TKR Suggestions needed for “tight band” feeling

[Sara61]

Considering this whole process takes 1 full year - I think we are all doing great - unfortunately we are all too hard on ourselves and expect to be back to normal too quickly, this Christmas I've decided to take back seat and let others take control - this time last year I was in enormous pain as I did everything on my own gift shopping/planning and executing Christmas celebration meals etc.

As today was my last PT session till after the New Y ear- I was put thru a mini test which had me fast walking for 6 minutes and then sitting on a chair with arms folded on my chest and rising up & down for 6 minutes I only managed 11 times - No doubt I will feel this tomorrow as it's not something I usually do

@star what a good idea - Thanks xx

 

[Stiff knee NC]

@Rockgirl4: Do you mind a follow up to your previous post? I am 19 weeks post op and see NO improvement in tightness. (I stopped exercising 3 wks ago to give knee a break; my ROM and straightening have both slightly decreased.) You mentioned that you had adhesions post op in earlier surgery. How did the dr determine that it was scar tissue and NOT fluid/inflammation? (Any kind of test? Or just how your ROM didn’t improve w/PT and biking). I feel that I, too, have significant scar tissue but no one (incl dr) is trying to figure out if it’s scar or just fluid/inflammation. I did get put on Celebrex (been on it for just 10 days) and he prescribed an expensive compounded cream that I’m trying to get insurance co to help fund! Would appreciate any info. Tks in advance...

 

[judgar]

Hello. What is the compound cream for..I still have tightness and stiffness.side of knee hurts when I walk a lot during the day, my biggest problem is it is still swollen a lot. That is what drives me nuts.

 

[Stiff knee NC]

@judgar: my understanding is that the compounding cream is to help w/inflammation. It has lidocaine in it, among other ingredients. It is $150! A less costly cream is $75. Very expensive...that’s why I’m trying to get the insurance co involved. I have the EXACT problem as you...if I’m on my feet for an hour or two, I get lots of pain/swelling. Have you tried a knee sleeve? Or even a compression stocking? It has been VERY HELPFUL! If you need specifics on the company or brand, just let me know! The sleeve that works best came from my PT...it is very lightweight and comes in a long section. He cut off a foot-long section for me to slip my leg into. I can take a pic of it if it would help!

 

[Jockette]

..if I’m on my feet for an hour or two, I get lots of pain/swelling.

This is fairly common for 4 months post op. I couldn’t even be on my feet that long, at 4 months, and I had a partial, promoted to be a quicker recovery. ( It hasn’t been!)

I really think your stiffness is par for the course. My knee/leg had a lot of improvement in the second year post op, and even more now in my third year.

I honestly think you need to try to accept your knee at this point, as it’s doing it’s best to recover, and remember that you are only 1/3 the way recovered. Where you are now is not where you will end up.

I tried a similar compound cream some years ago for a nerve issue in my foot. It was outrageously expensive and did nothing for my foot.

 

[Stiff knee NC]

@Jockette: I am finding “acceptance” very difficult! Lots of worrying that this is the best it will ever be (I know, I know....). Plus I’m used to being proactive...So RICE is challenging. Tks for feedback on cream...I had some compounded cream made last yr (I’m assuming it’s similar but I don’t have it any more)...it did nothing either!

 

[Jockette]

I really do understand how you feel. I’ve had the slowest recovery, ever! I worried over my poor ROM my entire first year. I was shocked by the pressure by everyone, except Bonesmart, to progress. Set backs happened to me and took ages to recoup.

But, recoup they did. My ROM increased in my second year as my whole leg finally relaxed and felt better. Sometimes you just have to wait it out. My leg got tight so easily that first year.

If I knew then what I know now, at almost 3 years post op, I wouldn’t have worried so much. I wasn’t an advisor back then and I’m sure our ever patient staff members inwardly groaned as they reassured me, again and agin, that I would heal in time, and on my own body’s timeframe. They were right!

