Woodpusher
member
United States@Rockgirl4, sleep tight as best you can and check-in during the morning.
TKR Rockgirl4's Recovery---already full of surprises.
- Thread starter Rockgirl4
- Start date
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Rockgirl4
Former BoneSmart staff member
@Woodpusher Hoping you get a good night's sleep too, sir!
I am so glad your OS is up to date on a joint replacement recovery! YAY! Now, listen to him and get busy healing that knee by doing nothing but your necessary daily activities! I sure wish all OSs would react the way yours did. Joint replacement patients would have a much easier time recovering.The Dr's verdict: stop all exercises/activity of ANY kind. Do nothing but get up for the bathroom. Ice and elevate continuously.If I thought I was being lazy, it's now time to be even MORE lazy.
OP
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Rockgirl4
Former BoneSmart staff member
@sistersinhim My surgeon's philosophy has been the only good thing about this recovery so far.
I can't lie and say I'm not stressing out about scarring down so badly again like after my ACI immobilization back in 2015/16. That fear is always there. I keep telling myself there is absolutely NOTHING I can do by worrying about it. It works maybe 8 out of 10 times. I don't like being different and guessing how my body will respond.
Is there a way to easily find @skigirl 's recovery thread? I know she went through something similar between her 1st and 2nd TKR and remember her posting about her 2nd recovery at one point (how different her first 2-3 months were)......I wasn't sure how to find it without scrolling through 100's of recovery threads (?)....
I can't lie and say I'm not stressing out about scarring down so badly again like after my ACI immobilization back in 2015/16. That fear is always there. I keep telling myself there is absolutely NOTHING I can do by worrying about it. It works maybe 8 out of 10 times. I don't like being different and guessing how my body will respond. Is there a way to easily find @skigirl 's recovery thread? I know she went through something similar between her 1st and 2nd TKR and remember her posting about her 2nd recovery at one point (how different her first 2-3 months were)......I wasn't sure how to find it without scrolling through 100's of recovery threads (?)....
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OP
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Rockgirl4
Former BoneSmart staff member
Post-op Day 6: I slept better last night, but I did take a Flexeril before going to bed. The Dr didn't want me to all of the time, but I figure even if only 2-3 nights, maybe it will help me turn the corner. I couldn't tell a differemce when waking up this morning or at 3AM when I took a pain pill---it was a less miserable "awake" night though, so I'll take anything. The pain was the same, but considering I had done the forced bending 2X for 30 mins and 15 mins (the last time) yesterday, I didn't expect much today.
As for today, we did have our friends swing by for just a few minutes. It was short, I was in a "just took a pain pill" stage, so it went ok. I've done nothing else but ice, elevate, nap, and get up for the bathroom. Thus, here's hoping no activity today leads to a better tomorrow.
At least nothing new and bad has cropped up, so that will be my accomplishment for the day. My bruises are spreading everywhere, the colors are getting interesting, and I did manage a shower. The fracture blisters are even drying up a bit. I came <this close> to scratching one last night in bed, and it burned for just a second. It was more like my fingernail caught on it and I noticed at the last second. That scared me, so I may cover them better tonight.
Oh yeah--I haven't cried yet today....maybe there's been a touch more improvement than I thought.
As for today, we did have our friends swing by for just a few minutes. It was short, I was in a "just took a pain pill" stage, so it went ok. I've done nothing else but ice, elevate, nap, and get up for the bathroom. Thus, here's hoping no activity today leads to a better tomorrow.
At least nothing new and bad has cropped up, so that will be my accomplishment for the day. My bruises are spreading everywhere, the colors are getting interesting, and I did manage a shower. The fracture blisters are even drying up a bit. I came <this close> to scratching one last night in bed, and it burned for just a second. It was more like my fingernail caught on it and I noticed at the last second. That scared me, so I may cover them better tonight.
Oh yeah--I haven't cried yet today....maybe there's been a touch more improvement than I thought.
There is no reason to force bend your knee, ever, but especially in the first week. Please don’t do that again and don’t let any “therapist” force bend it for you.
