TKR Suggestions needed for “tight band” feeling

[Stiff knee NC]

@Jamie: could you please give me your thoughts on the possibility that my pain/tightness is from some sort of allergy or sensitivity to the cement or metal in my knee? Have you EVER heard of this? Is there a way to “test” for it? Thanks...

 

[Stiff knee NC]

@Mamie: hi and welcome to Bonesmart! Lots of great support here! I had PT for the first time 3 days post-op and I was at 70...so I think you are not too far off from that (but, as always, I defer to the advisors/moderators). I didn’t get to 90 for many, many months! (My dr did put me on the continuous passive motion machine, which electronically bends your knee for you). It was slow but steady progress and at 13 mos (nearly) post op I am proud of my 110-115 range of motion! I worked very hard for every degree!!

In the early (3 mos post-op) I wore something called turbigrip (it comes in a long section that the PT people cut a length of to fit your leg). It’s sort of an elastic’y sleeve that really helped. Later on I graduated to a compression sleeve that I got from compressionstockings.com. (cep unisex w/silicone top). It has been a tremendous help!

You may find it helpful to read my thread from the beginning to this point. I have had all kinds of issues, probably more than most people!!!, so don’t think I’m necessarily “normal.”

Good luck w/your healing, too!!

 

[Mamie]

Thanks Stiff Knee NC

I have read your thread from the start. It reads a lot like mine. Thank you for the compression tube link. I have only one wrap 4” x 20 feet. Washing it takes time to dry so I had hoped to find extras.

I am not sure there’s ever a “normal“ in Life!

Reading different threads is comforting.and it gives you a feeling you arenot alone. Most of us crawl through the same rabbit hole and it’ to learn how everyone makes it through. Heartwarming shares makes me feel close to others and wanting to cheer them on in loud roars laughing or crying with each person because you can feel their pains and joys. It’s too bad surgeons or health care don’t go through some of this so tge you don’t need pain pills or you must reach...they have no clue for the most part. That’s why this group works in my opinion. Thank you for reaching back. It’s always reassuring to know while being slow you are still in the game. I wish you best of luck too.

Stop by sometime!
Mamie

 

[Jamie]

It's very unlikely that you are experiencing an allergy or sensitivity. If that was the case, you would not have periods of improvement that worsened with activity. The pain would be constant and getting worse.
We actually have quite a few people who continue to have pain, swelling or tightness in their knee - even as long as a year or more out from surgery. The fact that you were on the slower end of normal to regain your ROM would be a signal to me that you need to give yourself more time. Be sure you're not trying too hard with activity or exercises to "do something to stop the stiffness." That can do more harm than good.

I went back through your entire thread to review what has transpired since your surgery. They all show that you had a couple of things that may have put you on a path to a little slower recovery. You admit that you started out with some aggressive therapy that resulted in pain and swelling. Once you slowed things down, both improved for your knee, which was good. But it doesn't seem like you ever found that "sweet spot" where you do just enough exercises to keep the knee mobile, but not so much that additional pain occurs. It can be very tricky to discover what is just right and it can change over time, making it something you have to constantly be monitoring and assessing. We call that "listening you your body." Please take a look at these past quotes and you'll see what I'm talking about.

@Celle, @Tykey: I’m almost embarrassed to write after my “I’m so much better” post 3 weeks ago...but here I am. After water walking 3x/week for 2 weeks in a row w/no pain or stiffness either during or after in Jan, I got a month pass at the pool for Feb. Have been water walking 3x/ week for 1 hr, heel to toe, not very fast (can’t walk that fast in a pool anyway!). Have had nothing but trouble! Today, 15 mins into my workout, the stiffness started. I’m at the gym, too, abt 1-2 x/wk and I’m up to 8 mins on the bike and pedal machine. No problems there. I am trying to lose the holiday weight I gained AND get my exercise in. Should I just stop the pool and focus on gym exercises? I feel like I did not improve ANY the month of Feb. I’m at 29 weeks. Short of turning in my 62 yr old body for a 20 yo one!!, do you have any recommendations? I knew there’d be some backsliding but this seems more than normal. Tks in advance for ideas!

