TKR Pulled Ligament in Week 6 recovery

[BlueSkiesHere]

This is my first post and I'm so glad I found this forum! I have had my first right TKR on March 4th, 2022 and I've had a bit of struggle with ROM. So I am just about to hit 7 weeks on Friday at this posting. As of Monday my ROM at PT was 97 degrees and extension -4. Which is an improvement from 90 degrees a week ago. My surgeon said this past week I have 3 weeks to hit a 115 degree flex and 0 extension or he will do a manipulation.

The "twist" for me (pardon the pun) is a week ago I twisted my knee really bad (I did not fall) and now I cannot put weight on my knee even today. I've had it checked out and it is a pulled ligmanent, they say it is not torn.

I just switched PT's because the other was pushing me too far and I believe the extra fragility of the tendon was from her pushing my ROM too early. I have hope in this PT because he said stop all the exercises and stretches and gave me TWO exercises to do until I see him next (tomorrow). One exercise is a side prone stretch and the other is a prone knee flexion. I was doing so much it is hard to stop and trust. He will probably add on to this tomorrow.

I have definitely been experiencing the post-op blues and am really fearful with the set back and how to go forward. It is so frustrating! However with the wisdom I find here, I don't believe I need a manipulation (especially this early) because I see I have been making steady...slow...progress on the ROM. Has anyone had this experience?

By having to be on two crutches it has set me back on being able to move and do daily activities/chores which I was just starting to do before I twisted this knee. I was just using one crutch before the twist. The new knee is fine and healing nicely, just the tendon badly pulledl. How do you heal if you can't put weight on your knee? I can sit and bend the knee and the prone knee flexion is tolerable to bend the knee that way however this prone position does not give me as much bend. Help.

 

[Jockette]

Hi and Welcome!

I‘m so sorry that you have a pulled ligament to add to the mix! Treat your leg gently so that it can heal. Gentle movement is important, but so is rest, for healing.

I will leave you our Recovery Guidelines. Each article is short but very informative. Following these guidelines will help you have a less painful recovery.

Just keep in mind all people are different, as are the approaches to this recovery and rehab. The key is, “Find what works for you.“ Your doctors, PTs and BoneSmart are available to help, but you are the final judge as to the recovery approach you choose.

Knee Recovery: The Guidelines
1. Don’t worry: Your body will heal all by itself. Relax, let it, don't try and hurry it, don’t worry about any symptoms now, they are almost certainly temporary
2. Control discomfort:

rest​

elevate​

ice​

take your pain meds by prescription schedule (not when pain starts!)​

don't overwork.​

3. Do what you want to do BUT

​

a. If it hurts, don't do it and don't allow anyone - especially a physical therapist - to do it to you​

b. If your leg swells more or gets stiffer in the 24 hours after doing it, don't do it again.​

4. PT or exercise can be useful BUT take note of these

​

the BoneSmart view on exercise​

BoneSmart philosophy for sensible post op therapy​

5. At week 4 and after you should follow this

Activity progression for TKRs​

6. Access to these pages on the website

​

Oral And Intravenous Pain Medications​

Wound Closure​

The Recovery articles:
The importance of managing pain after a TKR and the pain chart
Swollen and stiff knee: what causes it?
Energy drain for TKRs
Elevation is the key
Ice to control pain and swelling
Heel slides and how to do them properly
Chart representation of TKR recovery
Healing: how long does it take?

Post op blues is a reality - be prepared for it
Sleep deprivation is pretty much inevitable - but what causes it?

There are also some cautionary articles here
Myth busting: no pain, no gain
Myth busting: the "window of opportunity" in TKR
Myth busting: on getting addicted to pain meds

We try to keep the forum a positive and safe place for our members to talk about their questions or concerns and to report successes with their joint replacement surgery.

While members may create as many threads as they like in the majority of BoneSmart’s forums, we ask that each member have only One Recovery Thread. This policy makes it easier to go back and review the member’s history before providing advice, so please post any updates or questions you have right here in this thread.

 

[Jockette]

How do you heal if you can't put weight on your knee? I can sit and bend the knee and the prone knee flexion is tolerable to bend the knee that way however this prone position does not give me as much bend. Help.

I don’t understand what putting weight on the knee has to healing? Your body heals all by itself.

