TKR PT Failure

[Jamie]

As you know, every person and every surgery is different for recovery. A couple of months is not unusual for side sleeping with a new knee. It’s good you’ve tried the pillows and they may work at some point, so don’t give up on them.

If you’re not doing so, I would try taking something for pain about 30 minutes before you go to bed. Some people use their prescription pain medication for this, but others have success with 1000mg of Extra Strength Tylenol. If you’re not icing your knee through the night, you might also try that. Also a heating pad on your lower back can help as well.

With the added sciatica problem, it may take a little longer for you. But time will eventually allow you to sleep on your side. You might also try lying on your side for short periods of time (15-30 minutes) during the day to see if that helps.

 

[Shea]

Thank you @Pumpkin. PT Failure x 2.

My second physical therapist and surgeon colluded to decide that nothing short of NFL rehab treatment would get me past my meager 87° bend. I don’t believe either one of them have been educated in gentle stretches, etc. and the three month window of opportunity was absolute in their minds.

PS I’ve already passed 87° bend from having escaped their protocol.

 

[Jockette]

and the three month window of opportunity was absolute in their minds.

My ROM continued way past 3 months, like all through my second year, and I even noticed a bit more in my third year!

 

[Shea]

Thanks, @Jamie. My practice sessions only last 30 seconds or so until I have to back off. I will definitely follow your other suggestions.

For the last week or so, the pain is not in my knee so much as my sciatic nerve, so I’m gonna need to work on that to get improvement.

Unfortunately, I looked up sciatic discussion groups for pain relief suggestions and I wish I hadn’t. I’ll baby it for a while longer in hopes in doesn’t become chronic.

It was self-inflicted because I kept trying to ride my new mini cycle to exercise my knee. It didn’t hurt at all when I was doing it, but resulted in my new sciatic pain, which has held on for the last 2 weeks or so. My heating pad is providing some relief though and I’m going to try the hot tub to see where that gets me.

 

[Shea]

@Jockette. I am a poster child for the bonesmart way. When I get both knees fully operational I’ll be able to do some decent exercises that will probably increase my ROM. I know the window of opportunity is very wrong, but I’m having trouble finding treatment personnel who also believe that. In the meantime, my bend will come naturally but will absolutely not come with the treatment exercises I’ve been given so far. I’m so grateful that I’ve been tutored the bonesmart folks.

 

[mendogal]

Hang in there, @Shea
As we BoneSmarties know, there's a lot of healing left to do at three, four, five months, and with that, better function will come.

I have noticed a few folks reportedly got some relief from sciatica pain with TENS units they buy online.

 

[Layla]

I’m so grateful that I’ve been tutored the bonesmart folks.

Music to our ears. Thanks for putting trust in the BoneSmart way!

I am sorry you're struggling with sciatic pain and hope you find more moments of comfort with each passing day.

 

[Pumpkin]

PS I’ve already passed 87° bend from having escaped their protocol.

There is a plus or minus error in goniometer reading, so I would say you most likely at 90 degrees.
I was gaining ROM at 18 months, you have plenty of time to gently increase your ROM.
Slow but sure will get you there.

 

[Shea]

@Jamie

I wanted to give you a favorable follow up after I tried your suggestions. I iced and elevated my knee and heated my hip for most of the day yesterday. Then I loaded up on OTC meds before I went to bed and I know I slept on my side for a lot of the night. Apparently I’m asleep enough to not know when it hurts but There were no unusual ill effects when I woke up this morning.

@mendogal I will definitely look into the tens units. It fits my needs for having body parts breaking down in various places, so the Extra Pain relief will be welcome. Thanks!

 

[Jamie]

This is great news. I’m glad it worked for you. Sometimes it takes a while to figure out just what our body needs to be comfortable. I hope this works for a while. Be prepared, though, that things can change and you might need to make adjustments. Hang in there…..it does get better with time!

 

[EalingGran]

I slept with my operated knee slightly bent and resting on a thin pillow with the opened ice cool jacket of my Aircast Cryocuff on top. I also took some night sedation ( zopiclone from GP alternated with some non-prescription sedative antihistamine). That helped me sleep on my side from about 4-5 weeks.

 

[Layla]

Happy Three Month Anniversary, Shea!
I hope recovery is going well for you. Each step has been a step toward strength and healing.
Cheers to progress yet to come. Enjoy the rest of the week!
@Shea

 

[Shea]

Thanks @Layla.

Woo wee! Look at my bend! It’s a wonderful surprise I discovered a few days ago.

