TKR Reassurance needed

[Jockette]

but straight only 5 so have to work on it to get it to 0

Actually 5 is close to straight, especially for so early in recovery. Don’t stress about it. You have plenty of time to get it 0. There is no Window of Opportunity. As your swelling goes down and you continue healing, it will straighten. Never force it.

Yes, that pillow stack looks good.

 

[benne68]

You are still very early days -- please don't worry about extension. For most of us, it takes a bit longer than flexion. My extension was slow to come back, but I know have two perfectly straight legs! If you'd like to read some do's and don'ts for extension, check out this article:

https://bonesmart.org/forum/threads/extension-how-to-estimate-it-and-ways-to-improve-it.9529/

I agree that your pillow stack looks good -- just be sure that the pillows are "attached" to one another with safety pins so they don't slide when you are using them. Take a look at the suggestion in #4 of this library post:

https://bonesmart.org/forum/threads/elevation-doing-it-the-right-way.7602/#post-161609

 

[William1950]

I had a PT sessions today some of exercises were a little painful but bearable.
When we came to exercises where I stand on my bad knee in various ways for a minute it was very painful, is that normal? It seem very important to the PT saying it was to improve some of the muscles and break down the scar tissue.
Your thoughts please.

 

[Jockette]

Unfortunately it does seem normal that PTs will tell you these things. I will never understand why they believe that painful exercises help us. They don’t. Pain is a sign that you are not healed enough to do that exercise.

This early in this year long recovery you are still healing the surgically damaged tissue that the surgery caused. You cannot strengthen damaged tissue, it must heal first.

Scar tissue is totally misunderstood, totally mentioned too often, and blamed for many things it isn’t. Scar tissue is necessary, it’s how our wounds heal. You don’t have to break it down, it will reduce over time naturally, as you heal. Overdoing exercises can slow that down, and even create more scar tissue, which can take longer to heal.

Here is a paragraph from a Bonesmart Library Article about scar tissue:

“Scarring is a complicated thing as there are several different types of it. Basically, 'scar' is a fibrous material which the body develops when there has been an injury or wound in the skin and/or deeper tissues. At its most basic, it is the matrix of new cells that binds the edges of a cut together. Once it's done it's job and sealed the wound, it settles down into a fine, thin line which is pliable and almost invisible.”

where I stand on my bad knee in various ways for a minute

If it was me I would decline to do this. Don’t do any exercise that is painful. It’s not necessary. There are other gentle, comfortable movements that you can do to give your new knee mobility.

 

[benne68]

I agree wholeheartedly with Jockette's suggestion to decline anything that causes intense pain.

You are still very, very early days in this recovery -- if a specific exercise causes pain, that's your body telling you that your knee is not ready to do that movement. A bit of discomfort is okay, but intense pain is not.

At this stage of recovery, all of the soft tissues in your leg are still healing from the trauma of surgery. It's much too early to be doing muscle-strengthening exercises. It's important to keep moving -- walking is good, as is bending and straightening gently (usually from a seated position) --but that's all that's really needed at this stage.

Unfortunately, very few PTs get specific training in joint replacement recovery. Instead, they apply the same techniques used for injury recovery, which don't work during the early post-op period when soft tissues haven't fully healed yet.

I know it can be hard to say "no" to a PT. But, remember that it's your knee and your recovery, and only you know what your body is feeling. You have the right to refuse to do anything that causes pain.

 

[William1950]

Thanks thats what I needed to hear. He was trying to get me to go upstairs as u normally would I told him I was not confident to do so but I gave it a try, boy the pain.
I told him I would b in touch if I needed him again which I won't
it was a mobile PT.
Love this site so helpful and positive. So down to earth.
On week 4 post op still a long way to go.

 

[sistersinhim]

At 4 weeks, you are only 1/12 of the way through this yearlong surgery, so it's not benefit to that healing doing things your knee isn't ready for. Please say "No!" any time you feel your knee isn't ready for doing that certain movement. Some of us didn't even take PT and recovered just fine. I did only my daily activities for my PT. Walking is the best way to recovery.

 

[Jamie]

Good for you for following your gut feelings about the pain you were experiencing. This was not the therapist for you. It’s sad that so many out there in this field don’t completely understand the recovery process for joint replacements.

The type of scar tissue many warn about is really called adhesions. If a person’s body forms adhesions, it’s usually not right at the beginning of the healing process. They occur when scar tissue is formed in places where it should not be - like between tissue or muscle layers. Years ago, it was thought that early and aggressive therapy helped to prevent adhesions from developing because the painful movement would break up the scar tissue as it was trying to form. While early and frequent movement is important, it is now being shown that aggressive therapy at any time during recovery is not the best. When you work your muscles to the point of real pain (not just discomfort), it can cause inflammation in that area. That’s your body’s normal reponse to pain. The hot tissues from inflammation are more likely not to glide smoothly over one another. Instead they stick together. When that happens, scar tissue (adhesions) can form in those places and restrict movement or cause pain.

Be sure to move about frequently during the day. A 5 or 10 minutes walk every couple of hours is good. Also challenge your knee with gentle bends and stretches that push or extend just to the point where your are uncomfortable. Remember that any movement at all is therapy, so your as you begin to add in some daily activities, you are doing therapy and exercising your knee. Stairs usually come later, so don’t be in a hurry to try those as an exercise until your body lets you know it’s ready.

