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TKR RTKR February 12th Recovery thread

Thank you, Alice Nutter!
Will pass the info on to Admin. I hope you have a lovely weekend! :SUNsmile:
@Alice Nutter
 
Alice Nutter said:
I think I might be heading for a Dear John letter to my PT guy. Yesterday he had me doing quad sets with ankle weights, at post-op 17 days. This is ludicrous. I am not interested in building strength yet; I am interested in stretching, bringing down the swelling, and using my new knee. He advised me to take a tramadol before the next session, which is a red line for me. I would think that if you have to take an opioid before you do something, then probably that something isn't something you should be doing right now.
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Write that letter, Alice Nutter!! :thumb: You're right, you need to heal first.
We're happy the forum is helping you sort thoughts and thank you for sharing your healing journey with all.

Taking meds before PT is not recommended because it can mask pain which is an important indicator of how your knee is responding to movement. Obviously you don't want to risk overworking the joint, straining the area, increasing swelling and inflammation, possibly causing damage, delayed healing or setbacks.
If you aren't able to come to an agreement with the PT, it may benefit you to seek out a better match.
May today be a good day!
 
Alice Nutter said:
I think I might be heading for a Dear John letter to my PT guy. Yesterday he had me doing quad sets with ankle weights, at post-op 17 days. This is ludicrous. I am not interested in building strength yet;
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Oh no, It is much, much too early to have you doing anything with weights. That's not appropriate until at least 3 months post-op.

I encourage you to drop him. He clearly has not had proper training in how to help someone recovering from joint replacement surgery. It's unfortunate that so many PTS think they can apply the same techniques that they use for sports injuries to someone who has had knee replaced.

We're here for you!
 
Excellent study, @Alice Nutter …. Thank you! We often get so busy helping people here on the forum that we don’t have time to research material. So we always appreciate it when our BoneSmarties help us out with that. We take this information and put it in our BoneSmarties Library and use the knowledge we gain from evaluating the study results to prepare new articles or update existing ones with new information.

I’m also very glad to hear that you have not given in to the pressure from a therapist that is clearly not working in your best interest. I agree with you that the Tramadol before therapy is a huge no-no. That’s a good way to find yourself injured with pain and swelling later.

This is a time to trust your own good instincts. You know your body better than anyone.
 
benne68 said:
Alice Nutter said:
I think I might be heading for a Dear John letter to my PT guy. Yesterday he had me doing quad sets with ankle weights, at post-op 17 days. This is ludicrous. I am not interested in building strength yet;
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Oh no, It is much, much too early to have you doing anything with weights. That's not appropriate until at least 3 months
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Agree with @benne68
I didn't use either weights or bands until about 5 months.
Ankle weights at 17 days is ridiculous and a recipe for injury. You definitely don't need this chap.
 
I thought I knew what it was like to feel stiff, but now there is a whole new dimension to that word. Not complaining - it's way better than the step-by-step disintegration of my old knee, and I'm working on the assumption that this too shall pass, but bloody hell!
 
Alice Nutter said:
I'm working on the assumption that this too shall pass
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Yes, it will -- but it will take time. The main cause of that stiff feeling is the inflammation inside your knee -- which will be slow to resolve. I was amazed that it continued even after the external swelling was gone. Just keep moving, but don't force it to bend.

You've got this, @Alice Nutter !
 
Well, I have changed my PT and I am looking forward to meeting the new one with a Bonesmart mindset. I realized that when it came down it I didn’t fully trust the previous one, particularly since he told me to take a tramadol before sessions. So I got proactive, researched, found a place that’s further away but is highly recommended, got the surgeons office to fax (fax! In 2025!) an order through and I have my first appointment next Friday. Wish me luck!
 
Hi Alice,
Wishing you the best of luck with your new physical therapist! Go slow and easy and be patient with yourself. I hope the PT is the perfect match and you make comfortable steady progress as you continue healing. :thumb:
@Alice Nutter
 
Had to laugh! Yes in 2025, because every hospital and physician group uses different softwear systems, faxing remains THE primary way for referrals to get transmitted (aside: I remember when faxes took over in the early 90s; before about 1992 or 1993 every single referral I made was by phone and every referral I received I had to take down every word by hand).

I hope this new PT is up to date and fully patient-centered. I can't work with PTs who don't consider me an equal partner!
 
