TKR The other TKR, on August 25th

[Bengalady]

I am 4 weeks post open, TKA. I did not expect this to be so difficult. I've had quite a few different surgeries, and recouped quickly. My knee feels like I have a thousand rubber bands wrapped around it. Stiff and swollen always. Besides the first five days, I feel no progress. How in the heck can I bend my knee If it's swollen by an inch, and painful to bend? Therapist says I have to push past the pain, expect it, and deal with it. I'm taking Tylenol 3, can't tolerate stronger. Being a nurse, I don't believe that pain concept. I'm tired of being cooped up, getting depressed. While my pre-surgery knee didn't work, I wasn't in pain per say. Please, tell me it gets better.....or is there something else I can do? I can flex assisted about 95......But I go through the wall. I try at home, but land up giving up due to pain.

 

[Tabbycat]

Hello @Bengalady and welcome to BoneSmart.
Don't give up hope! The thing is, your knee has gone through a huge amount of surgical trauma and right now you are in the middle of the 'angry tissue stage'. It will get better but it takes time. Your instincts are right, if you 'push through the pain' you will only cause more swelling and pain. It is counterproductive, whatever the physiotherapist might say. There is plenty of time to gain ROM, when the swelling goes down. A forum adviser will be along soon with a list of helpful articles on all aspects of recovery, but in the meantime just rest, elevate, ice and take your pain meds by the clock. You have come to the right place for good advice, there is lots of support here.
Take care.
Tabby xxx

 

[Floridagal]

I agree with everything Tabby said. A lot of us have been where you are and learned that by trying to force the ROM we were just increasing swelling and making it worse. This is a critical healing time for you. You will get the range once the swelling goes down. You will hear this often - ice, elevate, take your meds and rest. Don't lose hope. It is going to get better. This is the place to vent and learn.

 

[Pumpkin]

Bengalady,
Welcome to BoneSmart, glad you found us!
Sorry to hear you are having a rough start, what you knee needs is time to heal. 95 degrees at one month is great! When your swelling and inflammation go down, your ROM will be there, but first you have to let your knee heal.
You are still very early in this yearlong+ recovery, what your knee needs now is, Rest, Ice, Elevation, and Medication on schedule as prescribed.

My knee feels like I have a thousand rubber bands wrapped around it. Stiff and swollen always.

It is inflammation and swelling. "Tight band" feeling across the front of my knee

How can I bend my knee If it's swollen by an inch, and painful to bend?

Pretty much you can't bend your knee, until the inflammation and swelling go down. All the pushing and shoving for ROM is only resulting in more inflammation and swelling, blocking your ROM, and possibly setting your progress back.

Therapist says I have to push past the pain

Saying no to therapy - am I allowed to?
TKR: Evidence shows that less really is more when it comes to exercising!
TKR: work “smarter” and not “harder”

Please, tell me it gets better.....or is there something else I can do?

YES! There is something else you can do. I am going to give you the post op reading, and as I said earlier.
Rest, Ice, Elevate, and Medicate on schedule as prescribed.

First is the reading - everybody gets a free copy of the recovery reading!

Here are the BoneSmart mantras ....
- rest, elevate, ice and take your pain meds by the clock as prescribed
- if it hurts, don't do it and don't allow anyone - especially a physiotherapist - to do it to you
- if your leg swells more or gets stiffer in the 24 hours after doing it, don't do it again
- if you won't die if it's not done, don't do it
- never stand when you can sit, never sit when you can lie down, never stay awake when you can go to sleep!
- be active as much as you need to be but not more than is necessary, meaning so much that you end up being in pain, exhausted or desperate to sit down or lay down!

Next is a FAQ (Frequently Asked Questions) thread.

And here are some very crucial articles
The importance of managing pain after a TKR and the pain chart
Swollen and stiff knee: what causes it?
Energy drain for TKRs

Myth busting: no pain, no gain
Activity progression for TKRs
Heel slides and how to do them

Extension: how to estimate it and ways to improve it
Elevation is the key
Ice to control pain and swelling

Healing: how long does it take?
Chart representation of TKR recovery
Myth busting: the "window of opportunity" in TKR

Myth busting: on getting addicted to pain meds
Post op blues is a reality - be prepared for it
Sleep deprivation is pretty much inevitable - but what causes it?

