TKR Slow recovery from TKR

[Jamie]

@Westiemom…..so glad you chose to join the Insiders Club. You can now ask any questions you like here in your recovery thread.

Let me first reassure you that you’re well within normal for recovery. Three months is just the beginning of what can take a year or more until you feel normal again. Please try not to compare yourself with anyone else’s TKR. Our bodies are all different. You may have had more damage to your knee than your friend. Perhaps you had an altered gait because of damage. Maybe the surgeon spent more time to make sure he got things perfectly balanced with your knee. My point is, there are a bazillion possible reasons why one person heals differently than another. Your body is 100% in charge of this process. I suggest you read the POST OP CARE links so you understand what all is involved in recovery. Click on the link at the top of the page to find this information.

Also, Now that you’re an Insider, you have access to the hundreds of articles in our BoneSmart Library. We have these short beginning articles to get you started, but you can find more under the LIBRARY link at the top of the page.

Knee Recovery: The Guidelines
(Administrative Note: For those reading this thread, please be aware that these links are a premium service and only available to Insiders Club Members).

1. Don’t worry: Your body will heal all by itself. Relax, let it, don't try and hurry it, don’t worry about any symptoms now, they are almost certainly temporary
2. Control discomfort:

​

rest​

elevate​

ice​

take your pain meds by prescription schedule (not when pain starts!)​

don't overwork.​

3. Do what you want to do BUT

​

a. If it hurts, don't do it and don't allow anyone - especially a physical therapist - to do it to you​

b. If your leg swells more or gets stiffer in the 24 hours after doing it, don't do it again.​

4. PT or exercise can be useful BUT take note of these

​

the BoneSmart view on exercise​

BoneSmart philosophy for sensible post op therapy​

5. At week 4 and after you should follow this

​

Activity progression for TKRs​

6. Access to these pages on the website

​

Oral And Intravenous Pain Medications​

Wound Closure​

The Recovery articles:
The importance of managing pain after a TKR and the pain chart
Swollen and stiff knee: what causes it?

Energy drain for TKRs
Elevation is the key

Ice to control pain and swelling
Heel slides and how to do them properly

Chart representation of TKR recovery
Healing: how long does it take?

Post op blues is a reality - be prepared for it
Sleep deprivation is pretty much inevitable - but what causes it?

There are also some cautionary articles here
Myth busting: no pain, no gain
Myth busting: the "window of opportunity" in TKR
Myth busting: on getting addicted to pain meds


Your extension is great, so pat yourself on the back for this. Extension is usually the most difficult part of Range of Motion (ROM) to achieve. The fact that you’re somewhat limited in bending is most likely a fact of internal swelling. The knee compartment is very compact and it doesn’t take much fluid to cause pain or reduced movement. Once the swelling goes down, you’ll start to see improvements. This is not something you do more to achieve. Be sure you’re giving yourself adequate rest, ice, elevation time each day and not attempting to do a lot of errands, exercises, or household chores.

If you are not using your walker, I suggest you start using it again. Limping any at all when you walk is not good. The walker (or a cane or crutches, if you prefer) give yourself the stability to walk with a regular gait. This helps properly strengthen your muscles. When you limp, you stress muscles and ligaments and that can give you the type of pain you’re experiencing. If you’re having pain like you describe, take something for it. Extra Strength Tylenol can work fine. Just be sure to take it in 1000mg doses. You can take up to 4000mg per day. Be sure you count the acetaminophen in any other medications you take in that total. It is usually better to set a schedule throughout the day and night (one dose every 6 or 8 hours) so that you have constant medicine in your body at all times. This should make you more comfortable until things improve.

 

[Layla]

Thanks for joining Insider's in support of the community, westiemom!

I still have some pretty good aching in my knee plus the lightning jabs

This is likely nerves regenerating after surgery and it can go on for months.

I have my final checkup with my OS 3/12 and don't know enough to ask him.

Questions that may offer you reassurance after hearing your OS's response -
Is the pain I'm experiencing considered normal, or to be expected?
How long should I expect swelling to continue?
When can I return to my favorite activities? Name any.
PT - Yes / No? For how long?
Does my rate of healing seem within the range considered normal?

Personally, I wouldn't bring up MUA. If the surgeon feels you need to consider MUA...he'll bring it up.