OP
OP
Rockgirl4
Former BoneSmart staff member
@Jockette My surgeon had asked me to do it as just the ONE and ONLY thing post-op because of my history of severe scarring/inflammation. He's afraid I'm not normal (ha!!) and WILL lay down scar tissue quickly, as it's happened numerous times in the past. Regardless, it's off the table for now and "nothing" is the new norm. You better believe no therapist is doing it either!!!!
Check out this article:
Adhesions and scar tissue are two different things. Used correctly, the term scarring refers to the stuff that heals your wounds whether it's a surgical incision or a small cut with a kitchen knife. That is necessary to close your wound. Adhesions are excess fibrous tissue that stick muscles, tendons and ligaments down so they can't move the way they should. It look something like this
![[Bonesmart.org] Rockgirl4's Recovery---already full of surprises.](https://bonesmart.org/forum/attachments/adhesions-horz-jpg.71723/ "[Bonesmart.org] Rockgirl4's Recovery---already full of surprises.")
Obviously the scarring is necessary and if it doesn't develop, you'd be in trouble with a permanently open wound!
But adhesions are abnormal and actually relatively uncommon. They occur a lot less frequently than 'professionals' would have you believe. But so long as they can convince patients of this 'inevitable' demon, they will get compliant patients! That's the philosophy! Don't fall for it.
Adhesions and scar tissue are two different things. Used correctly, the term scarring refers to the stuff that heals your wounds whether it's a surgical incision or a small cut with a kitchen knife. That is necessary to close your wound. Adhesions are excess fibrous tissue that stick muscles, tendons and ligaments down so they can't move the way they should. It look something like this
Obviously the scarring is necessary and if it doesn't develop, you'd be in trouble with a permanently open wound!
But adhesions are abnormal and actually relatively uncommon. They occur a lot less frequently than 'professionals' would have you believe. But so long as they can convince patients of this 'inevitable' demon, they will get compliant patients! That's the philosophy! Don't fall for it.
OP
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Rockgirl4
Former BoneSmart staff member
@sistersinhim Thanks for the cool pics. They are very explanatory, as sometimes it's hard to visualize the differences. 
Force bending the knee upsets the tissues and keeps them inflamed and hot and is the best way to encourage adhesions.
I was told to do that also. My therapists and my surgeon, during follow up appointments, force bent my knee also.
Next time around I will not do it, and no one will do it to me, no matter who tells me to.
I was told to do that also. My therapists and my surgeon, during follow up appointments, force bent my knee also.
Next time around I will not do it, and no one will do it to me, no matter who tells me to.
The following is copied from this article from the Bonesmart Library that sistersinhim referred to:
https://bonesmart.org/forum/threads/mua-manipulation-under-anaesthetic-and-adhesions.3656/
“So, to recap:
... I would however, put in this warning about too much PT/physio done too aggressively and especially that causing excessive pain. What this does very effectively is cause the tissues to become over warm and even hot. (though a warm knee during recovery is normal and a sign of healing). This I am referring to is excessive heat. This means that the structures are becoming dry within and dry structures (muscles and ligaments) will get stuck together, resulting in the dreaded adhesions (image below)! So when you find yourself questioning the BoneSmart suggestions of rest and gentle exercising, remember that this is what we are trying to protect you from!”
The image mentioned is the one sistersinhim posted in her post.
https://bonesmart.org/forum/threads/mua-manipulation-under-anaesthetic-and-adhesions.3656/
“So, to recap:
... I would however, put in this warning about too much PT/physio done too aggressively and especially that causing excessive pain. What this does very effectively is cause the tissues to become over warm and even hot. (though a warm knee during recovery is normal and a sign of healing). This I am referring to is excessive heat. This means that the structures are becoming dry within and dry structures (muscles and ligaments) will get stuck together, resulting in the dreaded adhesions (image below)! So when you find yourself questioning the BoneSmart suggestions of rest and gentle exercising, remember that this is what we are trying to protect you from!”
The image mentioned is the one sistersinhim posted in her post.
And the short answer to this question is no, there’s not an easy way to find her thread.
She had her surgery years ago when Bonesmart was younger and had less members, and at that time members were allowed to have many recovery threads, so finding the one that would benefit you would be difficult. You would have to do a lot of reading to find it.
