TKR Softtail back for round 2

[Celle]

Putting this out there for any help. My knee overall seems to be progressing well except for one area and that is my quad muscle above knee. What is happening is I can barely do straight leg lifts without considerable pain in top of quad ,kneecap and inside upper part of my thigh. My flexion and extension are good for 8 days after surgery with 102 flex and nearly 0 straight. Feels like deep pain like bruise on top of quad, which is different than my left leg surgery where I could do the leg lifts much better. I know each surgery comes with its own set of aches and pains, just wondering if anyone relates to my condition at this time and if they went thru it and the results.
Thanks always good to hear stories from other bonesmarties.

What is happening is that you no longer need to do straight leg raises. Once you can do them, you don't need to keep on doing them.
It's causing pain and we advise "If it hurts, don't do it."
The pain is a warning that you're doing something your knee isn't ready for yet.

It's still very early days - only 8 days since you had major surgery. Give your knee a break and stop doing something that hurts.
Don't forget that your quads were man-handled, pulled aside and probably bruised during the surgery. They need time to heal, too.

You're making excellent progress, so ease off the exercises and let your knee heal.

By the way, do try not to compare your knees. No two recoveries are alike.

 

[DLR]

@Softtail agree with @NavyGunns about bruising. I had the same thing with my first knee, straight leg lifts put me through the roof and pain where you noted, surgeon told me it was deep level bruising. This time my bruising surfaced immediately and extensively and I can do straight leg raises with no problem.
Got to make the journey interesting lol...
How are you managing getting around? I am using a cane outside but as of yesterday maneuvering around the house with no supports.

 

[Softtail]

DLR ,thanks for the info. I thought that not being able to lift leg was probably normal, and like you the previous leg didn’t have this level of bruising so I too could lift that one fairly easily. Will just have to wait for this one to come around. Now getting around is fairly easy inside house with or without walker. I can walk around without walker or cane in house but for safety sake when doing my “exercise” walking I use the walker. For trips to bathroom etc. inside I just walk carefully without either. I ventured out at 7 days for dinner “ cabin fever” and used cane. Felt pretty secure for most part, but with weak quad, go slow. Pain is pretty well managed, rarely gets over 4 and that’s only for short time. Cutting back slightly on oxy, and weeks worth of gabapentin is used up.
Bowels are working with a little bit of push lol, so expect them to get more regular as oxy reduces. All in all pleased with recovery. Just got to deal with deep bruising of quad. How do you feel your recovery is coming vs. your previous knee? It’s crazy how one knee can vary in its recovery rate from other one. Hey at least it’s the last time we have to go thru this ,cause momma only gave me 2 legs .

 

[DLR]

Sounds like you are progressing as expected. I think that is the biggest change this time, my own expectations. It is different, I have more pain bending the knee when walking this time but I know this knee was more damaged than the first. Overall just more content to know it will work its way through in time as ligaments and muscles realign and strengthen.... that said I still have moments where I want to be done with this but as you said...this is it, 2 knees down none to go

 

[Softtail]

2 days away from 2 weeks and that good ole this is getting old sitting around feeling is seeping out. For me themost frustrating thing about the recovery period Is it is not straight forward. In some things you do, each day gets you a little closer to your goal but it doesn’t seem to work that way with the knee. It’s like two steps forward one step back or one step back one step forward or two steps back one step forward . One pain area changes places with another pain area, making this whole recovery period so darn hard to accept.
There is always that feeling lurking around that there is something wrong, something not healing right. Even having been thru it before, it’s still hard to accept the length of time it takes to see any significant improvement.
For me , my quad is just so darn sore, it’s hard to lift leg, where last time around I could lift it fairly easy early on. So what do you do ,you wait, which is not my best attribute , and hope it comes around. I fully expect it to, but when it’s actually happening ,you can paint so many what if scenarios it gets depressing.
I know all of my fellow bonesmarties go thru similar ups and downs, and there are good things happening now like good flexion and extension, but it’s that one odd symptom that keeps pulling you back to the dark side lol.