The only person I know who has had a TKR was up and normal after 3 months, so she doesn't understand why I'm not

You don't have to put up with this if it is frustrating to you. Consider gently telling her that every recovery is different, you are following your OS's direction and he is happy with your progress and that's all the matters to you. Then change the course of the conversation. If she persists after that, it's simply rude and insensitive. At the point,
kick her with your good leg...Oopsie! Kidding!

Happy Monday! I hope you have a nice week!

 

[westiemom]

@EalingGran
Thanks for the info. The nodule and swelling disappeared two days after appearing. I do ice with my icing machine most of the day and evening. I keep my leg elevated during the daytime and evening, but not at night. I guess I'm just a worrywart.

 

[westiemom]

@Layla

I did something REALLY STUPID last evening. We were going out to dinner and there are 4 steps to go down. I've been doing them one by one, one foot down and the other foot down on the same step. DH stands in front of me in case I get dizzy or whatever. Well, on the last step, I tried to go down normally. I put my surgery leg down on the bottom step, then tried to put my good leg down on the driveway. The pain was so bad, I thought I was going to pass out. The "band" around my kneecap hurt unbelievably. DH caught me as I fell forward; if not, I would have landed on my face on the driveway. The "band" usually feels about 1/2" wide, but during that moment, it felt like it was about 3" wide and spreading. During dinner I had to take a pain pill cause I just hurt so much. Today the ache is back to normal (like it's been for a week or so - no need for pain pills, except I am going to take 1000 mg. tylenol as Jamie suggested earlier).

That episode made me so scared cause the pain was just horrible. I'm being so careful with my walking now. I don't really do much during the day, just walking doing household things - laundry, making coffee, doing dishes, making salads, etc.

 

[Layla]

Hi westiemom, I am so sorry this happened, but thankfully you're not feeling any worse today, but back to your "temporary normal". That had to be frightening! Very happy hubs caught you or it could have been so much worse.

I'm sure when you stepped down you strained the soft tissues around the knee, which triggers inflammation.
Good you're taking it easy and resting when you feel the need. It's not too late to ice / elevate either for the inflammation. Glad you're engaged in the activities of daily living, keeping your knee moving. You can add some gentle stretches also. Motion is Lotion

You're not stupid at all, mistakes happen, especially during recovery when we're still learning what our new joint can handle. One misstep will not erase the strides you've made and you have made progress. Take it easy, listen to your body, as you have been, and know that you're doing your best.
Hugs
@westiemom

 

[Jamie]

I’m glad you were being careful, @westiemom. Steps can be tricky and you want to take things very easy until you regain the full strength in your leg muscles to go up and down normally. I know for me it was 6 months before I could go down stairs foot over foot. But I was still so weak in my leg muscles that I held onto the railing for dear life. You’ll get there. Don’t worry….what you’re experiencing is normal. If you feel up to it, you could ask your GP or surgeon to order some physical therapy to target your leg strength and balance. At three months out, it may be just a bit early for that, but as long as the therapy was gentle and didn’t result in any pain or swelling, you might feel more confident on your feet. Especially helpful would be some massage therapy and perhaps some pressure point therapy on your thigh muscles. Sometimes they get tightened up and need that release.

 

[westiemom]

I'm going to go back to my walker tomorrow. Have a dr. appointment an hour away tomorrow so will be going out. It's my cardiologist and don't cancel - too hard to get in to see him. But I'm going to take it as easy as I can for the rest of this week.

I can see my knee is more swollen tonite, so icing tonite. They say pride goeth before a fall (and I thought I could do it)!

 

[beralc]

@westiemom i don’t think it’s pride so much as you start to feel that it’s possible. Actually until you try something you won’t know if you can do it either. I find sometimes if I’m not concentrating my brain wants to automatically do foot over foot particularly upstairs but I catch myself just in time.
Good luck at the appointment x

 

[Jamie]

Sounds like a good plan. Don’t feel bad. We all get eager in recovery and want to just move forward to “normal” as fast as possible. Actually, you can “feel” it if you’re listening to your body when it’s ready to take on a little more of a challenge. Not everyone is that tuned into their body messages, but it is there. For me, it’s an “itchy” feeling in my leg muscles to do something different. It’s definitely NOT something that originates in the brain….it comes from within the healing tissues.

