TKR the long road back

[Jockette]

ROM (both flex and extension) can continue to improve for a long time, past a year. I am 18 months and my ROM is better than it was at 12 months. That happened as I continued to heal. Healing takes time. Lots of time.

Don’t let your surgeon or PT convince you that you have to get all your ROM back right NOW. Your knee doesn’t care about their timeframe, just it’s own.

 

[DLR]

@fish58 you are doing great. I am a week ahead of you and struggle with the swelling, soft tissue, thigh, calf pain. I try to remember that for years my leg was bent due to my knee, I learned to walk to compensate for pain. So all the muscles are suddenly in line and I am asking them to get their act together and work properly. Surgery fixed the bone on bone and my leg is now straight, but time will be needed to get the muscles firing correctly. That dreadful word..patience all the best

 

[kneeper]

I know you said in an earlier post that you can walk a mile and are doing exercises. It could be that you are doing a bit much given how early in the process your are. That could explain some of the pain and swelling. Just because you can do something doesn't always mean you should. It's all about listening to the knee and finding the sweet spot. Overall it sounds like you're doing great, though.

 

[Jockette]

Just because you can do something doesn't always mean you should. It's all about listening to the knee and finding the sweet spot.

I agree!

 

[fish58]

five weeks from surgery on Thursday Overall amazing recovery. zero pain in the knee when walking but Like everyone still a few problems.

flexion 125 extension 4 Not making much progress towards zero. doc told me it would be hard because of my pre surgery extension. I am not limping so functionally it doesn't seem bad but I really want to get to zero

second problem when every i aggressively start on strengthening exercises my leg and knee act up with a dull ach.
when I just stick to range of motion I have no pain at all

Third problem Swelling is mild but it doesn't seem to be improving much Just wondering what to expect. If it stays like this not the end of the world but would love the last swelling to dissipate

Steve

 

[sistersinhim]

Your knee is way too young to be starting strengthening exercises. We recommend you wait at least to the third month out. Right now you need to concentrate only on gentle movements. Your knee is only a little over 1/12 of the way of being healed. All those traumatized tissues inside, along with your bones, are trying to knit back together. You don't want to do anything to slow that up. As for extension, mine was slow coming in. I started walking with longer strides, heel to toe, to help mine. That did the most for me. If you try that, just be sure you have something to grab on to in case you lose your balance.

 

[Jockette]

You are having a fabulous recovery. The things you mention as problems are actually not problems, they are par for the course and will get better with time.

Unfortunately, patience is the name of this recovery.

This recovery takes a year, on average, so you are 5 weeks into 52 weeks. Try to relax and enjoy your lack of pain, wait a while more before trying any strengthening, the pain you have there is telling you your knee is not ready yet, but it will be.

Swelling will also go down as you heal.

Again, be patient with your extension, especially since your surgeon has already said it will take a while. An extension of 4 is actually pretty good for only 5 weeks out. Some people have extension numbers in the double digits.

 

[NavyGunns]

@fish58, from one guy to another, you need to back off a bit. Maybe getting a perspective from my experience will help. I’m currently 5 months (not weeks!) and I’m just now getting ready to add leg strength exercises back to my daily routine. There was No way I was going to try that at 5 weeks! The fact your knee hurts and you still have swelling is all you need to know to realize that it’s too early. If you insist on doing so, you are most likely going to add even more time to your recovery and run the risk of injury in the form of tendinitis or muscle strain. I know, because that’s what happened to me. I started leg exercises at around 3 months and it didn’t take long to realize it was too soon. I should have focused more on stretching as my biggest challenge now is tightness in the inside area of my legs. Over the past several weeks, I’ve focused more on good stretches to loosen up my leg and the IT band down the outside of my knee. I’ve seen a decrease in pain and greater flexibility. I think if you take a similar approach, you’ll find you are much happier with your progress. You can always work on leg strengthening once you’ve healed more.

 

[fish58]

thanks for all your input. navy guns, jockette, sistersinhim I like that heal to toe strategy I will start that today.

 

[sistersinhim]

I like that heal to toe strategy I will start that today.

When I first started it, I found I was unstable. So, be sure you have something around to keep you from falling! I hope it works for you. It did for me, but it's not quick. Those muscles and tendons in the back of the knee are large and will take time to stretch back our. Just don't fret about it. You'll get there!

