TKR Seven years out, Right TKR

[sistersinhim]

@julesm86, I did NO pt! I would sue anyone who did that to my knee! Your knee has been abused and is swollen, which is making it so tight you can't bend it. So many of us have told you and others that you don't have to go to pt. You will rehab your knee just by living and doing normal things. In the beginning days I did my heels pumps and slides and took care of my cats and myself. That's all. No exercises at all, but just normal living. After about 6 weeks I started rocking by and forth on my recumbent bike. It took probably a week or so before I could do a backward revolution. I did the backward for at least a week before I could do a forward revolution. I'm 3 months out now and do all my normal home and yard duties. I haven't tried riding my outside bike yet, but that will come soon! My suggestion to you is to quit pt and all your exercises. Just live your life. You have to get that swelling down and the only way to do that is to rest it and let it heal.

 

[Celle]

@julesm86
I'm sorry you are still having problems with your knee. Quite honestly, I think you've become trapped into thinking that you need to do lots of exercise, in order to rehab your knee. You don't. Too much exercise can irritate and inflame your healing tissues, which will delay your recovery.
This really is a case where "Less is more" - Less work = More progress.
TKR: work “smarter” and not “harder”
Knee recovery - Lose the Work Ethic!!
Life in the slow lane

It isn't exercise that helps your knee to improve. It's time, healing, and the reduction of swelling.
I did no exercise at all after my latest TKR, and it is perfect.

Yes, ask your surgeon for written confirmation that you need more time off work - and don't let your boss bully or "guilt" you into going back sooner.

I'm going to ask @Josephine to advise you. Please try to answer her questions as fully as possible, so that she can advise you appropriately.

 

[KarriB]

Using the strap to pull your knee back sounds like 18th century torture. Please don't allow anyone to hurt you like this again. Your knee needs to heal from a surgery, not rehab from a sports injury. There is nothing you can do to speed up this recovery process, but you can slow it down. You are only 7 weeks out of surgery, I'm including the activity progression chart so you can see what is acceptable for this point. Try reading @Floridagal , @uva55 , or @sistersinhim threads to see how they recovered. It wasn't easy for them, but they kept their pt non-aggressive which allowed their knees to heel.

https://bonesmart.org/forum/threads/activity-progression-for-tkrs.14334/

 

[Josephine]

Your story at 12 weeks is little short of ghastly! So I'm going to ask you some questions if you don't mind, and it would be very helpful if you would answer each one individually - numbered as I have done - in as much detail as you can then I'll come back as see where you are ....

1. what are your pain levels right now, including other forms of pain such as soreness, burning, stabbing, throbbing, aching, swelling and stiffness? (remember the 1-10 scale: 1 = no pain and 10 = the worst you can imagine)

2. what pain medications have you been prescribed, how much are you taking (in mg please) and how often?

3. how swollen is your leg compared to these?

4. What is your ROM - that's flexion (bend) and extension (straightness)

5. are you icing your knee at all? If so, how often and for how long?

6. are you elevating your leg? If so, how often and for how long?

7. what is your activity level? What do you do in the way of housework, cooking, cleaning, shopping, etc.

8. what kind of PT exercises and exercises at home are you doing? How much and how often?
This is the most crucial question so please help me by using the format I have left as an example
(which means please make a list and not an essay!)

Exercises done at home: (how many sessions each day)
enter exercise then enter number of reps and sets
etc., etc.

At PT (how many times a week)
enter exercise then enter number of reps and sets
etc., etc.

 

[uva55]

Definitely in the case of TKR recovery PT, less is more, the kinder you treat your knee the quicker your swelling will go down and you will be able to see your ROM come back, gentle exercises only. We are so brainwashed that no pain no gain is the only way, that it's hard to believe it's not always true,. Let your knee be your guide, she knows best right now!!

Good luck!!

 

[julesm86]

1. Pain usually 2-4
2. Tramadol 25mg 1q4hrs' +\- with 500mg Tylenol, oxycodone 5mg 1q4hrs +\- with 500mg Tylenol : for the past couple of weeks I've averaged 1Tram with 1 Tylenol twice a day & I oxy @ bedtime or after PT.
3. Moderate swelling
4. ROM 100/0
5. & 6. Icing & elevating about twice a day for 45min to an hour each, sometimes sleeping with the elevated with the ice machine.
7. Doing dishes, cooking, laundry, mopping & vacuuming, kitty litter, grocery shopping
8. Recumbent bike 10 min twice a day, stair climbing at least once a day, walking outside for 20 min, rocking back & forth on exercise bike (not made it around yet)
go to PT twice a week: 20 min in the hydro track (treadmill in a water tank): 10-15 min walking,
then leg lifts, squats, kicking up leg in back for the bend. Then 20 min in X10 machine.

Thanks Josephine! Thanks also to all of you for your encouragement & advice!

 

[Josephine]

1. Pain usually 2-4

Okay

2. Tramadol 25mg 1q4hrs' +\- with 500mg Tylenol, oxycodone 5mg 1q4hrs +\- with 500mg Tylenol : for the past couple of weeks I've averaged 1Tram with 1 Tylenol twice a day & I oxy @ bedtime or after PT.

To start with, what does this mean "1q4hrs'" because I don't understand it.
And you don't say at what times you are taking these?

I can see you are taking 1 Tramadol (is that 25mgs?) with 500mg Tylenol which is a very dose. Tylenol's effective dose is 1,000mg and it is rather pointless risking the side effects but not getting any of the benefits.
In short, you are under medicated.

