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TKR Still On Crutches At Eleven Weeks :-/

bsuecon

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Hi everyone. Just joined. I had tkr on my left knee March 5th. Tomorrow will be 11 weeks. My surgeon & PT are happy with my ROM (125 degree bend, almost zero degree straightening). Little to no pain, a small amount of swelling. My challenge is walking without crutches. I’m not able to put my entire weight & balance on my left knee or step up with my left on steps due to weak quad muscles. I’ve been doing all the exercises my PT gave me to the point of exhaustion & frustration. My doctor & PT seem to think that doubling down with the exercises will somehow speed up the process of me transitioning from crutches to a cane to nothing at all. However it has left me more frustrated, exhausted and sore. I think I’ve made incredible progress, however being on crutches this long seems to be an issue and now the ENTIRE focus is me getting off my crutches. I know everyone means well but at this point I’m ready to tell everyone to leave me alone! Thoughts from my fellow TKRs??
 

Jockette

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Hi and Welcome!


but at this point I’m ready to tell everyone to leave me alone! Thoughts from my fellow TKRs??
This is what I would do at this point. Exercising to the point of being really tired and sore is counterproductive in this recovery. It is not allowing your body to heal and regain strength naturally

It’s time to cut way back and let allow your body the privilege of sorting itself out, and it will, if you let 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
ice
take your pain meds by prescription schedule (not when pain starts!)​

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.
 

Sara61

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@bsuecon :welome: You are just over 2 months which is still incredibly early in this recovery, to me it sounds like you are pushing yourself to much, a good Rom and extension comes with time and not force, your knee will swell and be more painful hence you will need the crutches to help take the pain away. Try backing off a bit, do gentle exercises at home, or just for a while use your daily living activities and rest, ice and elevate that poor knee. :ice:
Once you have less pain you will be able to stand easier and then be able transition from 2 crutches to just 1 but there is no race so do it at your own pace xx
 
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Tykey

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I know everyone means well but at this point I’m ready to tell everyone to leave me alone! Thoughts from my fellow TKRs??
That's exactly what I would do, except the Bonesmarties of course. It takes time for the strength to come back, so go easy on yourself. I suspect that rushing to get your muscles to regain strength is working against getting your knee to recover.
 

Roy Gardiner

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ROM (125 degree bend, almost zero degree straightening).
I think I’ve made incredible progress
Be in no doubt, you have. You can improve with simple pain-free stretching exercises, and I recommend you do so for the straightening particularly. Here are my own ROM, Extension and Quad exercises but there are loads you can try. Once again, though, your progress is excellent.
I’m not able to put my entire weight & balance on my left knee or step up with my left on steps due to weak quad muscles
There are balance and strength issues here, obviously. Balance will come, but it's quite slow as your body adapts to the completely new structure of your knee. Just simple walking will help, with your crutches or without.
My doctor & PT seem to think that doubling down with the exercises will somehow speed up the process of me transitioning from crutches to a cane to nothing at all. However it has left me more frustrated, exhausted and sore.
Well it's true that the more you train, the stronger you will get. But that's only part of the story; training is mentally draining too, and it's clearly affecting you. Exercise until you're tired, sure, but not until you're wrecked!

But do note, it's not actually training that makes you strong it's the recovery from training. Training damages muscles, recovery builds them back stronger. And overtraining is a thing; if you feel too tired and sore, back off for a day. Just do gentle stretching and relax.
 
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bsuecon

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Thanks for all the articles and advice. It has been so stressful having that kind of pressure put on me to come off my crutches....and it doesn't make it easier to deal with when other tkr folks in the PT facility are off their crutches doing stuff I have yet to do and I'm watching them like uuhhh :unsure:

I'm considering taking a break from PT and just doing exercises at home.
 

Jaycey

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I'm considering taking a break from PT and just doing exercises at home.
Great idea! There is no timeline for this recovery. Everyone has a different experience. Unfortunately many PT have a checklist and try and fit everyone into the same schedule.

Rest the new knee and when you are feeling better go at your own pace.
 

sistersinhim

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I'm considering taking a break from PT and just doing exercises at home.
You will do fine staying at home. It's cheaper plus a lot safer! You already know what to do and can do them at home with no problem. Everything you do during your day is PT anyway. Exercises aren't that necessary, just gentle everyday movements rehabs that knee of yours.
 

Celle

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My challenge is walking without crutches. I’m not able to put my entire weight & balance on my left knee or step up with my left on steps due to weak quad muscles. I’ve been doing all the exercises my PT gave me to the point of exhaustion & frustration. My doctor & PT seem to think that doubling down with the exercises will somehow speed up the process of me transitioning from crutches to a cane to nothing at all. However it has left me more frustrated, exhausted and sore. I think I’ve made incredible progress, however being on crutches this long seems to be an issue and now the ENTIRE focus is me getting off my crutches.
I'm going to agree with everyone else on here. Don't worry about giving up the crutches yet. Your knee isn't ready to do that and if you give up the crutches before then, you will risk having a fall.

Crutches (and a stick) are just tools, to help you walk normally and safely. That's all. There are no prizes for giving them up early, and no penalties for taking a little longer.

Your poor knee - and you - have been subjected to pressure, to achieve a good Range of Motion (ROM) in just a short time. You've done that, but it's been at the expense of not allowing your knee any time to recover and heal within its own time frame.
Every knee is different, and it's not logical to expect your knee to conform to some artificial, "one-size-fits-all"agenda.

I'm sure you've been shown a couple of exercises to help strengthen your quads. My advice is for you to take some time off formal PT. Stay home, cut down drastically on the exercises, and use your knee as normally as you can in your everyday life. Just do a couple of the quad-strengthening exercises once a day.

Give your knee and yourself more time to rest, ice and elevate, and try not to worry about giving up the crutches yet.

You will find that you gradually start to give up those crutches naturally. You'll start leaving one behind, or walking by holding onto some furniture and then realising that your crutches are on the other side of the room. That will be the time to drop down to using just one crutch. Later, you'll feel confident enough to change the crutch for a stick.
Just let it happen naturally, as your leg heals and strengthens and you gain more confidence in it.
 

DBN

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After my right knee replacement on Feb 13, I am also needing a cane for walking and concerned that walking is not coming easier despite working so hard in PT and home exercising... went for my 3 month follow up with surgeon this week and it was recommended to stop formal PT for a few weeks and rest my knee... I feel like I have to give it a try because I agree with BoneSmart that I have not healed enough... like many of us, we are scared not to push ourselves or we will not progress.... but maybe the most important part is to push ourselves to honor the healing process!
 

kneeper

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What kind of exercises are they giving you? You do need to do activity to strengthen the quads, but like Roy said, sometimes they have people overdoing or have you expecting too much too soon. Has your PT suggested transitioning to a cane at some point?

I can tell you doing stairs is difficult at first. I know I took it slowly. In my first days trying steps I'd just do maybe 2-3 steps of a flight with the new knee first. And be aware that going down steps usually takes longer.
 

Birdwatcher

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Hi
I am the same place as you, also TKR March 5th, and also 120-125 ROM.
I get swelling and stiffness when I try to go for a longer walk, or if I do pt with a lot of weight bearing activities (which I have been doing every day, because I thought it was necessary).
When I walk, I now use walking poles instead of crutches, and I wear compression stocking. I somehow feel that the compression gives me a little stability when I walk. Maybe it's only my imagination.
I tried for a while to walk with no poles or crutches, but it didn't go very well, and after 3-4 days I had to give up walking completely, and rest for 2 days. Then I tried walking poles, and I started to walk short distances again.

Take care.
 

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