TKR t2paythepiper's LTKR Recovery Thread

[Layla]

(one PT mentioned elevating and massaging toward the heart for lymphatic drainage to help the swelling?).

Something interesting....It is our lymph system that rids the body of fluid (swelling). So you want to get the fluid to the lymph nodes in your torso area so your body can more quickly process it. The lymph system works rather slowly on its own and much more efficiently with the assistance of gravity. The fluid isn’t draining into the hips, but contained with the lymph system and moving to the torso and lymph nodes located there.

My colleague, CricketHip, who's expertise is massage Therapeutic Massage and has shared this exercise to assist in manual lymph drainage. This gentle, yet effective therapy will help prime your lymphatic system to move fluid and inflammation away from your leg, which in turn will help your range of motion and pain - you may want to give it a try and tag her if you have any questions.

While lying supine, take deep breaths...deep, as in breathing in to a count of 5, 4, or 3 seconds, whatever is most comfortable for you. Hold that breath for another count of 5, 4, 3 then blow out completely, still using the count that's comfortable for you. A series of at least 6 reps may help get the excess swelling to move. To ensure you are taking proper deep breaths, place your hand on your naval and watch while taking in your breath, if doing this properly you should see your hand move up. Repeat this whenever you feel up to it during the day or night. Lying flat (supine) is best as the lymph nodes seated in your groin are less restricted, allowing for better lymph flow.

In addition, after the breathing exercise, place your hands lightly on your upper thigh, at the crease in your groin and lightly stroke upwards towards your naval. Be patient because it can take the body time to respond.
Please feel free to tag, CricketHip, if you have questions.

Have a great weekend!

 

[mendogal]

Hi @t2paythepiper
Massage has many forms.

Massaging around the incision scar is simply using the pads of our fingertips to lightly trace circles; we're not aiming for affecting muscles, just to get the skin mobilized a bit.

Things change as you move upward onto the lower thigh and a bit sideways from the incision scar itself. If your fingertips encounter ropy areas or lumps, deeper pressure can be used on those - direct pressure downward on them, circular movements and also side-to-side.

 

[Layla]

Happy Two Month Anniversary!
I hope you're doing well and enjoying the month of June so far.
Take care and stay in touch!
@t2paythepiper

 

[t2paythepiper]

Thank you. I keep meaning to post an update but have been having more down days than up and I don't like whining LOL

Hard to believe I am coming up on 11 weeks and soon the 12 week mark.

This recovery is so much slower than my THR. I knew that intellectually going into this but living it is a different story. The THR was linear, always improving whereas the ups and downs with this have been more challenging than the pain.

I saw my primary doctory Friday and went through the Cliffsnotes of my recovery to date, all the while acknowledging how I know this is to be expected. Then I said that despite that, I really thought I would be an outlier and beat the curve. He smiled and said he had expected me to be one as well. That actually made me feel a lot better.

I have had two appointments with the PA and she says everything looks good. No damage from my fall and she says I need to be patient I see the surgeon next week.

The good is that functionally, I am improving even if the numbers don't reflect it. I have a few activities, like my recumbent exercise bike, that are good measurements of where I am on any given day. If I have trouble getting started with the first few revolutions, then it validates my suspicians I did too much the day before. I have involuntarily gone to a few ODIC meetings (lol) and each time dial it back. I keep saying I don't know my limits unless I test them.

I have less swelling but there is still enough that the knee is misshapen (especially the outside/lateral side), feels tight, hurts, etc. The swelling at the back of my knee has improved and that is a gamechanger! Overall, the pain seems to change from week to week which tells me it is healing. The cramps are gone (hope I didn't jinx myself) but the deep bone pain is there at night.

I am doing massage a few times a day on the scar and the swollen areas (used a roller on the back of the knee when it was swollen) and that seems to help. Have also used my heating pad a bit.

I sent my rented lift chair off to make some other patient happy and have transitioned back to sleeping in the bed. My dog is thrilled but it has interupted my icing routine so I need to work on that. I have joined the

PT cut me loose at exactly 6 weeks. I am disappointed with the entire experience but that would take a book. They discharged me with a few pages of exercises which included some we had never done (!) and excluded the really helpful ones that utilize equipment (which I could do at my gym).

I am finding it hard to get the right exercise/PT balance. Part of me feels like I should be stretching all day to try and get more flexion but I know that the swelling is in my way and will get worse if I do too much.

For what I am calling structured functional exercise I am swimming (mostly flutter/freestyle kick with board for legs right now), walking my dog and recumbent triking my dog. I do one or two of those a day, not all three!

For home PT I am using my recumbent exercise bike (no resistance), doing some stretches in the pool and in the house. Trying to define a core group that work for me that I do daily - rain or shine - and then layer in others on different days. So far that includes the exercise bike for flexion, hamstring and quad stretch, some variation of a heel slide and that lunge for flexion on a step. My thought was that when I have had a really busy day, I would still be able to do these even if just before bed. Need to find some strengthening exercises to add. There were some that one of the PTs did that I really liked but they never gave them to me to do at home. It has been slow trying to find them online.

I also joined a local rec center so I could attend water fitness classes with a fellow knee warrior. I think the company and schedule will be good for me.

I will post an update after I see the surgeon. As for numbers, extension is great (0) and flexion has been functional. PT said 120 but PA said 110.

Happy Summer!

 

[EalingGran]

It sounds like you are doing really well.

 

[mendogal]

A nice recovery!
For strengthening...

Basic principles: Take it very slowly and definitely without ankle weights or resistance bands to start with.

There is no physiological basis for the common "do 15 repetitions, rest, do 15 reps, rest, do 15 reps." This is really outdated!

I recommend starting with 6 - 8 very slow, controlled repetitions to establish a baseline. If tolerated without pain, the next day try a dozen. Only increase by small increments.

It's easy to stand facing a kitchen counter, holding on if needed, to practice tightening your core and alternate going up on tiptoe, then back onto your heels. I also practiced slowly shifting my weight onto one leg then to center then to the other leg, back and forth.

Did they have you do "quad sets" initially? There are sometimes other names for it. My team had me doing them immediately post op to start activating my quads. Sitting or semi reclining, with the legs extended out in front of you, you just tense the thigh muscles, so the knee straightens. It becomes a strengthening exercise by holding that muscle contraction for 5 - 10 seconds.

 

[Layla]

Thanks for the update. You're doing very well!
May be slower than your THR recovery, but you're making great progress.
Have a wonderful week!
@t2paythepiper

 

[Layla]

Happy Three Month Anniversary!
How is it going? Hopefully things are falling into place and you’re slowing getting back to life. Hope to hear from you soon.
@t2paythepiper