 

[Layla]

Good Evening westiemom!
I hope your appointment with the cardiologist went well and you're not too exhausted from the outing and appointment.

They say pride goeth before a fall (and I thought I could do it

You're trying to regain independence and that takes courage. Falls happen. Be kind to yourself and take one
step (safely ) at a time.
Sleep well tonight.

 

[westiemom]

Dh is pretty much insisting I sit and ice and elevate to take down the swelling I did. I wish the doctor had told me how long this slow progress is. He seemed to think I would be back to normal in 5 months. If I had really known it's a year-long recovery, my mindset going into this would have been different. DH says he doesn't mind doing most of everything, but it chafes me that I can't (or shouldn't) do so many things I want to do.

Cardiologist visit was fine; I had asked him about best NSAID for arthritis in hips and he said none - take aspirin. After 5 hours laying down to sleep, my hips wake me up in pain. So much for trying to get a good enough sleep time in.

Today the sun is shining and DH is grocery shopping for me. He's already called 3 times to ask questions about different items. Chicken for dinner tonite - yum!

 

[Layla]

Today the sun is shining and DH is grocery shopping for me. He's already called 3 times to ask questions about different items.

Men!
When it was a SHORT list, emphasis on SHORT, I'd actually snap photos of the products and send them to hubs phone. I figured if he couldn't find the items then...there was no hope!
Your husband sounds like a loving caregiver and a keeper!

 

[westiemom]

And he just called again about vinegar. He's definitely a keeper and tries very hard to help me (he is a man after all and doesn't seem to see things I do). We'll be married 47 years this summer so we've been thru a lot of ups and downs. He has clinical depression and a bad neck; I've had an emergency hysterectomy, totally torn rotator cuff, CHF, pacemaker implant and now my knee. Sometimes I can't believe how good he is to me after all this. He really is fabulous.

 

[Jockette]

DH is grocery shopping for me. He's already called 3 times to ask questions about different items.

In our younger days my husband rarely did any grocery shopping and we used to joke that he hyperventilated in a grocery store. One time he took our 3 year old with him, and the 3 year old knew where everything was!

 

[beralc]

@westiemom, sometimes you just get lucky and it seems a few of us here have the benefit of a partner in life who we just totally click with, who really meant it when they said for better or worse and in sickness and in health.
It’s great to go through life feeling you’re sharing the load. I feel myself very fortunate and clearly you are too.

 

[beralc]

Today the sun is shining and DH is grocery shopping for me. He's already called 3 times to ask questions about different items.

Men!
When it was a SHORT list, emphasis on SHORT, I'd actually snap photos of the products and send them to hubs phone. I figured if he couldn't find the items then...there was no hope!
Your husband sounds like a loving caregiver and a keeper!

Haha yes I often photo things I forgive him though because he does all the cooking and has been doing so much over these past weeks.

 

[westiemom]

I"m very fortunate to have him. Everyone said it wouldn't last cause he had broken up with his fiancee of 6 years when we started dating. First day was April 1 (I did wonder if he would show up), got engaged 5/11 and married 8/5 . Surprised everyone too that thought I was pregnant. And we're still just as happy as the day we got married! It is wonderful to find someone that you click with forever.

 

[Jockette]

I didn’t get married quite that fast, but it was less than a year.
We had 44 very good years together. He died almost 5 years ago and I can’t believe it’s been that long already .

 

[Layla]

we're still just as happy as the day we got married! It is wonderful to find someone that you click with forever.

Wow, that was quick for you two. When you know, you know!
You're blessed, westiemom. You two have been through a lot together and you know that old saying, what doesn't kill you makes you stronger. You're weathering the storms of life together in the best way.
Cheers to many more years of happiness!

 

[beralc]

I"m very fortunate to have him. Everyone said it wouldn't last cause he had broken up with his fiancee of 6 years when we started dating. First day was April 1 (I did wonder if he would show up), got engaged 5/11 and married 8/5 . Surprised everyone too that thought I was pregnant. And we're still just as happy as the day we got married! It is wonderful to find someone that you click with forever.

Funny. We met on the 26th August and we’re engaged by 16th November. When you know you know. We’ve been together 35years and know each other inside out