anything at all. I liked it.

I saw a lady with a cane crossing the street in front of me, and I just froze, looking for ways I could stay out of her way. So it’s instinctive I think.

i’m going to a celebration of life out of town in a few days, wish me luck. And now I know the value of a cane in crowds, I’m taking mine.

 

[Law]

I'm THR, but thought the same thing!

 

[EalingGran]

i’m going to a celebration of life out of town in a few days, wish me luck. And now I know the value of a cane in crowds, I’m taking mine.

Good luck! I used a foldable walking stick for many months when outside. That was because I had had a few falls pre-op due to my twisted leg. It really gave me confidence as I live in a very busy city suburb with lots and lots of commuters rushing for our Tube station. People do definitely notice and take care around you if you use a stick. They also give up seats on trains. I would recommend using it for as long as you need. Just be careful not to lean too much that it imbalances you. Try to mainly use it for confidence and only support if you are standing for long periods.

 

[Shea]

@EalingGran thanks for your comments. Your scenario scares me a little bit with rushing people and the tube.

Believe me, I have a constant reminder not to lean on my cane. In fact, I couldn’t wait to stop using the cane because it aggravated the daylights out of the arm that has the torn rotator cuff and arthritis. I’m paying for it today Because it is very easy to lean on it without thinking about it.

I will now use it for a shield at the gathering where many people will be walking around. And if someone wants to give up their chair for me, that would be great.

 

[ladyj]

I am probably the world’s most unsupple person. I was always bad at PE, never picked for a team for anything, couldn’t catch and couldn’t throw!
So for my knee joints to be so flexible is a real bonus.
I was however as an adult a long distance trail walker so before I smashed my left knee to smithereens, I was pretty fit.
I have no idea if that has anything to do with my knee muscles being so co operative now.
i thought that the first knee replacement and tibial re build might have meant that the supporting muscles had plenty of room to flex, but I certainly didn’t expect this right knee to be just as flexible.
Anyway, thank God I have been so lucky.

 

[kiwicurls]

@Shea I know exactly what you mean about the cane aggravating the daylights out of the torn rotator cuffs! I’m still using the walker at six weeks and it too, aggravates things in the shoulders. Can’t wait to ditch the walking aids.