TKR Unsure about my progress.

allin1

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I just want to be walking without a limp and a cane. I am an over achiever by nature. I don't think I expected it to be this hard because I'm younger. I guess I didn't really take into account that I have been in pain and struggling for 10 years and I have been compensating and babying my right knee for a long time.
I know its hard to believe that less can be more, but with this surgery it can. I've done very little between therapy appointments to try to get my knee less swollen and sore. By doing that, I've progressed well and got kicked to the curb by PT today, because I have done so well.
 
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KMLknee

KMLknee

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I just left therapy. I refused to let her push on me and I didn't do the leg press. I did do what they call a Cha Cha and I was able to do that without pain today. My active flexion was 118° and my active extension was 1° yayyyy!!!!
0° looks reachable now. I believe the heel lift in the shoe of my left foot has been beneficial. My limp feels less intense. No tears of frustration today.
 

InkedMarie

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You are not being lazy. You are recovering from major surgery. There should not be a time table. It’s no rush.
 

WhenImOld

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You and I are two peas in a pod. I keep pushing myself and overdoing it. My 'days off' essentially mirror yours. It's just so frustrating. I've been driving my car because it's the one way I can get myself to immediately move where u want it to!
We both need to tell ourselves that it's one day at a time and it's ok to rest it.
 
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KMLknee

KMLknee

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Agreed. It's just hard. You here so many things. I don't want to mess it up or forever hinder myself. But everyone in here says it's going to be ok and that killing myself is going to make it harder to recover fully. As much as it goes against my core I'm taking their advice and just stretching and taking it easy.
 

Celle

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Resting your knee is part of the treatment. How can it heal if it's constantly being made to work?

Try not to think of resting as "lying around, doing nothing." Instead, think of it as working hard, to give your knee the best possible chance of healing well.
In other words, when you are icing and elevating and watching TV, you are not 'lazing around' - you are "engaging in a carefully considered, proactively designed, heuristically programmed, dynamically structured recovery programme".
 

kneeper

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Bravo for refusing the leg press. :thumb:Unnecessary stress on your new knee.
And 118 is awesome.

Just keep challenging yourself a little bit but take it easy. That sounds contradictory but basically it means the knee is the boss and will tell you what you can handle. How I thought of it was for example: "Last week I could walk x far, let me see if I can go a little bit further this week." Your knee will not be shy in letting you know what's what. A guideline my PT gave me was if an activity made me sore for more than an hour (and I would add if I paid for it later in the day) I had done too much.
 
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KMLknee

KMLknee

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That sounds like a good rule of thumb. I have one more approved PT visit on Tuesday and she has put in for a few more to try and get my extension to zero. Can I say I won't be disappointed if it's denied?
 

Jockette

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Your extension will come along fine, even without PT appointments. Walking is good for encouraging extension. Just give it time.
 

sistersinhim

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You don't need PT to improve your extension, just walk with a longer stride, heel to toe, and it will come in. Though, I don't know why you are stressing about 1 degree. That's nothing to worry about at all.

My extension was slower coming in than some others were, but now it has gone past zero into the negative numbers. Shortly after my surgery, it was +10 degrees. 2 months later it was +5. Once I saw it was going in the right direction, I stopped measuring it and just went on with living and using my knee in my daily life. Remember I never took PT or did exercises, just did ADL.
 

Seatides

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It makes some sense that if that leg is shorter due to decreased joint space that it would keep my right knee from extending fully
Hi, @KMLknee ! I can completely relate to what you're experiencing now that you have one "good" knee (the TKR one) and one "bad" knee (the one that needs a TKR). I'm in a similar situation, but I'm at a little over 8 months post-TKR. I'm happy with my new knee, but am certain that my old knee is holding it (and me) back.

I think there should be more information and discussion in general about the impact on your overall recovery if you replace one knee at a time (when both need replacement) instead of replacing them simultaneously. I understood about the challenges of replacing both knees at once, but the effect on recovery of doing just one, when both are bad, wasn't part of the pre-op discussions (at least, it wasn't for me). I think doctors should at least advise you to have reasonable expectations for how you'll feel and what you'll be able to do once you have one good knee and one bad knee, versus two bad knees.

I hadn't heard about a shoe lift to equalize leg length "in between" TKRs and want to look into that. I still limp when I walk too, but it's not because of my great new knee! It's because of my stiff, swollen, painful old knee. I was going to wait a year to have the second knee done (which would be towards the end of this year), but maybe I won't put it off that long. You're planning to have the second one done about 6 months after the first, is that right? That sounds like a smart thing to do.

