TKR Surprised and a bit confuse...from looking around, that makes me normal - I guess!

socman

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Hello everyone. I had total knee replacement surgery this past Tuesday (1-17-23). Got home late on Wednesday. Feeling rather weird ever since, mostly because of the amount of pain, swelling, discoloration, and annoying muscle spasms that do not allow me to sleep. Anyone know what causes those spasms? When laying in bed, they seem to hit my leg about every 20 seconds when resting my leg. Kind of tickles at times, but most annoying and causing a bit of insomnia. Walking around slow and sure. Several trips around my home every couple of hours. Doing my exercises a bit while in bed. Starting my Perpetual Motion Machine (?) on Sunday. Any other suggestions beyond elevating the leg and ice? Trying to do the best things possible to aid recovery without become stupid in the process. Therapy starts on Monday ... gulp!

That's it. Glad to have found this group. I am sure it will present me with some great personal stories surrounding their TKR experiences.

Best regards,

Roger
 
I had those spasms and they were random and occurred more after activity. They have calmed down for me about 4 weeks post op. I'm 6 weeks now. I don't have them any more so something to look forward to. As to why they occur, I just chalked it up to the traumatized tissues complaining. Hang in there!
 
@socman Welcome to BoneSmart! Which knee had the TKR? We will put the information in your signature for you.

Are you taking any pain medication? Those spasms are very common. Nerves and soft tissues have been traumatised. Your pain medication should help ease this as will ice and elevation.

Here are your recovery guidelines:

Knee Recovery: The Guidelines
We are all different, as are the approaches to this recovery and rehab. The key is, “Find what works for YOU.“ Your doctor(s), physiotherapist(s) and BoneSmart are here to help. But you have the final decision as to what approach you use.

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. Here is a very general week-by-week guide. Activity progression for TKRs

6. Access 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 a 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 history before providing advice.
 
Trying to do the best things possible to aid recovery without become stupid in the process. Therapy starts on Monday ... gulp!
Following the Bonesmart way to PT will help you to have a less painful recovery with the same results. When you start therapy, let the therapist know that you are the one in control and will not do anything that causes extra pain or swelling. Pushing past discomfort causes increased inflammation, which causes more pain and swelling. That is a setback in your recovery. You have to recover from the therapy session before you can get back to recovering from the surgery. Easy does it=more ROM and less pain!
 
Hi Roger and welcome to the recovery side! My second tkr was Jan 11. I found Bonesmart just before my first tkr.
You won't do anything stupid now that you've found Bonesmart! For starters, read EVERYTHING that Jaycey sent you. It's all 100% true about recovery.
Ice and elevation and pain meds constantly are the best in early days to help control pain.
Those muscle spasms affect many of us. I'm taking a med for nerve pain and one that's a muscle relaxer. I've had spasms twice. Like you, I walk then ice. But, be careful you don't overdo the walking.
Good luck and yes, the early days can be crazy. Ask any questions here. You will get answers from the staff and support from everyone.
 
Hey Roger, You're on the right track. The first month is tuff, but it gets better. Some days you make good strides & some days not so much. A positive attitude works wonders. I've had both TKRs with the left done around Halloween. For me, I started riding a stationary bike with the seat at the highest level to just start giving motion back to my knee, then every 2nd or 3rd day lowering the seat 1 notch to keep the progress moving. It will hurt a little, I'm not gonna lie, but the feeling of accomplishment can be used to measure your progress. go slow (you know what that will be) & progress at your own speed. And the usual elevate & ice. Good Luck
 
Hello Roger and Happy One Month Anniversary!
How are you doing? We'd love to hear from you and know how you're feeling about the progress you're making. Hopefully you've settled into a comfortable routine and things are looking up. It's a process, but you'll get there.
Next time you're on the forum, please consider leaving an update. Hope to hear from you soon! :wave:
@socman
 
Thanks for the well-wishes. There have been days when the going has been tough - physically and emotionally. For the first three weeks, life was difficult with high degrees of pain. Physical therapy started right away and it really helped...painful, but helped!

Now, at the six week mark, pain is almost a post-mark in my personal history. Stopped all prescribed pain medication a week ago - glad to off that stuff. Was on oxycodone, but was switched by my GP to tramadol since oxycodone came with side effects.

Issues now: sleep deprivation. I am way off my normal sleep schedule and that stresses me out. I have also developed a strange thing in my impacted leg. I can get a "tingly" feeling in the knee area and then my entire leg muscles contract for about two second and then release. It's the strangest thing and very, very annoying and troublesome. The muscle contractions can continue with about fifteen seconds between "contracting times". They eventually stop. I think that icing my knee can also start the process...like I said - strange.