If you’re still interested this link might help:
https://bonesmart.org/forum/threads/finding-another-members-threads-and-posts.15316/
Woodpusher
member
I was going to say "forced bending of the knee for 30 and then 15 minutes"? @Rockgirl4 had the same surgery date as me, 5/21, and I'm not asked to be doing anywhere nearly as much. Right now I consider a 5 minute workout to be a lot. Between that and ADLs I've already bumped up my flexion and extension a lot.
So much in this recovery/rehab is just opinions of the particular medical team we are working with, there is no one set way to go about it. We have the right to decide which approach, or combinations of approaches that will work for each of us.
After spending the first several weeks doing everything I was told to do, I stopped doing everything my surgeon and PTs told me as it clearly was not in my best interest.
OP
OP
Rockgirl4
Former BoneSmart staff member
I don't know what I'd do without you guys right now. I'm seriously wondering if I panicked and assumed too much from the surgeon. I'm questioning everything about my decision-making.
He said to put my foot on the floor for 30 minutes, 2X a day, to let the leg remember that's what it's supposed to do, rather than letting it be propped up all the time. He said if it will move closer, try to get it closer to my other one. He didn't say "make yourself miserable", or "it WILL hurt" .... He didn't even tell me a number to achieve or a set range of wks at which he wanted a certain bend (that was from the PT the next day, and I was too foggy to remember what she said, and didn't really care.)
Maybe I'm so worried about pleasing everyone that I thought I should push harder--thinking a little force would be ok---when it obviously wasn't. The drugs make me wonder how much I interpreted wrong, as Shawn wasn't in the room with me. Last night on the phone, the surgeon never made me feel "less than" or that he needed a certain goal. Maybe I'M the problem.....
Afraid that EVERYONE is going to be unhappy with me and blame me. It's not a good way to heal, that's for sure, and I know I'm trying to please everyone and be prepared for a battle around every corner.
@Woodpusher My situation is just a mess of not knowing why the past happened. I feel the medical community failed me. After the ACI surgery in 2015, there was 8 wks of immobilization (straight leg brace, zero weight bearing). After the 1st week, I was put in a CPM machine for 6 hrs a day at 70-85 degs, then started light PT at 3 wks (table stuff, as no toe-touch weight-bearing was allowed for 6 wks). No cranking of the knee. Just letting it hang from the table and massage. By 8 wks, I was stuck at 95 degrees (dropped from 108 the week before). I wonder if this was when PT started getting "pushier" and more forceful. Can't remember. At 11 wks, I was only at 95 degrees and could barely walk with 1 crutch because of muscle atrophy in the right leg/hip/glute. The next step was a Lysis of adhesions surgery to cut out the adhesions (of which there were a lot), then an MUA a week later when my numbers dropped again (was told the quad had adhesions that needed broken up, and this time the quad WAS much looser after the MUA). Then 2 months of torturous, screaming PT 3 days a week for 3 hrs a time, plus home stuff every day---no days off from bending. I KNOW the last 3-4 months of all that was a problem, but I don't know why the first 8 wks was so problematic, or if I would have eventually gained my range. This has left every PT and surgeon with a "we don't know what caused it or how best to prevent it" mentality. I feel like a guinea pig. It's nerve-wracking and has genuinely given me PTSD regarding PT.
I need to get my &*%$ together and stop trying to please everyone or meet in the middle. I can't be sabotaging myself.
He said to put my foot on the floor for 30 minutes, 2X a day, to let the leg remember that's what it's supposed to do, rather than letting it be propped up all the time. He said if it will move closer, try to get it closer to my other one. He didn't say "make yourself miserable", or "it WILL hurt" .... He didn't even tell me a number to achieve or a set range of wks at which he wanted a certain bend (that was from the PT the next day, and I was too foggy to remember what she said, and didn't really care.)
Maybe I'm so worried about pleasing everyone that I thought I should push harder--thinking a little force would be ok---when it obviously wasn't. The drugs make me wonder how much I interpreted wrong, as Shawn wasn't in the room with me. Last night on the phone, the surgeon never made me feel "less than" or that he needed a certain goal. Maybe I'M the problem.....
