TKR The TKR Recovery Journey of a Fitness Instructor

[MargFit]

2 months and 3 days post op!

in my last post I mentioned severe calf pain, not due to DVT. I took @mendogal advice and stopped the constant stretching and massage. Lo and behold, in less than 2 days the pain was completely gone. When I went back to PT, they tried to get me to do calf raises just because those exercises were on my list. I politely told them to cross those off and we would not be aggravating my calves again. Regarding PT in general, I’m reminded again of how generic it can be. I have pretty much outgrown it, and graduated myself to once a week as I’m doing lots on my own. I am going to finish my 12 sessions, I have 2 left at this point, then I’ll be moving on.

Yesterday I did a big test on the new knee, I went to Disneyland! I live less than an hour away and have an annual pass, so going for quick visits is my norm. Typically I go 2-3x a month for just a few hours. I had my friend drive as I knew I was not ready for that distance yet. 15-20 minutes of driving at a time is my sweet spot right now. I am happy to report that getting on and off rides was way easier than I anticipated. We spent 3.5 hours there, did 11 rides, took our time walking around and ended up cumulatively walking approximately 4 miles. When I got home I was sure I was in the ODIC as I was limping a bit and super tired. However, immediately icing, elevating, TENS, and red light therapy have me feeling no worse for the wear today. The next couple of days I’m in easy does it kick back mode. So far, whenever I’ve tested my current limits, making sure to have lots of down time to recover afterwards seems to be working for me.

I am on track to return to teaching fitness classes and personal training in 3 weeks, and am doing my best to savor the rest of my time off to continue healing and enjoying the lack of a formal schedule.

 

[mendogal]

What a fabulous update!.
Disneyland would not have been on my list at two months, but it looks like while it was overdoing it, it was easily remediated. And what a tonic for you!!!!

 

[Layla]

Hello and Happy Three Month Anniversary, Margfit!
Your last update was awesome. I hope you're comfortably getting back into the groove of teaching fitness and personal training. Let us know if time allows. Have a happy healthy Spring 2024!
@MargFit

 

[Kinch705]

Your journey gives me hope! I am only 3 weeks post op but so impatient like you were. I have learned from your posts. Thank you! I will continue to follow your journey..

 

[EalingGran]

my last post I mentioned severe calf pain, not due to DVT. I took @mendogal advice and stopped the constant stretching and massage. Lo and behold, in less than 2 days the pain was completely gone. When I went back to PT, they tried to get me to do calf raises just because those exercises were on my list. I politely told them to cross those off and we would not be aggravating my calves again

Very wise. Calf raises are surprisingly tough.
My pilates teacher noticed recently that although my legs are now well balanced and my thigh muscles on the operated side are just as good as my unoperated side- my operated side calf was still a little thinner and weaker.
She told me to try some calf raises- including one legged ones at the counter whilst waiting for the kettle to boil. I am much, much further on than you ( now 16 months). I was amazed how I felt these after even a few repetions.
You are absolutely right to listen to your body and not let anyone push you around

 

[Davi]

Hello MargFit Thank you for posting your tkr journey. It is very helpful. I have been taking exercise classes most of my life up until 12/6/23 when my right knee popped during a low impact aerobics class. (ACL & meniscus tear) I had 2 arthroscopies, one right knee one left knee in 2007 & 2005. I was limping for the 1st 3 weeks after the injury on 12/6. I had to resort to a local gym just using fitness equipment as opposed to taking the classes that I was used to and liked very much. My tkr is scheduled for 4/11. I was curious how your scar is healing and if in addition to the scar on your knee, if you also have a scar on your shin from where the robotic arm was placed? Thank you.

 

[Axx72]

If anyone reads this and has any anecdotal experience with calf pain post TKR to share, I’d love to hear.

Do you still have your posterior collateral ligament, post TKR? Some have had theirs replaced and some get to keep their original. Replacements can be irritated easier during the healing process.

