TKR The TKR Recovery Journey of a Fitness Instructor

[MargFit]

I had TKR right knee on 12/14/23. Mako Robotic Arm with the Stryker Triathlon prosthetic joint. General anesthesia with a nerve block, one night in the hospital. I am 61 and a fitness instructor who is used to pushing through pain and has a high pain toleranice…or so I thought until now!

Fortunately coming into this feeling very strong made it easy for me to get up get moving with my walker at the hospital and then at home doing short laps around my backyard. My insurance wouldn’t cover in home care, so I have had to be my own PT until I start outpatient. I saw my dr on day 7 to have my bandage changed and had range of motion measured and was at zero fully straight and 112 bent. He warned me that some patients hear that early on and stop their exercises and regress. I think for me I’m the opposite. I took that to heart and with my push it personality, I overdid things the last couple of days. Now I’m dealing with pain on the medial (side closest to my other knee) that is making taking steps and walking excruciating. So I‘m here joining this forum to help keep myself in check, learn from others and not feel so alone in this crazy journey.

As far as pain meds, I weaned off the ocycodone on day 7 and am doing a cocktail of Tylenol and Aleve. I got sick and tired of feeling so icky from the narcotic but now I’m second guessing if perhaps there’s a way to integrate it back to help calm things, but not to the extent that it messes with my eating and sleeping.

Overall I’m glad to be on this side of the process but as much as people warned me about these first few weeks, I definitely underestimated the intensity of a TKR!

 

[mendogal]

Welcome to the Getting Better side! Here are some handy links....

KNEE RECOVERY GUIDELINES

1. Don’t worry: Your body will heal all by itself. Relax, let it, don't try and hurry it, don’t worry about any symptoms now, they are almost certainly temporary.

If you want to use something to assist with healing and scar management, BoneSmart recommends hypochlorous solution. Members in the US can purchase ACTIVE Antimicrobial Hydrogel through BoneSmart at a discount. Similar products should be available in the UK and other countries.

2. Control discomfort:

rest​

elevate​

ice​

take your pain meds by prescription schedule (not when pain starts!)​

don't overwork.​

3. Do what you want to do BUT

a. If it hurts, don't do it and don't allow anyone - especially a physical therapist - to do it to you​

b. If your leg swells more or gets stiffer in the 24 hours after doing it, don't do it again.​

4. PT or exercise can be useful BUT take note of these

the BoneSmart view on exercise​

BoneSmart philosophy for sensible post op therapy​

5. At week 4 and after you should follow this

Activity progression for TKRs​

The Recovery articles:
The importance of managing pain after a TKR and the pain chart
Swollen and stiff knee: what causes it?
Energy drain for TKRs
Elevation is the key
Ice to control pain and swelling
Heel slides and how to do them properly
Chart representation of TKR recovery
Healing: how long does it take?

Post op blues is a reality - be prepared for it
Sleep deprivation is pretty much inevitable - but what causes it?

There are also some cautionary articles here
Myth busting: no pain, no gain
Myth busting: the "window of opportunity" in TKR
Myth busting: on getting addicted to pain meds

We try to keep the forum a positive and safe place for our members to talk about their questions or concerns and to report successes with their joint replacement surgery. While members may create as many threads as they like in a majority of BoneSmart's forums, we ask that each member have only one recovery thread. This policy makes it easier to go back and review history before providing advice.

 

[mendogal]

We joke about the ODIC - OverDid It Club! - some of us are early joiners and learn quickly, others don't join until they have gained self-confidence (oops!), and yes some of us are repeaters.
You don't need to push to the point of pain... It's counterproductive. Walking, light stretching, and pacing yourself just within your current comfort level plus the slight slow testing just past it into mild discomfort will promote healing while letting slow milestones accumulate.
Icing and elevating pretty much full time helps with pain control and swelling.

 

[MargFit]

The ODIC haha yep I think I joined right away! Thank you for that and all the helpful links, this is exactly what I needed.