3. Moderate swelling

I would imagine so

4. ROM 100/0

Well, okay but not fantastic.

5. & 6. Icing & elevating about twice a day for 45min to an hour each, sometimes sleeping with the elevated with the ice machine.

Twice a day for 45mins? That's not enough. I always recommend to ice and elevate for at least 40-60mins and more than 4 times a day.

7. Doing dishes, cooking, laundry, mopping & vacuuming, kitty litter, grocery shopping

okay but try to spin it out over days and the week. For instance, Do vacuuming one day, mopping another, shopping another,

Your exercises (guess you missed the bit about making a list, huh?!)
Recumbent bike 10 min twice a day
stair climbing at least once a day
walking outside for 20 min
rocking back & forth on exercise bike (not made it around yet)

go to PT twice a week:
20 min in the hydro track (treadmill in a water tank):
10-15 min walking,
leg lifts
squats
kicking up leg in back for the bend
20 min in X10 machine

I can't answer these yet because you never answered the question fully.
It should have included "number of reps and sets"
Give me that information and I can give you an opinion!

 

[julesm86]

Sorry for the incomplete answers
2. Tramadol 50mg with 500mg Tylenol ~ when I get up I take it, then every 5 hours I take that unless I take the oxy 5mg with 500mg Tylenol for PT or at bedtime. I don't get up to take meds in the night.
8. For exercise:
at home no reps or set for what I do
PT twice a week:
10-15 min walk on treadmill in water,
2 sets of 20 for the leg lifts, squats & kick backs in water
20 min on X10 machine

 

[Josephine]

2. Tramadol 50mg with 500mg Tylenol. When I get up I take it, then every 5 hours I take that unless I take the oxy 5mg with 500mg Tylenol for PT or at bedtime. I don't get up to take meds in the night.

Okay

at home no reps or set for what I do

But what DO you do?

PT twice a week:
walk on treadmill in water 10-15 min- that's okay provided it's slow
leg lifts 2 sets of 20 - 40 reps are far too much. 5 or 10 is plenty
squats 2 sets of 20 - again, 40 reps are too much - read this BoneSmart philosophy for sensible post op therapy.
kick backs in water 2 sets of 20 - yet again, 40 is too much in one session.

20 min on X10 machine - as I see this, it is a form of CPM - well, I've never been in favour of CPMs as the evidence is that they don't do what it says on the tin.

(I thought we had an article on it somewhere but can't seem to find it. Must do some research!)

 

[julesm86]

Okay~~ at home
Recumbent bike 10 min 2x/d
Up & down stairs 1x/d
20 min walk outside 1x/d
Rock back & forth on exercise bike 5 min 2x/d
I do plan on skipping PT this week & only do my home exercises along with more elevating & icing.

 

[Josephine]

Okay, I see now and thank you. You're not doing a wild amount at home but I do think what the PT is having you do is responsible for the pain of which you have complained.

 

[julesm86]

@Josephine, thank you for you patience & help

 

[julesm86]

Hello everyone I took the past week off from PT & have been icing & elevating my knee more, and I think it's helping. Saturday I was able to make it all the way around on the exercise bike!!! And I measured my bend @ 105 (not great yet, but better than 2 weeks ago). I still have issues with swelling & trouble walking normal, but hoping & praying it'll come around & my ROM will improve!!!
I do go back to work 9/21 for 4-5hrs/day~~sorta bummed that she has me coming in for the afternoons 3 days a week because the traffic after work is just horrid at that time, so my 25 min drive turns into an hour~~after being on my feet all afternoon~UGH! I'm soooo nervous & stressed about going back not being 100% & not back to normal.
I see my OS 10/5 & am anxious to see what he has to say.

 

[Bikesouth]

@julesm86 I think you will be surprised at how good it will feel to get back into a work routine. Yes it will make you swell a little & have some soreness but the activity along with getting your mind off your knee will be good.

 

[julesm86]

You're probably right, @Bikesouth ~~thanks! This whole experience has left me stressed & nervous. I tend to worry & now more than ever. Just have to take it one day at a time.

 

[KarriB]

Be sure to take a few ice packs to work so you can ice there and I also iced while driving home. I just stuck an ice pack up my pant leg and it stayed in place. You may not feel like doing much when you come home. I went back to half days at 12 weeks and spent most afternoons icing, elevating and resting (also known as checking papers). I also felt to tired to cook most evenings, so if you have some meals in the freezer that would be helpful.
Keep working on that bike a few minutes a day. Congrats on your full rotation!

 

[julesm86]

well...tomorrow is the day...I go back to work (7am to noon) ~~ very anxious, nervous, scared, etc.!!! Please keep me (& my knee) in your thots & prayers ~thanks! I did get some compression stockings from my OS, but won't wear them tomorrow~just want to see how the knee does on it's own. I have my ice packs and cane all set to go with me, oh and meds too.
Thank everyone here for all you help, encouragement, support, answers & kindness thru the past 13 weeks~you all mean a lot to me and I consider you my friends. I do pray for each of you and your recoveries and issues that come up along this journey. Thanks again!

 

[mamazipp]

Best wishes on the first day back. Hope it goes smoothly.

 

[KarriB]

Don't be surprised if you're whipped at the end of the day. Spend the afternoon resting, elevating and icing.. Have a great day! I think you'll enjoy seeing your co-workers and chatting (if there's time).

 

[sheliac]

Saying prayers for you right now.


Shelia
RTKR - 8/23/16
LTKR - 10/11/16