When my PCL was irritated, I originally misinterpreted that as high calf irritation. Brought on more by hiking/climbing/stairs. Smoother movements like cycling seemed to be more tolerable.

Sometimes because there is not a ton of room for fluid in the knee join itself, that excess swelling will escape out the back of the knee with movement, which can also irritate the upper areas of gastrochiemus muscle.

The fix was rest, ice and TENS. I had probably been pushing a bit too hard at the time. Low impact static stretching helped too.

I hope it alleviates soon and is just a minor bump in the road.

 

[EalingGran]

My tkr is scheduled for 4/11. I was curious how your scar is healing

Hi @DAV - there is a separate thread for pictures of people's knee scars if you are interested.

 

[MargFit]

I was curious how your scar is healing and if in addition to the scar on your knee, if you also have a scar on your shin from where the robotic arm was placed?

I just measured my scar to respond, funny I had not done that yet as I am typically a person who would! So in total, the scar is 5.5 inches. Of that, 2 inches goes from bottom of knee onto the top of my shin. Overall I think it is healing nicely. It absolutely looked scary monster-ish at first. It is more of a light reddish now. At the top on my thigh it is a bit wider, which I am told happens from all the bending that happens there. It isn't so bad that I think I would need to have anything done to it down the road, it's just not super thin at that top end. I switched from Vitamin E oil to Vitamin E cream simply because I was having a hard time applying the oil and not getting it on my clothes. The cream absorbs fast. I workout in leggings all the time, even in summer, so my knees aren't on display too much for anyone to see the scar on a regular basis. All in all, I think when it's done and it's gone to a white line, it will be a nice badge of honor, and nothing to be freaked out by.

 

[MargFit]

Hello BoneSmart Friends!
I am thrilled to hear that my journey has been helpful to others. That was my hope when I picked the title of my recovery thread. Well, I hit 3 months post op yesterday. This coincided with my return to work. I will relate the good and the not so good. First I'll give a little update on what went on from my 2 month update to now as that might be of use to the fitness fanatics & warriors out there.

After my 2 month update, I knew I had 1 month left to accomplish both continued healing and try to regain some endurance & strength to prepare to teach again. I put myself back into the gym environment 2 times a week, then did the rest of my workouts at home. I knew I needed to ease into the noise, loud music, seeing that many people all at once. Having been quiet at home for so long, it really took it out of me going out so baby steps on that. I took Body Pump class at gym, then did it 1-2 times at week with my weights at home. If I was tired, I skipped a day. Resting stayed top priority. I took 1 cycle class a week, which actually felt great on my knee. If the instructor had a big climb or too much standing, I adjusted to what felt right for me. This is one the reasons I am a fan of cycle class because it is easier to do your own thing there than in another type of class. In between I would do easy stationary cycle rides on my own at home or gym, maybe 30 minutes in duration. The interesting thing with all of this was discovering that doing Body Pump (strength training class) and stationary bike didn't end up hurting me afterwards, but going for 1-1.5 mile walks was brutal and would have me limping. I even tried super slow 10 min walk on treadmill after stationary cycle and my knee told me NO! Go figure!

So, that was my month 2 into month 3 transitioning to get back to teaching. I was as ready as I could be but knew there was no way this first week of teaching wasn't going to be intense. In a perfect world, I would have taken another month or so off. My OS would have been happy to see me take 6 months off. However, as a part time employee, I am not covered under the Family Medical Leave Act and had been granted discretionary leave. The danger zone would have occurred had I not returned to work around this 3 month mark. My employers would have been able to let me go, and I would lose my highly coveted prime time teaching slots. Not that it would have happened, but from an HR standpoint, they can only keep someone out on discretionary leave for so long. This absolutely had to factor into my decision on timing my return. It is what it is. As I type this, I have made it through my first week back. I teach a pretty intense load. It works because I love what I do, I love the people in my classes, and my oh my did I ever get a warm welcome back at both gyms I teach at. I cannot in good conscience recommend doing what I am doing at 3 months post op unless it is your bread and butter as it is for me. But I will share what my class load looks like for those that need/want to see that there is hope to get back to your classes sooner rather than later if done carefully.

