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[TKR] Stiff knee when walking<

Discussion in 'Knee Replacement Recovery Area' started by Rosie2010, Jun 9, 2019.

  1. Rosie2010

    Rosie2010 new member
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    Hi everyone I'm new to the forum, absolutely inspired by all your tips and recoveries. I would like some advice please. I am 7½ weeks post left TKR and finding it hard to bend my knee while walking. I'm still using a wheeled walker outside. I can bend to about 110 and flex to +5 Any advice or tips would be great thanks.

    Left TKR was done 16th April 2019
     
  2. Jockette

    Jockette FORUM ADVISOR Forum Advisor

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    Hi and Welcome to Bonesmart!

    Your numbers are very good, the better, more relaxed bending will come in time, as you heal.

    Recovery from a knee replacement takes a full year or more for complete healing, so you have lots of time to continue improving, and you will.

    Use an assistive device, such as a walker or cane, as long as you need to, there’s no set time you should be done with it.

    I will leave you our Recovery Guidelines. Each article is short but very informative. Following these guidelines will help you have a less painful recovery.

    Knee Recovery: The Guidelines
    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
    5. At week 4 and after you should follow this
    6. Access to these pages on the website

    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

    We try to keep the forum a positive and safe place for our members to talk about their questions or concerns and to report successes with their joint replacement surgery.

    While members may create as many threads as they like in the majority of BoneSmart’s forums, we ask that each member have only One Recovery Thread. This policy makes it easier to go back and review the member’s history before providing advice, so please post any updates or questions you have right here in this thread.
     
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  3. Benay

    Benay graduate

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    Mine is too especially when I've just got moving or been on it for awhile. I've got good extension and flexion so had been wondering, swelling makes sense. Icing like a maniac.
     
  4. Pumpkln

    Pumpkln FORUM ADVISOR Forum Advisor

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  5. Glosnana

    Glosnana junior member

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    I'm at 7 weeks tomorrow and my knee is where yours is at! I started driving the past week- not every day but at least 30 mins each way and this has increased the stiffness I'm sure. I was back on my cane the past 2 days so do whatever you and your knee feel helps in these early days. Ice and elevate is now my daily mantra!
     
  6. Rosie2010

    Rosie2010 new member
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    Thanks Pumpkln. I just feel like I've gone backwards because I was doing great at five weeks then I had a physiotherapist appointment and he manipulated my leg and since then it doesn't feel quite as good. I've got a funny sort of feeling which I can only describe as a catching on something at the back side of my knee, if this makes sense. Driving a manual car seems to aggravate it. Only drive for about 15 minutes to my local supermarket.
     
  7. Pumpkln

    Pumpkln FORUM ADVISOR Forum Advisor

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    I assume you have quit going to PT or have asked for another PT or facility that is up to date on TKR's.

    Sounds like that manipulation has set your recovery back significantly, best if you give it a chance to heal by Resting, Icing, Elevating, and Medicating as prescribed.

    Please post your surgery date, a moderator will add it to your signature for you. Having the exact date will help us properly advise you. Thanks!
     
  8. Josephine

    Josephine FORUM ADMIN, NURSE DIRECTOR Administrator

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    @Rosie2010 I'd really like to offer you some structured advice but in order to do that, I also need to ask you some questions. Are you willing for me to do that?
     
  9. Rosie2010

    Rosie2010 new member
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    Yes Josephine ask away.
     
  10. Josephine

    Josephine FORUM ADMIN, NURSE DIRECTOR Administrator

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    Here y'go then!

    It would be very helpful if you would answer each one individually - numbered as I have done - in as much detail as you can then I'll come back as see where you are ....

    1. what are your pain levels right now? (remember the 1-10 scale: 1 = no pain and 10 = the worst you can imagine. And don't forget to factor in other forms of pain such as soreness, burning, stabbing, throbbing, aching, swelling and stiffness).

    2. what pain medications have you been prescribed, how much are you taking (in mg please) and how often?

    3. how swollen is your leg compared to these?
    ai63.tinypic.com_eta39s.jpg

    4. what is your ROM - that's flexion (bend) and extension (straightness)

    5. are you icing your knee at all? If so, how often and for how long?

    6. are you elevating your leg. If so how often and for how long?

    7. what is your activity level? What do you do in the way of housework, cooking, cleaning, shopping, etc., and

    8. are you doing any exercises at home? If so what and how often?
    This is the most crucial question so please help me by using the format I have left as an example
    (which means please make a list and not an essay!)

    Exercises done at home
    - how many sessions you do each day
    - enter exercise by name then number of repetitions of each
    etc., etc.

    Anything done at PT
    - how many times a week
    - enter exercise by name then number of repetitions of each
    etc., etc.
     
  11. Rosie2010

    Rosie2010 new member
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    Josephine here is my info.

    1. Pain level about 3.

    2. Only taking 100mg of paracetamol three times a day mostly since day three, when I was discharged from hospital as I hated the feeling of oxycodone which I was prescribed.

