Symptoms will go on their own. It just takes time. Try to be patient. As @sistersinhim likes to say, your body knows how to heal without anyone telling it to. Trust it’s process.
MUA Sleeping on my side, 5 weeks post TKR
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Symptoms will go on their own. It just takes time. Try to be patient. As @sistersinhim likes to say, your body knows how to heal without anyone telling it to. Trust it’s process.
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Happy New Year, Andypandy!
I experienced some bruising 2.5 weeks post surgery also. It should slowly ease and your best bet is to keep up with the ice and elevation, several times per day to reduce the swelling. Elevate your leg whenever you're resting to encourage fluid drainage.
It is our lymph system that rids the body of fluid (swelling). So you want to get the fluid to the lymph nodes in your torso area so your body can more quickly process it. The lymph system works rather slowly on its own and much more efficiently with the assistance of gravity. The fluid isn’t draining into the hips, but contained with the lymph system and moving to the torso and lymph nodes located there.
Avoid over exerting when you're exercising, gradually improving your ROM without forcing the joint.
Have a great holiday! I don't know about you, but I can't remember what day of the week it is these days with the holidays upon us.
@Andypandy
I experienced some bruising 2.5 weeks post surgery also. It should slowly ease and your best bet is to keep up with the ice and elevation, several times per day to reduce the swelling. Elevate your leg whenever you're resting to encourage fluid drainage.
It is our lymph system that rids the body of fluid (swelling). So you want to get the fluid to the lymph nodes in your torso area so your body can more quickly process it. The lymph system works rather slowly on its own and much more efficiently with the assistance of gravity. The fluid isn’t draining into the hips, but contained with the lymph system and moving to the torso and lymph nodes located there.
Avoid over exerting when you're exercising, gradually improving your ROM without forcing the joint.
Have a great holiday! I don't know about you, but I can't remember what day of the week it is these days with the holidays upon us.
@Andypandy
Andypandy
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You're welcome!
You're right, every day is feeling like Sunday. I think it will take until Monday to feel back on track again, lol.
It's so easy to question our recovery, just know that most of these odd occurrences and sensations will ease over time. At 23 days, you're still early into the healing process, in the entire scheme of things. It takes patience, but I think you'll do just fine.
@Andypandy
You're right, every day is feeling like Sunday. I think it will take until Monday to feel back on track again, lol.
It's so easy to question our recovery, just know that most of these odd occurrences and sensations will ease over time. At 23 days, you're still early into the healing process, in the entire scheme of things. It takes patience, but I think you'll do just fine.
@Andypandy
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Me again, head playing up. Tomorrow will be 4 weeks RTKR , surgery was 9th December 2024. Still swelling preventing me not getting to far with heel slides. Flat leg extension no problem, still having trouble lifting leg. Icing, elevating, walking around apartment regularly, both crutches. Doing little bits, but after reading on others progression at 4 weeks, am I doing anything wrong. I know the swelling is preventing so much for progression and again I just end up in a heap as I seem at stalemate. Seeing PT on Tuesday. So grateful for advice. X
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Time will tell. Looks to me that you're doing it right. Movement and stretches but without pain. Swelling will decline.
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I wonder if - in addition to swelling - your quads aren't yet activating fully and in coordination across all the little muscle bundles that make up a muscle. That could also contribute to trouble lifting your leg.
First I want to reassure you that the "normal" timeline is pretty broad and you're not experiencing an unusually slow recovery (some of us were unusually fast in range of motion because of living with overall joint laxity, which carries a high risk of routine injury so I don't wish it on anyone!)
Are you doing quad sets?
(That's where you can be in bed or recliner or sitting up as long as your leg is out in front of you, the degree of elevation and bend doesn't matter. You contract your quads and hold for a couple of seconds.)
Most people find quad sets, easily done while icing and elevating, don't cause pain. I just randomly did a bunch of them while resting - usually just before getting up for my hourly walk.
You can assist the quads to fire more effectively by touching a portion of the muscle with your fingertips while doing quad sets. This fingertip technique gets the nerves and the muscle fibers to better communicate (and works with any muscle that needs activating).
So you can target, say, your outer lower thigh for six or eight contractions. Next time, target the inner lower thigh. I found that on each new knee it was quickly obvious where things felt weaker, so that's where I would start to focus more of the quad sets.
They shouldn't hurt. They need not be done a whole lot. They may be very helpful.
