TKR Recovery the Clipless Way

[Clipless]

Hi everyone! Here's my 8 week update: I'm off all pain meds and feeling pretty good- withdrawals are over and done, thank goodness! I have decent enough flexion, whatever it is, and still short of full extension. I saw my OS this a.m., had my xrays done on this portable fluoroscope because the big xray machine was having its annual inspection.

(sorry, image is sideways). My OS seemed pleased with the overall progress of both knees, and his bedside manner is wonderful. I described November's "jumping kneecap" problem, which thankfully we could not duplicate during the exam. He said kneecap jumping is a bad thing, and wants me to come in if it starts happening again. I hope it won't.

He asked me to compare my two recoveries: I told him that aside from better flexion and less swelling, the second TKA isn't markedly easier than the first. I still have a limp, and this knee doesn't like climbing steps... as in, can't. It can barely handle baby steps. My other knee, for reference, didn't bend as well at 8 weeks but was much stronger on steps. Go figure. I haven't started riding a real bike yet because the act of lifting my right leg over the saddle makes my knee sad (as in "ouch, ouch, owee"). Nor does it want me to balance on it to swing my left leg up and over. It's just not ready.

My OS wrote a prescription for Aquatic Therapy, and wants to know how that works out for me. Lastly, here is a pic of my lovely hypertrophic scar. I gently massage it with cocoa butter daily, and that's about it.

 

[NightQuilter]

8 weeks! Congrats Diana. It will be a year in no time! It sounds like you are progressing well - though differently than last time.

 

[Wanttobebiking]

Congrats is right. You are through the worst of it. The biking will come. Water therapy sounds fun. I just signed up for a stroke improvement class that starts in late January. Getting ready for a mini-indoor tri, but trading the run part for a walk! I will be 8 months then. Looking forward to your first outdoor ride whenever that is!

 

[Clipless]

Thanks so much, you guys! I forgot to mention one weird thing; on Sunday evening I sat down on the sofa to watch TV, crossed my legs (new knee over old), put my head back and promptly fell asleep. When I awoke a couple hours later it took a while to uncross my legs thanks to excruciating PAIN! My prosthesis felt twisted or stuck. My "OUCHHHH!!!" awoke my poor little dog and frightened her terribly. I apologized, held her a while, then limped it off around the house. I used my walker until bed time, but was still sore in the morning. I went on to my scheduled OS appointment and mentioned the incident because my knee still hurt a bit. His response, essentially, was "What were you thinking?! Don't cross your legs!!!"

Two days later I'm fine, but I've had to resist the urge to cross my legs while watching TV. Old habits die hard!

 

[KarriB]

Great report! And eight weeks is really moving to nearly normal! Those old habits can be hard to break. After my TKR I would cross my TKR over my left WHILE elevating both legs. It didn't feel bad, in fact it kind of felt good. But every other time I go to sit I want to tuck my leg under me. That would not be good, probably an MUA-the A.

 

[Timetolive]

Crossing your legs is a hard habit to break! I propped up the other day and crossed mine at the ankles - then thought "what are you doing?" I am glad you were able to walk it off.

 

[Clipless]

Congrats is right. You are through the worst of it. The biking will come. Water therapy sounds fun. I just signed up for a stroke improvement class that starts in late January. Getting ready for a mini-indoor tri, but trading the run part for a walk! I will be 8 months then. Looking forward to your first outdoor ride whenever that is!

15 years ago I signed up for what I thought was water aerobics at the local parks & rec pool, however because the instructor was a former Olympic silver medalist we all decided to focus on swimming instead. I ended up learning to swim really well (for me), and got in the best shape of my life. Unfortunately I also caught mononucleosis, ugh. Sick for months. I love lap swimming as long as I don't have to share a lane. How soon after TKR were you able to kick comfortably?

 

[referee54]

. His response, essentially, was "What were you thinking?! Don't cross your legs!!!"

It is essentially the sports-medicine question that goes like this:

Player: "Coach, it hurts when I do this. (Shows and action.)

Coach: "Well, don't to that!"

 

[Clipless]

Crossing your legs is a hard habit to break! I propped up the other day and crossed mine at the ankles - then thought "what are you doing?" I am glad you were able to walk it off.

I read somewhere that ankle-crossing after TKR is fine. My folly is that I not only cross my knees, but I then proceed to tuck my top foot behind my calf like a pretzel. No bueno. Now that my mobility is returning the urge to sit like that is practically irresistible. I think I just need to sit less, walk more.

