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TKR Seventeen days post-op

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Hi, my name is Mal. Got a TKRr on Oct 21st. Had some bad days since then. Most of the pain has come from being made to bend by the physios. I still exercise well but have cut out most of the hard bending. Now I am thinking about getting on a mountain bike soon to build my quads up. Also have gone back on co-codamol and diclophenac. That seems to have helped. Mal.
 
Mal, I am going to give you our post op reading list--but first I am going to say this: Do not let the physios hurt you---discomfort but not pain. If your surgery was on the 21st it seems a little early to get on a bike---perhaps one on a trainer? I rode my bike outside at about 6 weeks, but before that I did not have the strength to ride it.

But, do some reading and we will talk again!! Kelly

First are the mantras ....
- rest, elevate, ice and take your pain meds by the clock
- if it hurts, don't do it and don't allow anyone - especially a physiotherapist - to do it to you
- if your leg swells more or gets stiffer in the 24 hours after doing it, don't do it again
- if you won't die if it's not done, don't do it

- never stand when you can sit, never sit when you can lie down, never stay awake when you can go to sleep!

The importance of managing pain after a TKR and the pain chart
Myth busting: no pain, no gain
Swollen and stiff knee: what causes it?


Progression of activity for TKRs
How Long Does Healing Take ......
Chart representation of TKR recovery
Energy drain for TKRs
Elevating your leg to control swelling and pain

Using ice -

Knee Replacement - Where Am I in Recovery?
So What Is It Going to Take? The Five “P’s” of Knee Recovery
Work “Smarter” and not “Harder”
About recovering a knee - from one who knows!
Some suggestions for home physio (PT) and activity progress

Myth busting: The "window of opportunity"

MUA (manipulation under anaesthetic) and adhesions
It's never too late to get more ROM!
It's Worth the Wait for ROM
Myth busting: on getting addicted to pain meds


Post op blues is a reality - be prepared for it
 
Hi Mal, us Brits (and most others) are highly sceptical about trying to force the bending. All that forcing does is to cause pain, swelling and a longer recovery time, just keep up the flexing up to the point of discomfort and no more.

Be confident, progress happens quite successfully if you leave it alone, seventeen days is far too early to be worrying about progress, your knee has been badly damaged, you must expect it to take it's own time.

Most of us have tried to do too much too early and got in difficulties, that's until we all got this same advice, after which our miraculous recoveries just "happen" without incident.
 
Hi Mal, remember the principle No Pain, More Gain. The Jane Fonda thing is for training, not healing.

Speaking of training, it's inadvisable to do any fitness training until all the swelling has gone and you're pain-free. You can set yourself back attempting to train whilst still injured.
 
Hi, thanks for the advice. I am starting my physiotherapy classes next Tuesday for 5 weeks so I am trying to strengthen and loosen the knee joint in the time until then. I find doing the squat exercise but only going down till gets uncomfortable and then stop and rest. We had a soft memory foam bed that did not give enough support so have got a three inch deep topper its now really comfortable
Mal.
 
Just under three weeks removed from a TKR ---you are very, very early in the recovery pahse---in fact,many call these days the "dark days" of recovery.

Do not let anybody push you pass the point of discomfort, and you should take it easy---rest, ice, and elevate and let the knee heal.

There will be plenty of time later on for hopping on the mountain bike, but it is way too early now---you will just aggravate the surgical knee and slow down your recovery---it is best not to rush things and just let your knee be in charge (which it is!)

Please take a look at those articles that have bee poster your way---they are full of tremendous information that will help you out---not only now, but down the road throughout the recovery!

Please keep posting and let us know how you are doing and what questions or concerns that yo have.
 
I'm glad it's going well, but don't lose sight of the fact that the knee is stiff, not from lack of use, but from swelling. So get the swelling down by being gentle with it (ie gentle exercises only) and as sure as eggs is eggs, the bend will just reappear without you trying. It takes weeks or months to maximise, mine's still improving after years!