Prone position never gives us a much bend as we get while sitting. Don’t worry about your bend, it will come. We’ve had members in a locked brace to keep their leg straight for weeks, due to the type of surgery they had, and their bend came in fine, in time.

Regaining our ROM is more about Time than repetitions of a list of exercises.

Time to recover.
Time for pain and swelling to settle.
Time to heal.

Our range of motion is right there all
along just waiting for that to happen so it can show itself.

In the general run of things, it doesn't need to be fought for, worked hard for or worried about. It will happen. Normal activity is the key to success.

 

[Jockette]

My surgeon said this past week I have 3 weeks to hit a 115 degree flex and 0 extension or he will do a manipulation.

There is no date, by which we must have a ROM number. We each recover on our body’s own timeframe. Doctors who demand this are not accounting for individual healing.

Myth busting: "window of opportunity" in TKR

This "six week window of opportunity" surgeons often speak about is little more than a myth. It presupposes that all patients have the ability to create adhesions which is far from the truth. It also ignores the simple fact that in the first 3-4 weeks after surgery, swelling reactive to the...

bonesmart.org

 

[Jockette]

I just switched PT's because the other was pushing me too far and I believe the extra fragility of the tendon was from her pushing my ROM too early.

BoneSmart philosophy for sensible post op therapy

You will have noticed there is a significant opinion here about the potential hazards of PT. You may feel that your therapists are experts and know what you should be doing. However, over the last several years I've been here, I have observed that the more intensive the regimen of exercising...

bonesmart.org

 

[BlueSkiesHere]

Oh my goodness. Already a wealth of information and support, @Jockette . Thank you. I feel like my insides just started to breathe. Intuitively I feel I know this but because it is a "professional" I can discount what I know. You are SO right...the body heals itself. I need to give that space and let it happen. ROM is right there all along.
Thank you. I now have this in writing to read over and over to remind myself.

 

[kiwicurls]

Welcome! I hope your setback is very temporary and you’re soon feeling much better.
I am new here, too, and the wonderful people who support us deserve a round of applause.

 

[BlueSkiesHere]

Yes, @kiwicurls ...I do agree! I am most grateful to this forum and wonderful folks. Thank you for your kind words.

 

[lovetocookandsew]

Your ROM is better than mine, and you're only at 7 weeks! Doctors who put forced expectations on patients with random numbers and dates irk me. Every patient is different, every recovery is different and there is no one set formula to force recovery. IMHO, you're doing great! Allowing that knee the time it needs to recover is your best path. We don't want you to become a couch potato, nor do we want you to force that knee somewhere it's not ready to go in order to avoid a threat of MUA from a doctor. Your doctor does not own your knee just because he's fixed it. It's your knee and your choice on how you want to recover. No one, not your OS, your PT or any family and friends, can tell you how to recover, only you can do that by listening to your knee and making the decision on how you're going to travel down the recovery path.

Changing PTs was a good idea, just don't allow the new one to push you beyond where you've chosen to go. Gentle stretches, and walking are a very good way to recover in the early days; as time passes and your knee begins to recover from the assault that is a knee replacement, you can add more to your recovery activities. Just remember-it's your decision!

 

[BlueSkiesHere]

Oh my @lovetocookandsew ...you nailed it. Thank you. You are absolutely right, it is my decision. With all of your support and encouragement I'm feeling more sure of my own common sense.

 

[Jockette]

With all of your support and encouragement I'm feeling more sure of my own common sense.

Common sense. There it is in a nutshell!

 

[BlueSkiesHere]

Me again. I've been looking throughout the threads for someone else who twisted their knee and pulled/strained a ligament and can't seem to find anyone else with this experience. Surely someone has! I noticed that @lovetocookandsew had mentioned gentle stretches (which I'm doing) and walking...however to clarify...I am on TWO crutches again and cannot bear any weight on the TKR again because of the strained ligament. I am very limited in chores/natural moving around which is part of my frustration in healing. To bear weight right now on that knee/ligament is VERY sharp inner knee pain. I did note that @Jockette said what does bearing weight has to do with healing, which I heard. At this point it feels as if I am addressing two injuries - a pulled ligament and healing from the RTKR.

