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TKR Stumbled 13 weeks post surgery

Hnutmiri

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I'm 13 weeks post LTKR. I've been off the Narcotics since 5 weeks after surgery because They weren't helping. I never had complete pain control since surgery due to allergic & adverse reactions to ALL pain meds. I Have been in PT for 13 sessions. Have a good extension but my bend flexation is only @ 105 on a good day. I saw the surgeon for a follow up @ 11weeks. He was happy with the progress, said no manipulation or x-rays were needed & wanted to see me again in 2 months. However last Monday I stumbled in my yard while watering the garden. I didn't fall but stepped wrong. Now my surgery site is swollen & has quite a bit of pain.
I went to PT the following day & they were gentle and worked only on stretching because my leg was super tight & soo sore. The therapist stated during his initial check & massage that he didn't feel like anything was seriously injured.... More like a strain to the surrounded tissues. I do my in home excercises daily & ice afterwards. But after my exercise today...I can hardly walk! I have therapy again tomorrow. Should I be concerned?
Has anyone else had a strain or accidentally injure themselves like this?
 

Celle

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Hello @Hnutmiri - and :welome:

Please will you tell us the full date of your knee replacement, so we can make a signature for you? Having the date in your signature will make it possible for us to see when you had your surgery, without having to keep going back to your first post.
Thank you.:flwrysmile:

I'm sorry you had a stumble and hurt your knee. It's most unlikely that you will have damaged the implant at all because those things are pretty tough. What you've probably done is pulled and strained the soft tissues that were pulled around during surgery. Look on it as the equivalent of a sprained or strained ankle if you like.

To reassure you, it would be a good idea to let your surgeon know, and maybe have him/her take a look at it, if you haven't already done that.

Now, if you had a sprained ankle, you wouldn't be doing exercises, would you? I think you should treat your knee the same way. There's no point in exercising it because it's swollen and inflamed. That's going to prevent any progress on gaining extension until the swelling settles.
So stop the exercises until your knee has got over this little setback.

Go to PT by all means, but ask your therapist to just do gentle massage and no stretching or exercises.

Instead of doing exercises, spend more time resting, while icing and elevating your knee, to help it calm down and become less swollen.
There are article about icing and elevation in the recovery guidelines, which I'll give you in my next post.

Don't worry about your Range of Motion.Both flexion and extension can continue to improve for a year, or even longer, after a knee replacement. There's no deadline you have to meet.
 

Celle

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And here are the promised recovery guidelines:
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. Try to 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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Hnutmiri

Hnutmiri

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Thank you for the warm welcome & responding so quickly. My surgery date was 05/13/20. It was very difficult during all the
Co-Vid19 stuff. My husband wasn't allowed to be with me or visit till I was released. After surgery it took the staff more than 4-6 hrs of consult with my surgeon to make a decision on pain control... finally given Dilaudid & valium.... So I was a relaxed zombie with continued pain. This is my 6th surgery on my body & has far been the worst recovery of all. I've already decided the other knee is NOT getting operated on .
 

sistersinhim

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I said that for me that this recovery was worse than childbirth and lasts a whole lot longer.

Ice and elevation should help to control your pain better. The whole time I was sitting or laying down the first 6 weeks or so, I was icing and elevating. It really does help with that pain and swelling.
 

kneeper

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Sorry to hear about your mishap. As others have said, you'll be giving the knee some TLC and not doing your regular PT exercises for a while. Ice, elevation and gentle movement will likely be the name of the game for a while.
 

Roy Gardiner

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However last Monday I stumbled in my yard while watering the garden. I didn't fall but stepped wrong. Now my surgery site is swollen & has quite a bit of pain.
More like a strain to the surrounded tissues.
Exactly. Your damaged tissue reacted more to the incident simply because it's damaged.
But after my exercise today...I can hardly walk!
Listen to the message it's sending. Ease off or stop, you can't really underdo exercise at this stage.
 
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Hnutmiri

Hnutmiri

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Thanks all of you for the support! It means the world to me. I have seriously felt very alone thru this. Between quarantine & my husband working 16 hr days....I'm dealing with this by myself. Since this is my 1st experience with this type of surgery, it's been difficult to honestly know what the right thing to do is. As someone mentioned....the Therapist is very pushy trying to score points in a sense. I hate it! Sometimes I think they cause more mental damage. Making the patient feel like they are not making progress. After reading so many stories from other tkr recipients, I'm feeling a little better about the current situation & continued healing.
 
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Hnutmiri

Hnutmiri

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I said that for me that this recovery was worse than childbirth and lasts a whole lot longer.

Ice and elevation should help to control your pain better. The whole time I was sitting or laying down the first 6 weeks or so, I was icing and elevating. It really does help with that pain and swelling.
Exactly! My childbirth experience was super long (26hrs)& natural....but when my son was born....it was over! Not like this crazy achy pain that just continues forever without any relief in between. It's like a he worst toothache and you can't get the dentist to pull it out.
 

sistersinhim

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Once you are recovered you will be so glad you did this, just like you're glad you had that baby. This one just takes a lot longer to reach that point.
 

Celle

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Not like this crazy achy pain that just continues forever without any relief in between. It's like a he worst toothache and you can't get the dentist to pull it out.
I think your pushy PT therapist has a lot to do with this. Too much exercise = pain. Cut back the exercises and spend more time resting, elevating and icing your knee, and see if that helps.

You probably pulled a muscle or some other soft tissue when you stumbled, so now you need to let it rest, so it can heal.
 

Celle

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By the way, it's your knee and you are the only one with the right to say what happens to it. You don't have to obey or even please your PT. He/she has to please you.
Saying no to therapy - am I allowed to?

At 3 months post-op, you really don't need to keep going to PT. Your ROM will continue to improve, just with your activities of daily living.
It's not exercising that gets you your ROM - it's time. Time to recover, time for swelling and pain to settle, and time to heal. Your knee has the potential to achieve good ROM right from the start, but it's prevented from doing so by swelling and pain. As it heals and the swelling goes down, your ROM (both flexion and extension) will gradually increase.

There's no need to rush to get ROM (Range of Motion) because it can continue to improve for a year, or even much longer, after a knee replacement. There isn't any deadline you have to meet:
Myth busting: the "window of opportunity" in TKR
 

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