TKR TKR Progress

[Odieodell]

I never felt icing helped me much except for initial first 3 weeks. I’ll try icing behind my knee in the evenings to see if that will help. I’m not a back sleeper so elevating at night doesn’t work for me.

 

[Jockette]

I wasn’t a back sleeper, either, until after this surgery. It’s much more comfortable with my legs elevated.

 

[Odieodell]

I’m at 14 weeks post-op and am still feeling concerned that I’m not gaining any flexion. I’m sure my flexion is still 95 degrees which is where I was at 4 weeks post-op. Yes, I have some swelling and I remain very active with golf which I’m very thankful for because I have no pain playing that.

How can so many here be certain this will improve in time through only daily activities? I know many people say it can take a year for a TKR to heal and I get that, but shouldn’t I be making a little gain every month? Something?!!

Recently, I’ve started to force bend it a bit with my good leg and hold for 10 second stretches hoping maybe this will help. Any other stretching and hold exercise anyone might recommend?

My incision looks great but it still feels sensitive at times and has a bit of a pulling/tearing sensation underneath the skin which I’m guessing is some remaining scar tissue.

I also still get quite a painful sensation behind the knee when I make a outward motion with my leg or pull back out of a shoe. It is almost like a burning cramping muscle, but the pain stops when I stop the motion. I’m guessing it is probably due to my golf even though I don’t feel any pain when I play. Hopefully, that will go away once golf season finishes in the fall.

I know everyone is different and I’ve read some stories here and am thankful I’m doing as well as I am compared to others. Then at the same time, I see people quickly gaining flexion and wondering why I am not. I diligently strength trained before surgery, started PT two days after surgery, but I completely stalled improving. It makes no sense to me.

I’ve read and followed comments of people who had MUAs and I never got the impression they helped people except briefly, so I still don’t regret not letting my surgeon do that.

I want to get back to biking, tennis and downhill skiing. Yes, I know it’s way early in my healing, but I want to know I will be able to do those activities again. Not seeing any improvement is very discouraging.

 

[glidefloss]

I’m at 14 weeks post-op and am still feeling concerned that I’m not gaining any flexion. I’m sure my flexion is still 95 degrees which is where I was at 4 weeks post-op. Yes, I have some swelling and I remain very active with golf which I’m very thankful for because I have no pain playing that.

Hi @Odieodell , have you tried using a stationary bike as a flexion gaining aid? I used it a lot during the early weeks post-RTKR (now 7 months hence) and to a lesser degree with my LTKR (now 12 weeks). The bike at the gym I go to is an upright one (i.e., not a recumbent one) with different height levels from 1 to 13. During the very early days post-op, I'd start at level 13 (I'm fairly tall with longish legs) and rock back and forth - my right leg took a little over a week before I was able to do a full rotation ... but after that, progress came much quicker and within a month and a half was able to drop the seat down to level 3 - which required a pretty deep bend. The best thing about having done that religiously for my right knee was that it got my left knee in great shape for it's own recovery when I had the LTKR. I very quickly managed to do a full rotation after my LTKR and within a couple of weeks got down to level 3. I would typically do 30 minutes on the bike - a few minutes at the highest necessary seat height, then dropping the seat height as the rotation got easier. After around 8 weeks I switched to the stairmaster and that has helped ease my post-LTKR left side lower back aches and started my road to cardio improvement.

Although I'm sure a lot of forum users have experienced a return to "normal" just doing daily activities, I didn't want to wait an indefinite period of time before returning to an active life. I took an aggressive approach to recovery/rehab and I'm very glad I did as I am now enjoying the Colorado summer - long bike rides, evening 3-5 mile walks, my first rugged rooty, loose rocks, steep hike - with my left knee at under 3 months.

I noticed too in your earlier post that you stopped icing after 3 weeks. For my RTKR I iced religiously even without any perceivable benefit. I gave up after a couple of days after my LTKR when I realized that icing (for me) drastically slowed the elimination of excess fluids in my legs, i.e., it slowed the decrease of swelling. (From day 1 post-LTKR, I elevated my legs against a wall at a pretty acute angle, around 60 degrees, and did a lymphatic massage of my leg. That caused me to pee a tremendous lot - with commensurate decrease in leg swelling. The couple of times I had my leg iced up while similarly elevated - using the Berg Polar Cube - peeing stopped altogether and the leg remained unchanged swelling-wise. Since the icing didn't provide me any pain relief and it slowed down swelling reduction, I quit it altogether.) The lymphatic massage was one of the things that allowed my left knee to recover so much quicker than the right - even if the pain the first few days was so much more intense than the right.

