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TKR So tired!

Activity progression for TKRs



Activities of Daily Living are assessed in hospital as a means of assessing your fitness to be discharged home. Your domestic circumstances will be taken into account as in if you are living alone, etc.

ADLs include:
~ Personal hygiene and grooming
~ Dressing and undressing
~ Functional transfers, e.g. Getting out of bed
~ Voluntarily controlling bladder and bowel elimination
~ Ambulation (Walking or using a wheelchair)
~ Housework
~ Meal Preparation
~ Care of pets
~ Meal preparation and cleanup

Walking and other activity
Walking is about the best exercise you can do but again, you need to moderate your time and distance.
Always use your walker, crutches or canes as appropriate, only moving from one to the other as you gain confidence.
Don't be despondent if you have to go back once in a while in the early days.

Week 1
Just walking around the house - trips to the bathroom and kitchen are included!
Be up on your feet several times a day as you need to but don't get obsessive about it
A 5-6 minute walk every 3-4 hours is plenty
Spend most of your time resting and elevating

Week 2 -
add this to previous instructions in Week 1
Start on a plan of walks around the house 3-4 times a day for about 5 minutes but don't

a) get obsessive about it
b) get into too much pain and
c) get too tired. Stop before you get to that point.



Week 3 -
add to all the previous
Lengthen the walks to about 5-10 minutes as before
Activity: prepare yourself a small meal or a snack


Weeks 4 and 5 - add to all the previous
Increase walks to out in the garden or street; to 20mins or longer if you feel up to it bt don't forget that means 10mins there and 10mins back!

Additionally activity:
Gather a little bit of laundry OR put it in the machine OR take it out but not all of it
Now you can do a little dusting and tidying;
Do a little meal prep (for yourself not the entire family!)

Weeks 6 and onward
- add to all the previous
Start taking car trips to the shops but keep them short and sweet at the start, no longer than 15-20 minutes
Take at least one 5 minute rest while you are out

Activity: a very little ironing, washing, meal prep but get someone else to clear up after. Wash up but someone else clears the table, brings you the dirty dishes, dries and puts them away after, NOT you!!

Week 10 add to all the previous
Bed making and changing sheets, cleaning bedrooms etc., can wait now by which time, all things being well, you should pretty much start getting back to normal but don't rush it. If you start getting pain and stiffness in your knee, that's a sign your knee doesn't like what you're doing, that you're rushing ahead too fast. Slow down, right down, and start again. This stage might last until week 14 or even 16 but if it takes a even longer, don''t worry about it.

Returning to work
It's becoming the norm for knee patients to be pressured back to work after 6 weeks or so. This can be done but it is even more important one needs to try and negotiate a "Phased return to work" because going straight back to full time work can be very hard on the new knee and cause tendinitis in various places. But in essence, I would advise that 6 weeks is far too early and 10-12 weeks would be a more sensible target!
 
Thank you for this info, it’s so helpful! I wish I could take the time off but with my job, it’s not possible. I make sure and rest and take it easy between jobs or limit my activities to those that are essential. I’m self employed so that adds to the stress level a bit!
 
If you can't take off from work then this is the way to go. Be sure to assess "essential" activities as what is truly essential. Think about anything you can let go for a while or get help with. Do you have family or friends who can help?
I found friends very willing to help. One friend gave me the best advice--give them small, specific things to do. Like before I could manage grocery trips--my sister would shop for me but there were usually odds and ends that would crop up. I might say: "could you stop at the store on your way home and bring me some milk and bread?"
 
Today is a rough day! I overdid it and went to a Farm to Fork dinner last night. I’m in a lot of pain and sitting in uncomfortable chairs at an angle set off my sciatica. I’m trying not to be weepy but I’m so frustrated. 6.5 weeks post op.
 
If you can't take off from work then this is the way to go. Be sure to assess "essential" activities as what is truly essential. Think about anything you can let go for a while or get help with. Do you have family or friends who can help?
I found friends very willing to help. One friend gave me the best advice--give them small, specific things to do. Like before I could manage grocery trips--my sister would shop for me but there were usually odds and ends that would crop up. I might say: "could you stop at the store on your way home and bring me some milk and bread?"

Yes, my family and husband do most all of the cooking and I try to help out with cleaning up and household chores. I know my husband is getting tired of a wife who is mostly miserable!
 
