TKR Thank Goodness I Only have Two Knees!

[mendogal]

The only heel slides I ever did on my own were sitting up in a chair.

On my earlier knee, when I was doing more active outpatient PT, they had me do the lying down one, but with my foot on a flat glider disc to reduce friction. It made it easy to move within my current comfort range - I have never ever let any PT for any rehab put me into pain - so I just figured, not having a glider at home, it wasn't appropriate for me to do the lying down ones!

Straps may be helpful for mobility in the early days when the leg won't lift of the bed. I have an aversion to the use of straps in therapy. There's no need to force ROM.

 

[selketine]

The only heel slides I ever did on my own were sitting up in a chair.

On my earlier knee, when I was doing more active outpatient PT, they had me do the lying down one, but with my foot on a flat glider disc to reduce friction. It made it easy to move within my current comfort range - I have never ever let any PT for any rehab put me into pain - so I just figured, not having a glider at home, it wasn't appropriate for me to do the lying down ones!

Straps may be helpful for mobility in the early days when the leg won't lift of the bed. I have an aversion to the use of straps in therapy. There's no need to force ROM.

That's interesting because the strap (it's a piece of soft cloth but long) version of the heel slide sitting up is WAY less painful for me than the lying down version. I don't force my knee with the strap but I think I can pull it up farther. Using my own thigh muscles when lying down I can't bend my knee that far. I'm guessing it's weak upper leg muscles? I've tried putting my foot in a plastic bag to help with friction and I also have a very slick blanket which seems to work best. I like the seated chair ones the most so I do those randomly all day. Probably those weak upper leg muscles need some help at some point haha!

My ability to walk pre-surgery was so bad (I used the walker around the house at times and couldn't go out much at all), I'm just really unstable. Sometimes the left knee is holding me back or making me more wobbly. I don't see myself letting go of the walker anytime soon. However I can strut like I'm on the runway with my walker hahaha!

 

[mendogal]

It sounds like your use of the strap is safe and sane!

"Randomly through the day" was my therapy approach on both knees with all exercises and movement. It seems to have the positive aspects of doing sets without the risk of overdoing it.

 

[Layla]

However I can strut like I'm on the runway with my walker hahaha!

Haha...trying to picture this, selketine. Made me chuckle.
Thankfully you're in no hurry to kick the walker to the curb if you're still feeling the need for that support. Glad you're finding the way to do heel slides that best suit you. Thanks for sharing your progress. Happy Sunday!

 

[MSuki]

On the lying down heel slides with the strap my PT has been adamant that I shouldn’t use my muscles at all, just pull with my arms using the strap, and stop before the point of pain. At PT she always puts a board under my foot so it glides more easily.

 

[sistersinhim]

On the lying down heel slides with the strap my PT has been adamant that I shouldn’t use my muscles at all, just pull with my arms using the strap,

I don't understand this at all. How can this be helping you achieve a bend if you don't use your muscles? IMO any bend that is assisted is not your true bend, that comes only when done without assistance using only your body to do it. It sounds like it is working for you so that is what counts!

 

[Susie-Q]

Probably those weak upper leg muscles need some help at some point haha!

I can attest to this. I've recently started some light weight training and exercises (I'm 2-1/2 years post-op) and my left upper thigh/groin muscle is very weak! The times that this muscle feels weakest is lying on my back doing reps of leg/ab work involving lifting the leg a few inches off the ground. It's only on the left side, my last TKR side.

However I can strut like I'm on the runway with my walker hahaha!

I'm picturing this and

 

[selketine]

On the lying down heel slides with the strap my PT has been adamant that I shouldn’t use my muscles at all, just pull with my arms using the strap, and stop before the point of pain. At PT she always puts a board under my foot so it glides more easily.

Just to note - the ones I was told to use the strap with are sitting up (in bed since I can't get on the floor). I like doing these cause they are easy haha. I have a super slick thin blanket on the bed and my foot glides easily. I'm guessing the strap is useful to get that extra little bit of bend (not comfortable but not painful).