 

[FCBayern]

@Softtail I definitely agree that not having a straight line recovery is very frustrating. I've been through a number of surgeries and every one but this had a straight line recovery, things progressively got better, no back sliding. But having been through this before you know it will get better, it's just really tough in the early days. Hope you can keep your spirits up.

 

[Softtail]

Fc for the most part they are, just not the patient type. Home nurse just left and signed me out of home care. She changed my bandage and described the new procedure they used to close my suture. Kind of like glue down the outside of both sides of the incision and a zip type apparatus between the two to pull incision closed. Different than previous one where they glued it a bit differently. Said all looked good , bowels are trying to come back to normal, and sleep , well I am used to stealing that anyway I can ,bedroom, couch , chair. For me because of RLS it’s a little trickier, but am managing.
One more week of home PTthen on to outpatient. Having been to the outpatient PT facility before, I really like where I go ,and if you read a lot here ,you can find a lot of horror stories about PT techs that really cause more harm than good.

 

[Irish471]

@Softtail , I found leg lifts and short arc quads excruciating when I tried doing them the first two weeks . They were on the list of exercises the home PT had, but I skipped those because they hurt too much. I worked on my quads by tightening the muscle and pushing down on a rolled up towel.

By the way, my husband rides and I stopped riding with him 9 years ago after my left knee reconstruction surgery. I told him (and others), hey, I went through a LOT of pain and sank a LOT of money into this knee. No way am I going to take any chances!

Hang in there! Things will start improving soon

 

[Fastpuls]

I too had the issue with my quad muscle and was not able to lift my leg at all until day nine. Improvement showing every day since. My big problem has been history of synovitis which is causing additional inflammation and interference with ROM gains. I wish you well, your posts are so informative and helpful

 

[Softtail]

Irish. Yep those leg lifts and sitting on chair with my thigh supported then trying to bend my leg up only worksto a point,after which it is very painful right under my knee . MyPTguy has me do this and when it getstothepoint where the pain sets in ,he has me use my foot strap to assist it to bend a little farther. This works. I also like you tense my quad muscle against pillow. Been afraid to get on my bike for some time because of weak knees. Not afraid of handling bike going down road, but was afraid of looking like fool if I came to stop,put my leg out ,and it collapsed ,sending bike to ground. Been riding since I was 16 ,never been down, so don’t want to end up sitting at intersection ,bike on ground, looking like I am unable to handle an MC.

Fastpuls. Yep that quad muscle sure puts a slowdown in recovery ,or appears to anyway. Probably par for course ,but any symptom that appears to be more pronounced ,let’s the mind start thinking ,wow,if only that darn quad wasn’t bruised so bad I would be farther ahead lol.
Looks like you and I are neck in neck with recovery ,2 days apart. Back to see my OS this Monday to see what PT route he sends me on. Today is probably last day for in house PT, but with quad so sorry may extend that another week.

 

[Momma-me]

My nerve block lasted only a few hours...??
I’m jealous of the people who said theirs lasted days

 

[Celle]

Yep those leg lifts and sitting on chair with my thigh supported then trying to bend my leg up only worksto a point,after which it is very painful right under my knee . MyPTguy has me do this and when it getstothepoint where the pain sets in ,he has me use my foot strap to assist it to bend a little farther. This works.

You're only a couple of weeks into what is a year-long recovery. What's the rush?
Your knee needs to lay a solid foundation of healing in the first month, so don't go stressing it with exercises that hurt, or pulling on straps. They're not good for it.
Your knee is wounded, not lazy or unfit.

Yep that quad muscle sure puts a slowdown in recovery ,or appears to anyway. Probably par for course ,but any symptom that appears to be more pronounced ,let’s the mind start thinking ,wow,if only that darn quad wasn’t bruised so bad I would be farther ahead lol.

Again, what's the rush? Your knee is going to take a full year to recover completely and nothing you can do will speed that up.

Recovery isn't a straightforward linear progression, as you're finding out.
It is 2 steps forward, one step back, or a roller-coaster ride.