It's a really tough time. What @kneeper said it true though. People are usually keen to help and just giving small clear tasks is doable. One thing about this TKR business that I've noticed is that you find out who your real friends are. I've been very lucky and appreciate the support and practical help I've had from family, friends and neighbours. I'll be sure to do the same for them if they ever need me.
Meanwhile, keep on keeping on and remember - this too shall pass.
 
@bellabee I’m a Realtor as well so I understand your need to work and it’s really tough in this market, but you really have to put your health first. I own my on office and employ an assistant but do you have any Realtor friends who can help you out? I know I showed some houses for a fellow agent who had a death in her family and also one who was down with her back.

Also your husband loves you and doesn’t mind helping you, even if he grumbles, (I know my fiancé did the same thing).....:yes: I’m not one who likes to ask for help, but I learned to ask and my friends really stepped up to the plate.

How are you guys using a TENS unit, on your leg or back?
 
This is a very frustrating time for TKR recovery. At six weeks most of us feel much better. Our minds are telling us to get a move on; we have life to get back to, things to do, and how long does it take a knee to heal anyway? It's all terribly frustrating. :bored:

Week six was when I finally got to go to the grocery store again! I remember because it was such a victory to be out in public. I walked with only a cane. It was wonderful. But think about that... a trip to the grocery store. I bought onions, chicken thighs, and a feminine product. That's it. Mr. Shoes did the rest of the shopping while I parked on a bench by the checkout counter. I was incapable of doing anything more.

You will eventually be capable of doing all the things. Right now, though, victories are going to be rather small, like going to the grocery store and buying an onion. Instead of cleaning the house you might wash some dishes. But each week will see new victories and if you can just keep your spirits up with those you will realize one day that you are doing quite a lot and your knee is feeling pretty good!

Patience is probably the most difficult part of recovery.
 
I'm a real estate appraiser and have the same issue with self employed- no work- no pay. I started back at 5 weeks but only did 10 hours or so spaced over the first week. I only did one inspection the first week and spent the rest of the time on the computer in 1 or 2 hours blocks. I didn't get up to full time until 10 or 11 weeks.

The first couple of months are tough regardless and the tiredness very slowly gets better. Do what you have to, cut back on nonessentials, ice and elevate as often as you can. Let your husband do as much you can get him to do. Don't feel guilty. This is a short time in the grand scheme of things. Cooking and doing dishes for 3 months won't kill him.
 
I agree with @SusieShoes , when I do little things, I'm so proud of myself and then I get to feeling pretty good and try to do more....:bignono: But don't be like me and visit the ODIC too many times, it will make you swell even more. I'm one week behind you and I sympathize with you, it's really hard when you are the boss and bread winner. But remember baby steps, and before you know it we will be good as new!
 
It's a really tough time. What @kneeper said it true though. People are usually keen to help and just giving small clear tasks is doable. One thing about this TKR business that I've noticed is that you find out who your real friends are. I've been very lucky and appreciate the support and practical help I've had from family, friends and neighbours. I'll be sure to do the same for them if they ever need me.
Meanwhile, keep on keeping on and remember - this too shall pass.
@bellabee I’m a Realtor as well so I understand your need to work and it’s really tough in this market, but you really have to put your health first. I own my on office and employ an assistant but do you have any Realtor friends who can help you out? I know I showed some houses for a fellow agent who had a death in her family and also one who was down with her back.

Also your husband loves you and doesn’t mind helping you, even if he grumbles, (I know my fiancé did the same thing).....:yes: I’m not one who likes to ask for help, but I learned to ask and my friends really stepped up to the plate.

How are you guys using a TENS unit, on your leg or back?

Doupie! That’s awesome! Yes, I’m the Broker and own my company. I have agents who work for me that have helped and there are many outside my office that have offered. Part of the problem is my own work ethicI like to do everything myself and I hate to impose on others. I’m limiting what I am doing for sure. Wednesday I have a home inspection and I will be able to sit for the 3 hours.
I’m using the TENS unit on my knee, calf and back. For my back though, I finally bought some lidocaine patches and that did the trick. I think pain in one area amplifies pain in my TKR. Today is starting out much betterI actually bought two TENS unit, one is a portable wireless one and the other is also portable but has 4 pads and wires. I use that one at home. Thanks for the response!
 
This is a very frustrating time for TKR recovery. At six weeks most of us feel much better. Our minds are telling us to get a move on; we have life to get back to, things to do, and how long does it take a knee to heal anyway? It's all terribly frustrating. :bored:

Week six was when I finally got to go to the grocery store again! I remember because it was such a victory to be out in public. I walked with only a cane. It was wonderful. But think about that... a trip to the grocery store. I bought onions, chicken thighs, and a feminine product. That's it. Mr. Shoes did the rest of the shopping while I parked on a bench by the checkout counter. I was incapable of doing anything more.

