[TKR] Thegoose2 on the go<

You are correct, the swelling is making it difficult to bend your knee. You are just days out of surgery. The swelling is going to take a while to settle down, probably weeks, if not more. This is normal. The surgery caused a lot of trauma and it will take your body a while to recover.

Treat your knee gently. Just bend slightly and gently. Short walks throughout the day is all your knee needs right now. It does not need “ X amounts of reps of exercises” this early.

Work on reducing the swelling by resting, elevating your leg, and icing (always putting a cloth beteeen the ice/gel pack and your skin)

Keep in mind it’s not exercising that gets our range of motion back, it’s Time:

Time to recover.
Time for pain and swelling to settle.
Time to heal.

Our range of motion is right there all
along just waiting for that to happen so it can show itself.

In the general run of things, it doesn't need to be fought for, worked hard for or worried about. It will happen. Exercise as in strength training is counter-productive and in the early weeks does more harm than good. Normal activity is the key to success.

 

Swelling most definitely affects the amount of bend and extension your knee can have. There's no room inside it and you can't squish all that fluid out of the way. The only way to do that is to get that fluid out of there!

You don't. That bend will come naturally after the swelling goes down. Concentrate on that. Just walking around doing your daily activities is enough for now. When the swelling goes way down, then you can gently work on the ROM. Your main goal is to get the swelling down!

 

I'd really like to offer you some structured advice but in order to do that, I also need to ask you some questions. Are you willing for me to do that?

 

Here y'go then!

It would be very helpful if you would answer each one individually - numbered as I have done - 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 forget to factor in other forms of pain such as soreness, burning, stabbing, throbbing, aching, swelling and stiffness).

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

3. how swollen is your leg compared to these?


4. what is your ROM - that's flexion (bend) and extension (straightness)

5. are you icing your knee at all? If so, how often and for how long?

6. are you elevating your leg. If so how often and for how long?

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

8. are you doing any exercises at home? If so what and how often?
This is the most crucial question so please help me by using the format I have left as an example
(which means please make a list and not an essay!)

Exercises done at home
- how many sessions you do each day
- enter exercise by name then number of repetitions of each
etc., etc.

Anything done at PT
- how many times a week
- enter exercise by name then number of repetitions of each
etc., etc.

 

That's about right for the first week out.

I think you should be careful of using a muscle relaxant as a adjunct to pain medication.
I'm not quite sure how you mix the hydrocodone and Tramadol but it appears to work for you.

Again, pretty standard for the first week.

All normal for the first week out. Don't get panicked about it. It might even get worse before it starts getting better!

Good but here's a good schedule to stick to: Ice and elevate for at least 40-60mins and more than 4 times a day.

You're probably doing a bit too much. You could do those little walks even less, say just for bathroom and kitchen trips. No need to make a passion for it!

Exercises all done once a day
hamstring stretch with strap, 3 times, hold 30 seconds, one set - do not use straps, weights or anything similar. Leave that until at least 6 months time
sitting heel slides with strap, 20 times, hold 5 seconds, one set - again, no straps and rather follow this method (this was in your "Knee Recovery: Guidelines" in post #4 of this thread)
quad sets, 15 times, hold 10 seconds, one set - much too much. I suggest you stop doing these
straight leg raise, 10 times, hold 1 second, 2 sets - SLRs: once you can do them, you don't need to do them any more!
hip abduction, 10 times, hold 1 second, 2 sets - hip abductions are unnecessary for knees!
exercise ball floor bridge, 10 times, hold 2 seconds, 2 sets - I did not do this one - I'm glad because bridges are not necessary for knees!
While sitting I do ankle stretches and quad stretches - these are only necessary for when you are almost immobile in the first 2-3 days after surgery. Since you are clearly more active, there is no need to do them now.

First PT was yesterday. She taught me the above and had me run through my sets so I would know what to do at home. Felt good to move but sore later. Will be doing 3 sessions a week (Mon, Wed, Fri) but not sure what it will consist of yet - I suggest you quit your PT sessions completely. This kind of exercising is totally unnecessary for knees and often causes far more problems than it resolves.

This proves 100% what I said before. Exercises will cause your leg to swell (more) and will therefore cause your ROM to lessen tremendously. I've seen it happen here far too many times.

You see, it's not the exercising that gets you your ROM, it's time. Time to recover, time for swelling and pain to settle and time to heal. One thing that seems to be missing from all the PT's protocols is that all your ROM is there right from the start, just waiting for all that to happen so it can show itself. In the general run of things, it doesn't need to be fought for, worked hard for or worried about. It will happen. Exercise as in strength training is counter-productive and in the early weeks does more harm than good. Normal activity is the key to success.

If you are concerned about refusing to do therapy, you need to read this Saying no to therapy - am I allowed to?

BTW, I recommend you read my recovery thread to see how little exercising I did for either knee! Knee recoveries UK style Parts I & II (Josephine)

 

Knees that are upset can be very bossy!

 

As long as we obey the knees, life will be easier!

 

You are in the dark, angry tissue stage. It will improve, try to hang in there.

I think the advantage of having both done close together is that once you are past this stage with the second, you’re done. As compared to doing them a year or more apart, you have really improved from the first one, then you are back to square one with the second.

I don’t know that first hand, but I think that’s how it might be.