@MissViv18: I feel for you. At least you are better than you were BEFORE surgery. (I am not, not even close). And I’ve read a number of posts from people who say, “a year, two or even two and a half years later, I still see improvement.” So don’t give up! I’m not...but I AM discouraged. But I have no alternative than to keep going!! I will be sending up wishes for improvement for you ❤

I had overly aggressive PT...and I’m now sure (in hindsight) that this slowed my recuperation.

My surgeon did not replace my kneecap
because it looked fine; this doctor said that arthritis could have affected it since my surgery 9 months ago.

Please try to keep in mind that, even though it is slower than what you expected or want, it is possible for your knee to continue to improve IF you don't allow that cycle of pain to increase. That means almost daily monitoring of your activities and exercise and the impact on your body the next day from whatever you did. This is not particularly fun, I know, but keeping your inflammation levels as low as possible is the only was to make the progress you want to see.

The symptoms you are mentioning can be associated with CRPS, but at 11 months it's probably a bit soon to put that label on what you're experiencing. All of the symptoms you mention are within the normal recovery, even at 11 months out from surgery. The fact that your symptoms are resolving is a very positive sign.

As with a previous post I made, CRPS is still a possibility, but I still feel like it's too soon to call it that.

Wondering what my next step should be. I’m on week 3 of gabapentin (taking 300 mg 3 x/day.) Not helping at all. Have had 3 acupuncture treatments...the scar looks less red but no change in tightness/pain.

Gabapentin or any nerve medication can easily take 3 weeks or more to be beneficial. Your dosage is relatively low and it might be that you need to up the dosage for a while to get things to settle. If you switch to another medication like Lyrica, it would also need the 3-6 weeks to effectively evaluate its impact. I'm sorry they didn't just increase your Gabapentin a bit to see if they could find a better level for you.

Was the last surgeon you saw your original surgeon who did the knee or your second opinion doctor? One of the surgeons you talked to mentioned the idea that your problem might be related to arthritis in your knee cap. You might want to go back to that doctor and talk more about that possibility.

The bottom line is that you must keep that positive outlook and try to give yourself some more time for things to settle and resolve. "Tight band" is such a common complaint after knee replacement surgery that it could be there is nothing wrong that time won't resolve. I hope this helps you and I'll be watching your thread for updates to see if things improve. Don't give up! It may take some time and maybe even a couple of new opinions, but we'll help you figure out some options to try and get to the bottom of things.

 

[Tykey]

I tried water walking, and all it did was to increase stiffness and soreness, I'd never recommend it!
Neither would I recommend gym work whilst you are still in difficulty, for the same reason. Wait until its all fit and then get back to it.
Neither of them seem to be working anyway, and to quote Dr Phil, "How's it doing for you?". (I used to watch Dr Phil on YouTube during the sleepless phase. I still can't stand his wife!!!)

BUT! I couldn't get rid of the tight band around the front of my knee. My wife told me I was walking a bit stiff legged. I figured my tendons and muscles just weren't being used, and realised that they didn't need strength and fitness, what they needed was getting looser, ie stretching. So I took my wife's comments to heart and started walking differently, making sure I rolled onto my toes each step, and kicking my heels up at the back. It's called my silly walk, and only used when nobody is watching.
The tight band and stiffness went away steadily (3 or 4 weeks), it became more flexible and the ROM increased.
So I'd recommend you abandon trying to get fit, and making your knee complain, concentrate on doing flexibility exercises which don't involve stressing it

 

[Stiff knee NC]

@Jamie: I needed your comments so thanks much for writing (hug). I actually was in talking to the PA today about a nerve block. I am desperate for pain relief....I have been SEVERELY depressed because of my constant pain/tightness. Plus I have blood sugar issues so I must exercise. Gym is closed and I don’t have any equipment at home. Trying to get a walk in 3x/ week. Will write again...but will be more mindful of finding that “ sweet spot” and alternating an exercise day with a resting day...

