TKR PT Failure

[Layla]

Happy Three Month Anniversary, Shea!
I hope the past couple of weeks have been good for you.
Have a wonderful weekend!
@Shea

 

[Shea]

I am soooo much better than I was a month ago when I first wrote.

When I get out of the bed, I can walk fairly normally instead of lurching to the bathroom and keeping a close eye on the nearest wall.

I can get out of chairs without arms and off of low toilets. What a relief! That will definitely help me get out more.

My stomach reflux is much improved after whatever; I got it after surgery so I’m thinking it was the opioids. My appetite is back too although I’m not as excited about that. The fatigue seemed to lift all of a sudden about a week ago and I’m willingly chopping vegetables and paying more attention to nutrition. I will definitely miss you GrubHub!

My knee area is still quite hard to the touch but definitely better than it was. I still feel swelling behind the knee. My ROM decreased quite a bit after PT ended abruptly but I think it’s coming back now. I’m definitely not measuring it but I’m back to being able to lift my leg high enough to get my sock on. I am following @mendogal’s advice to look at improvements instead of numbers.

I’m still icing three times a day for about an hour each time. If I don’t, I have pain. The sudden, sharp pains have receded although they come back if I overdo.

Apparently any kind of exercise is overdoing. I’ve walked outside for 10 minutes a couple of times which caused pain later. I’ve been back in the pool a few times, just dangling my legs while floating on a noodle. Heaven! My body is craving movement, especially my back. Yesterday when I went in I was very, very careful not to do anything too strenuous, some cycling movements, etc. and held firm to 10 minutes only. I just basically moved my legs around to get some stretches.

Last night I woke up at 4 AM with pretty severe pain in my knee that wouldn’t go away. I wasn’t too receptive about bringing ice into my warm bed so I took a couple Tylenols which allowed me to sleep for a few more hours.

So that leads me to my question. Is it a bad thing to do very light exercises if I feel pain later? I admit I’m getting a little frustrated about not being able to exercise or stretch and I’m considering telling my knee to shape up or ship out, we are going to exercise! Enough already!

Other than that, I’ve had quite a few good improvements in the last couple of weeks and that has been wonderful.

My shoulder continues to give me a lot of grief. I had a second shot a week ago in a different place to target the arthritis. I’m really hoping that does the trick because if it doesn’t, I was told I have to wait until I’m bone on bone and will need to greatly restrict activities to avoid pain. It struck my funny bone when I was told one of my restrictions is to not do any sudden movements. Is that possible? Smile.

The PA had her hands on my shoulder when I was doing one of the exercises she wanted me to do. That familiar out loud yelp of pain came back and she said that is arthritis. I was thinking it was the torn rotator cuff. I had promised myself not to do the second knee in January until my right shoulder is fixed which no longer looks possible. I’m hanging onto the fact that my shoulder is somewhat improved after my shot, and dearly hoping that I can limp along with cortisone until surgery is possible.

Thanks for the nice three month greeting @Layla! I’m hoping to get some answers about exercise induced pain, I’m at a loss about what I should be doing.

 

[Roy Gardiner]

Is it a bad thing to do very light exercises if I feel pain later?

Yes. Ease up on the exercise until it does not cause pain or swelling

I admit I’m getting a little frustrated about not being able to exercise or stretch and I’m considering telling my knee to shape up or ship out, we are going to exercise! Enough already!

You can and should stretch as much as you like, as long as it doesn't hurt.

Exercises to regain ROM are *stretches*, exercises to make you fit are *training*. Stretching exercises are gentle and do not make you breath hard, sweat or have an elevated heart rate. Training exercises do.

You cannot do training until healing is complete because it worsens damage to the ligaments and tendons that were affected by surgery. You can easily tell if this is happening because your knee will get stiff, will hurt, will swell up in the 24 hours afterwards. When this happens, stop.

Here is a longer explanation of the training/healing differences https://bonesmart.org/forum/threads/post-operative-exercise-–-the-bonesmart-view.25463/

Here are some ROM and extension stretches (there are loads, these are just examples) https://bonesmart.org/forum/threads/rom-and-extension-stretches.13159/

 

[Shea]

Thanks @Roy Gardiner, I appreciate your answer even though it’s not what I wanted to hear.

I’m looking forward to reading the links you sent.

Now that I’ve read the links, I realize that I did need to know what gentle stretches are.

 

[ladyj]

I am interested to see that you too had loss of appetite and reflux. I have that too. It isn’t particularly pleasant, but losing 10ths in weight is!

 

[Shea]

@ladyj that’s exactly what I lost and I’m amazed it’s staying off without exercise or much activity. It’s enough to get off my beta blocker too!

 

[ladyj]

Now I can start walking again, and I am lighter, I am feeling very encouraged!

 

[Shea]

Do gentle stretching exercises help not only with ROM but also strengthening my knee so I can walk longer distances without pain the next day?

 

[mendogal]

Stretching doesn't build muscle.
However, by improving your ROM you help normalize your gait and structure, which lets you walk more efficiently, hence potentially further.

 

[Jockette]

You will be able to walk longer distances as you heal in general, but it will take a while. Three months is 25% healed, in this year long healing process.

 

[Shea]

Thanks @Jockette and @mendogal

yesterday I realized I can walk around the house and grocery shop without a problem, it’s just the 10 minute walk outside that hurts. I think it’s the pace I’m going and maybe if I slowed that down I could walk around outside.

I know three months is early days but cabin fever has set in and the flowers are in full bloom.

 

[Jockette]

I did better walking in the house or in a store, but struggled outside, too. Then I realized that my driveway has a slope to it, to go down to the street. I realized maybe that was sabotaging my walk, in the early days, as it was uncomfortable to walk it, but more so going down.

 

[mendogal]

Yes, try slower shorter outdoor walks... Cabin fever is real AND fresh air and flowers are great for the mood!!

 

[mendogal]

I did better walking in the house or in a store, but struggled outside, too. Then I realized that my driveway has a slope to it, to go down to the street. I realized maybe that was sabotaging my walk, in the early days, as it was uncomfortable to walk it, but more so going down.

On my earlier knee replacement, I had MDH drive me down the driveway and park across the street where there's an actual sidewalk!

 

[Shea]

@mendogal

you know it! thanks for understanding. My sidewalks are flat and level so that’s all good. I think my muscle memory takes over and I think I’m walking beside a dog or exercising.