TKR Sher101 TKR Recovery 4/16/2

[Jockette]

Great update! And, title changed.

 

[Layla]

Love your last update, 101. You're doing so well! Wonderful news.
Happy Two Month Anniversary! I hope you have a great week!
@101

 

[101]

Hi @Layla. Thanks for your well wishes. I'm doing quite well, icing (found a lovely, inexpensive ice wrap to use sitting at my computer so not to be chained to the machine.) And I'm walking. Sunday I walked 40 minutes with my partner along the bay. It was lovely. May have been too far though, so pulling back a bit today.Yesterday I drove myself to a birthday party and didn't wear yoga pants for the first time in 2 months. Sort of a normalizing experience.

I have a few questions for you and other smarties.

1. 3 weeks ago I could go downstairs without pain. Now that I'm off painkillers except for ibuprofen and tylenol, I feel discomfort that sort puts a hitch in my step. I wonder if I'm pushing going downstairs or if it's safe for me to keep up the practice of trying.

2. I'm still taking 800 mg of ibuprofen 3xday. I worry that it is too much for my digestive system and kidneys to continue to handle without damage. I would stop, but it helps with the pain. I just wonder how long others take ibuprofen.

3. This is another "Am I crazy for..." question. I planned to put my place on the market and move in August. It's a contingency situation so lots of moving parts. It will be stressful, and I will handle it alone (with movers packing). So, am I crazy for thinking I can handle this? August will be 4 months post op.

Otherwise, started with a new PT who gave me the same exercises my old PT gave me. So much for that. When I tell people I am doing PT on my own, they proselytize without being called upon and preach the sanctity of PT, telling me I'll only get better if I follow PT instructions vigorously. So I guess I just keep my mouth shut?

sherry

 

[EalingGran]

And I'm walking. Sunday I walked 40 minutes with my partner along the bay. It was lovely.

That's great progress. I too found walking the best exercise. Seemed to suit my body without flaring up my knee so long as I iced afterwards.

When I tell people I am doing PT on my own, they proselytize without being called upon and preach the sanctity of PT, telling me I'll only get better if I follow PT

I never had formal PT apart from a couple of sessions in the hospital and I have really great ROM ( 150 plus flexion and zero extension).
I just followed some of the exercise book I was given and had private pilates lessons with my great teacher. I was never pushed to pain. Pain tightens everything and makes swelling worse.
If you are interested my teacher has loads of free pilates videos on YouTube. Google Katja pilates and they come up. There is a side lying glute strengthening one for post injury which has no squats. It was my main exercise routine after about 2-3 months - once I could get up and down easily.

 

[101]

@EalingGran Thanks for the recommendation regarding pilates. I will look for the exercise you mentioned as I am able to get on the floor.

 

[Layla]

I wonder if I'm pushing going downstairs or if it's safe for me to keep up the practice of trying.

Just keep trying, without pushing...it will come.

When I tell people I am doing PT on my own, they proselytize without being called upon and preach the sanctity of PT, telling me I'll only get better if I follow PT instructions vigorously. So I guess I just keep my mouth shut?

Shut the unsolicited advice / opinions down by politely saying that your surgeon is happy with your progress and that's all that really matters to you.

It sounds like you're doing well. Enjoy! Thanks for the update, 101
@101

 

[101]

I'm 3 months post op as of tomorrow. I feel I am progressing well enough except for a few areas. My efforts to get on and off a chair (and toilet) are awkward--I begin to sit and have to plop the last two inches. Getting up is easier. I was told this is because the hamstrings don't have enough strength. I think the term used was eccentric strength is lacking and I need to build to sitting by using pillows and doing reps. (I got this bit of advice from an online PT who came with a free consultation when buying his measuring app). I am just wondering how other folks dealt with this. Also, my adductor is tight from knee to groin. I massage and knead it, trying to soften it to no avail. I question whether it might come into play? Oh, and finally I have tight calves, especially on the surgery side. This has been going on for years with an ankle that has many tendon/ligament injuries and a tear in my hip labrum. I am going to someone in two weeks for some body work hoping that will help. Well, I know it will as he's very good, a PT and doesn't take insurance. He does Rolfing and other forms of manipulation. I hope I'm making sense. I think what I'm saying is I'm straddling both sides of the BoneSmart fence. On the one hand, I like the idea of doing nothing but ADLs and walking, and on the other it scares me to go it alone.

 

[EalingGran]

It sounds like you are doing well and understand your body and it's muscle% tendon issues. I'm straddling both sides of the BoneSmart fence. On the one hand, I like the idea of doing nothing but ADLs and walking, and on the other it scares me to go it alone.

Nobody here says you need to go it alone or just do ADLs beyond the first few weeks. It's just about listening to your body and not being bullied by over zealous therapists into exercises that are painful and damaging.

 

[mendogal]

About the adductors: I know from experience they definitely play a part in getting up and down. In the decades I did martial arts, lots of rolling and falling, they would sometimes charleyhorse (cramp) on me. And just two days ago, I did two consecutive days of 45 minutes pruning woody shrubs in my yard - so lots of dynamic squats! - my new knees were fine but the second evening there was that remembered adductor cramp!

I am going to guess your Rolfer PT will address that and your calves.