First I want to reassure you that the "normal" timeline is pretty broad and you're not experiencing an unusually slow recovery (some of us were unusually fast in range of motion because of living with overall joint laxity, which carries a high risk of routine injury so I don't wish it on anyone!)
Are you doing quad sets?
(That's where you can be in bed or recliner or sitting up as long as your leg is out in front of you, the degree of elevation and bend doesn't matter. You contract your quads and hold for a couple of seconds.)
Most people find quad sets, easily done while icing and elevating, don't cause pain. I just randomly did a bunch of them while resting - usually just before getting up for my hourly walk.
You can assist the quads to fire more effectively by touching a portion of the muscle with your fingertips while doing quad sets. This fingertip technique gets the nerves and the muscle fibers to better communicate (and works with any muscle that needs activating).
So you can target, say, your outer lower thigh for six or eight contractions. Next time, target the inner lower thigh. I found that on each new knee it was quickly obvious where things felt weaker, so that's where I would start to focus more of the quad sets.
They shouldn't hurt. They need not be done a whole lot. They may be very helpful.
Andypandy
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@Andypandy
I wish it were possible, but I can't give you or anyone a "one size fits all" answer to how often/how many.
At your stage, I likely had eight separate times per day in my "nest" - for me, the recliner with ice machine on - interrupted by walks, toileting, a brief visit to the kitchen etc. During each of those resting periods of 45 - 60 minutes each I did quad sets once or twice.
How many repetitions each time? Not many. I probably started with six. Once I knew I was tolerating them fine I increased. I never tried to hold the contraction more than 2 seconds - it's not to build strength at this point, it's to wake up the quads! - and after doing two or three general ones then I'd target an area with my fingertips.
Spreading out any of these movements into fewer reps at a time across the day helps keep the healing going!
I wish it were possible, but I can't give you or anyone a "one size fits all" answer to how often/how many.
At your stage, I likely had eight separate times per day in my "nest" - for me, the recliner with ice machine on - interrupted by walks, toileting, a brief visit to the kitchen etc. During each of those resting periods of 45 - 60 minutes each I did quad sets once or twice.
How many repetitions each time? Not many. I probably started with six. Once I knew I was tolerating them fine I increased. I never tried to hold the contraction more than 2 seconds - it's not to build strength at this point, it's to wake up the quads! - and after doing two or three general ones then I'd target an area with my fingertips.
Spreading out any of these movements into fewer reps at a time across the day helps keep the healing going!
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Andypandy
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On a downer this morning, Apologies. 4 weeks 2 days RTKR. Iced during the night 3 times, took a codeine at 03.30am as quite painful, managed couple hours sleep, but this morning really swollen and ankle. So good old brain is asking why! and I feel so despondent, can't see how I can manage exercises today, am I going backwards. Didn't do too much yesterday, but a little more than usual, only silly things, folded some throws, made cup of tea, up and about for 10 minute walks around apartment every couple of hours. Anyway, icing, elevating but my question is, should I try and push through this to exercise or just rest. Seeing physio Friday. Thank you, so appreciate your help.
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I would go easy if you feel really rough and elevate more to help swelling.
It's really hard to know what is normal when it comes to swelling- as everyone differs and some of us have poorer circulation/ lymphatic system and a greater tendency to swell post surgery.
Have you tried taking photos/ measuring to monitor if it is gradually getting better?
That way you will feel more positive if you see some progress, however small.
Also you can show this to your PT or doctor if you are still concerned.
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@EalingGran thank you, good idea to measure, will do. Also, is it advisable to elevate when not icing? Can you elevate continually or have breaks. Many thanks.
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I would elevate my leg when watching TV in the evenings. I have a lovely rocking stool which was left over from my daughter nursing my grandson. I found this really helpful for both gentle movement and elevation. You might find something similar cheaply on Ebay.
I’m sorry you’re hurting so much right now, I know these 4 weeks can feel like an eternity.
Pushing through will just make the swelling worse. Rest, ice and elevate. General movement is good for recovery but a list of exercises is not necessary. What is necessary is listening to our body and respecting it and giving it the time it needs to heal.
Apparently 10 minute walks are too much for you at this point, and that’s ok. You are healing from a very trauma inducing surgery.
I elevated any time I was not standing, it was several months, before I could sit comfortably with my feet on the floor. When I was sleeping, the elevation level was toes above the nose, I had a wonderful foam wedge the hospital sent home with me. (Whatever they charged me or my insurance, it was worth every penny!) If I was not in bed, and sitting on the couch, my feet were on an ottoman. (where they are right now as I type this!)