 

[judgar]

Do you still wear your compression sock. I put on one today and not sure if it will help

 

[Stiff knee NC]

@judgar: yep, I wear the compression sleeve about 15 hours/day. I don’t sleep or shower with it tho! Usually it helps tremendously...but my knee has hurt all day today (an “ache,” which is a new kind of pain, probably because my husband convinced me yesterday to do some stretching, which I did...)

 

[Jamie]

Please try to resist those "helpful" suggestions from those who care about you, but might not understand recovery from a knee replacement. I know it's difficult at times because in your heart I'm sure you are so ready to be over this. But the path of listening to your body and responding accordingly for any exercise or activity really is the best approach. There is no stretch, no exercise that will magically heal your knee. All those exercises and activities are on the table, but you must work up to each of them gradually at your own body's pace. Trying to hurry will only extend your recovery timetable.

 

[Stiff knee NC]

@Jamie: am going to put my husband (who is as frustrated as I am as you can imagine) in touch with you for a “ how to love and help a spouse w/a TKR!”

 

[judgar]

I did the compression sock. I can not believe on how it helped

 

[Bikeknit]

I know this won't work for everyone but a short gentle bike ride either outside somewhere flat and easy or inside (I put my bike on a trainer to use it as an exercise bike) seems to work wonders for my tight band. The gentle rotations seem to help.

 

[Stiff knee NC]

@judgar: SO glad it helped!

 

[Stiff knee NC]

@Jamie: Is it possible to STILL have swelling at 13 mos post-op? I’ve stopped exercising and am resting/elevating/icing but I’m having a LOT of trouble bending my knee first thing out of bed in the morning (and throughout the day). I bet my ROM is barely 100 and it hurts to get to that! (In the spring I could get to 120 without too much pain). Feels like scar tissue or swelling; surgeon still thinks it’s nerve related. I have an Oct. 21 appt w/a PA for the “best” knee doctor at a major university. Will find out about that bone cyst then, too.

 

[One Trick Pony]

Hi!
I'm at 16 months post-surgery and am still noticing slight improvements over time. I also still feel the band around the knee which changes in tightness. Sometimes feels tighter, sometimes less so - for no apparent reason that I can discern. I wouldn't say that I'm used to feeling it, I'm always aware of it and gives an artificial sensation of stiffness. But it's not painful in anyway, so I'm okay with it, though I hope someday it will disappear.

Although my flexion is greater than yours, I can feel pain on the outside or behind the knee occasionally if I suddenly bend it deeply after I've been on my feet for awhile. This is clearly tendon pain, which is easing very, very slowly over time and continuing to do so even now. I figure I'm going to be one of those very slow healers that is still noticing changes at 2+ years. This is why I don't get distressed at feeling that sharp tendon pain; I think (hope) it will continue to ease up and finally go away with time... Lots and lots of time. I notice that around the knee is still some very slight swelling, which is also very slowly decreasing.

I don't take long walks only because I am trying to preserve what is left of the other knee, which is now starting to act up. But I do lifts, slides, stretches, and occasionally ride a recumbent exercise bike. Other than the rigors of daily living, it is the best exercise I've found that supplies both muscle strengthening and stretching at the same time. Started out very, very slowly as the knee screamed at me every time I tried to ride. Slowed down a lot and can now ride as long as I want with a gentle pace. Sometimes it's a little bit sore afterward, but is manageable pain with Advil and Tylenol.

