PKR Red Rider's 60k mile tune up
- Thread starter RedRider
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Clipless
post-grad
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I ♡ Sedona! It must have felt wonderful to be back on your new knee! I will be there in 3 weeks, however no mtb as this will be a mother-daughter trip and she's just not into it. We'll do some hiking instead. Oh, the sacrifices I make for my kids. SIGH.19 weeks post op.
Headed out to Sedona last weekend for some 2-wheeled fun. Being off a bike for so long left a long list of sore spots; my knee lost its reign at the top of that list though.
![[Bonesmart.org] Red Rider's 60k mile tune up](https://bonesmart.org/forum/attachments/imageuploadedbybonesmart-forum1428415139-713540-jpg.30985/ "[Bonesmart.org] Red Rider's 60k mile tune up")
OP
OP
RedRider
senior
Slowly starting to stand-up and pedal on the bike. It's a hard truth realizing how weak my muscles still are. Even physically, one knee is still bigger than the other. I guess my question is what comes first, the healing then the muscle or just the opposite?
You really can't rush the healing process, that's one thing I've learned. I sound like a broken record around here but my knee is on its own timeline independent of anything I can do.
You really can't rush the healing process, that's one thing I've learned. I sound like a broken record around here but my knee is on its own timeline independent of anything I can do.
Clipless
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Hi Josh, I've been mashing on the spin bike for some time, but I don't feel quite secure to stand in the real world yet. I logged a few precious miles up in Keyesville during the high school races this past weekend. It was beautiful. What I did felt good, and I wanted more, but "mom" duties prevailed- I spent most of my time buying burgers, taking race pics, shaking cowbells, and standing in line for the last Shimano rear derailleur in the southern Sierras.
It takes time to reverse quad atrophy but you are doing everything right. You'll get there!
It takes time to reverse quad atrophy but you are doing everything right. You'll get there!
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OP
OP
RedRider
senior
Bike commute on Friday, definitely my longest bike trek post-op.
The route was 10% pavement an 90% dirt, which was awesome. The ride back was a push, and my knee was sore afterwards. Looking back, I could've done without the last 3 miles
The route was 10% pavement an 90% dirt, which was awesome. The ride back was a push, and my knee was sore afterwards. Looking back, I could've done without the last 3 miles
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mcirish
senior
Just thought I'd check in. Sounds like you are doing fantastic Josh. Keep it up. I am still battling with consistency as far as keeping up my quad strength. Hard to do with a highly energetic 3.5 year old heck-raiser. I joined an after-work fitness club. Only been less than a week, but I can tell it's starting to pay off.
OP
OP
RedRider
senior
Hi McIrish, thanks for checking in!
To be honest, I thought I'd be much farther progressed than I am now at 6 months. I'm still very weak when bending and still get some snap-crackle-pop on occasion. All the indicators are good though: Full ROM, no swelling w/activity and minimal pain when I'm not active. Im hoping it's a time and patience thing but can't help but be a little worried being this far out.
Glad the kiddo is keeping you busy, that's a good thing. The weather has been amazing lately, although everyone wants to talk about the drought. Have you been on your bike much?
To be honest, I thought I'd be much farther progressed than I am now at 6 months. I'm still very weak when bending and still get some snap-crackle-pop on occasion. All the indicators are good though: Full ROM, no swelling w/activity and minimal pain when I'm not active. Im hoping it's a time and patience thing but can't help but be a little worried being this far out.
Glad the kiddo is keeping you busy, that's a good thing. The weather has been amazing lately, although everyone wants to talk about the drought. Have you been on your bike much?
trailspud
graduate
The findings make sense. Hopefully, your other compartments stay okay for many years. I had an ACI (autologous chondrocyte implantation) at age 40 and the cartilage was good for about 5 years, but my other knee was degenerative and other parts of the first knee eventually were, too.
OP
OP
RedRider
senior
Had my 6-month review yesterday, my OS gave me 1.5 thumbs up. Why not 2? I didn't want to allude to my recent drop-out from physical therapy but brought it up to him. Apparently my "push hard and build muscle" approach wasn't working. He suggested a slow and steady approach, not to my surprise. I'm going to give physical therapy another try now with a new approach.
Oh, and the crunchy sound around full flexion: he said it's most likely scar tissue that will slowly dissipate once a patellar "groove" starts to work its way in. I'm not exactly sure what that means, but I understood it as, "wait it out, it will get better".