 

[Jockette]

Hi and Welcome!

We all do join the ODIC at some point! However, rest needs to also be a component of our rehab. Don’t look at it as doing nothing, look at it as giving your knee the best opportunity in which to heal.

 

[sistersinhim]

I actually printed off these and went by them daily. These really helped to keep my pain and swelling lower and my healing on target for me!

Activity progression for TKRs

 

[Layla]

So I‘m here joining this forum to help keep myself in check, learn from others and not feel so alone in this crazy journey.

Welcome to BoneSmart! Thanks for joining us. I look forward to following your healing journey.
Merry Christmas!

 

[Axx72]

@MargFit I can relate to much of what you have shared. Treating a TKR like an injury, from an active life, view is pretty easy. On one hand, we are fearful of not doing enough and on the other hand we have tendencies to get into the ODIC.

Finding your stride with a reasonable ratio between active progression and patience is never an easy process. Listen to your body when it tells you to slow down.

Merry Christmas and keep taking those little steps forward. We will all get there together.

 

[sistersinhim]

I pray your day is a blessed one with little pain!

 

[CatieViv]

I have been a member of the ODIC many times over the past almost 3 months since my revision! As for the pain meds, it might be a little too soon to wean off them. Try spreading them out a bit more. I too tried that one and paid for it!

Merry Christmas!

 

[MargFit]

@CatieViv, @Axx72 Thank you for your replies it is so helpful to hear from others! I do think I weaned off pain meds too soon and am going to bring back a dose or two today to see if it helps. What a weird and different Christmas this is, thankfully I enjoy resting and watching holiday movies even when I’m not recovering from TKR!

 

[benne68]

Welcome to BoneSmart, @MargFit

I'm one day behind you with my Left (second) TKR.

I definitely underestimated the intensity of a TKR!

Unfortunately, our surgical teams really don't do a good job of communicating how long a recovery this can be. It was a big surprise for me with my first knee, but I learned a lot here on BoneSmart.

Being physically fit prior to surgery will help with your muscle recovery, but remember that bones, ligaments, tendons and nerves take much longer to heal. I found this chart really helpful in understanding what to expect my first time around.

As a fitness instructor, you may be tempted to push through the pain, but DON'T! Give your body the time it needs to heal before you go back into training mode.

We are all here to support one another on this journey so please keep us posted on your recovery!

 

[MargFit]

Greetings
Here I am at 2 weeks post op and my oh my. First, to the staff members may I request the title of my thread be changed to The TKR Recovery Journey of a Fitness Instructor?

So many of the folks that take my classes that have had TKR kept saying oh after the first week you’ll feel so much better. I think the fact that I don’t feel better and in some ways worse has messed with my mindset. I can lie down and bend and straighten my knee quite well. But taking any steps at all became excruciating at the medial area of my knee around day 10 and remains so. I had chosen to wean off narcotics very early (day 4) and have realized that was not the thing to do so am back on and finding a bit of relief with taking little 3-5 min walks once or twice a day. Instead of oxycodone, dr had me try Tramadol and I seem to tolerate that better in terms of not feeling so dizzy, nauseous and lightheaded.

All of this to say, I’m grateful for this forum because if not for it, I’d be very concerned that I’m not feeling peachy at 2 weeks out. For someone who is usually the toughest in the room, this process continues to humble me. I sit and wonder how will I ever go back to my job of leading others in their fitness journey? Keeping the faith it will happen and these days of barely being able to walk will be a distant memory. When I get to PT in a couple of weeks, that should be an interesti experience for the trainer to get trained!

 

[Jockette]

I changed your title for you!

So many of us were not prepared for this recovery, me included. Everyone I spoke with was happy with their new knee and some even said they wished they’d done it sooner. I had a PKR, often promoted to have a fast recovery. Well, to say I was surprised and disappointed and frustrated in my “slow” recovery is a huge understatement!

