Bilateral TKR Rhody on the Road to Recovery

[Softtail]

Rhody, I know exactly what you are talking about when it comes to floor slides and putting your foot on a step .
I think both are appropriate if you do them correctly. With the floor slides I just use that to work my leg back-and-forth and increase circulation don’t try to push it too far under me ,just to stretch point.

With foot on step ,this according to my physical therapist is excellent when done correctly. By this I mean make sure your foot is not too low on the step. needs to be at a Heights that doesn’t have you bending down to push it forward gentle push straight forward to good stretch, hold 5 seconds, relax do again (10 times)

Both Pt guys were telling me, the floor slides , step stretch are there go to exercises, with “emphasis” on stretch not push to pain threshold. When You get your knee at right height, that’s just what you get stretch. To low it hurts. Again ,just some info if you decide to do this type of exercise, or you can stop and let your body take care of itself.

 

[Rhodyrhody]

Thanks @Softtail !

 

[Rhodyrhody]

New post-op accomplishment!
Mowed the back yard...ride 'em mower, of course, and only about 20 minutes needed, but still... No discomfort doing it and no immediate aftereffects. Now, for a precautionary ice and elevate in front of some college football.

 

[sistersinhim]

I'm just trying to ascertain if it's considered effective...

You should be the guide. If you see improvement with no pain, then it's definitely helping you. What's good for one might not be good for another and visa versa.

 

[beachy]

Celebrate with a cold one!
Cheers!

 

[Josephine]

I just really want to know about that exercise. I'm not sure why you'd say that the exercise I asked about would cause more swelling and pain than floor slides, when that doesn't seem to be the case at all.

Experience, professional and personal. You had a good experience of them and I'm pleased for you. Not everyone has the same.

I'm just trying to ascertain if it's considered effective...

Opinions vary!

 

[Rhodyrhody]

Thanks @Josephine !

 

[Softtail]

That’s what’s so great about this forum, options. The one big takeaway that runs true throughout the forum is definitely don’t do or let anyone else do to you something that causes you pain. Just have to pick the road you want to take to end up with that beautiful new pain free knee.

 

[Jockette]

Just have to pick the road you want to take to end up with that beautiful new pain free knee.

Well said!

 

[Celle]

Rhody, I think that exercise is OK, as long as you don't push too hard or bend your knee too far, or do too many reps.
Remember that the most important thing is not to do anything that hurts, at the time, or later, or that increases swelling.
You are in charge of your recovery and it's your job to listen to the messages that your knee sends you, and do everything you can, to keep it happy.

Remember, too, that it's not exercising that gets you your ROM - it's time. Time to recover, time for swelling and pain to settle, and time to heal. Your ROM is there right from the start, just waiting for all that to happen, so it can show itself.

It's still very early days in your year-long recovery. What your knee needs most at the moment is lots of rest, ice, and elevation and very little exercise. Doing too much exercise won't increase the speed of your recovery. It could even slow it down.
My surgeon doesn't allow any PT at all for the first month after a knee replacement. He says your knee needs that time, to start on its journey of healing. For that month, we rest, ice and elevate our leg, and walk around the house.
After that month, we just go to PT once every 2 weeks, where we are shown a few new exercises to do at home.
His patients all do well and achieve good ROM, as I did, and he hasn't had to do a manipulation to help with ROM for the past 4 years. I think that speaks for itself.

There's no need to rush to get ROM (Range of Motion) because it can continue to improve for a year, or even much longer, after a knee replacement. There isn't any deadline you have to meet:
Myth busting: the "window of opportunity" in TKR

I remember that before your surgery you were hoping to start working again soon after your knee replacement. Don't let that lure you into asking too much of your knee, will you?.

 

[Softtail]

Celle wraps it up pretty much in a nutshell. While some ,like me, enjoy working the knee with exercises a bit earlier than others, it’s important to remember your knee is healing so too much of a good thing (ie stretching, walking, standing) can get your knee to rebell. I believe I found that out last week when knee was feeling good so I added an exercise, and some longer walking periods to my recovery and the following day my knee let me know it was angry. I mentioned in another post my PT guy said similar to a bone break it takes 8 weeks for bones to recover from their trauma, so excessive walking early on can irritate knee ,which I found out. Needless to say I am in much closer communication with my knee now,cause I don’t like it when it gets angry.

 

[Rhodyrhody]

Thanks @Celle - one thing I can pretty much guarantee is that I'm not going to do anything that makes either knee hurt. Lol, at least not intentionally.

Had my outpatient PT eval today. He said:
right 6 degree ext, 90 flex, left 1 degree ext, 98 flex

I'm just going to assume that's ok. (mostly because it is what it is...)

I asked about the stair step flex exercise. He said that he thinks it's key to keep trying different exercises like that. He said the stair step was good, suggested floor slides and also heel slides (in bed). When I said the floor slides hurt, he said don't do it if or until it hurts, just try it once in a while because it's good for your knee to have different angles and approaches. When I said I don't want to do anything that makes them hurt, he said "Oh no, absolutely, the idea is not to make it hurt." I took that, plus the fact that most of the exercises he showed and gave me involve stretching of the calf, quad and hamstring muscles - without much pain at all 'in the knee' - to be a good sign.