Oh, and the crunchy sound around full flexion: he said it's most likely scar tissue that will slowly dissipate once a patellar "groove" starts to work its way in. I'm not exactly sure what that means, but I understood it as, "wait it out, it will get better".
KYata
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Hope your OS gives 2 thumbs up after a good long course of PT. I have learned so much from my therapist. Just the number of balancing exercises to regain strength and trust in my recovering knee is amazing and very helpful.
mcirish
senior
Not at all tbh. Was struggling to get gym time in for the past few months. Lucky to get in 2 workout sessions per week. I have taken to wearing exercise bands around the house and work just to get some sort of workout. It does draw some weird looks from people. This is weird, but i have started doing some really light drills....on the basketball court! I know
but all I am really doing is playing h-o-r-s-e by myself, some lay ups, set shots, little 5 ft. old man jumpers......3 days in a row for about 30 mins each session and my knee has not felt better since the procedure, which has really surprised me. No pain, no swelling, working up a nice sweat and most importantly, having fun! Donning the Donjoy brace of course, but it still feels awesome to be able to do it. I even borrowed some kid's football today at the park and fired off some 40 yard bombs....okay 35 yards, but still lol. Looking forward to hearing your progress.
OP
OP
RedRider
senior
@mcirish I feel you with the exercise man. The days I get out and move around, my knee actually feels BETTER. Maybe I'll try some hoops too.
So for a 6 month update I guess I can say things are moving along. I still have some pain, although completely different than before surgery. I'm hiking, riding my bike and basically doing everything I was doing beforehand.
I still have some weakness but my self-physical therapy renovation has helped immensely. The focus has been on strength training without loading (bending) my knee and exerting undue force on the joint. A couple exercise examples:
1) straight leg lifts with weights
2) leg cable pulls going from slightly bended knee to straight (with cable wrapped around my thigh).
These have helped immensely, far better than the overuse I was experiencing in formal physical therapy.
In all honesty, I thought I'd be farther in my recovery than I am now. The doctors outlook of "80% at 6 months and 100% by 1 year" keeps resonating in my head. I wonder what I could/should be working harder at, all within the scope of the slow healing process. The thought that my knee won't get any better than this is scary, and I can't help but wonder if this is the best I'm going to get out of it. Guess I'll just keep working at it though; I hear whining and complaining doesn't improve knee function.
So for a 6 month update I guess I can say things are moving along. I still have some pain, although completely different than before surgery. I'm hiking, riding my bike and basically doing everything I was doing beforehand.
I still have some weakness but my self-physical therapy renovation has helped immensely. The focus has been on strength training without loading (bending) my knee and exerting undue force on the joint. A couple exercise examples:
1) straight leg lifts with weights
2) leg cable pulls going from slightly bended knee to straight (with cable wrapped around my thigh).
These have helped immensely, far better than the overuse I was experiencing in formal physical therapy.
In all honesty, I thought I'd be farther in my recovery than I am now. The doctors outlook of "80% at 6 months and 100% by 1 year" keeps resonating in my head. I wonder what I could/should be working harder at, all within the scope of the slow healing process. The thought that my knee won't get any better than this is scary, and I can't help but wonder if this is the best I'm going to get out of it. Guess I'll just keep working at it though; I hear whining and complaining doesn't improve knee function.
mcirish
senior
@RedRider lol I think whining and complaining means you are like everyone else. 6 months in I wouldn't worry about percentiles of recovery. Just continue to grind if you can. If you have any concerns I wouldn't worry about falling behind, pushing it or overdoing it to try and keep up with someone else's ideal benchmark. Just try to maintain and hold whatever gains you have and try to methodically work whatever schedule you set up. You'll know intuitively when you can push it to the next level.
I am near the 1.5 year mark post op and I still have the sensation of "sand" under my kneecap, which has been the biggest hinderance to my recovery by far. I wish I had opted for the procedure you had. I probably would have gone that route if I had know the OS was going to shave the underside of my knee cap, but he never said he was going to specifically do that so....here I am.
I need to change out the front rim on my bike and get back into the routine of riding to work a couple times a week, especially now that the weather is turning toward our summer climate. That is when I seemed to make the most gains last year so I need to get back to that.
btw, have you read "The Martian" by Andy Weir? Just finished the audiobook. Terrific hard sci-fi story. Looking forward to the movie coming out in the fall. I am not a huge sci-fi guy, especially when the stories start getting too fantastic, but the author put so much detail into the science and technical aspects of the story. Nothing too out there, mostly near-future technologies. About a chapter or two in I started to forget I was reading a fictional story. I think you'd appreciate it. Kind of a cross between MacGyver and Castaway lol. What's funny is that the author's road to success is almost more interesting than the story, to me anyway.
