TKR Two years out from October 2023 TKR

[Jockette]

I agree, you don’t need to pull for that additional inch of a bend, especially since you say that hurts. Your joint will bend fine as it heals. Right now it’s swelling that is restricting the bend. Pushing for more is going to maintain, or even increase, the swelling, which is counterproductive. 12 days post op is way too early to worry about your bend.

Last Christmas I fell and landed on my almost 6 year old PKR. My knee and leg swelled big time and I couldn’t hardly bend my knee. I did no exercises and as the swelling went down, my ROM came back just fine.

Your ROM is directly related to your swelling. The new joint does not have to be worked to get more bend, the bend is already there just waiting for the swelling to go away so it can show itself.

 

[sistersinhim]

I guess I need more patience.

That patience muscle is the main one you should be exercising!

 

[Dmcfad2]

@Jockette @mendogal I have PT this morning and I will ask her about not using the strap. I do think my knee is a little more swollen this morning, possibly from all the heEl slides I did yesterday.

 

[Dmcfad2]

My PT said I should only be using the strap for assistance, not trying to pull it until it hurts. In my session this morning, when I started to do the heel slides, I got a pain on the outside part of my lower knee. It really hurt, so I didn't do them. This is the second time that has happened in therapy. It doesn’t happen when I do them myself. After my session, my knee is very stiff and achy. It already was feeling that way this morning and it’s worse now. I want to cry today. It’s the post op blues. I’m not seeing any progress. My pain is not getting better. When does that happen? I know it’s early days. I just feel sad.

 

[sistersinhim]

My PT said I should only be using the strap for assistance, not trying to pull it until it hurts. In my session this morning, when I started to do the heel slides, I got a pain on the outside part of my lower knee. It really hurt, so I didn't do them. This is the second time that has happened in therapy. It doesn’t happen when I do them myself. After my session, my knee is very stiff and achy.

Using a strap for assistance is not helping your knee at all. You need to use your own muscles. That way you are engaging your body to do the work, not a strap. Also, it is easy to overdo it by pulling with a strap.

You should not be doing anything that hurts. That is not productive in your healing. You need to be doing only up to discomfort and no further.

I'm one of those who never took formal PT. Due to birth defects, I've had 12 knee surgeries, 2 of them kneecap removals, and 1 TKR. Even after those I never took formal PT. But, I didn't just sit around and do nothing, I used my knee as it was intended to be used by walking around to take care of my daily needs along with the necessary house and yard work. As I healed I was able to do more. Icing and elevation were a huge part of my recovery.

Listen to your knee. It will tell you if you're doing too much by increasing pain and swelling. When that happened to me, I found that resting, icing, and elevating helped. Your knee knows how to rehab itself without being told what to do. Doing too much too soon causes setbacks because your knee has to heal from the inflammation caused by the exercises before it can get back to its normal, after-surgery healing.

 

[mendogal]

I'm so sorry you're having a hard time. Know that you're not alone.

I suggest that you consider stopping PT. It's clearly pushing you too hard, creating a continuous cycle of swelling and pain that makes you miserable and prevents healing.

 

[benne68]

I’m not seeing any progress. My pain is not getting better. When does that happen? I know it’s early days.

You're right, it is early days. You are in pain because your poor knee has a lot more healing to do.

My own experience with hip and knee replacements was that recovering from the THR was easier -- the pain dissipated earlier and I was walking normally much sooner. Since, like you, I had my THR first, I initially judged my TKR recovery against that -- and was in for a surprise!

What you are experiencing is completely normal for just two weeks post-TKR. Expect it to take many more weeks before the pain, swelling and stiffness go away. I found this chart really helpful in understanding why it takes so long:

 

[Loulou67]

I am still early days into my recovery too….. i’m struggling with bending the knee as it’s so swollen….. I have my next PT appt a week on Monday ….. I’ll keep trying but I’m not going to stress too much any more…… I am sure the leg will heal in time…..
I was very tearful beginning of the week, I think it’s to be expected….. sending you a hug x

 

[Layla]

Good Morning Debbie,
I am in agreement with the others that you should step away from PT, at least for awhile and allow yourself more time to heal. Please consider it. You mentioned that this is the second time the stiffness and aching increased after therapy, so it's hard not to believe that what you're doing is too aggressive, at least for now.
Give yourself the TLC you deserve and don't forget that you're only two weeks out of major surgery. Your leg endured major trauma, in a very small area, albeit controlled. Your muscles, tendons, ligaments and other soft tissue is going to cause you discomfort and pain for a while yet. Take your meds for as long as you need to in an effort to remain comfortably mobile. Continue icing and elevating so you're able to rest easy.
Hopefully today is better than yesterday.
@Dmcfad2