Afraid that EVERYONE is going to be unhappy with me and blame me. It's not a good way to heal, that's for sure, and I know I'm trying to please everyone and be prepared for a battle around every corner. @Woodpusher My situation is just a mess of not knowing why the past happened. I feel the medical community failed me. After the ACI surgery in 2015, there was 8 wks of immobilization (straight leg brace, zero weight bearing). After the 1st week, I was put in a CPM machine for 6 hrs a day at 70-85 degs, then started light PT at 3 wks (table stuff, as no toe-touch weight-bearing was allowed for 6 wks). No cranking of the knee. Just letting it hang from the table and massage. By 8 wks, I was stuck at 95 degrees (dropped from 108 the week before). I wonder if this was when PT started getting "pushier" and more forceful. Can't remember. At 11 wks, I was only at 95 degrees and could barely walk with 1 crutch because of muscle atrophy in the right leg/hip/glute. The next step was a Lysis of adhesions surgery to cut out the adhesions (of which there were a lot), then an MUA a week later when my numbers dropped again (was told the quad had adhesions that needed broken up, and this time the quad WAS much looser after the MUA). Then 2 months of torturous, screaming PT 3 days a week for 3 hrs a time, plus home stuff every day---no days off from bending. I KNOW the last 3-4 months of all that was a problem, but I don't know why the first 8 wks was so problematic, or if I would have eventually gained my range. This has left every PT and surgeon with a "we don't know what caused it or how best to prevent it" mentality. I feel like a guinea pig. It's nerve-wracking and has genuinely given me PTSD regarding PT.
I need to get my &*%$ together and stop trying to please everyone or meet in the middle. I can't be sabotaging myself.
OP
OP
Rockgirl4
Former BoneSmart staff member
It was painful for me to have my foot on the floor for months.
I have my own version of PTSD from my PT experience.
You’ve had a bad experience in the past. Your leg has been through so much. This TKR is a brand new experience. It’s a whole different surgery/recovery. Consider following the Bonesmart approach this time by treating your leg gently. Don’t do anything that hurts. Give your leg time to heal.
This is my favorite mantra for this recovery:
It’s not exercising that gets our range of motion back, it’s Time:
Time to recover.
Time for pain and swelling to settle.
Time to heal.
Our range of motion is right there all
along just waiting for that to happen so it can show itself.
In the general run of things, it doesn't need to be fought for, worked hard for or worried about. It will happen. Exercise as in strength training is counter-productive and in the early weeks does more harm than good. Normal activity is the key to success.
I sincerely hope you have an excellent and successful recovery this time, you sure deserve it.
I have my own version of PTSD from my PT experience.
You’ve had a bad experience in the past. Your leg has been through so much. This TKR is a brand new experience. It’s a whole different surgery/recovery. Consider following the Bonesmart approach this time by treating your leg gently. Don’t do anything that hurts. Give your leg time to heal.
This is my favorite mantra for this recovery:
It’s not exercising that gets our range of motion back, it’s Time:
Time to recover.
Time for pain and swelling to settle.
Time to heal.
Our range of motion is right there all
along just waiting for that to happen so it can show itself.
In the general run of things, it doesn't need to be fought for, worked hard for or worried about. It will happen. Exercise as in strength training is counter-productive and in the early weeks does more harm than good. Normal activity is the key to success.
I sincerely hope you have an excellent and successful recovery this time, you sure deserve it.
Momma-me
member
I'm so sorry for everything you have been through. I can relate. A botched arthroscopic in 2016, led to the next surgery in 2017, which was a patella femoral replacement AND an OATS (cartilage graft on the lateral condyle). I was in a straight leg brace, no weight bearing for 12 weeks. The PAIN from that surgery was completely out of control.. My quad totally shut down. I was in PT for 3 years straight trying to regain strength and learning to walk again. I never really recovered. My arthritis ended up spreading to the other compartments, hence the revision 4 weeks ago. It's been a LONG grueling road that I wouldn't wish on anyone. I am somewhat "high strung" as you say you are as well. But I think we have been through SO MUCH that it's hard not to over think things and get worried that something else is wrong. I don't have any other experience to draw from.