I am near the 1.5 year mark post op and I still have the sensation of "sand" under my kneecap, which has been the biggest hinderance to my recovery by far. I wish I had opted for the procedure you had. I probably would have gone that route if I had know the OS was going to shave the underside of my knee cap, but he never said he was going to specifically do that so....here I am.
I need to change out the front rim on my bike and get back into the routine of riding to work a couple times a week, especially now that the weather is turning toward our summer climate. That is when I seemed to make the most gains last year so I need to get back to that.
btw, have you read "The Martian" by Andy Weir? Just finished the audiobook. Terrific hard sci-fi story. Looking forward to the movie coming out in the fall. I am not a huge sci-fi guy, especially when the stories start getting too fantastic, but the author put so much detail into the science and technical aspects of the story. Nothing too out there, mostly near-future technologies. About a chapter or two in I started to forget I was reading a fictional story. I think you'd appreciate it. Kind of a cross between MacGyver and Castaway lol. What's funny is that the author's road to success is almost more interesting than the story, to me anyway.
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I was reading your comments about you wondering if this is as good as your knee will get.
Im a sporty person (poor knees have taken a battering over the years) and reluctantly had my first PKR two years ago. Its been good and is very stable and does everything I ask of it. The interesting thing is it has improved greatly just over the last six months - so thats eighteen months after the op!
During the preparation for my second, very recent, PKR I did lots of quite full on water exercise and the increase in flexibility in the first knee was quite a surprise! I was actually trying to rev up my overall quad strength etc and the fringe benefits were good for that first PKR regardless of the time lapse. This was despite me being pretty active and strong anyhow.
So I think you will find your knee will continue to improve and that like me you will be pleasantly surprised after the two year mark.
My second PKR is doing ok - its healing merrily and I will be gentle with it and make sure its strengthened slowly but surely without undue stress on the new tissue and healing bone. After eighteen months it will be ready to show me just what it can do and I will be back to enjoying more sport again I'm sure!
Im a sporty person (poor knees have taken a battering over the years) and reluctantly had my first PKR two years ago. Its been good and is very stable and does everything I ask of it. The interesting thing is it has improved greatly just over the last six months - so thats eighteen months after the op!
During the preparation for my second, very recent, PKR I did lots of quite full on water exercise and the increase in flexibility in the first knee was quite a surprise! I was actually trying to rev up my overall quad strength etc and the fringe benefits were good for that first PKR regardless of the time lapse. This was despite me being pretty active and strong anyhow.
So I think you will find your knee will continue to improve and that like me you will be pleasantly surprised after the two year mark.
My second PKR is doing ok - its healing merrily and I will be gentle with it and make sure its strengthened slowly but surely without undue stress on the new tissue and healing bone. After eighteen months it will be ready to show me just what it can do and I will be back to enjoying more sport again I'm sure!
OP
OP
RedRider
senior
Hi @Hopper , thanks for chiming in. It's always nice to hear positive testimonial from someone who's been in your shoes. So tell me, do you think your 18 month improvement came from muscle tone or flexibility? As hard as I try, strength training has been a challenge. Seems no matter how hard I push things, my knee is on its own healing schedule. Like you said, this is such a longer-term recovery than I ever expected. And my evidence is the slow, gradual gains I make.
Keep me posted on your progress; you're in the deuce club so you've got plenty of input to share with us!
Keep me posted on your progress; you're in the deuce club so you've got plenty of input to share with us!
At physio with my first knee I was quite puzzled that other KR patients were whizzing along on the exercise bikes yet I, the one who had loved spin classes, couldn't get the wretched pedals to rotate. Bonesmart members at a similar stage were cycling merrily too. Not me. Horror of horrors - it took me, the sporty strong one from a family of cyclists, six weeks of pathetically rocking the pedals back and forth until, yippee, they went right around!
Lesson learnt - my knee had its own healing agenda too.
The left knee should have been operated on 4 months later but family circumstances meant it wasn't and the left knee's continuing deterioration meant I was unable to push my new knee too hard exercise wise - but it was working really hard to support the mangled left one.
I was very concerned that I had missed the boat in strengthening and gaining flexibility in my PKR and felt it possibly wouldn't and couldn't now happen.