Andypandy
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@Jockette many, many thanks. It's so hard to determine what's right and what's wrong, but our bodies are the one's we should listen to. This is definitely 1 step forward, hundreds back. That was the other question I meant to ask: should we elevate during the night, even if not using ice. So far I have been careful and swelling/stiffness gone down a little. Managed a couple of heel slides, quad set. As the saying goes, I want to run before I can walk. Hard to get your head round that this is a marathon. I so appreciate your kind advice, don't know where many of us would be without you all. X
I seriously don’t understand why we are given so many exercises to do, with the impression if we don’t do them, we’ll never recover. This is so not true! Yes, movement is good, but it seems rehab has gone way past that to an extreme.
Example: Boys will be boys, and while two of my grandsons were playing last summer, the not quite 3 year old fell, twisting his leg, and broke it. He was in a cast for 6 weeks. (and what a trooper he was, he learned ways to get around even though he couldn’t stand on it because the cast had a bend to for 4 weeks, then he got a waking cast for the last 2 weeks.) Anyway, the cast came off and he slowly got back to normal. And guess what, no PT. He did what he could, as he could and he recovered wonderfully. If a 2 year old can use common sense to recover, certainly we as adults after TKR can do the same, without a list of exercises that would probably stress a body that didn’t just have major surgery that caused a lot of trauma to the area.
Truly, gentle bends and short walks are all you need while you are swollen and in so much pain. The swelling and pain will lessen over time, and gradually you’ll be able to do more.
Example: Boys will be boys, and while two of my grandsons were playing last summer, the not quite 3 year old fell, twisting his leg, and broke it. He was in a cast for 6 weeks. (and what a trooper he was, he learned ways to get around even though he couldn’t stand on it because the cast had a bend to for 4 weeks, then he got a waking cast for the last 2 weeks.) Anyway, the cast came off and he slowly got back to normal. And guess what, no PT. He did what he could, as he could and he recovered wonderfully. If a 2 year old can use common sense to recover, certainly we as adults after TKR can do the same, without a list of exercises that would probably stress a body that didn’t just have major surgery that caused a lot of trauma to the area.
Truly, gentle bends and short walks are all you need while you are swollen and in so much pain. The swelling and pain will lessen over time, and gradually you’ll be able to do more.
If you think about it, a TKR is much worse than a broken leg. Two bones are sawed off and is much more traumatic than a broken bone. Those sawed off bones have to heal, not to mention all the soft tissues involved in this surgery. Aggressive PT earlier than about 5-6 months does more harm than good.
Jockette, I'm glad your grandson's healing went well.
Jockette, I'm glad your grandson's healing went well.
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I am sorry you're having a rough time of it AndyPandy. It's good you're able to ice during the night when you're in pain. I don't think you should try to push through the exercises if it's causing more than mild discomfort.
You can certainly elevate when you're not icing, but the combination if icing / elevation is better when you're able to do both. Elevation is important because It is our lymph system that rids the body of fluid (swelling). So you want to get the fluid to the lymph nodes in your torso area so your body can more quickly process it. The lymph system works rather slowly on its own and much more efficiently with the assistance of gravity. The fluid isn’t draining into the hips, but contained with the lymph system and moving to the torso and lymph nodes located there. So elevate as often as you're able while lying down or sitting.
It is difficult for me to compare the recovery of a young child with a broken leg to that of an adult who's flesh was cut, along with soft tissue such as muscles, tendons and ligaments being disturbed. After which a prosthetic was inserted into the bone. It's typical for us as adults to to experience fear of re-injury, have concerns about not healing properly, or wonder why our recovery is lagging on. This is normal. A child on the other hand heals much more quickly. Kids naturally adapt to physical limitations quickly, and in most cases have experienced less trauma in life, so aren't as fearful, and are less likely to have the anxiety involved in movement that as adults we question. They don't worry about dislocation as many of us do in our recovery. As adults many of us need guidance in how to retrain muscles, exercises to improve our ROM and also to rebuild strength. Then there's adjustments in gait as it once again changes post TKR.
