PKR Red Rider's 60k mile tune up

[RedRider]

So the straight-leg lifts have been working really well! I've ascended into a new level of recovery at this point, one that focuses on strategic strength training and a more predictable outcome afterwards. The elliptical and stationary bike are feeling much better, and my regular hikes are slowly gaining distance.

...And I must emphasize slowly. It's coming along but by no means at the pace I was told nor expected. The take home message here is PATIENCE!

 

[Poppet]

Great update @RedRider -- you are so right, patience.... A very close friend of mine (member) posted to me early in my recovery this mantra -- "recovery from a joint replacement is a marathon not a sprint". I have never forgotten that, and it it helped immensely.

I am so thrilled for you that you are slowly returning to your activities - good for you

 

[SuperSnapper]

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.[/QUOTE]

I found that using an aerobics bench and stepping up and down with light weights in each hand built up quad strength nicely. Also standing with one foot flat on the end of the bench and bending the knee on that side until the other foot touches the floor, then straighten both legs and repeat. I generally do 2x 10 reps of each with each leg .It gets harder when you increase the height of the bench or the weights for the first exercise. Both these exercises where prescribed for me by a physio after arthroscopy and they were really good at building up quads. I kept to light weights though. I was measured on a really hi tec machine after doing these 3x per week for 12 weeks and my quad strength did increase significantly.

 

[jacs65]

@SuperSnapper how soon could you start using weights. Only 5 weeks post op I am not considering for leg squats etc but would like to use small weights for upper body work.

 

[SuperSnapper]

@jacs65 I started using light weights on machines at the gym at about 10 weeks under the physio's direction but was very careful about it and did suffer a few pains so left off particular exercises. She also told me not to use the cross trainer for a few more weeks after that as it is actually quite hard on the knees after surgery.

I think it's up to you but 5 weeks is still very early even for upper body stuff. It's only my opinion but I would wait a few more weeks and then start off with really, really light weights and see how it goes. There's lots of stuff you can do that will keep you mobile and strength training can come later. I am still not up to using the same weights I used before my operation. Even now if something hurts , I leave if for a few days and try with a lighter weight later on.

 

[jacs65]

Thanks @SuperSnapper that's useful to know.

Definitely not starting to lift weights anytime soon. Information about the Cross trainer is interesting also, I wouldn't have thought that, but when you consider the movement carefully it must take the knee beyond the normal range of movement perhaps.

All makes sense what you say though.

 

[Hopper]

Sensible @jacs65
Apparently lots of research shows lighter peoples knee replacements generally last longer - so thats a good reason not to increase weight loading if the force is travelling directly through the knee. Often exercise just using ones own body weight gives a good enough degree of resistance, especially in these early days.
Its also a jolly good reason to lose some of the weight Ive accrued through being less active because of my cruddy knees. Im so looking forward to long, long walks and cycling again.

 

[RedRider]

... Also standing with one foot flat on the end of the bench and bending the knee on that side until the other foot touches the floor, then straighten both legs and repeat.

Thanks @SuperSnapper! The "foot drop" was a real challenge for me initially. I think I'll revisit it and maybe include weights. You don't have to dip very deep to feel the burn.

 

[SuperSnapper]

@RedRider It is a really good exercise! Don't overdo it but I found it helped the quads so much. Hope it works for you too.

 

[SuperSnapper]

Forgot to say I did ten on each leg of each exercise 3x per week and it was great.

 

[PolarBear60]

That's one of the exercises I've been doing in physical therapy, and I'm seeing steady improvement.

 

[SuperSnapper]

There's another one where you sit down, hold a ball ( Light weight, about 10" diameter) between your feet and lift it up and down from the knees. Helps if you have trainers on! You can do this while watching TV.

 

[RedRider]

Thought I'd check-in with an update on my triumphant summer return.

Thanks everyone for the exercise tips. They provided a good base of strength, but now I'm running (well not literally) at full steam it feels like. The knee is feeling great and has gotten a lot of workouts over the past few months. I had two amazing backpacking trips, one of which I clocked over 30 miles and 4k feet of elevation! Like an old truck, it takes time time to get warmed up but once it does, it's chugs right along.

I'm still not 100% though. There's still a lot of weakness down there and I've noticed I use my back more than my legs when bending down...definitely a habit I'll need to break. Some days are better than others but overall the trend is progressing forward, with no looking back!

 

[referee54]

That is a great report!!! Thanks for checking in. About the muscle weakness and such---recovery can take upwards to a year, and I can tell you first hand that the stamina is one of the last things to return.

 

[trailspud]

You will get that strength back. Just keep having fun

 

[RedRider]

Been getting a little hip pain on the "bad knee" side when walking. I've stepped up the mileage lately and this issue started over the last month. How much of this should I contribute to realignment/re-conditioning and when should I be worried?

 

[trailspud]

@RedRider
Which is your "bad knee" side? The PKR one?

 

[RedRider]

Yeah, the PKR one...although "bad" isn't quite the best terminology to use these days.

Great paper this month on the differences between onlay and inlay patellofemoral replacements. There was a lot of discussion between the two in a previous thread that I had started. This paper provides a great definition (minus the suttle Arthrosurface spin):

"Currently available trochlear components can be divided into two groups: inlay and onlay designs. Inlay design trochlear components are implanted flush with the surrounding cartilage after creation of a bone bed within the native trochlea. Onlay design trochlear components completely replace the anterior compartment by using the same anterior cut as known from total knee arthroplasty."

A matched-pair comparison of inlay and onlay trochlear designs for patellofemoral arthroplasty: no differences in clinical outcome but less progression of osteoarthritis with inlay designs.
Feucht MJ1, Cotic M, Beitzel K, Baldini JF, Meidinger G, Schöttle PB, Imhoff AB.

 

[RedRider]

Vacation time! Spent a week in Switzerland hiking our faces off. Clocked over 40 miles and who knows how much elevation over a 4 day period. My knee was up for the challenge and did well. Granted, things were sore at the end of the day but hey, this was the Swiss Alps, not exactly a walk in the park.

 

[Braunzie]

WOW!!! That is awesome!! Thanks for sharing!