An update on the new PT...he said it is like I have a football injury with the injured ligament and the 1st week is letting the inflammation heal and calm down. The 2nd and 3rd week is when my ligament is rebuilding and healing soft tissue and it is not until the 4th week you can begin to start gradually building on strength again. I am in my 2nd week of the ligament injury and the PT exercises he has given me are just two lumbar stretches - one on the floor and one in the chair so I am not weight-bearing. The only knee flex exercise he has give me is the prone flex knee where I am lying on the floor. So he has greatly reduced the amount of PT exercises the other person I "fired" was doing and this is manageable. It is just the constant chatter in my HEAD. Now I go back and forth with will the ligament ever heal...will this affect my ROM since I am only doing the floor prone flex....on and on.

I apologize for the long thread, but I am looking for someone else who has "gotten themselves" out of this mess. Frustration is nipping at my door.

 

[Jockette]

I think your pulled/strained a ligament is the most important thing to let heal right now. By short walks, I mean, to and from the bathroom. If that’s all you can manage right now, then that‘s all you should do. Your knee, and your ligament, will heal, and healing takes time. It’s only been a little more than a week since the ligament injury.

Keep your heal slides very gentle. Your knee just needs some movement. We’ve had members in a brace for weeks, due to different types of surgery, and their ROM came back fine.

Frustration is nipping at my door.

It might help to reread the post op blues article.

 

[BlueSkiesHere]

Thank you once again, @Jockette . Alright...I hear you again. I am going to read the post op blues article again and again. Geez...thank you all for your patience with this thread. Now...if I can just extend that to my own recovery. <3

 

[Samsrf]

@BlueSkiesHere just read your thread and found it very jealous! I hope you recovery has moved along at YOUR pace. I come to this forum when the weight of the expectation of a certain number by a certain time starts weighing on me. I know this was from a few weeks ago- but thank you for sharing- it has helped me

 

[BlueSkiesHere]

@Samsrf ...thank you for your kind reply. Let me tell you it does get better and just like everyone saying...gentle, gentle and at your own body's healing. I have found a nice balance between listening to my own common sense and the PT person. What they are saying is very true...ROM does come and mine has been slower than some of my friend's experiences, but it is ok. Breathe and continue on. I wish you complete success.

 

[BlueSkiesHere]

Update and question...so I'm at week 10 now and definitely improving. I'm on one crutch now and my flexion is at 115 in a good minute. So I'm content with that, a great improvement since the pulled ligament derailed me. However, this past week - a very sore inner knee is happening. I can walk and bear weight but it tends to throb and I'm trying to move forward with walking and my exercises but not overdo it. Just saw the surgeon this past Friday and he gave me two minutes (literally) and said see you in September. That's good - glad to be done with him and his ROM pressure for awhile, but this inner knee pain/soreness is wearing me down. Any sage advice? Anyone know what this is and will it pass? Does not seem to be the ligament since I can bear weight and walk.
Another good news to share...I'm able to do 5 minutes on my stationary cycle, full circle. I am only doing it once a day and it does not hurt.

 

[sistersinhim]

After a few months, my inner leg started hurting, too. I requested my surgical report and found that my doctor had done a medial, (inner), release. Well, that certainly explained my lingering pain. It is possible that your surgeon did the same during your surgery. Lateral and medial releases are not that unusual in this surgery. You can request your surgical report to find out more. My OS never told me he had done one, and that's not unusual either. Sometimes the only way to learn more about your surgery is to read it in your surgical report.

I suggest you ice that area more to see if that helps. If not, you could try heat. Both will be a trial and error thing.

 

[pjkopks]

I'm sorry you have had a set-back. I'm at five weeks and feeling frustrated that I seem to have developed a rather sharp pain behind the knee which I did nothave before. Your post makes me wonder if I could have pulled a iigament.

You are not alone with post-op blues. I see that comment often. I had no idea pre-surgery what this recovery would involve. It is very easy to get discouraged, so I appreciate the forum with comments from those who are in the middle or have been through the recovery.

I'll follow your thread to see what others say, but changing PT, in your case, seems to be a wise decision. Mine seems focused on ROM which worries me about tomorrow session given my new pain. It is so hard to know when to be assertive, for me.

 

[InkedMarie]

Hello @pjkopks if your name is Patsy….I just read your post in the fb group!

Marie