TKR Ups and Downs

[StandTall]

Hi, I discovered bonesmart.org today at 6 weeks out from TKR Oct. 8. Once again searching for info and reassurance that today's sudden pain is no big deal.

I recognize the post-op blues. Thought I was springing into a new, optimistic mindset. Yesterday, my surgeon said I was doing well; keep up the good work; don't forget to rest.

This morning I over did it with my tv exercise program. I've been repeating one episode of the show focused on stretching and gentle movement for connective tissue. I'd been cautious and holding back, but today I let go and relaxed into it. After all...my surgeon had said there's nothing I can do that will damage my knee.

By late afternoon at PT, my pain showed up fierce and got in the way of my anticipated full rotation on the bike. So, I'm going to take a break from exercise and do some RICE. See what tomorrow brings...and tonight. (It's still hard to get much un-interrupted sleep.)

I look forward to the forum!

 

[Jockette]

Hi and Welcome!

No need to push any exercises, your body will heal fine if you take things slow, so as not to cause any extra pain. We’ve all been where you are and learned the hard way that our knee is in control of what we do.

Which knee did you have done? We‘ll add that and your surgery date in a signature for you.

I will leave you our Recovery Guidelines. Each article is short but very informative. Following these guidelines will help you have a less painful recovery.

Knee Recovery: The Guidelines
1. Don’t worry: Your body will heal all by itself. Relax, let it, don't try and hurry it, don’t worry about any symptoms now, they are almost certainly temporary
2. Control discomfort:

rest​

elevate​

ice​

take your pain meds by prescription schedule (not when pain starts!)​

don't overwork.​

3. Do what you want to do BUT

​

a. If it hurts, don't do it and don't allow anyone - especially a physical therapist - to do it to you​

b. If your leg swells more or gets stiffer in the 24 hours after doing it, don't do it again.​

4. PT or exercise can be useful BUT take note of these

​

the BoneSmart view on exercise​

BoneSmart philosophy for sensible post op therapy​

5. At week 4 and after you should follow this

Activity progression for TKRs​

6. Access to these pages on the website

​

Oral And Intravenous Pain Medications​

Wound Closure​

The Recovery articles:
The importance of managing pain after a TKR and the pain chart
Swollen and stiff knee: what causes it?
Energy drain for TKRs
Elevation is the key
Ice to control pain and swelling
Heel slides and how to do them properly
Chart representation of TKR recovery
Healing: how long does it take?

Post op blues is a reality - be prepared for it
Sleep deprivation is pretty much inevitable - but what causes it?

There are also some cautionary articles here
Myth busting: no pain, no gain
Myth busting: the "window of opportunity" in TKR
Myth busting: on getting addicted to pain meds

We try to keep the forum a positive and safe place for our members to talk about their questions or concerns and to report successes with their joint replacement surgery.

While members may create as many threads as they like in the majority of BoneSmart’s forums, we ask that each member have only One Recovery Thread. This policy makes it easier to go back and review the member’s history before providing advice, so please post any updates or questions you have right here in this thread.

 

[kneeper]

As you've discovered, 6 weeks is still pretty early and it's easy to overdo. Good plan to ice and rest and go easier next time.

 

[Roy Gardiner]

I'd been cautious and holding back, but today I let go and relaxed into it.

Easy mistake to make, I suspect most of us have done it. The rule is to do a little bit more when you feel you can, then stick at that new level for a few days. If you get no bad effects, again do a little bit more. Always small increments.

 

[StandTall]

Hi. I have been working hard at home and in physical therapy. Only now am I learning that what's needed is rest, gentle movement, and a positive outlook. I have had difficulty with pain management since sustaining liver damage from Tylenol in the first week. I elected to stop oxycodone in week 4 from fear of addiction and wanting to drive. So my options have been limited. I just tried Tramadol this week and can't tolerate it. My Physical Therapist pushed my knee and me into more pain in order to attain a certain rom. At the same time he said it was "up to me", but the threat was that if I didn't get to a certain # by a 6-8 weeks it would be much harder. I changed PT and started pool therapy with hope for a less painful experience though I'm still hurting from the first session yesterday. I've been very discouraged and depressed (even crying myself to sleep). I've always thought I was tough, but I'm a softy with this. I'm so glad to have found this source of info and support. I wish it had been sooner.

 

[Sunnytimesahead]

@StandTall, welcome to BoneSmart! All the wise moderators on this site will be along shortly, but you are describing almost exactly my recovery from knee replacement! I too went through aggressive PT with all the accompanying pain, which only brought on continuous swelling, which as you well know, inhibits that all "so important" ROM that the therapists strive for. I too was very discouraged and truly believed it was due to my not working hard enough. Due to a Covid scare, I stopped therapy and did little of the exercises at home I thought might be causing the swelling. After my 2 week hiatus, my range improved 15 degrees! I'm living proof that the BoneSmart way of recovering is best for knee recovery - at least in my case.

Please keep reminding yourself that this WILL get better! Many of us have been in the same place physically and emotionally that you are in now. You have a set of friends on here that will help you with their advice.

 

[StandTall]

Thanks for your comment sunnytimesahead. It is very helpful to hear your experience of gaining rom when you took a hiatus! That gives me encouragement.

 

[sistersinhim]

You'll notice that I have merged your two threads together as we prefer that members in recovery only have one thread.

This is for three reasons:
1. if you keep starting new threads, you miss the posts others have left you in the old threads
2. it often ends up that information is unnecessarily repeated
3. it's best if we can keep all your recovery story in one place so it's easily accessed if we need to advise you.

Please keep all your questions and updates on this thread. Bookmark it if you can, so you don't lose it.
Don't worry that we won't see your questions as, between us, the staff read all new posts every day.

If you prefer a different thread title, just post what you want and we'll get it changed for you.
If you need an urgent response to a question, just tag a member of staff.
Tagging other members and answering tags

Here are the instructions on finding your thread, How can I find my threads and posts? Many members bookmark their thread, so they can find it when they log on.

 

[sistersinhim]

It sounds like you have been pushing your knee way too hard and it is rebelling with pain. I suggest you cut back on the exercises and just let your daily activities rehab your knee. It is much gentler and you can recover with less pain and swelling.

 

[Jamie]

StandTall, I'm so sorry to hear of the challenges you've had so far with your recovery. I'm sure the diagnosis of problems with your liver came as a huge shock to you and I hope it doesn't have a negative impact on your health for the long term.

I'm glad to hear you've figured out that your knee will benefit more from gentle movements, lots of healing rest, ice and elevation than from aggressive physical therapy and pushing. Pain management is the other aspect of recovery that needs to be resolved. The ice and elevation will help with pain, but getting your medications (whether prescription or over the counter or a combination of them) set at a level and schedule that works for you is also very important. Be sure that you are taking whatever works best for you on a set time schedule so that you keep some medication in your body at all times. If you wait until you are hurting to take something, you play catch up and it actually takes more meds to settle things down. It's better to maintain that set schedule for a while in the early weeks of recovery.