TKR Update on Slower Recovery

[Mar]

More hopeful! So after quitting PT awhile back I decided to call a place I use to go to that did a lot of massage and other things besides just exercises. When I talked to them I asked about the massage to help the swelling to decrease. So they had a cancelation today. Today is also my 1 month out from surgery. She talked a lot about what I wanted which was to focus more on the swelling. She was great, she actually seemed to understand that my knee doesn’t like being pushed. She said it can work for some people but some it just doesn’t work. The only exercise I did was the recumbent bike. She checked may flexion which was only 60, yikes! I started at 87 after surgery. So we’re going to focus first on getting the swelling down. She did a lymph massage (not sure what it’s called) and also massaged around my scar. They put a tens unit on and ice after. She said they will do even more massage on the muscles next week. I feeling better about things now.

Another thought on my swelling is I had one vein removed from this leg probably 4 years ago. After Monday’s grocery store venture that really set me back with swelling I noticed I now have another large vein that must be deeper and not visible that popped out with the swelling that looks pretty twisted and lumpy. I’m sure it’s compromised as well. I’m wondering if this is a reason for some of the swelling. Anybody have issues with bad veins and increased swelling? I can flex my knee without any pain, but am stopped going further the pressure from the swelling.

 

[Sisterpat]

Mar, I have some pronounced varicose veins, but they have not been related to knee swelling as far as I can tell. It may well be that you just overdid at the grocery store. Give it some time. Ice and elevate and take it slow.

 

[Jockette]

I also have some varicose veins that gave me trouble years ago, but they didn’t flare up with my replacement surgery/swelling.

I agree with SisterPat, you most likely overdid more than you thought with that walk. Sometimes what seems like a simple setback can take a long time to recover from. New knees are such drama queens!

 

[Mar]

So my new PT showed me an exercise for flexion that I hadn’t seen or heard of before. I lay on my bed with my leg up on the head board. Then I slowly bend till just before there is any pain. She said to do 5 reps 3-4x day. Seemed pretty easy and I actually think I got more bend with less effort then any other flexion exercise I have tried. Since I’m 1 month out now is that a safe exercise that I can incorporate? The only exercises she has me doing right now are those and the recumbent bike rocking for just 1-2 min 3 x day.
Does anyone else have the issue of when they measure me it’s laying on the table and flexing my knee. I get the least progress from that position. If I sit in a chair and flex I get more bend in my knee. The sliding down the wall seemed like I got even more flexion. Shouldn’t it be the same in all positions?

 

[liam2015]

That's how they do it where I am also. I think there is a reason why they measure like that but I don't remember. I think I read it on here. It does seem to flex more in the different positions.

I like that exercise also although I do it in a different way. I lay on my back, raise my leg and bend my knee to a comfortable flexion. I also will pull my legs to my chest which helps my back and you can see the difference between the 2 leg bends.

Your new p.t. sounds very wise. Good luck with recovery.

 

[Mar]

They never measured me that way with my first TKR 8 years ago. Back then I would sit on the table and slowly bend my knee till I couldn’t anymore. Works better for me for some reason.

 

[Cabu]

I had only the one appointment with physio and the exercise she gave me for flexion was to lay on my stomach and bend my knees upwards and gently push the operated knee with my other foot to increase bend and hold for 60 sec for 3 sets 3 times a day and for extentions to roll a towel under my knee and press down onto it for counts of 10,3 sets 3 times a day. That was a little over 3 weeks ago and due to unforeseen circumstances she couldn’t see me again and I didn’t bother looking up another one yet .......however I do find I’m getting a good bend on my knee no idea of what degrees or anything and I’m not sure of the extension either because I keep overdoing stuff and not giving the swelling a chance to go down so it feels right and I don’t think the extension feels particularly flat

 

[Sisterpat]

Yes, I’ve heard the suggestion about the headboard/wall thing. I even tried it myself sometime back on my first knee. At a month out I think it could be all right as long as you don’t go to the point of pain. You need a certain amount of quad strength to control the slide downward, though.
As far as measuring, I agree that it’s not my best flex position, lying on my back, but that’s how they measure me, also.