 

[Pumpkin]

Bengalady,
Please add your surgery date to your signature, hover over your username top right, click on signature, add your information there, Thanks! If you need help, post your surgery date, a moderator will add it for you.
How to create a signature

Here are two gentle activities we recommend:
Heel slides and how to do them and Extension: how to estimate it and ways to improve it .

 

[uva55]

The first few weeks are the toughest, we all experience pain and swelling, what really helped me is icing and elevating as much as possible, if I was not moving I was icing and elevating, also ALWAYS take your pain meds as prescribed even if you feel you may not need them. Once the swelling goes down you will be able to bend the knee and your ROM will improve, I did not have any aggressive PT, I only did heel slides and stretching exercises to help with extension, right now just concentrate on getting the swelling down and you will feel better.

This is a long process and you will need lots of patience, I am 9 weeks post op and feel so much better, but I still get swelling and ice every day through out the day and also need the occasional pain pill specially before bedtime.

Look around BoneSmart and you will find that we all go through what you are feeling right now, soon you will start seeing an improvement in your recovery.

I hope you feel better soon!!!

 

[skigirl]

A stiff, swollen knee is often the result of too much aggressive PT. Use your own common sense on this. If you hold a garden hose filled with water--can you bend it? and if your force it what happens?

Your knee is swollen and needs rest. I recommend a weekend in bed with your knee propped up on three pillows. No exercising at all. Just rest and watch tv or read. Luckily the Olympics are still with us!! If you feel better at the end of two or three days, then your answer is sitting there. If you take off a week to get the swelling down, you can always return to PT---after telling them that you would like someone recently trained in rehabbing a tkr who understands that less is more when it comes to early rehab.

take the time now to correct the damage the PT has done to your knee. Once the swelling is reduced you will feel much better. Walking is enough exercise for a week or so while you work on the swelling. I also saw a lymphatic massage specialist who did wonders with my knee---even though I was not a believer before I went there!!

Elevating your leg to control swelling and pain
Using ice

Remember---a break from PT of a week or even two will only affect your progress in a positive way at this point. I walked my dogs every day for 20 min and really, that is enough exercise while you are still so swollen.

 

[KarriB]

Ditto everyone above! Rest, ice and elevate that knee for a while without pushing or torturing yourself. When my first PTs had me doing things that were painful, I said "no thanks" and refused squats and step ups. My TKR goes up steps just fine now and did at 3 months too.

Read over what everyone said above and read the info left for you. Your ROM will come once the swelling subsides in the knee and surrounding tissues.

 

[birdwatchr]

[I've had quite a few different surgeries, and recouped quickly.]

I felt the same way. I always recouped from surgery very quickly, but TKR really does a number on you. You will need to take it in stride and rest, rest, rest. I did not realize how much of a major surgery it is, and no one told me, although the anesthesiologist did tell me I would be in a LOT of pain, and I had to understand that. It does get better. I am 10 weeks out and feeling much better. You will too. I was also very limber and flexible, with minimal pain. Surgery created more pain than I could ever imagine. I am regaining my flexibility, although slowly. I never would have thought it would get better, but it did. I am looking forward to getting even "more better"! Pain wise, I am doing very well. Flexibility wise, I need more time. Some people are in reverse with that. But it will get better and you can vent on this website.

 

[LoveGiants]

Welcome, @Bengalady! Your post and mine yesterday are *very* similar. I had my RTKR five weeks ago and I'm getting a bit stir-crazy and am really ready for the swelling to go away. BUT! There's so much to look forward to, and I'm reminding myself to look at that. I'm confident it WILL get better! Hang in there (also talking to myself).

The ladies that posted have given excellent advice.

 

[Roy Gardiner]

Therapist says I have to push past the pain, expect it, and deal with it.

Wrong, see all the posts above.

Your knee is damaged needing healing, not unfit needing training.

I am 4 weeks post open, TKA.

Possibly the worst time as you will have maximum swelling and reaction. It will improve now.

 

[newlybionic]

I'm also a nurse. While our training may have been to push for exercise to get better, I can tell you I tried it both ways. I did far better following the advice given here than 'working hard' or letting a PT push my leg to make it bend. The major keys for you will be to elevate and ice as shown in the articles above and to stop all PT now until you are farther along. My current OS gave me the info to 'not do anything that hurts'. I stayed true to that advice.