 

[Dmcfad2]

I am hesitant to step away from PT. I am really not miserable. I’m sorry if it comes off that way. Yes, I did have a little down moment, but it didn’t last long. Most of the time, I feel pretty positive. I just get frustrated and then get weepy. I’m sure the meds help with that, too. My emotions are all over the place sometimes.
I do think PT is helping me, even though I was achy afterwards. I get achy and sore anyway, just doing things around the house in the course of my day. My therapist really doesn’t push me at all. She doesn’t want me doing anything that hurts. I push myself, so I just need to give myself a little break. I can do all exercises pretty easily except for the heel slides. She told me not to do them if they cause me problems. She’s not even worried about my flexion. She says it will come in due time. Again, I put the pressure on myself to get “better”, so I’m going back off. I don’t have another PT session until next Monday. That gives me a break of 5 days.
So, the positives:
I am walking around the house without the walker a lot. I need to practice the heel-toe walk. Because my knee hurts when I bend it, I want to keep it straight, which causes me to limp. So, I really concentrate on heel/toe and follow through. The more I do it, the easier it gets. I get my staples out this morning and I’m thinking that will help in that stiffness I feel, too.

I am able to get myself in and out of bed and even lift my leg without assistance. It does still hurt, so I will use my other leg to help.

I am slowly cutting back on pain meds. I have cut some of my pills in half and substituted Tylenol for some of my day doses. I still need the oxy at night before bed and in the morning when I wake up. I also take half a pill along with two Tylenol in the middle of the night if I wake up all stiff.

I am happy with my progress. I’m feeling pretty good this morning. Here’s to a beautiful day.

 

[MichiganGal]

HI Everyone - I am reading the posts and so relate to the struggles you are going through. My first months of recovery have been challenging and frustrating. I stopped doing formal PT at the 8 week mark and in a few days it will be 5 months post surgery. During the early days of PT I would come home, my knee would be so swollen and I was exhausted. The swelling continued for days and I listened to them instead of my body and kept pushing. I will say that I am a big supporter of PT (I work it the rehab field) but I am a bigger supporter of listening to ourselves and challenging the medical field. This last round of PT was a hard lesson for me and I wish I would have listened to my body more.
My advice - listen to you, talk to your PT and make major modifications. If you PT is not willing to work with you and your pain/recovery then you need to find someone that will.
Since I ended my PT my swelling is much better, I am walking everyday, doing my home projects and feeling so much better. I still exercise but I do it my way and listen to my body. If I have an ouchy day (like from doing 5 hours of yard work this past weekend) I don't walk for a couple of days, extra ice and just stretch.
Give yourself time and grace to heal. I know I was not giving myself grace like I do others and it really affected my mood and healing.
This is a long haul heal to give you a better life - give it the time it deserves.

 

[Dmcfad2]

Oh, I wanted to say that something happened yesterday and I was very lucky. I think God was watching out for me. I have an electric recliner. I haven’t been sitting in it much, as I’m using the couch right now. But, I decided to sit there last night for a bit. I have to move forward in the chair as I lift the foot part because of the lack of bend in my knee. So, I was sitting forward in the recliner and elevating the foot part. As the foot part came up, there was too much weight in the front, which caused the recliner to tip forward. I felt it happen. It was too late. I slid down the front of that recliner like I was on a slide and landed on my butt with my feet straight out in front of me. My husband came in and lifted me off the ground from behind to a standing position. I didn’t even tweak my knee. I just landed, plop, on the ground. I won’t do that again. I was pretty lucky.

 

[Dmcfad2]

I am still early days into my recovery too….. i’m struggling with bending the knee as it’s so swollen….. I have my next PT appt a week on Monday ….. I’ll keep trying but I’m not going to stress too much any more…… I am sure the leg will heal in time…..
I was very tearful beginning of the week, I think it’s to be expected….. sending you a hug x

Thanks, Loulou. I don’t have much bend at all, which concerns me. But, I’m going to try to stress less about it myself. Thanks for the encouragemen!

 

[Layla]

My husband came in and lifted me off the ground from behind to a standing position. I didn’t even tweak my knee. I just landed, plop, on the ground.

You were lucky and thankfully you didn't tweak your knee and weren't hurt.

Did you two laugh afterward? After you realized you were ok I mean. Sometimes laughter feels like the best medicine and I know I had to laugh at how pathetic I felt some days in early recovery to keep from crying!
Hope you have a few good laughs and a good day today!