Yet it did!
I feel my improvement was ridiculously simple - due to exercising in a supportive medium - water - and exercising using a variety of workouts quite vigorously but not to the point of muscle or joint fatigue. I listened carefully to my joints - the new one and the old one. I went carefully and steadily - not too much pushing but gave myself a solid work out and was able to use movements in the water that are unsustainable on land. (Id done quite advanced water workout classes in the past.)
I built up my quads of course, knowing that would provide good all round support after my next PKR and did stretching exercises too. The water provided enough resistance. Slowly but surely I found flexibility increasing greatly. Im delighted.
I didn't think Id ever get a good hamstring stretch again - but its suddenly there!
Im not chomping at the bit to get in the water with my second new knee. Im prepared to give it time so Im off to physio today and will be looking to maybe push a bit in the water at the 6 month mark. I think for me that will be good. I have observed that we are all so different in our healing and that listening to our body is essential.
Slow gradual gains are good. Im sure that knee of yours is still healing steadily and will heal really well as you have youth on your side - a great benefit for regeneration of tissue, bone, muscle etc.
It looks to me like you are doing pretty well - hiking, cycling etc. Might it be that working really hard at the strengthening was stressing the healing process? I can understand how keen and determined you are to get back to normality and be able to forget about that PKR of yours. In another 6-12 months I'm sure that will be the case. Be patient my friend - it will come good for you.
Lesson learnt - my knee had its own healing agenda too.
The left knee should have been operated on 4 months later but family circumstances meant it wasn't and the left knee's continuing deterioration meant I was unable to push my new knee too hard exercise wise - but it was working really hard to support the mangled left one.
I was very concerned that I had missed the boat in strengthening and gaining flexibility in my PKR and felt it possibly wouldn't and couldn't now happen.
Yet it did!
I feel my improvement was ridiculously simple - due to exercising in a supportive medium - water - and exercising using a variety of workouts quite vigorously but not to the point of muscle or joint fatigue. I listened carefully to my joints - the new one and the old one. I went carefully and steadily - not too much pushing but gave myself a solid work out and was able to use movements in the water that are unsustainable on land. (Id done quite advanced water workout classes in the past.)
I built up my quads of course, knowing that would provide good all round support after my next PKR and did stretching exercises too. The water provided enough resistance. Slowly but surely I found flexibility increasing greatly. Im delighted.
I didn't think Id ever get a good hamstring stretch again - but its suddenly there!
Im not chomping at the bit to get in the water with my second new knee. Im prepared to give it time so Im off to physio today and will be looking to maybe push a bit in the water at the 6 month mark. I think for me that will be good. I have observed that we are all so different in our healing and that listening to our body is essential.
Slow gradual gains are good. Im sure that knee of yours is still healing steadily and will heal really well as you have youth on your side - a great benefit for regeneration of tissue, bone, muscle etc.
It looks to me like you are doing pretty well - hiking, cycling etc. Might it be that working really hard at the strengthening was stressing the healing process? I can understand how keen and determined you are to get back to normality and be able to forget about that PKR of yours. In another 6-12 months I'm sure that will be the case. Be patient my friend - it will come good for you.
OP
OP
RedRider
senior
@Hopper it wasn't until recently that I finally caught onto what you already know: low impact strength training is the key. Basically, if it make you hobble for a few days then it isn't doing you any good.
Funny thing I've noticed though is that these low-impact workouts actually make my knee feel better. What does that mean? Let's just say that when I skip a few days, the knee gets all stiff and achy. It's like the joint gets lubed up during the process and if I stray from the gym, it starts to dry up. Purely speculation though.
Anyone have suggestions for additional quad/knee exercises that don't involve extreme bending or loading? I've been dominating the straight leg lifts (even with ankle weights) and would love to graduate to a tougher challenge. Maybe I'll throw some more weight on the quad pulls with the cable.
Funny thing I've noticed though is that these low-impact workouts actually make my knee feel better. What does that mean? Let's just say that when I skip a few days, the knee gets all stiff and achy. It's like the joint gets lubed up during the process and if I stray from the gym, it starts to dry up. Purely speculation though.
Anyone have suggestions for additional quad/knee exercises that don't involve extreme bending or loading? I've been dominating the straight leg lifts (even with ankle weights) and would love to graduate to a tougher challenge. Maybe I'll throw some more weight on the quad pulls with the cable.