 

[Mar]

I guess my quad strength is good enough as I didn’t have any trouble controlling it but good to know to pay good attention to that so I don’t accidentally give myself an MUA

 

[FCBayern]

So my new PT showed me an exercise for flexion that I hadn’t seen or heard of before. I lay on my bed with my leg up on the head board. Then I slowly bend till just before there is any pain. She said to do 5 reps 3-4x day.

I would just say start slow and listen to your knee @Mar. I would start with two reps a day and then pay attention to how the knee feels that night and the next day. If you don't have additional pain and swelling try adding one more rep the next day. It pays to start slow and ramp up slowly. One day of over doing it can set you back days or weeks.

 

[kneeper]

So my new PT showed me an exercise for flexion that I hadn’t seen or heard of before. I lay on my bed with my leg up on the head board. Then I slowly bend till just before there is any pain. She said to do 5 reps 3-4x day. Seemed pretty easy and I actually think I got more bend with less effort then any other flexion exercise I have tried. Since I’m 1 month out now is that a safe exercise that I can incorporate? The only exercises she has me doing right now are those and the recumbent bike rocking for just 1-2 min 3 x day.
Does anyone else have the issue of when they measure me it’s laying on the table and flexing my knee. I get the least progress from that position. If I sit in a chair and flex I get more bend in my knee. The sliding down the wall seemed like I got even more flexion. Shouldn’t it be the same in all positions?

You can do these bends in a variety of positions--with each knee they showed me different ones. Try not to fret about the measurements. (I know from experience, that it's easy to focus on even when you know it's not productive.)
I had a lot of swelling in the first month and my PT switched her focus to bringing that down rather than exercises. I did a few heel slides and so on, but icing and elevation was key. It sounds like your knee needs more rest and ice rather than stressing about exercising. I think this PT you have now is on the right track.

 

[Mar]

Yes, it wasn’t easy to find one more focused on swelling then on movement. I just know if at 6 weeks I go to the surgeon and am only at 60 degrees he won’t be too happy

 

[doxiemom2017]

My PT has me doing those headboard slides. I do mine on the floor, sliding on a smooth door. The tricky part is getting back up from the floor. That has gotten easier each time. When I first started the slides, I would really push to get my knee to bend more. Once I found this forum and read about a different approach to PT, I changed my method! Now, as you described, I slide until I feel stretch resistance. I go through the repetitions, and I have found be the end of the exercise I can get as far as I had when I was pushing it. So now I don't have pain when doing PT! What a grand idea! I am at 5 1/2 weeks and am at 92 degrees. I am anxious to get more, but with the help of this forum, I know I will get there in time!

Like Sisterpat mentioned, my PT measures me lying on my back also.

 

[Sisterpat]

doxiemom, I could never even get down on the floor much less get back up . Kudos to you!

 

[Mar]

Wow, I would be afraid if I got on the floor I would never get up. That’s amazing! Today I did the heal slides and I would say I am very close to 90. So I got on my back to do them how they measure me and I doubt I was more then 60. I just don’t understand that? I mean I’m not going to worry about it but I just don’t understand it at all, lol.

 

[Sisterpat]

Me either, Mar !

 

[doxiemom2017]

doxiemom, I could never even get down on the floor much less get back up . Kudos to you!

@Sisterpat it is a challenge definitely! The first time I felt like a turtle on its back. This is something really important to me even before surgery that I am able to get up from the floor. Getting up and down is not graceful at all, but I am finding the exercise to be another way to see how my recovery is coming along!

 

[Jockette]

I’ve only been on the floor once since my surgery 4+ years ago, and that was because I tried to use my husband‘s rolator walker as a seat, it slipped away from me, and I landed on the non carpeted floor!

 

[MARYCOOL]

I try to stay off the floor, as well! I had to get something from under my bed one day, and I accidentally knelt on the newbie...boy did I get up fast!!

 

[Sisterpat]

Well, I’m still hopeful for floor occupation in a few years, otherwise I’ll never be able to use this emoticon truthfully .
Seriously, my Sister had both knees replaced about 2-3 years ago and, while she doesn’t kneel much (Marycool I bet that was a jolt for you!), she can get down on the floor to reach things and gets up without too much difficulty.