Try really hard not to compare your recovery with anyone else‘s because no two knees are alike, and some surgeries require more internal “work” than others, as well as slightly different surgeon techniques, which can affect our recovery, and also, how each body reacts and heals on its own time frame.

Mostly, respect your healing knee and what it wants, because it will be the boss for the next months. Keep in mind, recovery is temporary, if we do indeed respect it, and once healed, you’ll be back to doing things you love. However, if you push your knee to do things it’s not yet healed to do, you only create setbacks, which will somewhat lengthen the recovery.

 

[MargFit]

3 weeks post op, finally turned a corner! I can actually get around my house and not be in excruciating pain, yay!

Today also was my first visit with my OS. All looks good, and I’m thrilled that the bandage is off and I can take a regular shower. Range of motion was -3 extension, 118 flexion so all good there. I can test out short drives in a week or so, and will begin outpatient PT soon.

Here is the cautionary tale part of my update. Prior to joining this forum, I had a picture in my mind of how I was going be, how long this would take etc. My OS had said long ago I was looking at 3 months off of work, but I naively thought it was negotiable. Today he absolutely forbid me from returning to work (leading fitness classes) until mid March. Silly me thought to go back around 8 weeks. He is right of course. So a new note has been sent to both of the gyms I teach at. It’s hard not to worry about being gone so long. The fitness world can be very fickle. Will my classes like my substitutes better? Or will my substitutes run my classes into the ground because the members dont like them? Ridiculous thoughts of that nature. But there’s only one chance to heal properly. My well being depends on it. Once I digested that I’ll be away from teaching classes that long, I feel relieved. Now the pressure is off trying to rush things along, because I have gotten the message loud and clear there is no rushing this.

 

[mendogal]

That's a fine update!

Yep it's sure easy for the mind to spin out especially when we're separated from our "normal life" ....

And yep, it's an incredible relief to adopt the attitude that the knee and it's priorities are in charge for the foreseeable future.

 

[MargFit]

4 weeks post op, and for me this is where the magic is happening. The magic of actually feeling glimpses of my normal self. Also, the notion that I will have my life back eventually is much less far fetched than even a week ago. Little things like not feeling wiped out after a shower or making a smoothie. Not needing a morning nap just the afternoon nap.

I celebrated today by taking my first test drive. I made sure to have my son with me in case things felt too painful. I absolutely would not want to drive much more than 15-20 minutes away at this point. But my reflexes were fine, no issues there. This is such a huge milestone! Another step towards normal life. Definitely can tell driving will be like restarting any kind if exercise, start small and work back up to longer and/or more frequent trips out.

UnlIke many others, I have not had formal PT yet. That begins next week. It will be nice to drive myself there and back. With past knee surgeries (I have had 4!) the facility I went to was underwhelming at best. The therapists did not listen to my requests for gentler work, completely ignoring that I was doing the hard stuff on my own in my classes and needed them for restorative work. Often I felt their regimen set me back. This time, I am going to a different facility that has better recommendations so I am hoping to have a more positive experience. I feel much more prepared to advocate for what I want from all that I have read on this awesome forum!

My immediate goal: to do my best to stay out of the ODIC! Because this magical shift has all the makings of tricking me into doing too much!

 

[sistersinhim]

What were your previous knee surgeries? I will add that information to your signature for you. Being through knee surgeries already has put you ahead of the game in knowing what to do. This joint replacement is different though. From reading our posts, you already know what to do and what not to do! Be strong and don't let PT force anything on you that you don't want to do.

 

[mendogal]

Driving is a great milestone!!!!
While I had really good ROM early on, it took me 6-8 weeks to venture out as the driver.

Besides advocating for yourself about not going past your comfort zone, it's important to not let them talk you into "you're doing so well, let's get you stronger!" Muscles need 6-8 weeks to heal, and major surgery is not a mild athletic sprain!

 

[MSuki]

Love hearing that positivity, hope things go well for you at physical therapy. It’s always easier when you go in with a plan.