TKR Sept 25 - left knee

[Jockette]

@KJ24 I moved your recent post, above, over to your recovery thread.

Over the course of this recovery there will be pain here, there, and everywhere, as we heal, due to the extensive trauma during the TKR surgery. Time is a great healer of it all. What did you do different that caused this pain to show up?

 

[EalingGran]

Agree with @Jockette that all kind of pains can occur after knee surgery depending on our own particular issues and weaknesses pre-op. Also depending on how we try to counterbalance and protect our healing knee.
As regards the sleep issue @mendogal had some good advice. I used Nytol ( OTC diphenhydramine) but also got some zopiclone from my GP. I alternated these to spin out my prescription. All pain is worse at night and a few decent hours of sleep really helps settle swelling and pain.

 

[KJ24]

@KJ24 I moved your recent post, above, over to your recovery thread.

Over the course of this recovery there will be pain here, there, and everywhere, as we heal, due to the extensive trauma during the TKR surgery. Time is a great healer of it all. What did you do different that caused this pain to show up?

As per my PA, I didn’t do anything wrong. I tore my calf muscle in that leg back in 2001. The PA thinks that the scar tissue in that calf is causing tightness which is pulling on the hamstring causing the fibula to be tight. Everything right now is assumed as she is not really sure why the fibula is sore, since it is not part of the knee surgery.

 

[mendogal]

Lots of things we experience post op aren't directly attached to the surgery...

This is what I've come to think of as the Great Structural Reset. In your case likely complicated by the scar tissue from that old muscle tear.

Our arthritis-affected weight bearing joint, over time, creates a lot of structural changes as the body tries to compensate. Some muscles and tendons lengthen and stretch while their counterparts contract and tighten. This can happen slowly and below our level of consciousness even as these forces start tugging at bones, skewing our pelvis, our posture, our gait.

All at once in surgery everything is essentially reset by the surgeon. Part of recovering from a hip or knee replacement, besides the actual healing, is a re-modeling of our structure to adapt to our new improved structure.

 

[Jockette]

As per my PA, I didn’t do anything wrong.

I didn’t mean to imply you did anything wrong. Sometimes we do a different, or new, activity that results in a new pain. This can happen often throughout our recovery. I’ve been there, done that!

 

[Rockgirl4]

I have a fibula problem in my right leg--the one in which I had my first TKR in 2019. I have loads of scar tissue wrapped around my fibular head from a set of 4 procedures/surgeries in 2015-2016. My TKR surgeon saw it during the TKR and said he couldn't remove all of it, as it would likely come back and/or irritate the nerve. It does still irritate the peroneal nerve running down the front of my leg at times if I overdo things, and occasionally my chiropractor manipulates it for me to help with ongoing soft-tissue problems in that lower leg. He's a lower-extremity specialist chiropractor and has helped a great deal, as the tightness and things getting "stuck" makes my ankle/shin/calf area burn with tightness and pain.

The idea is if the fibular head isn't translating (moving) appropriately, the rest of your leg compensates for it. That created so much pain and stiffness in my lower leg last winter/spring that I could only walk for 5-10 minutes at a time. I saw a PT who helped me strengthen everything last March/April, but I still have issues with the fibular head not moving correctly at times or feeling stuck. The chiropractor has helped most so far, though everyone is different.

 

[sistersinhim]

I hope you continue to feel improvement in your fibular.

 

[Layla]

Happy Two Month Anniversary!
I hope you've experienced some relief since we last heard from you.
Best Wishes for a good week and a Happy Thanksgiving!
@KJ24

 

[KJ24]

Happy Two Month Anniversary!
I hope you've experienced some relief since we last heard from you.
Best Wishes for a good week and a Happy Thanksgiving!
@KJ24

The first time PT did the fibula manipulation did not hurt all that much, but the girl that did it massaged it more than actually moving the fibula head. This past Wednesday was my second session and boy did it hurt. I was white knuckling the table before he was done. After PT I drove to a local community park two minutes away and sat in my car a cried for a good half hour. I can’t stop worrying that something is wrong with my knee and I will have to have another surgery to fix it. I feel like my doctor just thinks I’m a wimp when I tell him how painful it is to walk. The fibula bone feels like it is crushing the side of my knee. Every time I call and complain it seems like he blames me for my pain. On Wednesday when I called it was “maybe PT is not having you work on strengthening your anterior tibialis and peroneal muscles. OR your not doing enough PT at home”

I don’t know what else to do but cry and pray to God

 

[EalingGran]

This past Wednesday was my second session and boy did it hurt. I was white knuckling the table before he was done

This really doesn't sound right. I wouldn't allow that kind of manipulation.