 

[fish58]

6.5 weeks post op continuing to progress 130 flexion 5 extension. From the very beginning extension has been difficult. pre op I was 25 degrees.and had a huge limp. I watched my walk today and at 5 degrees it does not appear that i have a limp at all It certainly doesn't hurt to walk or apply weight just can't get the last few degrees of extension. I went on line today and purchased device that straps your leg into full extension. I am hoping that may help. Overall I am thrilled with my progress walking two miles a day swimming and using the elliptical just really struggling with the last 5 degrees. Love to hear any suggestions how to get last 5 degrees

 

[Jockette]

Love to hear any suggestions how to get last 5 degrees

The answer is patience. Everything else is going very well for you. Extension is actually going well for you, also. You weren’t straight before surgery and to be +5 now is really very good.

It took several months for my extension to return, and I was straight before, it was only surgical swelling hindering mine.

went on line today and purchased device that straps your leg into full extension. I am hoping that may help.

Please don’t use this. You really are doing well. You can’t force healing, and that’s all you need. Trying too hard can backfire and cause problems.

 

[fish58]

7.5 weeks post op. Made a little progress the week on extension down to 2.5 ext 130 flex. I bought that leg straightening board and I think its really helping. Walking 2 miles every other day now without much of a problem. My PT is threatening to kick me out of therapy. My hamstrings are incredible weak not sure if I will ever get them strong again. Overall very happy. Still a residual dull ach hoping that eventually fades

 

[sistersinhim]

With all you're doing, having just an ache is quite good. Most of us still have pain at that stage. I helped my extension come in by walking with long strides, heals to toes gait. You might want to try that for a while.

 

[Celle]

7.5 weeks post op. Made a little progress the week on extension down to 2.5 ext 130 flex. I bought that leg straightening board and I think its really helping. Walking 2 miles every other day now without much of a problem. My PT is threatening to kick me out of therapy. My hamstrings are incredible weak not sure if I will ever get them strong again. Overall very happy.

Your extension will continue to improve slowly. There's no need to rush to get ROM (Range of Motion) because it can continue to improve for a year, or even much longer, after a knee replacement. There isn't any deadline you have to meet:
Myth busting: the "window of opportunity" in TKR

And it's not at all unusual for extension to take longer to achieve than flexion does. That's because those large muscles and tendons at the back of your leg need to be stretched slowly. Try to do it too fast and they'll just shrink back, like elastic does when it's been stretched.

I don't see any need for you to continue with PT. You won't lose the flexion you have now and your extension will continue to improve, especially if you lengthen your stride a little when walking. Be patient and it will happen.

Again, be patient with those hamstrings. They will grow stronger, but you need to give them time. What's your rush? You're only 7.5 weeks into a recovery that takes a full year.

Patience, Grasshopper.

 

[fish58]

8 weeks post op today. Funny how the more things get better the more I notice the small problems. Extension is better at 130 and 2 degrees extension. How is that for being ungrateful!

The good news. NO PAIN WHEN I WALK! Pre-surgery I couldn't walk a mile now I walk 3 miles daily.

I still have some issues. Almost all the swelling is gone but I do have one stubborn patch outside of the knee just off the knee cap. I think it might be the IT band not sure. It's the size of a silver dollar and doesn't seem to be declining

I also have very weak hamstring because of old ACL reconstruction from scarring and taking of a tendon called the semi-tendinosis to use as my ACL graft. Any suggestions on how to strengthen without irritating it?

 

[sistersinhim]

I'll tag @Josephine for you. She can tell you what you need to do.

 

[Josephine]

Any suggestions on how to strengthen without irritating it?

It this tendon has been harvested as an ACL graft, I don't see how you can strengthen it. But you can strengthen the muscles around it by simply walking - maybe treadmill at the gym. But not yet a while! Wait about another 2-3 months.

 

[Josephine]

@fish58 Hellooo?

 

[fish58]

Sorry for the long time lag in writing. 14 weeks post op. Can truly say my knee replacement has so exceeded all my expectations. I have zero pain when I walk. I have zero limp and I used to have a terrible limp. I walk 3 miles a day only limited by my other knee that probably needs a replacement. The swelling is completely gone. Pre-op my knee was permanently swollen now I have zero swelling

My knee replacement has been life changing My poor brain still always thinks "I can't do that it would hurt to much" Oh yea I can do that haha! My only regret is I waited too long. I never in my wildest dreams believed I could have this good an outcome. Finally I pray my knee lasts 20 years but I just had to try running since I haven't run in 37 years since my horrible ACL injury. I ran one time last week 1 mile it felt great I won't do it again but so nice to know I can.