You need a healthy balance in finding the right PT. Therapy that's too aggressive can cause extra stress on the newly operated knee, leading to swelling, inflammation and pain. Gentle PT will focus on controlled movements that aid in circulation and soft tissue healing without overloading the joint. Stretching and low impact exercises should help restore ROM without triggering pain. A more gentle approach will encourage you, help you remain consistent and build confidence in the new joint and its capability along the way.
Each recovery is unique and while the philosophy we share here successfully works for many, there will be exceptions. Between the recommendations found here, your surgeon's recovery protocol and any physical therapy you may engage in, the key is to find what works best for you.
At not quite one month post op you are in a place common to experiencing post op blues. Please know that you're not alone, this is temporary and it will get better. Hugs Andypandy
@Andypandy
It's good you're able to ice during the night when you're in pain. I don't think you should try to push through the exercises if it's causing more than mild discomfort.You can certainly elevate when you're not icing, but the combination if icing / elevation is better when you're able to do both. Elevation is important because It is our lymph system that rids the body of fluid (swelling). So you want to get the fluid to the lymph nodes in your torso area so your body can more quickly process it. The lymph system works rather slowly on its own and much more efficiently with the assistance of gravity. The fluid isn’t draining into the hips, but contained with the lymph system and moving to the torso and lymph nodes located there. So elevate as often as you're able while lying down or sitting.
It is difficult for me to compare the recovery of a young child with a broken leg to that of an adult who's flesh was cut, along with soft tissue such as muscles, tendons and ligaments being disturbed. After which a prosthetic was inserted into the bone. It's typical for us as adults to to experience fear of re-injury, have concerns about not healing properly, or wonder why our recovery is lagging on. This is normal. A child on the other hand heals much more quickly. Kids naturally adapt to physical limitations quickly, and in most cases have experienced less trauma in life, so aren't as fearful, and are less likely to have the anxiety involved in movement that as adults we question. They don't worry about dislocation as many of us do in our recovery. As adults many of us need guidance in how to retrain muscles, exercises to improve our ROM and also to rebuild strength. Then there's adjustments in gait as it once again changes post TKR.
You need a healthy balance in finding the right PT. Therapy that's too aggressive can cause extra stress on the newly operated knee, leading to swelling, inflammation and pain. Gentle PT will focus on controlled movements that aid in circulation and soft tissue healing without overloading the joint. Stretching and low impact exercises should help restore ROM without triggering pain. A more gentle approach will encourage you, help you remain consistent and build confidence in the new joint and its capability along the way.
Each recovery is unique and while the philosophy we share here successfully works for many, there will be exceptions. Between the recommendations found here, your surgeon's recovery protocol and any physical therapy you may engage in, the key is to find what works best for you.
At not quite one month post op you are in a place common to experiencing post op blues. Please know that you're not alone, this is temporary and it will get better. Hugs Andypandy
@Andypandy
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Week 1
Walks around your home - trips to the bathroom and kitchen count
Be up on your feet several times a day, without getting obsessive about it
A 5-6 minute walk every 3-4 hours is plenty
Spend most of your time resting, icing and elevating
Week 2 - add this to previous instructions in Week 1
Walks around your home 3-4 times a day for about 5 minutes without getting into pain, or too fatigued.
Week 3 - add to all the previous
Lengthen the walks to about 5-10 minutes
Activity Suggestion: Prepare yourself a small meal or a snack
You are here -> Weeks 4 and 5 - add to all the previous
Increase walks to outdoors weather / conditions permitting. Aim for 20 minutes, or longer if you feel up to it.
Ten minutes in one direction, then turn around and head back.
Keep in mind that this is only a rough gauge. Some excel, some lag behind and both are okay!
I hope you have a pleasant rest of the week!
Walks around your home - trips to the bathroom and kitchen count
Be up on your feet several times a day, without getting obsessive about it
A 5-6 minute walk every 3-4 hours is plenty
Spend most of your time resting, icing and elevating
Week 2 - add this to previous instructions in Week 1
Walks around your home 3-4 times a day for about 5 minutes without getting into pain, or too fatigued.
Week 3 - add to all the previous
Lengthen the walks to about 5-10 minutes
Activity Suggestion: Prepare yourself a small meal or a snack
You are here -> Weeks 4 and 5 - add to all the previous
Increase walks to outdoors weather / conditions permitting. Aim for 20 minutes, or longer if you feel up to it.
Ten minutes in one direction, then turn around and head back.
Keep in mind that this is only a rough gauge. Some excel, some lag behind and both are okay!
I hope you have a pleasant rest of the week!
