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TKR Violent night spasm

Inkneed

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I see there are many that experience violent muscle spasms on this site. It’s 3:50AM, week 9 and I just had what can only be described as an EVIL episode. It literally feels like a demon raised my leg and tried to snap it sideways! This is the second one I’ve had and the first time I screamed from a state of sleep and terrified my poor wife and son who heard it. There were others, but not as severe. The one this morning had me holding my breath while I “rode it out”. So painful and really frightening. It felt like I might have damaged my implant due to the violent initial blow. I slowly got out of bed and walked around to try to loosen it up and then elevated and iced it.

I did have a busier day previous which included walking my dog twice for 30 minutes each time and I made a big dinner. I too had cut down my PT, some days not doing any and I seem to get better results in lessened stiffness and swelling. My ROM has been stuck at 35 to 45 degrees no matter how hard I pushed myself.

I was really worried about “the window of opportunity” and I’m scheduled to get a mechanical splint device put on me at my PT’s office to manipulate it. I’m reconsidering whether I should even do this after reading the posts on here as it appears I might be doing more harm than good? Sorry to be bouncing around a few subjects here. This for me has been the most painful, mentally challenging and exhausting experience of my 55 years.

The best advice I’ve seen on here is not to worry and let your body heal itself. There’s no race to get full ROM and it’s OK to cut back PT. I’d appreciate any comments or words of advice concerning the night spasms, they’re nasty! Best wishes to everyone!
 

eaglemom

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That sounds oh so painful and frightening. To me it would seem your completely over doing. What is the date of the surgery? There is nothing wrong with backing way off of all your activities until the knee settles down. Possible contact the surgeon and a muscle relaxer might help? Remember no matter how far along you are in healing ice and elevation are your friends.
 

Roy Gardiner

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:welome: to BoneSmart

It felt like I might have damaged my implant due to the violent initial blow.
IMO that's extremely unlikely. They are very strong!
I did have a busier day previous which included walking my dog twice for 30 minutes each time and I made a big dinner.
:idea: I think you have probable cause right there.
I was really worried about “the window of opportunity”
Please don't. There is no such thing. Soft tissue will always react to stretching/training.
I’m reconsidering whether I should even do this after reading the posts on here as it appears I might be doing more harm than good?
:thumb: We know that Continuous Passive Motion machines are a bit out of favour now, I'm with you on reconsidering
My ROM has been stuck at 35 to 45 degrees no matter how hard I pushed myself.
Pushing won't help, sorry. Stretching exercises have to be gentle. If you are genuinely stuck, that is, your knee comes to a full stop when bending and just won't go any further, you may have adhesions (where soft tissue has stuck together around the knee). Week 9 is early in recovery to be considering this, and adhesions are rare, so proceed with caution. Chat to your surgeon.

And, if you have a static bike, I'd consider using that to try, gently, to improve ROM.
  • Set the bike to zero resistance
  • Set the saddle low enough so that a single rotation is a challenge; difficult but not painful. When a rotation becomes easy right from the start, lower the saddle a max of 1cm.
  • Gently turn the pedals, through discomfort but without pain.
  • Continue until the knee is 'warmed up' and the rotation is now easy, or for 2 minutes, whichever is the shorter time.
  • Repeat several/many times a day, but don't go mad. Diminishing returns will apply; my guess is that half a dozen reps would be enough
  • Do not pedal fast or for more than 2 minutes, this is a stretching exercise, not training.
  • And if you get any pain or swelling in the 24 hours after doing this, cut it down until you don't
Here is a bit more chat and some pix and how 'healing' and 'training' are different

and your personal copy of the general reading:

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

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

5. At week 4 and after you should follow this

6. Access these pages on the website

The Recovery articles:

There are also some cautionary articles here


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 a 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 history before providing advice.
 
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SkiBikeHikeDude

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Week 3 and 4 post surgery for me I had your nighttime spasm experience every night. I would wake up yelling out in pain, waking up my wife and scaring her to death. It got to where I dreaded going to bed.

My surgeon told me I was doing too much (even though I felt I was barely doing anything) and he prescribed cutting way back on activities, including ADL, standing, or even sitting with my feet down. He suggested going back to crutches or my walker, which seemed a bit extreme to me.

I took his advice and cut way back on my activities and mostly spent the past two weeks lying in a chair with my feet elevated and icing several hours a day. The good news is that it is working, and I am sleeping through the night and my pain is way down. The surgeon said the pain was from overdoing it and that my knee was telling me it was still healing and needed more rest.

I was not excited to cut back, but it helped. I am finally feeling like I can now return to walking and doing more activity, as long as I only increase by about 10% a day.

I suggest you really take it easy. No dog walks. No cooking dinner. Stay off your feet. See if it helps.
 

Cjackso21

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I have had terrible cramps and spasms and they are clearly due to over activity or something new. I also realized that my electrolytes were off as I tried an electrolyte tablet (Nuun) and it definitely reduced the cramps. I also accidentally found a product from Melaleuca called Pain a trate that (like icy hot) that when I did have a cramp, I rubbed this on it and it went away quickly. Good luck! I have a hard time stopping activity as I have to walk a lot for work so finding these products really helped!
 

Jockette

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Hi and Welcome!

Please tell us what surgery you had, and the date, and we’ll make a signature for you. :flwrysmile:
 

MerlinWizard

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My wife had an amputation over a year ago. While it's not a knee, I think the general physiology is the same. Her amputation was due to an accident many years ago and several failed ankle fusions.

Anyway, she had violent cramps in her calf muscle after the amputation. While at the time, I thought it was related to the amputation it's not because I got those too!

The surgeon told us that if you don't use your muscles they will on their own spasm to keep blood flow going and to fight off atrophy. I still get them in my right thigh. This usually occurs, and you guess it - at bedtime!

Merlin
 

BBCG

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That sudden pain sounds awful! I’ve had lighter ones like that too, but I realized that I sometimes do not drink enough water during the day, on the nights when they startle me awake.

I found a massage therapist after my first TKR in 2016 that I saw for ongoing pain, and she used a magnesium gel on my knee during a gentle massage about 2 months out. I was given a small amount of the gel that I used on my then new knee. Now, 5 years later I purchased a bottle of the gel myself and apply it to the areas of my new knee leg that are centers of the muscle/nerve spasms and it makes a big difference. An 8 oz bottle is more than one usually needs...
 
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FourCats

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Could you tell us more about the magnesium gel? I’d like to give it a try.
 

BBCG

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The magnesium gel might be mentioned somewhere in articles; I kind of think I saw something earlier, and I mentioned it on someone’s thread last week, but will include it here.

It’s made by Ancient Minerals, and comes as a spray (my massage therapist said that form was not as potent), a lotion, and a gel. The gel is sticky, so that’s a bit of a downside, but tonight I just slathered it on my leg too, in fact. I might choose the lotion, as it might be less sticky, but I’d check to be sure it still contains the same potency.
 
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