I feel like my doctor just thinks I’m a wimp when I tell him how painful it is to walk. The fibula bone feels like it is crushing the side of my knee. Every time I call and complain it seems like he blames me for my pain. On Wednesday when I called it was “maybe PT is not having you work on strengthening your anterior tibialis

Two months is very early for strength work. You are still healing from the surgery.
I had a different issue ( overstretched MCL) which gave me some pain post surgery- but I couldn't really work on strengthening my quads until about 4-5 months. I am so sorry you are in such pain.

 

[Layla]

This past Wednesday was my second session and boy did it hurt. I was white knuckling the table before he was done. After PT I drove to a local community park two minutes away and sat in my car a cried for a good half hour.

This is heartbreaking. I don't see how enduring pain such as you described in PT is beneficial.

On Wednesday when I called it was “maybe PT is not having you work on strengthening your anterior tibialis and peroneal muscles. OR your not doing enough PT at home”

OR you're doing too much and your body is desperately trying to heal from the trauma of surgery, but is unable due to the continual irritation of healing soft tissues etc? How about cutting yourself some slack and taking a break, give yourself the TLC you deserve for a week, or longer, as a trial, and see if you feel any better. What do you have to lose, but the pain? Pray for direction, then listen to your gut.

 

[Jockette]

OR you're doing too much and your body is desperately trying to heal from the trauma of surgery, but is unable due to the continual irritation of healing soft tissues etc?

I totally agree!

And I agree that is way too early for strengthening.

I’m so sorry that your doctor does not have more compassion. Some doctors, while excellent with their surgery skills, just don’t understand recovery, other than text book “this is how we think it should go.”

I was white knuckling the table before he was done.

Been there, done this! My PT bent my knee so far, at one week post op, I thought it would explode. (I still had stitches!) that I did this and ended up damaging my shoulder and after a shoulder X-ray, the diagnosis was acute tendinitis. So extremely painful and so unnecessary.

If it was me, I would not allow this “massage” again.
Saying no to therapy - am I allowed to?

After PT I drove to a local community park two minutes away and sat in my car a cried for a good half hour.

I’m so sorry. Maybe you should consider a different PT office with a more up to date protocol, or, stop going for a while to let your body relax and heal. You can always go back when you have healed more, and/or if you want to. By now you should know what PT type things you find helpful and you can do them on yiur own. No need to do the painful things. Just going about your regular day gives your healing knee all the mobility it needs. I call this Natural PT.

 

[sistersinhim]

Painful PT = bad PT for the majority of joint replacement patients. I did no PT, just natural PT doing my daily activities around the house and taking care of my needs. If you find an up-to-date therapist that knows how to rehab a joint replacement, you will be so much better!

 

[KJ24]

OR you're doing too much and your body is desperately trying to heal from the trauma of surgery, but is unable due to the continual irritation of healing soft tissues etc?

I totally agree!

And I agree that is way too early for strengthening.

I’m so sorry that your doctor does not have more compassion. Some doctors, while excellent with their surgery skills, just don’t understand recovery, other than text book “this is how we think it should go.”

I was white knuckling the table before he was done.

Been there, done this! My PT bent my knee so far, at one week post op, I thought it would explode. (I still had stitches!) that I did this and ended up damaging my shoulder and after a shoulder X-ray, the diagnosis was acute tendinitis. So extremely painful and so unnecessary.

If it was me, I would not allow this “massage” again.
Saying no to therapy - am I allowed to?

After PT I drove to a local community park two minutes away and sat in my car a cried for a good half hour.