    3. moderate swelling.

    4. flexion is about 100 and extension is +5.

    5+6. elevating for about an hour while icing for 20 minutes once a day.

    7. I live alone so only cooking for myself and tidy up and put things in dishwasher, hoovering, doing laundry in and out of machine and hanging it outside when weather permits, bed making, cleaning the bathroom. Not all of these everyday but cooking definitely. Driving no more than 10-15 mins to supermarket and about 15 mins walking round shop with a walker, not everyday maybe three times a week since about a week and a half ago.

    8. I did do the exercises they give you when you come out of hospital sometimes but if I'm honest not everyday as they hurt to much, so I don't do them.

    heel slides 5 reps when prone, 8 when sitting
    walk outside for about 20-30 mins once a day

    I haven't seen a physical therapist since week 5 and when I did he only gave me the same exercises as the hospital so I haven't done any. That was only my second visit. I haven't got another appoint until 3rd July and I will be 11 weeks post op by then.

    Hope I haven't missed anything.
     
    Last edited: Jun 12, 2019
  12. Hshdobb

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    Hi Rosie. I had my left TKR on 4/24. I guess we do things different here in the U.S. I go to pt 3x week. He usually adds a new exercise every week. I get stiffness too. Use ice packs . At least 4 x day. It hurts more at night when I’m trying to sleep. If I put an ice pack on it in bed, it helps a lot. Wake up with it on but warm a few hours later. I drive an automatic with my right foot so driving hasn’t been a problem since week 3. I’m retired so don’t have to go back to work but I work for an agency and told Them I’ll be available in September. They said they’ll have work for me. Couldn’t imagine working right now. It’s no5 just the knee. I think the recovery has an overall negative effect on you in my experience. I get tired and chills. Feel sickly in addition to the discomfort. Good luck with your recovery
     
  13. Rosie2010

    Rosie2010 new member
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    Hi Hshdobb, yes I think things regarding physical therapy are different here in UK if you don't have private health care. We have to rely on our under-invested and overworked NHS staff and hospitals. I feel quite positive in my recovery as the pain from my new knee is nothing like the bone on bone pain as before my TKR. Don't get me wrong, I still have pain but it's different now I know it will get better with time. Good luck and a speedy recovery.
     
  14. sistersinhim

    sistersinhim FORUM ADVISOR Forum Advisor

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    The after surgery pain is definitely different from the arthritis pain. What good about the after surgery pain is that it will get better while the arthritis pain only gets worse.
     
  15. Josephine

    Josephine FORUM ADMIN, NURSE DIRECTOR Administrator

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    Moderate swelling adds about 4 points to your pain score which makes your pain score about 7.
    You could have asked for something different, like Tramadol. Part of the reason for your swelling is inadequate use of pain meds. But as you've been taking paracetamol most of the time, that's okay but I suggest you take it 4 times a day as 6hrly intervals.
    Not bad and it will improve as your swelling goes down.
    You accomplish little or nothing in 20 minutes. Ice for at least 40-60mins and more than 4 times a day.
    That's quite a lot of activity. Did you read all the recovery articles Jockette left for you in the second post of this thread? And especially this one Activity progression for TKRs? Please read it again and make sure you follow the recommendations. I also recommend that you make use of the mobility karts in the supermarkets. I know they are available in Tescos, Asda, Sainsburys and Morrisons. I use them all the time!
    Good! They largely unnecessary anyway!


    heel slides 5 reps when prone, 8 when sitting - your flexion is already 100 so these are unnecessary
    walk outside for about 20-30 mins once a day - that's good but make sure you don't exceed that amount
     
  16. Rosie2010

    Rosie2010 new member
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    Thanks for the reply, I will follow your advise and start icing more.
     
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  17. Rosie2010

    Rosie2010 new member
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    @Josephine Hi not sure if I need to start a new thread or change my original one, or even who to address, but I would like some more advice please.

    When I go to sit down from standing the back of my left TKR knee, (left side) feels like it's got a thick rubber band that twangs and I'm sure I've heard it click a few times. If I push on it slightly before I sit it doesn't happen. This has been like it for about four days now. I'm 8½ weeks post TKR
     
    Last edited: Jun 14, 2019
  18. Josephine

    Josephine FORUM ADMIN, NURSE DIRECTOR Administrator

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    You never need to start a new thread - we have a one thread for recovery policy here!
    Quite normal, so normal we have an article in the Library about it "Tight band" feeling across the front of my knee
     
  19. Rosie2010

    Rosie2010 new member
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    Thanks for the info Josephine, but the twanging is coming from the back of my knee in the knee bend to the left side and it makes a click sound when it goes from standing to sitting, I don't know if this makes any sense as I'm not great with knee anatomy, too complicated for my little brain :heehee:.
     
  20. Josephine

    Josephine FORUM ADMIN, NURSE DIRECTOR Administrator

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    I think it would be the same, never the less
     

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