The only other thing is that I have developed what I call a nervous stomach which usually hits me at night. It amounts to strong "butterfly" feelings in my stomach area...makes you feel like you want to move. This sensation also passes, but can linger for an hour or so. I think it may be connected to the stress I feel (not much, mind you) about the interrupted sleep pattern I have had since the first week. I try to go to rest and sleep in my bed around 10:00 p.m., but only get about one - two hours of sleep. Usually I end up having moved my left in a way I should not have moved and the pain wakes me up...then it's game over for sleep. I end up in my recliner which, quite frankly, I am growing bored with, i.e., I am tired of just sitting in my recliner most of the day with my leg up. It has become harder to fall asleep in the recliner...but it does happen once I grow exhausted enough.

Good news - road my semi-recumbant bike on a local nature trail three times last week. I went for 8, 6, and 8 miles. It worked my leg, but never to the point of pain. I could just tell that my knee area was being stretched out a bit more than usual. Kind of like riding in one of those motion machines that they strap you into while in the hospital. The outside of my knee area did swell up a tiny bit after riding my bike

"Graduated" from therapy a week ago. I was proud of myself for really taking it seriously and tried me best to push myself all the way through the experience. I have been steadfast in my exercises at home from the beginning of therapy until this very day. I now make it a point to modify the exercises in order to push myself just a tad...nothing crazy.

That is about it. If you have ever heard of the things I describe above I would like to hear what you have to say. Those two issues, entire leg muscle contractions (from knee healing????), and the nervous stomach are the only things bugging me at this time. I have come to realize that this is going to take some time to get over. I think folks are right when they talk about six months to a year for proper healing to take place. At least I know what to expect when my right knee is taken care of later this year!

Really love the information and support that this website offers!

Thanks,

Roger
 
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Good news - road my semi-reclining bike on a local nature trail three times last week. I went for 8, 6, and 8 miles. It worked my leg, but never to the point of pain. I could just tell that my knee area was being stretched out a bit more
Sounds like you are doing amazingly well.
Not sure about the other issues but I definitely had the sleep issues.
I got a prescription of zopiclone from my GP which I used intermittently to get at least some good/ better nights sleep.
I also find valerian and melatonin useful.
Others here ( @beachy ) have used trazadone.
You might find if you sleep better that the other problems settle.
 
@socman Wow! You are doing amazing. The sleep deprivation sucks…I’ve been there and a year post-op still gets me up in the middle of the night! Keep goin!
 
Hi, Just thought I'd post as we had TKR same day. I have struggled to stay positive and am anxious not to look at stuff online that may not aid me (partially guided by friends and professional opinions).
However I am feeling that I could do with a bit of support from people who are actually going through the same thing.

I hope you are doing well now, we are both approaching week 7.
Welcome to the club!!
 
Hi @socman @HaylingIslander
I too had my TKR on Jan 17. Roger, I have not had any of the stomach issues you described, but my surgeon prescribed Omeprazole to alleviate stomach issues. I am still taking them. As for the spasms, he also prescribed Valium for that but I did not take many (maybe a week or 2) and have stopped them.
I too stopped PT in my 6th week and I am working out at my Y being careful to no over do any of the progress I have made (last time I was measured my ROM was 118). I also just try to walk about a mile or two a day. There is a club in this forum called the OverDidItClub (ODIC) trust me, you don't want to join that club I flirted with joining).
My biggest problem still (as you have) is sleep. I've told everyone here I feel like a parent with a new born. I feel tired most days. I thought I turned the corner on Saturday by getting almost 6 hours of continuous sleep. Felt great all day Sunday. Last night was not as good. 2-3 hours. My surgeon would not prescribe any sleeping pills :-( told me to take Melatonin :-( Anyway..just wanted to let you know there are many in the group having similar issues. Ice and Elevate ;-)
 
Just had my six week check up with surgeon. X-rays and physical exam indicated that all was doing well. Told me to approach bike ride in a slow and easy way...not too many miles and at a slow speed. Told him about sleep issues and he recommended Tylenol PM (he knows I do not like take prescription medications). I am surprised by the degree to which my knee can still temporarily swell up and the stiffness is an issue most of the time.

For now, I just plan to keep following my exercise routines and push myself just a little bit more each week. I think that such a measured approach to healing and recovery is the best approach. Hopefully, the sleep issues, my nervousness stomach, and those darn leg muscle contractions will all begin to diminish over time. Thanks for all the support coming from you guys. I appreciate it...even at 1:00 a.m. - Ya, can't sleep, again. I think I am arriving at a point where I have decided to just embrace these sleep issues as my new normal and not try fight it and get upset by it.