BTW - in my experience as a body work junkie, the very best PTs are those who took it upon themselves to cross train in advanced body work (beyond basic "Swedish-Esalen). They do thorough assessments, great hands-on, and teach self-care.

 

[Layla]

Happy Three Month Anniversary!
I wish you the best with your therapy sessions. Please stay in touch, we’d love to read about your progress.
@101

 

[101]

Thanks @Layla. Will do.

@mendogal I always appreciate the advice I get from you and @EalingGran. Sense you all have been through it, I find it even more helpful.

I've just listed my property for sale with the intent of moving in September. Hope I can pull it off.

 

[101]

I just saw the PT for body work. He suggested more time on the bike to get my heart rate up and facilitate drainage (still have quite a bit of swelling). He said that and walking are all I need to do. When I told him I still ice 3 times a day, he said I should stop. Icing after physical therapy is outdated. Or icing at all because it causes rebound swelling and prevents knee bend from improving. I didn't dare ask about icing for 45 minutes or longer. I know it's been said here that icing less than 45 is the outdated thinking. I wonder why it's more up to date, that what he's reading now. Oddly, he measured my rOM at 110. This was without the usual push like other PT's want you to do. At home I measure 122-127. Anyway, not sure what to do. I really trust this guy and manual manipulation really helped--for a day anyway--until I did too much yesterday - walking 2 miles and biking 15 minutes no resistance. Oddly my knee is OK. It's my low back, sacrum and glutei that have be groaning today. So help please. Ice/no ice/ice longer less often? BTW, swelling runs in the family. It certainly does in my body.

The good new is I've given up my toilet seat riser though I have to think very hard about what I'm doing in order to sit down smoothly. Up is no problem.

 

[mendogal]

My understanding is: it's icing 20 minutes or less that creates rebound swelling. 45 minutes doesn't and it also is potent pain relief. Anyhow, do try it and if it doesn't work for you, there you go!

Yes! no resistance biking was great for reducing swelling after my ACL graft surgery. Sadly, with my replacements the swelling interfered with my ability to do revolutions. Go for it!

Generally at your stage I wouldn't do a two mile walk the same day as PT and biking 15 minutes. Alternating days, doing considerably less biking if you walk 2 miles and vice versa may yield less swelling and less pain in back, sacrum, glutes.

 

[101]

Thanks @mendogal for your always speedy response. It's so reassuring to know I can come here for an answer when anxiety ratchets up.

 

[benne68]

When I told him I still ice 3 times a day, he said I should stop. Icing after physical therapy is outdated. Or icing at all because it causes rebound swelling and prevents knee bend from improving

I believe the research he is referencing involved patients recovering from injury -- like a sprain or a strain -- and not from surgery. Unfortunately, it seems a lot of PTs are misintepreting that and applying it universally.

I agree with mendogal that you are probably overdoing the exercise and that alternating days of activity might help.

Try to be patient. You are barely 1/3 of the way through this year-long recovery. It will get better with time.

 

[EalingGran]

I iced 3 times a day for months ( about 7 months) because I found it soothing and helped me sleep.
I now have a fully functional knee that does everything I need to do (walk 10-15,000 steps per day/ look after a three year old/climb lots of stairs)

 

[101]

I iced 3 times a day for months ( about 7 months) because I found it soothing and helped me sleep.

This makes me feel better! I think I'll ice right now. Thanks @EalingGran

Try to be patient. You are barely 1/3 of the way through this year-long recovery. It will get better with time.

@benne68 Thanks for the reminder. My partner is 5 weeks into his own knee replacement and healing. He is following PT - sort of. He feels compelled to quote his numbers to me, so it gets a bit competitive. Fortunately, we don't live together, or who knows if we'd live through it.

 

[EalingGran]

He feels compelled to quote his numbers to me, so it gets a bit competitive.

Try not to get competitive- everybody is different and it really doesn't help.
I have had a very good recovery but I got very miserable in the early weeks/ months because my daughter-in- law's father seemed to have made a much faster recovery from his PKR. Turned out his was the much commoner medial variant whereas I had the rarer and more tricky lateral partial with underlying residual ligament issues.
More recently I went back to a group yoga class and overdid some of the trickier poses because I couldn't resist pushing myself to do what others were doing.
Just listen to your own body and ignore anyone who tries to make you feel bad or do stuff that doesn't feel good.

 

[101]

The following is from @hammertown. I'm pasting it here so I can find it for my reference: I continue to make progress on TKR and I go to physical therapy 2 times a week. In addition to the home stretching exercises every day, I elevate and ice my knee every day. Last week, I was stuck at 109 degrees of flexion.

I went to see my surgeon and he felt my quad muscle was too tight and it was preventing me from getting higher flexion. He instructed me to sit in a chair at home, do a heel slide getting my foot as far back as possible. Then holding my foot in place, slide forward in the chair and massage my quad for 30 seconds. I was told to do these heel slides (10) times.

I used a massage gun on my quad to loosen it up during the heel slides. I went to PT today and my flexion was 120 so the heel slide with a quad massage seems to have improved my flexion. I finally feel like I turned the corner on my TKR. I no longer need a cane and I only take Tylenol when needed.

 

[sistersinhim]

I'm so glad you found something that worked for you. That's the key...something that works for each one of us. This is not a 'cookie-cutter' recovery. It's different from each one of us.