Whatever it is you end up doing, I hope it brings you the results you want. All the best!!

 

[Odieodell]

@glidefloss I do have a recumbent stationary bike. I have not been using it since I decided to try just daily activities. I thought the PT appointments which included several minutes on a recumbent bike were causing swelling and not helping me. I was able to do a full rotation with the seat quite far back at 3 weeks. Now after stopping formal PT 7 weeks ago, I’m still no further ahead. I may have to give the bike a try again.

I do find if I take a 500 mg Tylenol my leg feels better overall. I think it helps take down the swelling, but I hate taking medication, so I rarely take any unless the back of my knee tissue is really sore. I worry about medication side affects.

I have never done a lymphatic massage on my knee. I’ll have to look up how to do that.

In the evenings I do have my leg up on an ottoman, but not elevated. I should try icing more often then, but really never feel improvement from icing.

 

[glidefloss]

Hi @Odieodell , since Tylenol is not an anti-inflammatory, I doubt that it'll help tamp down swelling. My go to pain killer/anti-inflammatory is Advil (Ibuprofen), which I used a lot of years ago when I used to run marathons and ultras ... so when I had my TKRs, I knew my body'd tolerate it well. I'd also use Aleve as a secondary pk/a-i. That said, like you noted, it's good to be aware of unwanted/expected side effects.

In re the bike ... when moving the seat up closer to increase the knee bend required for a full rotation, do so as incrementally minute as possible ... and carefully gauge the effect of the new bend on your knee before again incrementally increasing the bend.

In re lymphatic massage, a user on this forum had mentioned it to me months ago ... leading me to look for what it was on YouTube. I'm sure my version of the massage might not count as a true "lymphatic massage" but it really did the job amazingly well ---- that in conjunction with steep elevation while massaging. I've since stopped doing it since neither my lower leg or thigh swell anymore - regardless of amount and level of activity. In re my knees themselves, there's a tight band feeling that's pretty much always there ... very slowly receding. In terms of degrees of tightness - if my right knee (7 months) is a bacon cheeseburger, my left knee (12 weeks) is an extra extra extra bacon cheeseburger.

When subjected to heavy activities, the swelling in my knees are largely internal - so I can't get at it by massage ... elevating my legs does the job, with the occasional Advil or Aleve.

As folks are quick to point out in this forum, all knees are different and exercises/etc that work for one person/knee might not work at all (or might even be debilitating) to someone else.

All the best!

 

[Odieodell]

I’m 16 weeks post-op now and not much has changed. The knee continues to slowly heal.

I have been noticing a pulling/tearing sensation of feeling of soreness underneath the skin to the lower part of my incision, but only when I lay on my side and bend my knee. Assuming it is scar tissue, I daily massage the area to loosen it up. However, every evening it feels like I’m back to square one with it. Does this ever go away?

 

[glidefloss]

Hi @Odieodell , I think I know that pulling/tearing sensation albeit on the front medial side of my left knee (99 days post-op today) as something similar would occur every now and again ... with no perceivable rhyme nor reason for when it comes up. That said, it doesn't really bother me since it is pretty much a pain free sensation.

Does your sensation hurt? If so, is it a sharp pain or more a dull, lingering one?

The past couple of days, in addition to elevating my legs, I've resorted to using my leg compression massager in the evening as I've been working my legs extra hard this week - having biked 40 miles Sunday, did the Manitou Incline hike (in Manitou Springs, CO; 2,728 steps, gaining ~2,000' elevation in .8 miles, total of 5.28 miles) on Monday, and a tough PT session on Wednesday. The knees responded well to that level of activity ... but the extra pampering is helping get the legs ready for a longish hike tomorrow. I don't ice my legs as it seems to impede recovery - different strokes for different folks on that one!

Hopefully your own recovery has been making progress, the new sensation nothwithstanding.

All the best!!

 

[Odieodell]

Does your sensation hurt? If so, is it a sharp pain or more a dull, lingering one?

It is only noticeable when I lay on my side with my knee bent. The pulling/tear sensation feels like the incision is opening up, but that has healed very well. I’m assuming it is scar tissue pulling underneath the incision. I keep hoping the tissue will heal separately, but it seems to keep reattaching itself.