I wrote a book for last year‘s three month anniversary for my LTKR and I could write the same thing this year; Except that my ROM measurements are far superior because I didn’t do PT.

The first and last time I tried to do any type of knee exercise was on a mini cycle and I got myself some long lasting sciatica as a result.

Prior to my second TKR, medical professionals and friends were thinking they would cheer me up by saying oh, well now you know what to expect so it’ll be easier. I quietly disagreed, thinking these people were not two weeks away from getting their knee sawed on. I remembered well the challenges that were ahead.

But, now I think they may have been right. I’ve been very calm about letting my knee heal by itself, knowing that all will turn out in the end. (All due accolades to the Bonesmart medical professionals for telling us that .) Plus, I didn’t have to listen to PT people telling me three times a week I just wasn’t cutting it and that all my measurements were bad because I was slacking off.

If it hurts, I don’t do it, and plenty of things hurt and put me in the ODIC, requiring several days of elevation and ice. As soon as the swelling goes down, I’m right back out there again, challenging my knee with backed up chores, socializing, walking 15 minutes a day, etc. before my knee says STOP right now.

My sciatic pain has improved, bottom to top. It’s lingering in my back now.

I am reassured by @mendogal’s posts saying the rest of our body has to adjust to our new knee and various body parts can complain as they readjust. This is true for me.

I don’t know why some people fly through physical therapy and others like me are incapacitated. Does anyone know? Also, can any of the resident experts guess what my flexion is now? Thanks in advance.

 

[Jockette]

What a great report! We are all different, and you took charge of your recovery, and listened to your body and you’re coming along great!

Here is a diagram of a knee’s ROM.

 

[Jamie]

What wonderful words that tell the story of your second knee recovery. There are as many reasons as there are people in this world as to why some people are able to move through recovery faster than others. But the comforting fact is that just about everyone gets to the goal of a functional knee. And that is how you need to think of yours….not in terms of a number, but of what things you can do as you progress through recovery. An unscientific estimate of the ROM in your photo (hard to determine more precisely because your thigh is covered by your shorts is at least 90 degrees. It does appear you may still have some swelling and when that passes, the rest of your ROM will be there.

Keep doing what you’re doing as it is obviously working for you. And thank you soooo much for the photo to prove it!!

 

[Layla]

Such a positive, uplifting and inspirational update, Shea! Thanks for sharing the great news with us.
May it only get better!
@Shea

 

[Shea]

Thanks for the illustration, @Jockette. I’ve been looking all over for something like that. I noticed the stick figure had his heel up. I thought that was cheating. I may end up baring some leg and keeping my heel up because I swear I’m at least 140. smile

 

[Shea]

I’ve been wondering and worrying about a problem I’m having.

At 4 1/2 months postop, I’m still getting sharp pains and aches in my knee when I try to walk or swim more than one day at a time. The ODIC pain lasts for four or five days and I haven’t been pushing it when it hurts that badly. Definitely icing and elevating too.

I need to girl up for a friends reunion at Niagara Falls in September. So far, there’s no way I can do the walking that’s necessary.

I have somatic issues so that might have something to do with it. I am doing somatic brain retraining/Neuroplasticity every day.

Somatic means to me that I suffer with symptoms long after they should have gone away. My brain’s way of protecting me I guess. I don’t think there’s anything abnormal going on with my knee, it’s the same pain I’ve felt since the surgery.

So my question is, should I try to push through the pain or keep babying it until it’s better? I’m OK if there’s no good answer for that.

 

[Jamie]

I don’t think you should ever try to push through pain. Doing so puts you at risk of really overdoing things and slowing your recovery.

You don’t mention how much you’re trying to swim or walk on the days you do that activity. With these types of activity, it’s best to build up slowly. Especially with any water exercise it is so easy to overdo things because the water supports you so well you feel wonderful while doing it.

So, how have you approached doing these activities?

 

[Shea]

OK, that matches my opinion, don’t push through pain. Thanks.

I keep walking a little further each time, because I’m walking faster, but it’s about 15-20 minutes each time. My knee allows me to walk once every four days or so.

Swimming is actually just me floating on a noodle and gently moving my legs and arms for about 15 minutes, although I feel like I could go a lot longer. I make sure I cut it off at 15 minutes. Again, my knee likes a four day interval for complete rest but I’ve been doing my ADLs since the second week.

I’d probably be a lot calmer about this if I didn’t need to walk normally in 4 months. I keep thinking I need to push through this to increase my stamina, etc. but it sounds like I just need to accept my knee for what it is.

Thanks for your input @Jamie.