 

[kneeper]

Your "95 assisted" tells me two things. 1) your PT is likely pushing you too hard. Most of us here have found the best way to do bending under our own power. 2) If you can get to 95 at 4 weeks, you're doing well!
The bend is in there. If you give the swelling a chance to come down (by not overdoing; just push your self to the point of discomfort) you'll see the ROM gains continue over the next several weeks.

 

[skippyhak]

I'm on Day 52. This is my 2nd replacement. Had left knee done 18 months ago. It's a tough road but each week it gets better. I've found at about 6 to 7 weeks out it changes and the movement improves and pain is reduced. But pain NOT GONE. I'm still using pain meds 5-325 OXY on good days 1 pill and today (probably 3). I have some days where it's like a migraine headache; just aches and it is relentless. Over the counter pills does nothing noticeable. But the prescription meds make the days manageable. Without it the pain would take over and to me that leads to depression pretty quick. I also "fired" my PT....kept pushing for "we're running out of time".
My 1st knee still had swelling at 100+ days but at 6 months out my ROM and extension were great. My new PT is more "once the swelling goes you'll do fine." I'm going with that program.
Good luck!

 

[sistersinhim]

I agree with everyone. I never did pt after any of my knee surgeries, just heel slides and extension exercises. Just living your daily life rehabs your knee. I'm 11 weeks today and back doing almost all my normal jobs. My ROM and extension are very good. I still have to take pain meds, especially when I overdo. But, that's to be expected. So, please do yourself a favor and do no exercises or pt for at least 2 weeks. Follow the Bonesmart mantra and you will see a huge improvement. I promise!

 

[BBCG]

Bengalady, I am so sorry for all you are going through! I also found this wonderful group of experts early in my recovery and quickly realized these folks have walkedcthecwalk and are not just trying to push us past reasonable points! I refused to do somethings my PT wanted but we work well together now. I told her about this group and highly urged her to pay heed to the experts here!
You must find something to help with pain, though, so I suspect some here will mention what has worked for them. I am taking narcotic pain Meds still because I know I must be able to relieve pain for healing to take place. I suspect someone here will help you understand there are so many options!
Do explore others posts here as I learned so much by doing so!
Will send pain-ending thoughts your way!

 

[Bengalady]

Thank you everyone, so kind. I feel somewhat more hopeful; its' just for some reason, I did not know it would take so long to recover. No one told me, nor did I ask. Although, I knew I had to do this anyway. I landed up having to REST, as it now turns out, I have sprained my back. I've been going to a chiropractor for massages, and a few other things.....nothing drastic. Its helping me some, but really depressing, knee AND back now ? I received new PT orders, incorporating the back. I went back today, same therapist. She just did evaluation though, then I'll have someone else rest of rehab. She told me that reason I hurt my back, is because I'm shifting my body to the left, to avoid any pressure on my right. I went without my walker today, but she advised that I'm not ready for that yet.....I need to learn to walk straight. Oh well. I'm trying my best with the ice................but, my leg goes numb after 5 minutes, and I stop. I'll keep trying though. Gosh. I want to go in a whirlpool so badly. Thank you again.

 

[zzevi]

@Bengalady sorry to hear your feeling down in the dumps. I read up prior, talked with people and felt very prepared prior, I have days where I wonder what I got myself into also. I needed the replacement, life was getting hard without having it done. Thought I set aside enough recovery time and would be in tip top shape by now.......that's not the case. It does it better day by day, you will actually notice it more in terms of weeks. I was very restless in the beginning, needing to prove to myself I could still handle everything I was doing prior, the only bad thing is I think I set myself up for additional disappointment by pushing to much at first and not doing as much icing and elevating as I should. My restlessness has subsided now some what, don't mind taking the time to elevate and ice as much as I can see the benefits from following those directions more closely. So if you can find somethings to keep you content reading, sewing, knitting etc... I mention these things, but my mind was to mushy to enjoy any of these activities till lately.......guess the best advice I can give as it does get better.

 

[uva55]

My best friends during recovery were ice and elevating, if I was not moving I was icing, even under the knee, I still do it if my knee swells and it feels tight. This is a long recovery and it takes lots of patience, you can't speed it up, the more you push yourself the more your knee is going to swell and hurt, be careful with PT, don't allow them to push you too hard. I started to see major difference after 5 weeks and by no means does that mean no pain of swelling, remember it can take 12 months or longer for full recovery an we each recover at a different pace, what matters is getting to the finish line!!!

 

[readymade]

Yay! I am feeling quite educated and relieved at the moment !