 

[Layla]

Love this site so helpful and positive. So down to earth.

Thank You! We really appreciate your kind words and thank you for sharing your journey here and supporting BoneSmart as an Insider.
Happy Sunday! I hope you have a beautiful week.

 

[William1950]

Good morning from the UK

I was reading another post about their left knee TKR journey.

My concern at the moment is my swollen left knee it appears to stay the same size was hoping I would see a slight reduction I will be coming up to week 5 on Wednesday. So the question is this normal?
I elevate my leg I put a gel pack on for 20 minutes I do not have those ice machines, I do ankle pumps, walking with a cane try to walk around the house and out in the garden, do exercises but not sure if I am doing enough.

As I suffer with health anxiety I am incline to see the worst as I mentioned in my first post so I need reassurance that I am on the right track and guidance.

 

[Jockette]

You are doing just fine. Swelling can take a long time to diminish, like sometimes for months. This is normal. And, it will fluctuate, depending on your activity. Some days it will be less, but then after a busier day, it will flare up again. All normal.

 

[Layla]

Hello and Happy Monday Looks like you're right where you should be.
It's understandable that you're wondering about swelling. You're still early in recovery and can expect to have noticeable swelling for at least 3-6 months, my OS relayed to me that after joint replacement, some experience swelling up to a full year post op. When you contemplate the controlled trauma your leg endured, it will make sense that there's swelling. Walking, physical therapy, even sitting for prolonged periods of time can increase swelling.

I elevate my leg I put a gel pack on for 20 minutes

We recommend icing for at least 45 minutes, each session. You can do this several times per day, always placing fabric between the ice source and bare skin. Icing for up to twenty minutes only several times a day is what most of us have been advised to do following an injury. Some therapists may even recommend this after joint replacement surgery, But with this surgery, ice is a critical part of pain management and should be used not only on the joint, but any surrounding areas of discomfort.

Icing helps bring relief from the soft tissue trauma and internal swelling. Icing is a great natural pain reliever and best of all, it's free. While some care providers do put a maximum time on icing, others suggest you ice as often as you see fit. Icing after therapy, exercises, or prolonged activity that challenge ROM and endurance should help ease any discomfort, or may keep pain at bay. You can find relief through icing for weeks to months post op.

Elevation helps also.
It is our lymph system that rids the body of fluid (swelling). So you want to get the fluid to the lymph nodes in your torso area so your body can more quickly process it. The lymph system works rather slowly on its own and much more efficiently with the assistance of gravity. The fluid isn’t draining into the hips, but contained with the lymph system and moving to the torso and lymph nodes located there.

Stop by any time you need reassurance and we'll do our best to ease your mind.
Wishing you a peaceful week of healing.

 

[Legseleven]

I second the ice and elevation. I iced regularly for 4 months.

 

[sistersinhim]

I iced and elevated the whole time I was sitting or lying down. You can't over ice if you have a thin cloth between you can the ice source. I also swelled for around 6 months after increased activity. Ice and elevation was always my go-to treatment.

 

[Layla]

Happy One Month Anniversary!
Yay...one month of recovery already behind you. Time flies when we're having fun.
Kidding aside, I hope you have a great week as you head into the second month of healing with your new knee.
Stay in touch, we're here for you.
@William1950

 

[Aussie Bill]

Hi William1950, I’m William from 1962. I think you’re doing well.
I’m a bit behind your surgery - mine 20-03-2026. Did my Physio 1st two TKR’s at home on my own mostly but did Hydrotherapy after 4 weeks at an out patient clinic. This is a long recovery process. I was told it would be 6 weeks before I return to work this time, full TKR 10 weeks. I found using Cryo cast or ice packs really helps if used regularly. Good luck with your recovery,

 

[William1950]

Morning
I am a bit low this morning my knee appeared to get better at the beginning of the walk felt I was moving forward. Then yesterday I did 2 lots of exercise, was doing the icing and elevation, resting did not walk so much then later on in the afternoon my knee felt really tight above my kneecap. Therefore I started to get anxious so when I went to bed with the wrong mind frame I had a really bad night, then when I went to bed when knee felt better then I got a bit more sleep still not great but better. Off to my hydrotherapy today so hopefully it might bring me back on track.
Just wanted to sound off its so frustrating.

 

[William1950]

Still not sure what r the best exercises to do. Maybe I am not walking as much as I should how long should I walk for starting my week 5 post op.

 

[William1950]

My early post should say early in.the week not walk.

 

[EalingGran]

Maybe I am not walking as much as I should how long should I walk for starting my week 5 post op.

It really depends on your knee and how it feels. My knee really liked walking but hated standing and I couldn't do water exercises ( as I couldn't judge overtwisting/ overdoing it).
I gradually built back up to 10,000 steps/ day over 2-3 months but I still iced and rested/ elevated my leg for 6-8 months.
It also depends on what sort of activity you want to build back to and also what terrain you have nearby.
I had busy city pavements with lots of old tree roots- so I used a stick for several months. It was partly to help prevent falls and also to signal in crowded places that I was vulnerable.
I would rest half way with a coffee and also walk where I could take a bus back if I overdid things.
It really is important to think about your longer term goals, listen to your knee, build up gradually and not overdo things. If your knee swells or gets more painful then ease off a bit.