Don't be discouraged, and be happy for your progress! Remember how awful it was when both knees were bad.
 
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KMLknee

KMLknee

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I agree completely. I may have done better having the left one done first since my surgeon said it was worse on x-ray than the right one. But the right one hurt worse. I'm actually trying to have the left one done as early as possible. He will not do it sooner than 3 months so that would be August 27th. I'm trying to get it scheduled as soon as possible after that date.

I agree that they should tell you that the discrepancy might be a problem. I now have joint space in my right knee and bone on bone in the left. This is making my left leg slightly shorter. It's not much but just enough to keep my right leg from fully extending when I walk. Therefore, I'm kinda stuck with less extension. I know that 2 degrees extension is not horrible but it sure makes it hard to walk normally. The heel lift that the therapy office recommended was "The Clearly Adjustable Heel Lift" I found it on Amazon for half the price. It has layers of 1mm thickness that can be removed or replaced to obtain the right amount of lift for you. Not like others that are a set height.

I'm not quite sure that I have a "great new knee" since I still have some mild pain and swelling. But I feel like once it fully heals I will be happy with it. I hope the heel lift is of benefit to you, but I would check with your surgeon or PT to have your legs measured and verify that that is your issue. This is so hard. I can't imagine trying to rehab both knees at the same time. But then again it's hard with one good and one bad. The bad knee is compensating for the new knee and that increases the pain in it. I'm not sure there is a good option. I have a very good surgeon but like you, I think they should have a more thorough discussion prior to surgery. Now I have a better idea of what to ask. Good luck with your second surgery. And thank you for sharing your journey with me. It makes it easier knowing I'm not in this alone.
 

DiannesNewKnee

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Ok so back to today. Apparently the muscle at the inside of my quad just isn't "firing" according to the therapist.
I’m 4 weeks post op and having trouble with that too. I’m going to focus on heel to toe gait like Pumpkin suggested.

You’re doing really well!
 

sistersinhim

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My old knee really hurt until my new knee healed more and got strong enough to take over some of the work. Now, my old knee is only just a little bad and the new knee is good! Hopefully, I won't have to ever have the old one replaced.
 
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KMLknee

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Thank you. It seems the limp is a bit better today. But as soon as they measure again it won't be . I'm focusing on heel toe as well. I have always walked heel toe but somehow those tendons and muscles Are so tight it makes it very hard. It's requiring way too much effort , lol. We will both get there sooner or later. 4 weeks post op was really challenging as I was still in a lot of pain. I hope it is going well with you.
 

Jockette

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I have always walked heel toe but somehow those tendons and muscles Are so tight it makes it very hard.
Many members think PT is needed to alleviate tightness. Tightness is a normal occurrence after this kind of major surgery. Your surgeon did major carpentry work and disturbed every millimeter of soft tissue in this area. You aren't tight because your muscle is underused and needs to be stretched and rehabbed. You're tight because your tissue is healing...and full healing takes a full year or more.
 

Bikeknit

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Thanks so much for this discussion. I have some similar issues. 2 bad knees but replacing one at a time. My less damaged knee also hurt more and I went back and forth deciding. I finally did the more damaged knee first but still don't know if that was right. I put a drugstore insole in my shoe to even me out. Similar to your heel lift solution. Seems to be working. I'm not as much of an overachiever as you are but still I'm anxious to get back to bicycling and return to hiking which had become too uncomfortable to be fun. So I push a little too hard and swell up. Arrggg. Appreciate reading about your challenges. It gives me hope.
 
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KMLknee

KMLknee

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Hello everyone. I hope you are having a good week so far. They approved another 5 therapy visits. I'm done after that. I am no longer letting her push on my knee at all. I told her that it was just too painful and wasn't helping me to get the active extension, even though she can push it to zero. We are working on balance, stability and getting my vastus medialis to do what it's supposed to do. It is engaging but it's really weak. I wanted to ask, had anyone used a pedal exerciser (the under desk type, just pedals with adjustable tension since I have no space)? I am thinking about using one to help strengthen my quads and to keep my knee loose since it seems to tighten up so much throughout the day. Especially at night before bed. Speaking of bed, has anyone else experienced muscle spasms and what feels like electric shocks through the knee when trying to go to sleep? It's driving me crazy. Thank you in advance for your input and guidance.
 

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