TKR RTKR February 12th Recovery thread

[EalingGran]

Sorry to hear about the stomach bug. There has been a lot of Norovirus here in London and I got a nasty gastric bug in Hamburg last week. Just take it easy and rest as it can really wear you out.

 

[beralc]

Sorry to hear you’re unwell @Alice Nutter I’ve been dreading getting a bug/virus. Hopefully you’ll soon be recovered, but as you say at least your resting and elevating.

 

[sistersinhim]

These bugs seem to be all over the world and really nasty. Missing some PT won't cause any problems or setbacks and is probably even good for your healing knee. In these early days, extra rest is exactly what it needs.

 

[Alice Nutter]

Thank you. I'm back from the brink but it was a rocky few days. Missing PT didn't bother me too much; missing a concert on that I'd been really looking forward to on Friday evening did. It was in a small venue where getting up and walking around would have been possible, too...Oh well.

I had another lightbulb moment today which some people might find useful. I have been concentrating on my gait when I walk to eliminate any limping - my left hip and lower back tell me when i have been limping - and I realised that if I look where I want to go (ie ahead) rather than where I am going (ie the ground immediately in front of me) my posture is much better, and so is my limping. This is something I learnt from riding a motorcycle - it's very important to look at where you want to go instead of the obstacle you want to avoid, because the bike will go where you look. The body is similar. It does require proprioception; you have to 'read' where you are putting your foot down from the sensation, rather than look. I realise that because I have been unable to trust my old bad right knee for so long, I had got into the habit of always looking down to make sure my foot wasn't going to go down on something unstable, because I could not rely on the knee to support me. Now I can, because my new knee isn't going to give way. I'm not advising complacency on uneven surfaces - I don't want to fall - but I am trying quite hard to keep my eyes level rather than down. If that makes sense.

 

[Jamie]

Wise comments, @Alice Nutter … this type of thinking bodes well for a great recovery! You’ve learned things about how your body works that will help you get where you want to go more quickly. By looking ahead rather than down, each step challenges your body to relearn how to properly function. Good for you!!!

 

[mendogal]

Great point!!!!

When teaching "defensive walking" that forward gaze is so important. My shortcut is suggesting folks aim both their heart and their eyes on the horizon and trust their peripheral vision.

 

[Alice Nutter]

Great point!!!!

When teaching "defensive walking" that forward gaze is so important. My shortcut is suggesting folks aim both their heart and their eyes on the horizon and trust their peripheral vision.

Peripheral vision! That's the phrase I was looking for.

 

[Alice Nutter]

Nearly 6 weeks post-op now. I have my second follow-up appointment on Thursday, and am hoping that I get cleared for swimming - my scar is healed and scabless - and returning to Pilates. If that is the case, I will probably swop out PT for Pilates. My new PT has taught me some very useful stretches, but I have never been a gym bunny and have to admit to getting bored doing some of the exercises they make me do there. They have introduced some light strengthening stuff with machines, and I feel my body is now ready for this, but doing the same thing over and over again has never been my thing. I only discovered Pilates (Reformer) last October, and what I immediately liked was that there were very few repetitions before you switched to another movement. Back in the real world, I am definitely feeling less pain. I am walking further, and on uneven ground, now that the snow has finally cleared. My dogs appreciate that too. I probably do about 3/4 mile, which isn't far, but includes going downhill, going uphill and treading carefully to avoid branches, roots etc. It's wonderful to be able to rely on a strong new knee, when for so many previous years it was always in the back of my mind, especially going downhill, that my knee could either give way or click in a very painful way. I am doing all ADL's. It's very gradually becoming less challenging to sit at my desk (I'm a writer) for up to an hour, I have taken to pedalling away on the upright bike when I watch TV, I still ice and elevate at least once a day for about 45 minutes, more if my knee feels particularly tight. I do home PT exercises when and if I feel like it, for as long as I feel like it, no more. I don't think I'm getting ahead of myself; I think I am at where I should be at around now. It's an interesting journey, for sure.

 

[benne68]

I probably do about 3/4 mile, which isn't far, but includes going downhill, going uphill and treading carefully to avoid branches, roots etc

That's great for just 6 weeks post-op! Especially if it's on uneven ground. Good for you!

Just remember this recovery takes a full year, so don't overdo. Sounds like you are listening to your body, which is the very best recipe for recovery.

Let us know how your Thursday appointment goes.

 

[mendogal]

Walking plus Pilates is a great and safe regimen to keep your recovery on track, and easy to monitor your knee's reaction and readiness to progress

 

[Layla]

I am walking further, and on uneven ground, now that the snow has finally cleared. My dogs appreciate that too. I probably do about 3/4 mile, which isn't far, but includes going downhill, going uphill and treading carefully to avoid branches, roots etc.

Walking on varied terrain as you are and stepping over any obstacles in your way is great as it strengthens muscles, improves your balance and coordination, helps improve flexibility and ROM and encourages a natural gait. Then there are the cardio and and mental well being aspects also, so this is wonderful progress Alice. Keep up the good work and enjoy the walks. Best Wishes for your appointment on Thursday!

 

[Jamie]

You really are doing great. I think your decision to switch Pilates for the PT is a good one. I share your feelings about repetitive exercises (other than walking). It does get boring. My trainer always had a new routine every time we met. She said your muscles get used to those repetitive exercises and then get a bit lazy when doing them. Changing up keeps your body and mind more alert.