Overtime, I think that I will simply work through all of these things - it will all work out for the better. I wish all of you continued success with your own recovery experiences! It is just reassuring to know that no one is alone in all of this. It sure seems like we all have joined a club, of sorts.

Roger
 
@socman You are only 6 weeks out! All these symptoms will ease with time. No need to push yourself to do anything. That knee will tell you quickly when you have gone too far.

Continue to ice and elevate. Swelling can continue to occur long after surgery.
 
Hi,

I am seven weeks post-op. I have what I consider a kind of weird thing going on with my left leg after tkr surgery. While I am sitting in my recliner, I will experience situations in which it feels like all of my left leg muscles are contracting as if a TENS machine was hooked up to my leg. This is not a single muscle twitching or cramping...rather when this happens it is like all (most) of my leg muscles fire off cause my leg to stiffen and move or turn to the right...towards my other leg. When this happens, my entire leg stiffens and then relaxes before starting up again after 15 seconds. It only occurs with my surgical leg and no where else on my body.

I am just not sure what to call it. Seems to have started after tkr surgery. This makes me think it could be related - perhaps it is a common sign of certain healing taking place. I am just not sure. When I search the Internet, most Google articles have to do with twitching or cramping and this is not what I am experiencing.

The only thing that seems to stop this is to walk around and move the leg. I also think that this situation can happen after or while I ice my knee area. Whatever this is, the muscle contractions lasts for a couple of seconds, then the leg relaxes, but then about 15 seconds later---wham, it can happen again...and again...and again.

I do not think that this is restless leg syndrome. Like I said above, it's like I have a TENS unit attached to my leg with the electrical pulse from the TENS unit causing my entire leg to "contract"...you can see the muscles contracting.....I am not sure that I am adequately describing this.

What is frustrating for me is that there does not seem to be a condition that is called a specific name that I can point to and say..."Yes! That is exactly what I am experiencing".

By the way, my issues: For sure, I am sleep deprived as I am lucky to get 2 hours of down time in my bed before I am up for the night. Thank goodness for nap time! Medications: OTC stuff, and I am not taking any opioids.

I wonder at times it this is related to lower back issues like sciatica or piriformis syndrome from which I suffer from time to time.

This was not an issue for me prior to my tkr surgery.

Any suggestions or information about whether this can be a normal part of the healing process would be welcomed. I am just at a loss to understand or explain things better.

Roger
 
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@socman Sounds like nerves are waking up post all the trauma from surgery. Moving around will ease this but it can take quite awhile for nerves to heal.

I asked previously on this thread - are you taking any pain medication? If not, I would recommend you ask your family doctor for something to address this nerve pain. There are medications that target nerves and most people find them very effective.

You will notice that I merged your newest post with your original recovery thread. For several reasons, we prefer that you only have one recovery thread:
  • That way, we have all your information in one place. This makes it easier to go back and review your history before providing advice.
  • If you keep starting new threads, you miss the posts and advice others have left for you in the old threads, and some information may be unnecessarily repeated
  • Having only one thread will act as a diary of your progress that you can look back on.
Please post any updates, questions or concerns about your recovery here. If you prefer a different thread title, just post what you want and we will get it changed for you.

If you need an urgent response to a question, just tag a member of staff.

Many members bookmark their thread in their computer browser, so they can find it when they log on.
 
Opps....sorry for doing that. I completely understand the reasoning why - makes perfect sense. I have to get use to this posting stuff. I have never joined such a group as this. What a great website. Thanks, Roger
 
Happy Two Month Anniversary!

I agree with, Jaycey, that you may want to talk to your physician about the spasms.
Another option that may be worth looking into is Magnesium.
Magnesium supports the following:
Bone health
Healthy blood sugar
Cardiovascular health
Muscle relaxation and nerves
Promotes healthy sleep (falling asleep and staying asleep)


An article on Magnesium -
https://bonesmart.org/forum/threads/magnesium-is-a-star.20301/

I hope you have a nice weekend!
@socman
 
The way I looked at the nerve stimulation was that with all the tissue, muscle and bone manipulation from the TKR in addition to pressure from swelling, there is totally gonna be pressure on the nerves running through the joint area. I had less nerve reaction issues when swelling went down tbh.

TKRs do not do well in one position for long= wake up, move, try to relax more than a few times at night. My family thought I was nuts to be up at 2AM walking aimlessly around the kitchen in the dark…lol. Gotta do what you gotta do I guess. It does get better… you will be overjoyed when you can get 4+ hours in a row. Will be worth it in the end.:)
 

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