Let's do our best to stay positive and think the best! Sometimes I think my faith has run out... but somehow, I dig deep and find it again. Hugs to you xoxo
Let's do our best to stay positive and think the best! Sometimes I think my faith has run out... but somehow, I dig deep and find it again. Hugs to you xoxo
Been there, done that.
OP
OP
Rockgirl4
Former BoneSmart staff member
Post-Op Day 8----aaaannnnnndddd we've turned a corner! 
Today is definitely a better day. I woke up pretty sore, but something about yesterday and the first part of today were just easier. By this afternoon, I could easily say maybe the worst is behind me (??)---trying not to jinx it.
The Home Health PT came by at lunch. She mostly worked on soft tissue, easing into the more bruised areas that are definitely stiffer. We talked through it with nice conversation, so I wasn't paying attention to everywhere her fingers were going. That made me MUCH more relaxed, and by the time those 10-12 minutes were over, my leg definitely felt happier. We talked a lot of form and function. She was able to remind me of some things to do when I first stand up or get out of bed in the morning to hopefully ease those first few steps and the liquid fire feeling in the leg. Some of this is basic stuff, but my brain has been in "oh my gosh--is this going to hurt" mode, with every step, so I wasn't thinking straight.
Without doing sets of exercises, I showed her how well my quad was firing and how I could easily do a straight-leg raise. Since my strength is so good anyway, she didn't want/ask me to do a bunch of things--just trying to keep the leg happy and continue to get swelling down. She's big on function, not numbers, which I love.
She gets to come back 1 day next week, then I'll start outpatient with someone I already know and has my philosophy. So yeah--I'm feeling better about things.
I still get a 3-4 hr period of the day (and it can occur at ANY time!!!), where I hurt all over and just feel cold and blah, or sometimes clammy and blah. Anyone else have something like this?
I know my blood pressure is up, but I tend to have issues with narcotic meds and pain cycles raising mine. So far it's mainly the top number, but I've had some palpitations too .....the PT said not to worry, as they see it a lot, but since I DO have high BP and had big problems with this 3 yrs ago, not to completely ignore it. It required huge medication adjustments last time, so I'm not about to ignore it.
As for other accomplishments, the hubby yelled at me when I emptied the dishwasher earlier, so I DO think I've turned that corner. Every other day I wouldn't have even considered it, so that's progress!!!!
Today is definitely a better day. I woke up pretty sore, but something about yesterday and the first part of today were just easier. By this afternoon, I could easily say maybe the worst is behind me (??)---trying not to jinx it.
The Home Health PT came by at lunch. She mostly worked on soft tissue, easing into the more bruised areas that are definitely stiffer. We talked through it with nice conversation, so I wasn't paying attention to everywhere her fingers were going. That made me MUCH more relaxed, and by the time those 10-12 minutes were over, my leg definitely felt happier. We talked a lot of form and function. She was able to remind me of some things to do when I first stand up or get out of bed in the morning to hopefully ease those first few steps and the liquid fire feeling in the leg. Some of this is basic stuff, but my brain has been in "oh my gosh--is this going to hurt" mode, with every step, so I wasn't thinking straight.
Without doing sets of exercises, I showed her how well my quad was firing and how I could easily do a straight-leg raise. Since my strength is so good anyway, she didn't want/ask me to do a bunch of things--just trying to keep the leg happy and continue to get swelling down. She's big on function, not numbers, which I love.
She gets to come back 1 day next week, then I'll start outpatient with someone I already know and has my philosophy. So yeah--I'm feeling better about things.
I still get a 3-4 hr period of the day (and it can occur at ANY time!!!), where I hurt all over and just feel cold and blah, or sometimes clammy and blah. Anyone else have something like this?
I know my blood pressure is up, but I tend to have issues with narcotic meds and pain cycles raising mine. So far it's mainly the top number, but I've had some palpitations too .....the PT said not to worry, as they see it a lot, but since I DO have high BP and had big problems with this 3 yrs ago, not to completely ignore it. It required huge medication adjustments last time, so I'm not about to ignore it.
As for other accomplishments, the hubby yelled at me when I emptied the dishwasher earlier, so I DO think I've turned that corner. Every other day I wouldn't have even considered it, so that's progress!!!!