 

[Wncretired]

Nearly 6 weeks post-op now. I have my second follow-up appointment on Thursday, and am hoping that I get cleared for swimming - my scar is healed and scabless - and returning to Pilates. If that is the case, I will probably swop out PT for Pilates. My new PT has taught me some very useful stretches, but I have never been a gym bunny and have to admit to getting bored doing some of the exercises they make me do there. They have introduced some light strengthening stuff with machines, and I feel my body is now ready for this, but doing the same thing over and over again has never been my thing. I only discovered Pilates (Reformer) last October, and what I immediately liked was that there were very few repetitions before you switched to another movement. Back in the real world, I am definitely feeling less pain. I am walking further, and on uneven ground, now that the snow has finally cleared. My dogs appreciate that too. I probably do about 3/4 mile, which isn't far, but includes going downhill, going uphill and treading carefully to avoid branches, roots etc. It's wonderful to be able to rely on a strong new knee, when for so many previous years it was always in the back of my mind, especially going downhill, that my knee could either give way or click in a very painful way. I am doing all ADL's. It's very gradually becoming less challenging to sit at my desk (I'm a writer) for up to an hour, I have taken to pedalling away on the upright bike when I watch TV, I still ice and elevate at least once a day for about 45 minutes, more if my knee feels particularly tight. I do home PT exercises when and if I feel like it, for as long as I feel like it, no more. I don't think I'm getting ahead of myself; I think I am at where I should be at around now. It's an interesting journey, for sure.

Our surgeries were one day apart. We are pretty much on the same trajectory. I’m thinking I will ditch PT also, as I am at 125/0 and strength is coming along nicely. Like you, I do my own PT daily and feel confident that I will continue progressing. I agree that you/we are where we should be.

Good luck with your continued improvement!

 

[EalingGran]

Just be careful with the reformer pilates machines early on.
Have a look at my excellent pilates teacher's free YouTube classes. She has loads of different ones- Google Katja pilates and they come up.
I did her side lying/ no squats glute strengthening one as my go-to post op recovery plan.
Pilates is an excellent choice for rehab as it emphasises listening to your body and not pushing to pain.

 

[Alice Nutter]

Just be careful with the reformer pilates machines early on.
Have a look at my excellent pilates teacher's free YouTube classes. She has loads of different ones- Google Katja pilates and they come up.
I did her side lying/ no squats glute strengthening one as my go-to post op recovery plan.
Pilates is an excellent choice for rehab as it emphasises listening to your body and not pushing to pain.

Oh, I agree about the Reformer. I'm going to take a couple of private classes witht he instructors who specialise in rehab work, and see what they suggest.

 

[Alice Nutter]

I had my six week follow-up visit today. She said the scar looks great, I can go back to swimming, go back to Pilates, all good. However, she was concerned about my extension, wants me to come back in three weeks, and insists that I should do at the very least fifteen minutes a day of the bridging exercise (sitting on one chair, leg extended and heel resting on another chair, let gravity do the stretching) which has made me nauseous with pain since the beginning. Once again she said that if I don't do this now, I will never get my extension to 0°. It's quite threatening. Does anybody have any ideas on how I can gently coax my leg to extend more fully so that I pass the damn test in three weeks time? I still have significant swelling which I think impacts both extension and flexion, and am hoping that returning to the pool and doing stretching exercises in the water will help that. I ice and elevate at least once and often twice a day.

 

[Jamie]

The only way to get extension is through gentle stretching over time….sometimes a LOT of time. It’s the last thing to come for most people. Please don’t worry about the idea that you may never get full extension back. You are less than two months out of surgery. There is plenty of time and your therapist is operating under older information that current studies do not support. If you were just sitting around eating bon bons all day, it might be another story. But you’re not. Get in the pool and do walking and stretching exercises there. If the exercise with a chair is not comfortable for you, try lying on your tummy on the edge of your bed. Your knee joint should be right at the edge so that your lower leg extends out beyond the bed. Relax comfortably in that position as long as you can without having a lot of pain. Mild discomfort is okay. You can do this stretch several times a day. Try and work the time up in very small increments until you get to about 15 or 20 minutes. It may take a while to get to that level if you have swelling or your soft tissues are tight. But you should see some progress if you do this consistently.

 

[Layla]

Hello and Happy Friday!
I am sorry you feel threatened, that's awful. To me, a good PT should encourage and support you, not use fear or threats as motivation to get you doing something that actually causes you to feel nauseous and in pain. You will progress at your own pace and you will get there, Alice Nutter. Your therapy should be a little challenging, but you also need to be heard and feel respected, not threatened. Consider asking for modifications and if you continue to feel threatened, you may want to look for a better match in a PT.

I'm glad to hear your six week follow up visit went well. I'd say you are on your way!
Have a lovely weekend!
@Alice Nutter

 

[Alice Nutter]

Just to be clear, it wasn't my PT who said the menacing words about the window of opportunity for extension, it was the surgeon's assistant. The surgical team have been pushing the bridging exercise since the beginning. I saw my PT today and discussed it with him. He gave me some more dynamic stretching exercises, and pointed out that when I'm warmed up and moving, my knee IS straight. My hunch is that the stubborn swelling is not helping, and that getting into the pool next week will loosen me up quite a bit.

 

[Jamie]

I think you’re right on target, @Alice Nutter . You know your body better than anyone else. Don’t feel guilty one bit for following the signals your body is giving you. I’m glad you have open communications with a therapist who seems to better understand recovery than some of the members of your surgery team.