TKR The roller coaster ride begins again

[jbucks]

I'm 11wks post-op and still having a stiff feeling around the knee when walking. The stiff feeling is not there when I'm off my leg only with ambulating. When will the stiffness go away? I don't remember the stiffness at this point of my RTKR, but this LTKR is taking its time healing and I'm getting very impatient with the recovery.

@Tomsgirl i have the same pain. I am 8 weeks out. My PT says it is normal. IT band issues. I am doing clamshell exercises to try to ease the pain. MY PT says the stiffness is still swelling and sometimes no matter how much ice you use it will take time to dissipate and re-absorb. I am sure @Josephine will give us more information. That woman is a wealth of knowledge

 

[Josephine]

My PT says it is normal. IT band issues. I am doing clamshell exercises to try to ease the pain. MY PT says the stiffness is still swelling and sometimes no matter how much ice you use it will take time to dissipate and re-absorb.

IT band issues are NOT normal and it is caused by exercises like clamshells! It never ceases to amaze me how PTs think that the answer to exercise induced pain and tendinitis is MORE exercise! Nothing could be further from the truth! Stop the clamshells and let your body rest. That's what it desperately needs right now.

 

[Josephine]

I'm 11wks post-op and still having a stiff feeling around the knee when walking. This LTKR is taking its time healing and I'm getting very impatient with the recovery.

I'm going to ask you some questions and it would be very helpful if you would answer each one individually in as much detail as you can then I'll come back as see where you are ....

1. what are your pain levels right now? (remember the 1-10 scale: 1 = no pain and 10 = the worst you can imagine. And don't compare this with the bone-on-bone pain you had before surgery!

)

2. what pain medications have you been prescribed, how much are you taking (in mg please) and how often?

3. how often are you icing your hip and for how long?

4. are you elevating your leg, how often and for how long?

5. what is your activity level? What do you do in the way of housework, cooking, cleaning, shopping, etc., and

6. what kind of PT/exercises are you doing? How much and how often? (and detailed details would be appreciated, please! Reps, sets and session and all that)

 

[Tomsgirl]

Hi Josephine,
To answer your questions
1. Pain levels are usually 1-2 , no pain at all when sitting or lying down about a 2 from the stiffness when I'm ambulating
2. I have OxyContin 10mg 1 every 12 hrs Percocet 3/325 1 every 4hr for breakthrough pain voltaren 75mg 1 every 12 hrs for swelling, I've only been taking the Voltaren and Tylenol 1G as needed, but I do still use Percocet after PT because the swelling and pain usually increases about 2 hrs after I get home

3. I ice my knee for 24 hrs at least an hour at a time after PT and I still elevate whenever I sit down

4. I have not yet returned to work so I still only do light housework, cook quick meals, vacuum, dust , make the bed and laundry. There is only myself and my husband so really not too much. As far as activity I do a 20 min walk outside and quick trips to the grocery store as needed. I have 2 flights of stairs in my house so I'm up and down at least 5-6 times a day

5. I do the stretches, ankle pumps, straight leg raises 3 sets of 10
Hamstring stretch 3 for 60 sec
Squats 3 sets of 10
Clamshells 3 sets of 10
Stationary bike 6 min
Quad stretch 3 for 60 sec
I go to PT 2x/wk.
I do these only once/day

 

[Jamie]

We'll wait to see what Jo says, but my feeling is that you are doing way, way too much for just 2 months out of surgery. I suggest you cut way back on the activity and exercises for a couple of weeks and see how you feel. I'm betting you will be in a lot less pain. And...remember that stiffness is a form of pain and it also is a signal that you need to watch how much you are working this new knee.

Try not to compare this recovery with your other knee. No two are ever the same and it can be an exercise in frustration if you start thinking you are somehow "behind" in your recovery. Quite honestly, I'm betting that you really can't remember the details of your recovery anyway from a year and a half ago. It's pretty easy for a person to forget at least some of what you experience after that much time.