I’m so sorry. Maybe you should consider a different PT office with a more up to date protocol, or, stop going for a while to let your body relax and heal. You can always go back when you have healed more, and/or if you want to. By now you should know what PT type things you find helpful and you can do them on yiur own. No need to do the painful things. Just going about your regular day gives your healing knee all the mobility it needs. I call this Natural PT.

I love this PT center they worked with me for my other two surgeries, foot and back surgery, and did a great job. They are only doing what the doctor told them to do. PT will now only be once per week because I’m running out of visits.

 

[KJ24]

Painful PT = bad PT for the majority of joint replacement patients. I did no PT, just natural PT doing my daily activities around the house and taking care of my needs. If you find an up-to-date therapist that knows how to rehab a joint replacement, you will be so much better!

I was told by my doctor that PT had to do the fibula manipulation because the head was locked by a tight tendon. I don’t know who to believe any more. All I want is to be able to walk again without pain. I have more pain now than I did before surgery.

 

[Layla]

KJ,
I do understand your situation is unique. I am sorry for the pain you describe as worse than what you endured pre-op. It certainly isn't our intention to confuse you, but understandable that conflicting opinions are perplexing.

If you want to continue with PT can you speak to the therapist and ensure the manipulation is gradual, as you're able to tolerate? Consider asking whether there are more gentle techniques or stretching exercises before attempting the more aggressive manipulation. Ask for mini breaks during these sessions if the pain becomes overwhelming. See if there are some gentle stretches you're able to do at home to loosen the tendon.
Please be open with them about the degree of discomfort / pain you're dealing with so they're able to work with you to make the process more tolerable, while still effective.

Also, wondering if you're able to request the PT you had for the first session, expressing that you worked well together and felt she's a good match for you. If so...go for it.

Wishing you comfort and speedy relief. Keep us posted, we do care.
@KJ24

 

[KJ24]

Well last night, Friday, was painful. I over did it walking during the day. The problem was on Thursday my knee felt great. It wasn’t painful to walk and that tight band feeling was gone. It was amazing my leg get normal again. I was naive in thinking my knee was better than it was. Instead of waiting for Saturday to go shopping with my husband I decide on Friday to do it by myself. I only went to two different stores but walking around, standing in line and driving to each store put the knee over the edge. I was fine until about an hour after going to bed. I was woke up with the worse throbbing and stiffness, I thought I was back at week 1. I am slowly learning that recovery is going to take many months and not just weeks like the surgeon told me.

 

[Jockette]

It’s so easy (and deceptive) to keep going when we’re in the moment of feeling good! This recovery is definitely a balancing act. Rest up today. Don’t look at resting as doing nothing, look at it as giving your knee the best opportunity in which to heal.

I am slowly learning that recovery is going to take many months and not just weeks like the surgeon told me.

I’m so sorry your surgeon told you this. I, also, had unrealistic expectations with my surgery. I had a PKR and going by what I read beforehand, I expected to be fully recovered in about 2 months. When that didn’t happen, all kinds of visions of things going wrong went through my mind, as well as quite a bit of anger at not being better prepared for this long recovery. I don’t know what I would have done without Bonesmart to give me better guidance and support. I just wish I’d found Bonesmart before my surgery, not 4 weeks after!

 

[Layla]

Oh no KJ...I'm so sorry!
You feel like you turned a corner, then....BAM you hit a wall.
You're not naive, it's so easy to push it on days we're feeling good. You've officially joined the ODIC (Over Did It Club) Each of us seem to land there at least once in our recovery. Hopefully with lots of rest today, ice, elevation and meds as needed you're feeling a little better tonight.

Check out this article from the Recovery Guidelines, if you haven't read it yet. It's interesting.

Healing: how long does it take?

How Long Does it Take to Recover from Joint Replacement Surgery? Most patients undergoing total hip/knee replacement surgery want to know when they'll be able to return to their normal life. "Recovery time" is a common question posed to specialists and non-specialists alike. There are many...

bonesmart.org

I hope you sleep well tonight and Sunday is a better day for you!
@KJ24

 

[Layla]

Hi there...I hope you're feeling better since you last posted and you're content with the progress you're making.
Wishing you a Happy Three Month Anniversary and a very Merry Christmas!
@KJ24