How many degrees does it bend already? If it's 90 or over, you are doing great, and don't listen to anyone who tries to push you to reach targets. British physiotherapists very rarely do, but if they do, sack 'em, because they are as much use as a chocolate teapot!!
 
earlybirds13 said:
I am starting my physiotherapy classes next Tuesday for 5 weeks so I am trying to strengthen and loosen the knee joint in the time until then.
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Please remember this - your muscles aren't weak they are injured. They don't need 'strengthening' they need rest and to be treated gently so they can heal.
earlybirds13 said:
I fine doing the squat exercise
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In light I what I just said, it's far too early to be doing squats. Leave it till around week 7.

Also, you never answered my question about have you read the articles? You've now been left them twice, once by me and again by skigirl. Have you read them yet?
 
Hi 4wks on monday since tkr just been out dog walking , i am elated, about a mile no pain ,but still elevated and iced and pain relief as soon as i got back ,just need to straighten my knee now but not neen straight for 43 ,years but soon will be,mal in sussex.

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earlybirds13 said:
Hi 4wks on monday since tkr just been out dog walking , i am elated, about a mile no pain
Click to expand...
Be careful---four weeks seems like a long time, but it is still early yet---be careful to not overdo things---too much too soon. It is great that you are not in pain, but remember that your knees need a ot of time to heal, so try not to be tempted to go too far.
 
Agreed!! Don't overdo and if you do just rest and ice and elevate.
Sounds like you are doing great!
Well done!


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referee54 said:
I speak from, well, er um, experience. I had a rather lengthy learning curve when it came to overdoing things.
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thanks for all your help over the last month , it has been roller coaster now i am getting more ups than downs , i dont know if it is usual at 4 wks post opp my leg seems to belong to me all at once , i am going to physio tues am , last wk the physio put nearly all his weight on my knee to straighten it is that ok , it has been bent for 43 years , i want it straight but the pain was eye watering
 
To me that sounds really quite a risky thing for a PT to do. My physio was very gentle, he did very gentle stretching to improve ROM, my exercises were always very gentle. I did only very basic exercises for 6 weeks....heel slides, leg lifts, pressing my knee down gently, foot pumps and so on. I'm 5 1/2 months out of TKR and because of another issue, do very little exercise now but have a good ROM.
In this, the tortoise usually seems to do better than the hare.
 
earlybirds13 said:
last wk the physio put nearly all his weight on my knee to straighten it is that ok , it has been bent for 43 years , i want it straight but the pain was eye watering
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Don't do it. See my exercises thread from the sig for some simple extension exercises, one with a partner probably the way your PT did it. But do it right, little and often and no pain.

43 years FGS; it's going to take a while.
 
that is what i thought even though he hurt me at the time it was ok later, will concentrate on the static bike , one thing i do to straighten my leg is when i have got my foot on the chair i put the ice bags over the knee and put a 2 kilos hand weight on the ice works well.
 
earlybirds13 said:
it has been roller coaster now i am getting more ups than downs , i dont know if it is usual at 4 wks post opp my leg seems to belong to me all at once
Click to expand...
That is great news! I am happy to read that your ups are coming at a better rate now!

earlybirds13 said:
last wk the physio put nearly all his weight on my knee to straighten it is that ok , it has been bent for 43 years , i want it straight but the pain was eye watering
Click to expand...
Never let this happen again! Never confuse pain with progress! Take your PT to the point of discomfort and no further. The more pain you are in, the slower the progress you will get.
 
I agree. Pain does not equal progress. To the contrary you can surely set yourself back!!!


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Hi @earlybirds13 I have just had a revision done two weeks ago. It's made a massive difference to me already. I was unable to straighten my leg, it was permanently bent. No end of private physio, exercising, strengthening worked. In the end I got referred back to the surgeon. Best thing that could have happened.

The MUA (manipulation under anaesthetic) will hopefully do the trick for you. That was never an option for me. My knee was swollen and so painful I was on high doses of morphine xxx

So good luck with that. Please post the date you are going in for this and we will all be thinking of you.

Kindest regards
Nana moon 27 xxxx
 
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