 

[sistersinhim]

I can just see you sliding gently and slowly out of that recliner. I bet after your hubby got you back up you two had a good laugh about it. I, too, have an electric recliner that I used, and I can understand how that could happen. Thank God you didn't hurt yourself.

 

[Dmcfad2]

@sistersinhim @Layla
Oh, yes, we laughed about it. It was pretty funny. I was so lucky!
Day 14:
Got my staples out today. My scar looks fantastic. I can feel a little less stiffness in my knee.
I can lift my leg straight up all by myself. I can also lie on my back and open it to the side and close it without assistance.
I am finding it easier to walk around the house heel to toe. I am feeling just the slightest more bend in my knee.
I did 3 sets of 5 heel slides without the strap using my own muscles. I didn’t get much bend but I did it on my own. I’m not going to strain anymore. I’ll let time/nature take its course.
My surgical pain is slightly better today. Things are improving!

 

[sistersinhim]

This sounds like you had a great day! Yippee!

 

[Dmcfad2]

Day 16 of my recovery journal:

I am feeling better every day. Still have achy pain after being active around the house in the late afternoon and pain and stiffness in the morning when I wake up, but it’s not too bad. Still taking 10 mg oxy before bed at around 9 pm and 10mg in the morning when I wake up at about 6 am. Then, I take 5 mg around 2 pm. That seems to be enough to keep me out of pain for now. I anticipate dropping the mid day pill soon and substituting Tylenol next week as my pain gets better. Hoping to be off all narcotics by the end of next week. I am tapering down so I don’t have any withdrawals.

I sleep pretty good. I was able to roll on to my side last night and that was like heaven. I do wake up about 5 am very stiff and can’t go back to sleep, so end up coming out to the kitchen to get a cup of coffee. I am getting a good 7 hours of sleep most nights.

I am still icing all night long with my ice machine, 20 minutes on and 20 minutes off. I keep it on my knee most of the day, too. I probably don’t elevate as much as I should. It really starts to make the back of my knee ache, so I do it for about 20 minutes 5-6 times a day.

The stiffness in my knee is slightly better and it loosens up the more I move it around. Still not bending much, but I think it’s slightly better. I walk around the house without my walker. I’m getting about 4000 steps a day just walking around the house. I’m doing light housework, making beds, cooking dinner, cleaning dishes.

Beginning to see a light way off at the end of the tunnel.

 

[Dmcfad2]

I am having withdrawals coming off my pain meds. I planned on stopping today because I really don’t need them anymore and I don’t have that many left, anyway. I went all day, but broke down and took one tonight because I am feeling so uncomfortable from the withdrawals. I’m not sure what to do. I guess I just need to power through and tough it out. But, it‘s REALLY uncomfortable.

 

[Jaycey]

I guess I just need to power through and tough it out. But, it‘s REALLY uncomfortable.

Sorry you are dealing with this! It's always best to taper off your meds very gradually. You can do one of two things to begin reducing the amount of drug you are taking:

1. Begin spreading out the times when you take the drug. If you are currently taking it every 4 hours, for a couple of days make it every 5 hours, then 6 for a few days and so forth until you reduce to one pill a day (usually at bedtime, cuz that's when we seem to need the pain relief most). Then at that point, you can start taking half a pill for a while and then no pill. At that point (no pill), you would take them only periodically when you have pain that over-the-counter medication won't take care of.

2. You can stay on the same schedule (like every 4 hours) and cut back on the amount of the narcotic with each dose. That can be done by asking your doctor for a lower-strength medicine or by cutting pills in half. Only reduce the amount by 1/2 pill at a time if you are staying on the same schedule - not a whole pill. Then when you get to the point that you're taking a half pill at each dose time (that's about as small a dose as you can get), start spreading out the time between doses. This approach works if you need the pain medicine during the day for PT appointments or other activity where over-the-counter meds won't work.

As you're cutting back, expect that you may have to use NSAIDS to fill in the gaps for pain.... Aleve (Naproxen), Advil (Ibuprofen), Motrin or try Tylenol (Paracetamol).

Just be sure you don't try to cut back too fast. You'll feel it if you do and will need to make adjustments accordingly to slow the taper. The whole process can take several weeks, so be patient and make sure you are stable for a day or so at each level before you make another reduction.

Or....you can contact your doctor and ask what schedule THEY prefer you do. But I believe a person will do just as well taking care of this yourself. Only YOU know how you feel at any given time. You want to cut back just enough so the over-the-counter meds work and not so much that you get those flu-like symptoms or have pain.