The ones without the strap are lying down and boy those are killer but more on my upper thigh. I honestly can't tell if theoretically my knee could bend more but I just can't do it with my thigh muscle or my knee is also stopped there. If that makes sense.

The whole right side of my thigh must have a muscle there and it's sore. I don't feel like I'm overworking it but it's sore even when I rub it. Same down the right side of my shin where there's a lot of bruising.

 

[MSuki]

I don't understand this at all. How can this be helping you achieve a bend if you don't use your muscles? IMO any bend that is assisted is not your true bend, that comes only when done without assistance using only your body to do it. It sounds like it is working for you so that is what counts!

Call me clueless! I was doing it with my muscles at home until she told me not to in PT. By that point I was probably not doing them at home any more because I was doing the exercise bike instead. I think she was having me loosen them up with movement prior to being measured? I don’t remember being told that on the first knee, but the newer knee bends just as well as the older knee at this point. I would have thought the benefit of doing this using your muscles would be more hamstring exercise.

 

[EalingGran]

also have this really strong feeling of wanting to bend my TKR knee when I sit in the recliner like I was going to sit "criss cross apple sauce" style. I sit with it bent as much as comfortable for a little bit then stretch it out. Why does this feel better than when I do it seated or lying down? Is it bad for it?

I think it is a normal feeling. My knee liked a little bit of movement and found the worst thing was being completely still or even worse standing....
I was very lucky because my daughter had left a rocking stool ( part of a rocking chair nursing mother set) at our house when she finished breast feeding. My husband complained of the clutter but it was a Godsend. I just rested my foot on it and rocked gently. It was just the right amount of movement and my knee loved it. If you can find something similar on Ebay I would recommend it.

 

[selketine]

also have this really strong feeling of wanting to bend my TKR knee when I sit in the recliner like I was going to sit "criss cross apple sauce" style. I sit with it bent as much as comfortable for a little bit then stretch it out. Why does this feel better than when I do it seated or lying down? Is it bad for it?

I think it is a normal feeling. My knee liked a little bit of movement and found the worst thing was being completely still or even worse standing....
I was very lucky because my daughter had left a rocking stool ( part of a rocking chair nursing mother set) at our house when she finished breast feeding. My husband complained of the clutter but it was a Godsend. I just rested my foot on it and rocked gently. It was just the right amount of movement and my knee loved it. If you can find something similar on Ebay I would recommend it.

I actually still have the rocking chair and stool we bought for when our first was born and it's in my husband's "office" area. I'll go sit in there and try it out!

 

[selketine]

I went out to Target today and walked around the store (two levels to it). It's the closest place to my house and it wasn't busy at all. Wow was this super exciting to get out and actually be able to walk in a straight line for more than 20 feet (our house is small). My husband drove and pushed the cart and I used the walker. My knee actually feels better for some reason like it loosened up a bit. Maybe I'll change my tune later but so far, so good.

I also accomplished the very important task of buying FOUR bags of M&M's in different flavors. Apparently I've been craving them even though I usually never eat them. I kept finding different ones (Valentine, Easter although it's too early!, Lunar New Year ones too). I'm probably set for awhile. SO much more exciting than going to the doctor.

I've been off the stronger pain meds (took a half one evening). I'm hoping that I'm mostly over the hump with those. I didn't really need to taper much since I wasn't taking many anyway. Generally wishing my ROM was better - it just feels like it should bend more than it does since it feels otherwise pretty decent. I'm fairly unsteady however - party because of the left knee needing replacing and partly because of the ligament sprain on the right knee. I have some work to do to recover my balance and it's possible I will need the walker/rollator until I get the left one replaced. My walking was poor before surgery. I can tell I'm sometimes just putting all my weight on my new knee when I'm standing cause the left one hurts more. Wow what a difference between them!