 

[Celle]

I can cross my legs now, at 14 months out, but certainly I couldn't do it without pain until about a year post -op. I guess that crossing your leg puts some sort of twisting force on your new knee.

 

[Clipless]

I can cross my legs now, at 14 months out, but certainly I couldn't do it without pain until about a year post -op. I guess that crossing your leg puts some sort of twisting force on your new knee.

Exactly. OS mentioned "shear forces". Good to know I might be able to cross comfortably again someday, thanks!

 

[Celle]

Cross - yes. Be like a pretzel - not advisable!

 

[newlybionic]

I was at a meeting about a month ago and I just crossed my legs without even thinking about it. The person I was talking to pointed it out to me. I was a little stiff straightening it out again but I thought I finally forgot about that I had a TKR for a little while!

 

[Wanttobebiking]

I love lap swimming as long as I don't have to share a lane. How soon after TKR were you able to kick comfortably?

I still can't kick as well as I could before surgery but it gets easier each time I swim. I started swimming at 7 weeks, and could hardly kick. At about 3 months it was much better, but the lifeguard came up to me after a swim and suggested the class, so that gives you some idea of my kicking ability at 5 months.

As for crossing my legs, I have been doing it since about 5 weeks and it is so comfortable now that I barely realize I am going it. The stairs are still elusive, though!

 

[Clipless]

I have a concern! @Celle , or anyone who can shed light on my problem, or just comisserate... I am 10+ weeks post op RTKR and still can't climb stairs leading with my new knee. I can manage baby 6" steps, but only if I lean on something. My quad fires. I can do straight leg raises, but not as easily as a few weeks ago. My LTKR, for reference, had a weak quad but I could climb steps reasonably well at 10 weeks, even big, tall steps! My RTKR is your classic wet noodle- no strength. I was really hurting after last Friday's PT so I took a week off to rest. My knee isn't screaming at me anymore, but arrrgh so weak.

So, is this progression (or lack thereof) par for the course, or do I have reason to worry? Am I just being impatient again? I want to begin some strength training, but I feel trapped in a vicious cycle of pain and weakness.

 

[Celle]

This second knee is taking longer, but i don't think you have to worry. It will get there. I know that some people take about 4 months before they can do stairs one foot at a time.
Try and be patient with this knee.

 

[Wanttobebiking]

Hi Clipless! I was "kicked out" of PT by my OS at 8 weeks, and stairs were still a problem for me. I could do them but it hurt, especially going down. At about 4 months, I stopped going down normally because the pain had gotten worse and I put myself back into PT for strengthening. It seems to be working but it is slow. I am now 5 months and I still have a ways to go. I do a few steps normally each day and the pain is a 2 or 3 when it was an 8 before. My glutes and quads were/are weak. What's odd is I can bike, walk, etc...but steps are and remain an issue. When I start to worry, my PT calms me down and says it is way too early to worry and reminds me that I am progressing. Hang in there. It will get better.

 

[newlybionic]

I'll add my voice to @Wanttobebiking Im also 5 months out and am having problems with stairs. Some days I can do them but other days I can only do them in baby steps.

 

[Clipless]

Thanks, everyone. I don't often need reassurance, but when I do I'm glad my BoneSmart friends are here for me!

Today I went back to PT but announced that I needed to hold off on hamstring and extension stretches. No problem, the therapist was accomodating. I asked instead to work on quads and gait. I can't seem to ditch the limp. She instructed me to recline on a special table with a system of red ropes, slings and pulleys. This type of neuromuscular therapy is called "Redcord". My PT explained the goal of Redcord is to "wake up" inhibited muscles and counterbalance something else (I didn't totally get that part). So I did three sets of a simple exercise, 4 reps each, while she "perdolated" (vibrated) the ropes. Then she had me immediately stand and walk back and forth across the room, and.... my limp was gone!!! I was flabbergasted, to say the least. I walked back and forth the distance of the large therapy room four times without a trace of limp. After jokingingly proclaiming this a "Christmas miracle" we ended the session and I went on my way. By the time I reached my next destination 10 minutes later the limp was back, however it seems my therapist may be onto something with Redcord. We have three more sessions. Then, like many here, I must quit PT for financial/insurance reasons. Here is an internet photo of the crazy Redcord apparatus:

 

[Wanttobebiking]

Maybe three sessions will do it for you. I have never heard of this therapy, and I am all for a Christmas miracle or two or three...