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TKR Rt TKR Aug 2019 Still in Pain

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Happykitty

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Hi, I had my tkrs done separately, left in Dec 2018 and right on Aug 27, 2019. The difference in recovery is night and day. With the left I was back at work and off prescribed pain at 6 weeks. The right is another story. I know I should not compare them but the right knee was so tight from the very beginning but I was able to use a crutch. I started in home pt on Sept 2, 3x week. I had my 3rd visit on Sept 6 with no issues so my therapist suggested going up and down stairs a couple of times which I did. Here's where everything went downhill. 36 hrs later I could not put any weight on my foot, I could barely walk and so much pain. Couple of days later I saw my surgeon for my 2 week follow up and he said an xray showed no damage from the pt, but knee was extremely inflamed. Its been 4 weeks later and I've had very little improvement. I ice my knee in the morning to get moving. By the time I use the bathroom, make cup of coffee, my leg swells up again. Im even going to therapy 2x week and bought a small pedaling device to increase my ROM, but nothing seems to help me get over the hump. Pain is at a 4 to 5 with pain meds. All I want to do is lay in bed. What should I be doing differently? I am depressed.
 

judgar

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If you had surgery aug 27 th you are only 4 weeks. It takes time.you need to rest.
 

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Stop . Ice elevate and go lay in bed.
The staff will be along soon to give you more guidance
That pedlar and PT isn't what gives you ROM but that myth is very popular
 

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Im even going to therapy 2x week and bought a small pedaling device to increase my ROM, but nothing seems to help me get over the hump. Pain is at a 4 to 5 with pain meds. All I want to do is lay in bed. What should I be doing differently? I am depressed.
You may be working a little too hard to recover. Try backing off some activities.

Do the things you do at PT increase your pain? If so, tell them you want to cut it back.

This is a tough surgery. You were very blessed with the recovery on your other knee, but this knee has it’s own recovery and you need to respect that.

You want to lay in bed a lot because so much of your body’s energy is going towards healing, and there’s little left over to do other things. Maybe this knee needed more work done and it’s more upset than the first knee.

If it was me I’d put the peddler away for a few weeks, you can always use it later when you feel better. Don’t do the stairs any more than you have to. Just going about your daily activities will give your new knee the exercise it needs, at this early stage. As you get better and stronger you’ll be able to do more.

Indulge that poor knee by resting, icing and elevating. Don’t think of this as wasting time and doing nothing, think of it as giving your knee the best opportunity in which to heal.
 
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Happykitty

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Thanks all for the feedback. I was feeling pressure to push myself at pt, because I want to get back to normal, but pt does cause me alot of pain during the sessions and afterwards. I'm going to skip my session tomorrow.
 

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You really can’t push yourself to be back to normal. Healing takes its own sweet time, unfortunately.

In general, complete healing can take an average of a year, and even longer for some of us.

I’m in the “even longer” category with my partial. It’s been 2.5 years since my partial was done and I am still seeing improvement.
 
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I guess I'm feeling pressure because my boss is expecting me back to work around 8 weeks. I have to be patient.
 
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Jockette, if I have a question on let's say, swelling, should I post the question in my thread or should I find a forum on that subject and post the question in that forum? New to me, thanks.
 

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Post all your questions here in this thread.

We permit members to have only one recovery thread. Here’s an article explaining why:
https://bonesmart.org/forum/threads/only-one-thread-per-member-in-recovery-please.10322/

You started a thread on Monday, and then this one today. A moderator will merge them together, tonight or tomorrow. It’s really important to keep all your information together.

Do you still have any concerns about the knee done in January? If so, we’ll merge with that thread also, so everything will be together.

What is your question about swelling?
 
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I'm okay with the left knee, so you dont have to merge those threads. My question is on elevating the rt leg. I experience an intense burning sensation from my knee down right after I stop elevating it. It can last about 10 minutes. Is it a circulation issue?
 

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When you stop elevating are you sitting with your feet on the floor? I don’t know if that burning sensation is a circulation issue, but I remember it was months before I could sit with my feet on the floor. I avoided it as much as I could until it healed enough to handle it.
 

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Hi again, @Happykitty

You'll notice that I have merged your newest thread with your original recovery thread for your new knee. I've also merged your thread for your first knee, so you'll be able to read back and see how you were really doing at this stage of recovery. As time passes, our minds tend to forget the worst of our pain, so your memory of your first knee may be rosier than it really was.

For several reasons, we prefer that you only have one recovery thread:
  • That way, we have all your information in one place. This makes it easier to go back and review your history before providing advice.
  • If you keep starting new threads, you miss the posts and advice others have left for you in the old threads, and some information may be unnecessarily repeated
  • Having only one thread will act as a diary of your progress that you can look back on.
So please post any updates, questions or concerns about your recovery here, and don't start any more threads.