 

[sistersinhim]

What you are feeling is probably areas that are still healing together. You are less than 3 months out from your surgery. You will be having different areas that are painful for quite a while yet. Scar tissue is what is holding your soft tissues together. What you are referring to is adhesions.

 

[Odieodell]

@sistersinhim so am I doing the right thing in massaging them to keep them loose?

My flexion still hasn’t improved, but I’m thankful I have no knee pain during daily activities. At this point of recovery and not having pain, I surprised I still have swelling. I admit I’m on the go all the time, so rest comes only at bed time and I’m still not icing it. How long does it typically take for swelling to go away?

 

[benne68]

You are very fortunate that you are now about to function pain free. That's a big milestone!

At this point of recovery and not having pain, I surprised I still have swelling. I admit I’m on the go all the time,

Swelling is the knee's way of letting us know when we've done too much. It's not surprising you are still have swelling if you are on the go all the time. Perhaps you need to cut back a little or at least, take some breaks during the day and elevate your leg.

I still have occasional episodes of swelling (and I'm 10+ months post-op). I just came back from vacation where I did a lot of walking on cobblestones and uneven surfaces. It was a lot for my knee and I had swelling. A few days of cutting back on activities, elevating and icing is already helping.

Remember that this is a year-long recovery and you are only one-third of the way through.

 

[sistersinhim]

so am I doing the right thing in massaging them to keep them loose?

You, more than likely, do not have adhesions. If it feels OK, then massage. If it is painful then don't do it, it's only hurting your recovery.

At this point of recovery and not having pain, I surprised I still have swelling. I admit I’m on the go all the time, so rest comes only at bed time and I’m still not icing it. How long does it typically take for swelling to go away?

Swelling is what is keeping your bend from improving. You need to cut down your activities and ice as much as you can, along with elevating at the same time. Getting that fluid out of your knee will improve your bend.

 

[Odieodell]

So I found out kneeling on the new knee is uncomfortable when I had to crawl underneath a desk to plug in a new printer cord. I also can’t run fast enough from ground bees. I got nailed twice!

 

[benne68]

Ouch! Sorry to read this, @Odieodell.

Those ground bees are truly nasty! I had trouble with them last fall when I was weeding and, apparently, disturbed a nest. I was swollen and sore for days. This year, I'm letting the weeds grow so we don't have another encounter.

 

[Susie-Q]

I have been noticing a pulling/tearing sensation of feeling of soreness underneath the skin to the lower part of my incision,

This is normal. I still have a pulling sensation every once in awhile and tightness. Since my incision is 11 months old now, I will take a little lotion and massage it into my scar to soften the skin and it helps with that pulling sensation.

You will slowly get more comfortable kneeling but it will feel weird for quite awhile. I'm able to kneel on a cushion to pull weeds and the carpet for short periods of time but not for too long. Kneeling in the first few months was quite painful.

 

[hawk2go]

The past couple of days, in addition to elevating my legs, I've resorted to using my leg compression massager

There could be some issues with using a compression device. Be sure to consult your surgeon to make sure this is appropriate for you.

@Odieodell - when you are ready, you can try desensitizing the knee when you kneel. The video I watched recommended, kneeling on very soft surfaces (like a sofa) for the 1st week and gradually increase surface hardness over several more weeks until you could comfortably kneel on the floor. I'm in week 1 because neither knee likes kneeling much. Thank goodness I have no call for kneeling in my dailies.

 

[Odieodell]

So today my husband and I tried hitting Pickleball. We’ve only played it once before a couple of years ago. I was hoping it might help loosen ion my knee to get me back on the tennis courts. I definitely guarded the knee as I moved to get to the ball. It was never painful, but it just isn’t loose. I could tell my calf muscle and ankle got the bulk of the workout. It will be interesting to see if my knee protests tomorrow. I found I need to play Pickleball left-handed like I do ping-pong. I play tennis right-handed. I still prefer tennis and hope I can get back to playing. I know it’s still early in my healing, but am trying to nudge my ROM a bit with this activity.

 

[Odieodell]

My knee didn’t protest me playing Pickleball. My upper quad is a little sore, but that is a good thing so I plan to keep playing to see if it will help my ROM. Stay tuned!!

 

[sistersinhim]

Yay, that is wonderful news!