You will eventually be capable of doing all the things. Right now, though, victories are going to be rather small, like going to the grocery store and buying an onion. Instead of cleaning the house you might wash some dishes. But each week will see new victories and if you can just keep your spirits up with those you will realize one day that you are doing quite a lot and your knee is feeling pretty good!

Patience is probably the most difficult part of recovery.

Thank you for the response! I’m afraid I’m not very good at patience! I have to start being better about it. I just had high expectations for myself and it’s frustrating. Thanks for the vote of confidence!
 
I'm a real estate appraiser and have the same issue with self employed- no work- no pay. I started back at 5 weeks but only did 10 hours or so spaced over the first week. I only did one inspection the first week and spent the rest of the time on the computer in 1 or 2 hours blocks. I didn't get up to full time until 10 or 11 weeks.

The first couple of months are tough regardless and the tiredness very slowly gets better. Do what you have to, cut back on nonessentials, ice and elevate as often as you can. Let your husband do as much you can get him to do. Don't feel guilty. This is a short time in the grand scheme of things. Cooking and doing dishes for 3 months won't kill him.

It’s so nice to hear from people that are also in the industry! Yes, I’m trying to let go and do less, it’s not in my DNA and I’m fighting myself everyday! Thanks for the response!
 
I agree with @SusieShoes , when I do little things, I'm so proud of myself and then I get to feeling pretty good and try to do more....:bignono: But don't be like me and visit the ODIC too many times, it will make you swell even more. I'm one week behind you and I sympathize with you, it's really hard when you are the boss and bread winner. But remember baby steps, and before you know it we will be good as new!

True! ( what is ODIC, lol) I’m not so much the bread winner as much as I like to think so... I just love what I do and my clients are all repeat clients. So they only want “ me” which is good and bad! I’m trying to remember baby steps! Thanks again for the reply!
 
ODIC-Over Did It Club. It’s really not a privilege to be in it though. Lol. I’ve had a flexible membership card.

I, too, like to do everything myself and around week 4 or 5 I was so done with sitting around. BUT it’s worth doing as visiting that club leaves you down for a few days.

I didn’t speak up when my PT bent my knee a couple weeks ago, and I totally knew better and it took 4 days for me to recover. Your extension and bend are great for your time in recovery. Better than mine. I go today and I’ll ask to get measured but at 6 weeks I was 90 and 10.

Take it easy, this recovery will be just a little blip in time when you look back on it. The things you think are so important to do right now, really aren’t. Lol. Sounds kind of brutal but it’s really true in the grand scheme of things.

Wishing you a great day:))
 
It's so easy to think that you should be further ahead than you are. Many surgeons don't warn their patients that recovery from a knee replacement takes a long time. It takes a full year for complete recovery, although you will feel much better long before that.

This recovery is a long haul, more like a marathon than a sprint, so you have to pace yourself and dig deep for as much patience as you can find.
Where are you in recovery?? (TKR)
 
I noticed that it’s taking me a few days to recover from the pushing and PT.
If this is happening to you, then PT is not helping you at all. It's just setting your recovery behind. With you doing all the work you are, you don't even need to take PT anymore. You are getting plenty of exercise!
 
ODIC-Over Did It Club. It’s really not a privilege to be in it though. Lol. I’ve had a flexible membership card.

I, too, like to do everything myself and around week 4 or 5 I was so done with sitting around. BUT it’s worth doing as visiting that club leaves you down for a few days.

I didn’t speak up when my PT bent my knee a couple weeks ago, and I totally knew better and it took 4 days for me to recover. Your extension and bend are great for your time in recovery. Better than mine. I go today and I’ll ask to get measured but at 6 weeks I was 90 and 10.

Take it easy, this recovery will be just a little blip in time when you look back on it. The things you think are so important to do right now, really aren’t. Lol. Sounds kind of brutal but it’s really true in the grand scheme of things.

Wishing you a great day:))

So true! Thank you! Today is a much better day just working from home, pt and chilling out.
 
I noticed that it’s taking me a few days to recover from the pushing and PT.
If this is happening to you, then PT is not helping you at all. It's just setting your recovery behind. With you doing all the work you are, you don't even need to take PT anymore. You are getting plenty of exercise!

Thank you! I’ll keep that in my mind!
 
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