 

[Caloparker]

What are clamshell exercises?


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[Caloparker]

Found video on you.tube.y IT band was really tight. The PT used a roller bar and massaged up and down it. Not pleasant. However, it did seem to loosen up. No clamshell exercises.


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[Tomsgirl]

I use a roller at home and after my PT session is over she does a deep tissue massage to the area, very painful when she starts but does feel better after she's done. I've cancelled PT for the next week and am just doing the stretches and stationary bike at home to see how it feels over the next few days.

 

[Josephine]

1. Pain levels are usually 1-2 , no pain at all when sitting or lying down. About a 2 from the stiffness when I'm ambulating

Okay - are you sure you're not undervaluing your pain?

2. I have OxyContin 10mg 1 every 12 hrs
Percocet 3/325 1 every 4hr for breakthrough pain
Voltaren 75mg 1 every 12hrs for swelling
I've only been taking the Voltaren and Tylenol 1G as needed but I do still use Percocet after PT because the swelling and pain usually increases about 2 hrs after I get home

I don't believe in "breakthrough" pain. It's just a cacky way of proving you're not taking enough to start with!
Volteren is diclofenac and an NSAID, quite a viscious one actually, so far as your stomach is concerned. NSAIDs, acetaminophen (Tylenol, paracetamol) differences and dangers. Besides which it's a) a useless pain med and b) not suitable for the kind of swelling that occurs after major surgery.

3. I ice my knee for 24hrs at least an hour at a time after PT and I still elevate whenever I sit down

Could do more.

4. I have not yet returned to work so I still only do light housework, cook quick meals, vacuum, dust , make the bed and laundry. There is only myself and my husband so really not too much. As far as activity I do a 20min walk outside and quick trips to the grocery store as needed. I have 2 flights of stairs in my house so I'm up and down at least 5-6 times a day

That's good.

I do these only once/day and I go to PT 2x/wk
I do the stretches, ankle pumps, straight leg raises 3 sets of 10
Hamstring stretch 3 for 60 sec
Squats 3 sets of 10
Clamshells 3 sets of 10
Stationary bike 6 min
Quad stretch 3 for 60 sec

How many reps in each set? These mean nothing without that.

 

[Tomsgirl]

Josephine, sorry I left out 10 reps in each set, and as far as the pain (maybe I undervalued it a bit) more like a 4-5 on the pain scale.

Thanks, Sheryl

 

[Josephine]

Thank you

So
I do these only once/day and I go to PT 2x/wk
I do the stretches, ankle pumps, straight leg raises 3 sets of 10
Hamstring stretch 10 x 3 for 60 sec
Squats 10 x 3 sets
Clamshells 10 x 3 sets
Quad stretch 10 x for 60 sec
Stationary bike 6 min

So that's actually not so bad though I'd do 5 reps at home and hold your stretches for only 30 seconds
Also take at least one full day off each week.

pain (maybe I undervalued it a bit) more like a 4-5 on the pain scale.

I think you did! You need to be on a much more regular programme of pain meds. Tylenol and voltaren are obviously not doing it for you. Take the Percocet more often, maybe three times a day

 

[Tomsgirl]

I am now 13 wks post- op and I have finally started to feel better! I stopped out patient PT 2 wks ago and began doing just the gentle stretches and exercise bike for 10 min at home, what a difference, the ITband is finally getting better and my knee is no longer painful and swollen like it was whenever I left PT! I can even come down the stairs now one foot over the other, slowly, but it feels like I can see the light at the end of this long tunnel! This time next year my LTKR should feels as well as my RTKR, I am definitely looking forward to that!

 

[Jamie]

Wow....a post like yours makes our day here on BoneSmart!!!

We talk and talk about the gentle approach to therapy and recovery that works for most people, but it's always wonderful to have a member tell how it works for them! Thank you so much for taking time to do that.

Keep up the great recovery.

 

[Josephine]

Most excellent!