When you get to where I am, I think you’ll feel the same way. Yes, it takes a very long time. Yes it’s frustrating. But that’s the nature of this recovery and we can’t hurry it along. This recovery takes an average of a year. You have lots of time to improve.

 

[Jockette]

I also have the advantage of being on Bonesmart for over 2 years. I’ve seen so members come and go. Members who thought they’d never improve to come back and tell us they’re doing great! During my first year I had my doubts that it would ever happen to me.

 

[Seatides]

I don't have anything new to add to this wonderfully reassuring discussion. I'm just a month out from surgery and that's the biggest issue for me: the stiff puffy leg in the morning, loosening up during the day, I feel better and am more active, then at night it gets stiff and gimpy and swollen again; it hurts and it's hard to sleep. I do my exercises when I'm not too sore and swollen.

Last week I went for an outpatient PT session and I cancelled the one scheduled for 2 days after that because I was in a lot of pain from the therapist's "stretching" of my leg muscles. He was concerned that the back of my knee wasn't flat against the table. I feel that whatever he did has made my discomfort and swelling worse the past few days. I think I'm going to find someone who takes a gentler approach.

 

[Sara61]

@Seatides I'm 9 weeks post op and not once my PT has even suggested stretching my knee or leg - the extension will come with walking - I think you would be wise to find someone else xx

@Stiff knee NC one of my first questions at the beginning after the operation to both my surgeon and PT was what cream/ointment should I use, they both replied none... yes they said you can buy expensive creams "that say they work on the package" but with time and patience and as Jockette says this will all come to us naturally be it 1,2 or even 3 years.
Gentle exercises, day to day activities and Rime time is my new motto.ī

 

[Helizabug]

Time is so weird now too. It goes so slowly that it can be hard to mark the improvement, but that slow, steady improvement is most likely happening.

I feel like months have passed, and it’s only been two and a half weeks. When I get frustrated, I try to remember that my sense of time is all warped right now.

 

[Stiff knee NC]

@Jockette: I admire your attitude so much! In all honesty I will be despondent if my recovery takes more than a year (or 2, or 3). Every day is hard for me. SO much tightness and pain. Hours and hours in the recliner, icing and elevating. Some days are better than others, of course, depending on my activity level. Your perspective makes ALL the difference to people like me. Thanks for taking the time to encourage me, a complete stranger

 

[Stiff knee NC]

@Jockette: I love seeing comments from Sara61, Seatides, Helizabug, etc.! How did these people plug into this conversation (thread)? Are they “following” me (great!). I clicked “follow” on a few people who have taken the time to comment on my thread...does that mean I will see their thread?

 

[Jockette]

.! How did these people plug into this conversation (thread)?

Members see your thread when they are here:

Knee Surgery Recovery Area

For post-operative knee patients, on the "other side"

bonesmart.org

They click on your thread, read and reply. You can do the same on other members’ threads.

 

[Jockette]

Every day is hard for me. SO much tightness and pain. Hours and hours in the recliner, icing and elevating

Have you told your surgeon that you are in this much pain? Maybe you should ask for an appointment.

Tightness is one thing, and definitely par for the course, but a lot of pain is something he/she should know about.

I didn’t realize you were in a lot of actual pain, I thought you were just referring to feeling tight. If you are doing any rehab that causes pain, stop doing it. Just do your Activities of Daily Living:

No exercising: what does that really mean?

When it is said here on BoneSmart that you should do "no exercising" what is NOT meant is "do nothing at all"! There are what we call ADLs or activities of daily living and these you should do, always. These are the ADLS Personal hygiene and grooming Dressing and undressing Functional...

bonesmart.org

 

[Stiff knee NC]

I want to tell you abt my early experience w/PT. I’ve not shared this before. I DO credit my PT w/helping me get to where I am now ROM wise (and “flatness” wise). That said, tho...at abt 6 or 7 weeks, I was sitting on the edge of the table w/the PT pushing my knee back. He wanted me to do better. He pushed so hard that I thought I was going to faint and I burst out crying. Cried the entire way home, too. And then I got mad, said that I’d never permit that again. I didn’t know any better and thought that I had to go thru pain to improve. (I hadn’t found Bonesmart at this point.) There was some wariness on both our parts from that point on...but I never had that happen again, either. Sharing this to spare someone this experience...