Don't worry that we won't see your questions because, between us, the staff read all new posts every day.
If you need an urgent response to a question, just tag a member of staff.
How to tag another member; how to answer when someone tags you

If you prefer a different thread title, just post what you want and we'll get it changed for you.

Here are the instructions on finding your thread, How can I find my threads and posts? . Many members bookmark their thread, so they can find it when they log on. Please do that if you can.
 

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Isn't it fascinating how different 2 recoveries on the same body can be? I'm constantly surprised. I got lucky and had my 'difficult' knee first. This one has been much easier in some ways, but still challenging and annoying. I think it would be even harder if I'd done this one first and then had to go through the journey I had in the early days of the July knee.
 

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My question is on elevating the rt leg. I experience an intense burning sensation from my knee down right after I stop elevating it. It can last about 10 minutes. Is it a circulation issue?
Well, it's partly connected with your circulation, but it isn't a problem and it's not uncommon.

While you're elevating your leg, gravity is helping to encourage the swelling in your knee to go "downhill" towards your body, so it can be re-absorbed into your circulation.

When you get up after elevating, gravity has the reverse effect, encouraging fluids to go down towards your ankle and foot. This change in direction causes the burning feeling you have.
Some people find that their ankle swells and you may remember how any bruising you had travelled downhill, towards your ankle.
As time passes, your body will adjust to the changes in position and you won't feel them so much.
 

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I guess I'm feeling pressure because my boss is expecting me back to work around 8 weeks. I have to be patient.
Lot's of people think they need to get ready to go back to work by doing more exercise. Actually almost the opposite is true. You need to let the body heal in order to get ready. Gentle exercise and lots of ice and elevation are the way to go. And naps--don't forget the naps. :wink:
 
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Happykitty

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Now that I understand how elevating affects the leg, it makes sense that I would feel discomfort when I stop elevating my leg and the fluid rushes back down into it. I skipped pt on Thursday, since then been icing and elevating my leg at least 4 times a day and resting alot. I wasn't doing that before. I'm seeing some slight improvement when I put weight on my leg, doesn't feel as stiff which is great
 
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Happykitty

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Good morning, I'm 7 weeks postop right tkr. Some FYI, I'm still taking prescribed pain meds, Oxycodone every 6-7 hours, but can skip night dose since I take 3 Gabapentin at bedtime. Also on celebrex 2x day and 3 Tylenol 325mg mg for 3x a day. Knee is very stiff, of course in a.m. but also when I get up after sitting for more than 15 minutes. Knee is clunky, dull throbbing and still very sore. Applying heat, ice and some elevation 3x day. Going to pt 2x wk, flexion is at 110, but extension is stuck at minus 5 to 10 degrees. Just had 6 wk follow up appt with my surgeon. Xray was normal, but he is concerned about the extension, said that its imperative that I actively work towards 0 extension. He wants me to have therapist push me on this. I have another follow up in 3 weeks with my surgeon at which time if exension has not improved, he will recommend a brace to help with extension. If that doesn't work he'll recommend a MUA which he does not want to put me through. About 2 wks ago, my therapist put me through a very agressive session which resulted in me laid up for 24 hours, painful! i want to avoid the mua, so I'll have to push through the pt. Also I am now sitting and elevating my leg with a rolled up towel under my ankle with a 2 lb ice pack on my knee for 10 minutes and at least 3 times a day more if I can tolerate. My next pt appt is on Tues, will let you know if I've improved. I expected to get back to work at 8 wks, 2 day wk to start but I doubt that will happen with how I'm progressing. Thanks for listening.
 

Jockette

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I’m sorry to hear your surgeon is so impatient about your extension. His approach is very different from the Bonesmart approach, which is:


Personally I would follow the Bonesmart approach. I will never allow someone to push down on my knee and I won’t put any weights on my knee like he said.

You cannot rush this recovery, it will take its own time. 7 weeks is still pretty early in this 52 week, on average, recovery.
 

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i want to avoid the mua, so I'll have to push through the pt.
Pushing through the pain of PT is just causing more swelling, which is harming your extension. You need to concentrate only on getting that swelling down. You do that by icing, both the front and back of your knee and elevating, toes above nose. The next thing is to stop all exercising. Just use your knee normally in your daily activities. I have had 11 knee surgeries and never took PT. I just used my knees in my daily activities. This rehabbed them just fine, and without the agony of exercises that the knees weren't meant to do at the time.

Your knee isn't out of shame, it's injured and traumatized by a very invasive surgery. It needs to heal, not to do exercises. Would you exercise a broken bone or sprained muscle or tendon? Of course not. Your knee has all of those. Watch a live video of a knee replacement on youtube and just see what was done to your poor knee. You will then understand why it need TLC, not aggressive exercises.
 

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