TKR Steve's LTKR 2022.07.18 Recovery

[benne68]

I still have swelling and ROM isn't really progressing satisfactorily.

The swelling is the reason you don't feel that your flexion is improving. In addition to the swelling you can see and feel, there is likely internal swelling. Your body needs time to heal from the trauma of surgery.

You are still only a month into a year-long recovery. I found this chart really helpful in understanding why it takes so long:

In these early day, the most important muscle to exercise is your patience muscle so you don't set yourself back.

Good luck.

 

[shr]

I still have swelling and ROM isn't really progressing satisfactorily.

The swelling is the reason you don't feel that your flexion is improving. In addition to the swelling you can see and feel, there is likely internal swelling. Your body needs time to heal from the trauma of surgery.

You are still only a month into a year-long recovery. I found this chart really helpful in understanding why it takes so long:

In these early day, the most important muscle to exercise is your patience muscle so you don't set yourself back.

Good luck.

Thanks. This is a very good chart. I found it on another thread where you'd posted it and printed a copy to keep with my training log as a reminder. Where did you get it? I also dug out a training log from my RTKR in 2011 and found that this recovery is going about like the first.

 

[Susie-Q]

Not sure where the chart originally came from but it's in one of our many articles found here:

Library Index

Special links Stories of amazing knee recoveries Adjusting Activities As We Age with New Joints Stories of amazing hip recoveries Dancing after THR: 4 months pics THR Hips that have lasted 32, 40, 41 and 45 years 67½ year old - the THRs, not the patient! A abbreviations and acronyms Activity...

bonesmart.org

Healing: how long does it take?

How Long Does it Take to Recover from Joint Replacement Surgery? Most patients undergoing total hip/knee replacement surgery want to know when they'll be able to return to their normal life. "Recovery time" is a common question posed to specialists and non-specialists alike. There are many...

bonesmart.org

 

[shr]

I agree with @benne68, there is no date by which you should be at any number. I don’t even know why some PTs are taught this, and/or believe it.

I think it's because flexion and extension are readily measurable if not perfectly repeatable. I do wonder if PTs get evaluated on this sort of thing.

 

[WFD]

I think it's because flexion and extension are readily measurable if not perfectly repeatable. I do wonder if PTs get evaluated on this sort of thing.

According to one of my PTs, insurance companies look at the results and if they are not happy with the results, can reduce the reimbursement rate for that PT organization, or even potentially refuse to do further business with them. Medicare is said to be particularly aggressive in this regard.

Don't know about the UK.

 

[Jockette]

@shr and @WFD
I‘ve moved your comments to Steve’s thread so we don’t take the agsmom’s thread too far off the current topic.

I do find it interesting that the ROM number seems to be so important to the medical team, and yet the tool they use to measure it is far from an exact measurement. I don't think even the same person can hold it against a patient in the exact position each time. And each leg is different.

I think there are many other ways to “measure” the progress of recovery, like, when you start sleeping better, when you can move around easier, when you can start walking a bit further, when your swelling goes down (which by default will improve ROM) and when your pain levels start to lower. These are all great milestones in recovery, no matter what our ROM number is.

In one of my final PT sessions, at less than 8 weeks post op, my PT asked me a whole list of these types of questions.

 

[shr]

5 weeks with the new new knee and doing well. ROM 3 to 105 degrees at PT this morning. A more practical milestone reached this week were going up and down the stairs to the second floor alternating legs instead of leading with the good leg going up and leading with the weak leg going down. More fun is being able to get the left leg into the driver footwell of my Mustang Mach 1 and work the clutch.

 

[sistersinhim]

Wow, you are doing great!

 

[shr]

Of course I shouldn't get too excited about this progress just like I shouldn't get too worried about setbacks. Still a long way to go on this recovery road.

 

[Jaycey]

@shr Slow and steady my friend! You are making great progress.

 

[shr]

Thanks @Jaycey. Week 6 and it's been two steps forward and one step back. Started out great but then a PT was too aggressive chasing better ROM numbers and I had a couple of bad days of increased swelling and pain. Decided to discontinue pain meds and doing OK without them. I'm back to where I was before the PT mishap, ROM 3 TO 106 deg.

 

[Jaycey]

@shr aggressive PT + trying to cut down on pain medication = OUCH! Please don't push for ROM. It will come on its own.

Be sure to ice and elevate. That too will help you increase your ROM.

 

[shr]

Thanks @Jaycey. I have been icing with ice packs and elevating though I'm sure more wouldn't hurt. I've ordered an ice machine which I think will encourage more time on ice. Biggest downside of discontinuing paid medication has been poorer sleep quality.

 

[sistersinhim]

You'll love the ice machine! The water stays cold for hours unlike the ice pack lasting only minutes.

 

[shr]

Yes @sistersinhim I do love the ice machine.

Followup with my OS today. X-rays look good. He'd like to see more ROM but isn't concerned about it. I'm sure that I'll get there. My first TKR is at 128 degrees out of a maximum of about 130 degrees.

 

[benne68]

He'd like to see more ROM but isn't concerned about it

So good to hear that you have a sensible OS who recognized that ROM comes with time! And that 128 on your right knees is great for 10 months out.

 

[shr]

Eight weeks post LTKR and still doing well. I've taken a break from PT but had a Rolfing session last Tuesday which was very helpful, leaving me much better balanced.

 

[Jockette]

I had to google Rolfing, so now I have a general idea. What was it like?

 

[shr]

Rolfing is generally pretty intense depending upon how tight you are and what you can tolerate. In this case my rolfer focused on the operative leg being very gentle around the knee and becoming more forceful around the hip, lower back and ankle. She also did some lymphatic massage to help with the swelling. Before starting she had me stand while she observed saying she wanted to bring the left side down and I realized about 75% of my weight was on the right leg. Afterward she had me stand again and my weight was evenly distributed and I could move more easily.

 

[sistersinhim]

This sounds amazing and something I might try out. My walking, because of birth defects in my knees, has always been 'off'. This just might help me. Is it covered by insurance?

Do you feel like it has helped with pain, swelling, and stability? After this surgery many find stability to be a problem for a while.