 

[Susie-Q]

I went out to Target today and walked around the store

This is a lot for your baby knee! I hope you don't end up in the ODIC (OverDid It Club) later! Seriously, I don't think I could have done this at 3 weeks post-op but everyone is different.

Generally wishing my ROM was better

Don't worry, you will get there! It's not a race!

buying FOUR bags of M&M's in different flavors.

My weakness was the PB M&Ms. I ate WAY too many!

 

[benne68]

Generally wishing my ROM was better - it just feels like it should bend more than it does since it feels otherwise pretty decent.

At this early point in recovery, you still have swelling inside the knee -- even if it's not noticeable on the outside. Any internal swelling will prevent you from bending. As the fluid in there dissipates, your flexion will automatically improve. In the meantime, just keep moving it gently.

You are doing fine for just three weeks post-op!

 

[selketine]

Yes @Susie-Q I may realize later tonight I joined the ODIC but....M&M's!!! Actually I went in thinking it would be a shorter trip but it felt good to walk. I almost think it loosened up the tightness in my leg or I got some rhythm to my walking I can't seem to get in the house.

@benne68 I sure hope it gets better. Actually the walking loosened it up a bit I think? Bending my knee feels like the only structural thing I can't do. The rest just seems more like (eventually) building strength and would be taken care of when my other knee gets done.

 

[Layla]

Lunar New Year M&M’s?!!!!
Glad you enjoyed your Target run and hopefully you’re not feeling any worse for wear this evening.

My knee actually feels better for some reason like it loosened up a bit.

Likely from the movement, but it may take some trial and error to get down the amount of activity you’re able to tolerate currently. Hopefully no ODIC for you.
We have a member on the hip forum that used to go to the big box stores in recovery due to the size and area be could cover as he practiced walking. He pushed a shopping cart in an effort to hone his gait, but also benefitted from the exercise. Enjoy those M&M’s…but not too much.

 

[MSuki]

I wake up feeling stiff most mornings and doing 30 minutes on my recumbent bike loosens me up so i know what you mean. As my old PT liked to say “motion is lotion.”

 

[mendogal]

Walking as tolerated has been my single best knee therapy.
At nearing eight months the new one STILL doesn't like sitting - yes, my sitting at a time tolerance has improved a lot, but if I've over the course of the day been overly sedentary, the knee and those shortened quads and ITB express their displeasure. And what biking does for MSuki, walking does for me. A knee relaxing lubricant that also gives me a little workout, straightens my posture, and expands my lungs!

 

[selketine]

So far doesn't seem like I was any worse for wear for the walking yesterday and I'm actually surprised! The right side of my leg which has been sore loosened up and maybe my knee a bit. I'd go back and do that more often but I have to get my husband to drive me and he's working so not an option - and I'd buy too many M&M's or goodness knows what!

I might try walking outside a bit but it is cold and I'm very cold averse. Not for lack of good clothing layers and outwear either. I've stopped using the ice machine because it was making me miserable and my knee felt stiffer (and that incident where I woke up with the chills that I couldn't stop and felt like I was going to die lol). I use an ice bag or refrigerated wrap at times (with a barrier). I loved the ice machine in the summer when it was hot outside - no problems. My leg swelling has gone down a lot. I have a PT appointment tomorrow morning so we will see how that goes. I need to learn how to do stairs a better way if nothing else. No one has worked with me on that yet.

I need to move where it is warm - why oh why is that not in the BoneSmart board recommendations for anyone having TKR surgery is beyond my understanding!!!

 

[Jockette]

I need to move where it is warm - why oh why is that not in the BoneSmart board recommendations for anyone having TKR surgery is beyond my understanding!!!

I love this!

I'd go back and do that more often but I have to get my husband to drive me and he's working so not an option - and I'd buy too many M&M's or goodness knows what!

Maybe on his days off he can drive you to a store with things you're not as interested in, like maybe Home Depot, or maybe if you’re not sports minded, Dick’s?