I stopped trying to climb stairs about 4 months ago because it still caused so much pain afterward, and my quads still weren't strong enough to easily manage it. Then the other day I was at the Rec. Center in my neighborhood and was able to climb 2 flights of stairs (twice) with very little effort. Going down has always been easy for me. So the knee did a lot of healing in those 4 months that I had no idea about! After starting out being very aggressive about PT and getting great flexion and extension very early on, to now where I do very little formal exercises. I've concluded that the knee heals much better if you don't do the aggressive stuff. So I came out of the gate like a racehorse, but am now leisurely trotting toward the finish line, in no hurry to get there. Just daily living has been enough. It's slowly healing on it's own without my intervention. In fact, my intervention has often been a source of setbacks. I was raised with the "no pain, no gain" attitude about life, and I have been very stubborn about releasing that old idea. But at least where this knee is concerned, that attitude has been very counter-productive to healing. Finally had to say "Uncle!".

So you see, you are not the only one that is a slow healer. There are many like us. I don't know the reasons for it taking so long, but as long as I feel confident that the prosthesis is intact, all the rest will resolve in time. I don't have the expectation that it will ever be as before, and will probably have some discomfort at times, but C'est La Vie! Try to be patient. It can be a long haul, but you'll get there... one day at a time. Try not to compare your progress with anyone else. You just be you.

 

[Stiff knee NC]

@One Trick Pony: thanks for sharing your experiences AND giving me a pep talk! Seems like I need the latter every two weeks or so. I have had a lot of pain and have been very down in the dumps related to my slow healing. I, too, have pain on the outside of my knee and behind my knee! Looking back, I think I had too aggressive PT, which probably set my healing back. Trying to stay positive... tks, again, for taking the time to write. I REALLY appreciate reading other people’s’ stories. Take care and continued healing!

 

[One Trick Pony]

I suffered wicked depression for a long, long time because I just got so weary of all the pain and setbacks. Every day I felt like I couldn't do it one more day. It felt like I would NEVER make any real headway and doubted the prosthetic, the surgeon, myself, everything and everyone. It was horrible and I didn't know how to handle such a deep and dark place for so long. So I know how you feel. Really.

Try reeling back the PT. I know its hard to do because everyone is telling you that you MUST do it, and it makes sense to you that doing hard work is what is needed. Funny thing is, it's really not. So pay them lip service, then do what YOU want to do. It's obvious your knee is going to take it's own sweet time with this, so don't fight it. It's gonna win anyway!

 

[KnitChica]

Try reeling back the PT. I know its hard to do because everyone is telling you that you MUST do it, and it makes sense to you that doing hard work is what is needed. Funny thing is, it's really not. So pay them lip service, then do what YOU want to do. It's obvious your knee is going to take it's own sweet time with this, so don't fight it. It's gonna win anyway!

@One Trick Pony: For me, reeling back the PT is one of the hardest tasks to do for my recovery. As you said, EVERYONE (OS, PT, family, friends) is telling me to work my knee harder, work thru the pain, push every exercise to the max. Only here do I find the most sane advice. So, I always feel as if I don’t have any “clout” to doubt the OS & PT. They’re the experts! Not me.

 

[Stiff knee NC]

@One Trick Pony: only someone who has gone through this can know just how dark and depressing it can get. I actually had to get off some meds the pain doctor associated with my surgeon’s practice had prescribed because it was not helping but more importantly, it was causing my depression to get to a scary point. Doing a little better...

I gave you the wrong idea on PT... I haven’t had PT in a gym since November 2019... and had 2 water PT sessions in December. That’s it. I went 3x/week from aug-NOV 2019 and, looking back, that was probably too often. But I did what they told me!

Live and learn! Like knit chica said, above, listening to what Bonesmart advisors say has been the most reliable. My trouble is that I didn’t “find” BS until November...

Take care, everyone!

 

[Stiff knee NC]

Question for forum advisor or moderator: someone just sent me a “personal message.” Is it ok to respond? For some reason I thought all comments had to be on the forum and personal messages weren’t really allowed. She just wants to know the name of the company from which I got my compression sleeve. Pls advise... thanks!