Body Pump Classes: I am doing 4 a week. No weights for squats or lunges. Range of motion isn't as low, I now cue my classes to go as low as their hips and knees will allow. Seeing me do less seems to be encouraging for the class rather than not motivating. They understand on any day, we can adjust the exercises to meet us where we are.

Les Mills Core: 1x a week: this is an athletic 30 min functional core cross training class. Lots of hip, glute activation which was just like PT moves but more advanced. Lots of planks and hovers. No knee issues for me in this one, just had to watch out for lateral motions and not go to my full range on those.

Circuit Training: 1x a week. I do all low impact moves, and can tell the class how to do jumping version and utilize a member as an example of high intensity. This is my new norm as I have no plans to ever try high impact again.

Mat Pilates: 2x a week. This class is great and have not found anything that hurts my knee. I am able to kneel on my new knee, I was concerned how that might feel. I just roll my mat up doubled and I am ok. In the past, I have used yoga knee pads, these are great and easy to tote in gym bag. The core strength is so important in this TKR journey and Mat Pilate just feels good.

Barre: I was most worried about this. I teach this in what is called the musicality method so there are lots of ballet inspired moves done to the beat of the music. In the moment it felt good, I think after the fact this one snuck up on me and the knee wasn't too thrilled.

So the good? I made it, I got flowers, cards, hugs, and saw the happy faces of the people I am privileged to help on their health and fitness journeys. I cleared my schedule to have nothing other than teaching in the morning and rest of day nap, ice, TENS and red light on repeat. The bad? It was too much too soon. I would be lying if I didn't say I am trashed energetically. My limping is back. I am sure I am prolonging my healing process.

Between now and 4 months post op, I hope to have found my groove again with being back to work. I hope my body adjusts to this amount of output. I plan to continue prioritizing rest and recovery daily over all else, and monitor if worse comes to worse, if I should need to step back a bit, I will. For now, onward and upward!

 

[EalingGran]

Crumbs! That is amazing. Good luck. I just hope you can keep up OK. Just don't do anything more than you have to is my advice- it is still early days.

 

[MargFit]

Crumbs! That is amazing. Good luck. I just hope you can keep up OK. Just don't do anything more than you have to is my advice- it is still early days.

That is the plan! I have already had requests to help cover classes for other instructors that I turned down. No extra work for a long time, mine alone is hard enough. I just hope the knee pain I’m having is more of an acclimation to high usage as opposed to causing harm.

 

[Davi]

MargeFit Yes do be careful not to overdo it. I can relate. I miss my fitness classes. Though I am not an instructor, I could be with all the years I've been taking fitness classes, I went regularly. I miss the barre class, Pilates, spin, Body Pump, core cardio & strength classes and some Yoga. Twice a week I would take a core cardo class back to back with a Barre class. On Saturday's I would take Body Pump and then Spin. It's been 3 months now and now I am only able to do free weights & stationary bike & treadmill. I am trying my best not to get bored but I'd rather be bored then in pain. It's the rotational, twisting & turning moves that got me into trouble so unfortunately I may not be able to resume some of those classes but as long as I can stay in shape and keep strong that's what's important to me. I may need to get the other knee done at some point. Anyhow, thank you so much for sharing your experience. Sounds like you are doing great! My journey is just about to begin. Was at my pre-op today and heard many times, "it's going to be painful." The MA called in prescriptions for pain med Percocet, Celebrex, Gapapentin, Tramadol, and said I need to take baby aspirin. They said I can go to a dispensary and pick up some THC 10 mg gummies if I want to that some people don't tolerate opioids.