This is where me and my knee are at today: it's all about stiffness and discomfort, not really pain, although there is a deep ache that can only be alleviated by icing. The past couple of nights I had difficulty staying asleep for more than an hour or so at a time because of the ache, then it dawned on me that also I hadn't iced before going to sleep as I had all the previous nights. So guess what I was doing at 2:00am? What I really notice is incrementally small amounts of progress every day - being able to walk up a few steps on the stairs regularly (holding the handrail of course) and today, being able to walk DOWN a few steps regularly, something that was unimaginable a couple of days ago. I'm walking outside more, although inhibited by the amount of ice still around here in New England, and yesterday I drove for the first time. The exhaustion is still very real, but I notice that I have more appetite for life, driven partly by the knowledge that this operation was absolutely necessary and that eventually my right knee will be better than it has been for years, decades even. That's an exciting idea. I am switching to a new PT place for my next session on Friday and hoping that I find their approach more compatible than the last one. I'm a believer in slow and steady wins the race. Pushing discomfort is fine with me; extreme pain is not. If that doesn't work out, I think I will just carry on doing home exercises assiduously, and measure my progress according to my own criteria. After all, the surgeon's assistant at my first follow-up last Friday said I was doing great, moving well and "even smiling." So I must be doing something right.
 
Wow what aggressive therapy to start! I too fluctuated between following bonesmart or all the therapists. They really scare you. Then I got the flu and could hardly exercise. I decided not to worry about it and started exercising just on the stairway every time I passed it after a couple of weeks of hardly any exercise. What progress I have made! Hardly any stiffness. I walk around as if I never had surgery. I am sure my flexation has greatly improved. We will see when I go back to therapy. I don't push it to pain. I can go upstairs with both legs (using handrails) By the way I am two months post surgery.
 
Alice Nutter said:
the surgeon's assistant at my first follow-up last Friday said I was doing great, moving well and "even smiling." So I must be doing something right.
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Love this!

Walking up and DOWN stairs this early in recovery is amazing! I could not descend stairs normally for month post-TKR. You are doing really well.
 
benne68 said:
Alice Nutter said:
the surgeon's assistant at my first follow-up last Friday said I was doing great, moving well and "even smiling." So I must be doing something right.
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Love this!

Walking up and DOWN stairs this early in recovery is amazing! I could not descend stairs normally for month post-TKR. You are doing really well.
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It’s REALLY EXCITING! The first time I did it was by accident - I just went down a couple of steps and realised I had used alternate feet. Previously I had attempted it deliberately and gone “woah, there’s no way.” It was the realisation that it was my head, not my knee, telling me that such a thing was not possible that made it possible. I’m being very cautious about both up and down - no more than three or four steps, holding the handrail etc. I am also trying to work on looking where I want to go rather than at my feet. It makes for better posture.
 
Suearl2020 said:
Wow what aggressive therapy to start! I too fluctuated between following bonesmart or all the therapists. They really scare you. Then I got the flu and could hardly exercise. I decided not to worry about it and started exercising just on the stairway every time I passed it after a couple of weeks of hardly any exercise. What progress I have made! Hardly any stiffness. I walk around as if I never had surgery. I am sure my flexation has greatly improved. We will see when I go back to therapy. I don't push it to pain. I can go upstairs with both legs (using handrails) By the way I am two months post surgery.
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I think there’s a whole world of PT possibilities in our daily activities of living. The stairs, crouching down to load and unload the dishwasher, stretching to put things away, even opening a sticky sliding door. It means thinking about how you move, how you load your body, what muscles are implicated. It’s quite exciting really.
 
Alice Nutter said:
I think there’s a whole world of PT possibilities in our daily activities of living.
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You're right!
You can also engage in gentle stretches and controlled exercises on your own to restore strength and flexibility. There's massage to reduce stiffness and improve circulation, water therapy if that's of any interest, which reduces strain on the joint while improving mobility. Something that is often overlooked in recovery is good nutrition, as in an anti inflammatory diet to aid in healing and reduce swelling. And good old icing sessions to reduce swelling or heat once you are further along can help relax overworked muscles.

Good luck on Friday, Alice! If it doesn't work out for some reason, you seem to have a healthy handle on what does work. You're doing very well! :thumb:
 
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