One thing I do have to say is that any sets of exercises...leaves me pretty physically tired, pretty quickly. Not necessarily pain...just really tired from the waist down. And again, I'm just going to say that's God diverting my energy from "other stuff"... to healing.

@Softtail like you, I have found, on a couple occasions, that excessive walking around can lead to some irritation. A little swelling, a lot of stiffness and some extra tired to boot. It's hard to peg sometimes when "enough's enough", because it (walking around) definitely seems like it can have a delayed effect.

 

[Celle]

I like your PT therapist. If only they were all as sensible as he is!

 

[SusieShoes]

I like your therapist, too. What he says about “trying” exercises makes sense when done the way he’s suggesting, with step ups and slides. Wait a while longer (three months or more) before trying machines like leg presses. But testing the knees with light exercise is a way of querying them: “Are we good? Can we do this?” The knees will tell you what they think.

I tested my knees in PT a few times. More than once I tried an exercise a single rep and said, “Nope. Not doing this. Bad idea.” The knees knew right away. They’re pretty spot on when it comes to what they can do, and what they shouldn’t be doing. But a few times I was very pleasantly surprised, like when I did the first step ups. I was afraid my “bad” left knee would have trouble... but while it did hurt more than my right knee, it had no trouble doing the step up at all, and didn’t swell more afterward. So after that point I included the step ups in my PT. Listen to the knees.

Sounds like you’re doing well. Three weeks is still early days.

 

[Rhodyrhody]

Did it...made it to the three week mark. As expected, lots of ups and downs and some pain/discomfort.
Can't say that it's been at all enjoyable, but nowhere near as bad as feared.

Highlights: Started working half days the day before the two week mark. (Even tho, I had a sinus infection last week that was actually as, if not more, bothersome than the knees). Mowed the backyard on Saturday (riding mower, only about 20 minutes...no impacts). Worked a full day yesterday and plan to do so from here on out.

Lowlights (lessons learned?): Sunday, a friend came by and we went out to breakfast. Did some walking around and spent about an hour and a half with legs down, no ice. Pretty much beat for the rest of the day. Yesterday, in addition to work, I went to my PT eval and to another MD appt for Mrs. R. With timing snafus, all tolled, I probably spent 3.5 hours either in the car, or sitting in waiting room chairs with legs down. Big mistake, significant end-of-day pain.

I start each day pretty much the same...coffee <absolute must-have>, milk (to choke down acetaminophen and aspirin) and about 30-40 minutes of icing.

When I'm working at home and don't have to go anywhere, I have several options ...feet down at desk or, in recliner, or on futon with legs propped up by pillows on ottoman. In any of those positions, am able to ice, thanks to these pocketed things they gave me at the hospital, that I'm able to secure with Velcro. Those work much better than I anticipated, can even strap them on and walk around the house.

The two best pieces of news...have had a single awesome craft beer each of the last couple nights AND have dropped almost a dozen pounds since prior to the surgery.

 

[MissViv18]

Sounds like you are doing really well! Hope my recovery goes as well as yours. I check for your updates each morning. Thanks for the updates and keep them coming.

 

[Rhodyrhody]

Hi there @MissViv18 !
Not sure if I'm doing 'really well' or not...I'm just hoping for 'normal' (normal as normal can be under the circumstances - which seems to have quite the range). For sure, no part of this has been 'easy'... but would also say that, most of the worst, has been self-inflicted. Upside of that is...I guess I have 'some' control, downside is well...I'm not that bright...

Good luck with your procedure, you're not far away now!

 

[sistersinhim]

I agree that you are doing well for less than a month out! You are listening to your knees, and learning what you can and can't do! You've got this!

 

[Rhodyrhody]

Off to first real PT visit today (Monday was my 'eval', but we did do quite a few exercises). Hoping for the best.

Questions about sleep:
- Am able to get comfortable and get to sleep fairly easily. On my side, pillow between legs, ice pack strapped to my right (more painful) leg. The problem is 'moving.' When I need to move or shift...usually results in a good amount of pain. My guess is it's stiffness from being stationary for a couple hours. Willing to take it in exchange for the sleep, but, was wondering if anyone had any ideas/suggestions to bypass that pain session?

-Sweats. Some nights, I just sweat...a lot. Am not on any meds except aspirin and tylenol, so not sure why. Wondering if it's just the pain, or if other factors contribute? (The room is not hot and I don't use a lot of blankets)

 

[2@atime]

@Rhodyrhody wondering about who you follow in college football and how much acetaminophen you’re still taking since you mentioned enjoying a cold .

I’m 10 weeks post-op today and taking between 3000 and 3500 mg of Tylenol (only thing I’m taking) and haven’t had any alcohol since July 5th.

Missing a beer or a glass of Pinot Grigio or my 18 year old single malt...but very concerned aabout the effect in my liver consideringgn how much Tylenol I’m taking.

Any thoughts?