 

[Stiff knee NC]

@Jockette: I should clarify...when I’m sitting I don’t have pain. The bad pain comes when I stand and the knee gets tight (which is every day). I did see my dr 2 wks ago for my 4 mo check up. That’s when he prescribed Celebrex and that compounded cream, and has me in this “3 x 10” contraption to straighten my leg (he says I have a slight limp). (I can send photo of it if you’d like).

 

[Jockette]

, and has me in this “3 x 10” contraption to straighten my leg (he says I have a slight limp). (I can send photo of it if you’d like).

Yes, I’d like to see a photo. I don’t know what that is. How often and how long do you use it?

He pushed so hard that I thought I was going to faint and I burst out crying

Unfortunately, too many of us have had similar experiences. I did at PT and I was one week post op!

I cannot stress enough that this is not only unnecessary, but it is bad for our knee. For anyone/everyone that is reading this, you do not have to allow this type of treatment.
Saying no to therapy - am I allowed to?

Next time I go through this surgery, I am not going to allow any PT to touch me.

 

[Rockgirl4]

@Stiff knee NC My experience with adhesions involved my knee/leg stiffening to the point where there was a definite hard stop, at which point the knee would NEVER bend further. No pushing by a PT, nor decrease in exercise could improve my flexion. Sitting all day didn't cause ANY improvement or change, so there was a definite "stuck" point. All the rest in the world didn't help my range of motion, and the knee literally felt STUCK.

The same PT tried to convince me I had adhesions a few weeks earlier, but at that time, he could force it further (now I know he shouldn't have!!), and biking DID help my range. When I had TRUE adhesions though, biking was impossible, and forcing the knee became impossible, and resting the knee accomplished nothing---in provement at ALL. The biggest thing to note was there was no pain either. I was told that's a sign---if you're swollen/inflamed, you'll have pain and discomfort. If scar tissue is just in the way, with no swelling/inflammation to worry about, it would make sense there might be no pain.

Also keep in mind I ended up getting to the point of adhesions because of some very bad advice by that PT as time went on, plus I got super sick and was in bed for almost 3 wks with no biking, no weight-bearing AT ALL. I caught the flu from my son and ended up with "borderline" pneumonia. I was basically bed-ridden with fever for 10 days with the next 2 wks almost as bad. The knee was already hot/swollen/inflamed from overly aggressive PT before that, so it was a very very bad combination of things.

Personally, at 4-5 months post-op from TKR, if you gain anything at all from resting, icing, elevating, pr riding your bike for 5 minutes, you probably do NOT have adhesions. I also find it hard to believe you could have ~115-120 flexion with adhesions too. That just doesn't go together.

I definitely feel your frustration and get it. I'm used to being super active and busy. At almost 7 months post-op, I still can end up with a very stiff knee from doing too much one day.... and each day still differs from the one before. Luckily, I can see steady, but SLOOOOWWWWWW improvement though, and there's never been a hard stop like before either...so I know it's a matter of time and patience.

Lastly, you mentioned the straightening device your surgeon has you using. I've used one for straightening and bending back in 2016. Both hurt my knee A LOT. I could easily see that keeping your soft tissues aggravated enough to hurt constantly. Daily pulling/force on your soft tissues
is guaranteed to keep the knee in some state of unhappiness, even if it is helping your range of motion. I was supposed to sleep in my extension brace and could only tolerate it an hour each evening. It was B.R.U.T.A.L.

I hope this helps. Let me know if you want some more clarification. I don't mind at all.

 

[Helizabug]

@Stiff knee NC with regard to how we found your thread, I, for one, always click on the New Posts option near the top of the page. I generally read through all the knee replacement posts, though some are a little too scary for me so early in my recovery.

I was particularly drawn to yours because I am also in NC.

I hope things improve for you.