 

[Softtail]

Celle , you know I love ya, and every one here going thru this , or having gone thru this ,but you have to remember I am an old jock, and sitting around waiting for things to happen,which I am sure they would, is just not my thing. That was pretty evident in my first go around with left leg.

That said , having followed my “controlled”PTprogram ,ie no pain is gain ,that I talked out with my in house PT tech, here is my latest update. On Thursday this week ,doing my assisted leg lifts sitting on chair, trying to straighten knee out , I could get a small lift until very painful under knee, after which I could assist pulling leg up farther with strap , (pain free), another few degrees. Pt tech told me this would help me reactivate the quad muscle, so I did this for last 2 days. He also told me it was the fluid under my knee that was causing the pain once I got to the angle of bendwhere it hurt. This morning , doing same exercise , Iwas able to get another 10 to 20 degrees out of it unassisted. Progress yes. Also , coming home from hospital,my leg felt like a dead log, much more pronounced than with previous implant. I could not lift it at all without strap. In fact wth left leg, I could pretty much lift it from day one on ,so not being able to do this at all was a shock. For that reason I didn’t even try to do straight leg lifts that I could do with previous leg. Since I found I could now lift leg further this morning, I tried the straight leg lifts, and wow, I can now do it with almost no discomfort.
Celle, this could possibly have happened if I had just been sitting around, maybe even sooner by a few days, but I just can’t do it that way. All I can do is plod along with my active PT approach, hoping for the best. At least this way , right or wrong, it keeps my spirits up, which exercise has always been my go to thing when down and out.
Again not the approach for everyone, just my way of pushing forward.

 

[Softtail]

Knee continues to get better . Lowered oxy by 5mgs. ,and plan to eliminate by end of week 4. Start outpatient PT Monday, looking forward to it. Flexion at 3 weeks 115, extension 0, swelling still present, as expected but reduced. Continue my home PT 2sessions per day, followed by ice and elevation. Doctor released me to chip n putt, holding off till week 8 for full round of golf. Return to Trolly run next Saturday. Lucky , Ahead of game from left leg, which has turned out great, so will continue with my present approach to recovering from knee replacement. Hope fellow bonesmarties can do as well.

 

[DLR]

@Softtail awesome update!

 

[Momma-me]

@Softtail I can't believe you were walking unassisted on day 8!!! Holy moley! That is amazing! I'm day 10 and nowhere near that happening.

 

[Softtail]

Momma me, yes after reading here about a number of other forum members, I consider myself extremely lucky.
Will continue with my PT plan, and hope it continues.

 

[Softtail]

DLR hope your recovery is going as well . Favorite advancement for me ,got rid of the raised potty insert. Never did like using it lol. Off the cane and any walking supports too, which is always a plus.

 

[Softtail]

Momma-me just an add on about my walking unassisted day 8. It’s true I could, but frequently doing my house walk arounds,Iwould push the stroller along because I liked to pick up pace and length of stride , so used as insurance policy. When I went out ,I took cane. Mostly for moral support, but by start of 3rd week, I was pretty much walking all over without anything. You are unique and your leg will heal in its own time, so don’t worry about needing supports to get around. Far more important to get to where you feel safe unassisted ,then to set an arbitrary date for ditching the walker/cane/crutches.

 

[Softtail]

Starting week 6 of right tkr , and some interesting things coming up. Since there are no more knees to replace, and am getting more and more mobile with new right knee , other weak areas of my body are popping up. Have found Hips from lack of use are stiffened up , so therapist is working on them. I feel an overall weakness in upper thigh and hip area, which therapist believes is due to long term inactivity of muscles and tendons in this area. . Only time will tell. Knee itself seems to be coming along, certainly in regards to flex and extension, but an annoying catch has popped up in my knee when I bend it. It’s not all the time by any means , but when I bend the knee quickly it occasionally feels like it catches on something and is painful. I can get it to go away if I straighten knee then Reuben’s it, but sure is annoying. Just curious if anyone else has had this catch thing happen, since I can’t recall left leg doing it.