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TKR Walking Post Op

Pamjam68 said:
so I guess I will load up on Tylenol prior to PT. I still have a fair amount of pain at ten days post op
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I repeat, PT should not hurt. Don’t do anything that hurts. If it does hurt, you are doing something your knee is not ready for.

Yes, there will be pain as a result of this traumatic surgery, but doing things that increase that pain, like exercises, is not advised.

I am going to tag @Josephine
our forum administrator and nurse director to address your concerns.
 
Pamjam68 said:
I will load up on Tylenol prior to PT
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You should NOT, on any account, take pain meds to cope with PT. Big BIG no-no!

You see, pain serves a purpose which is to warn you when you're experiencing too much pain.
 
Pamjam68 said:
It seems my latest OS only gives pain meds first week post op (yikes) so I guess I will load up on Tylenol prior to PT.
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Masking the pain with meds is really bad for your recovery. You need to feel when it's too painful. Your knee knows when it's too much for it If it doesn't feel all that pain, then it has no way of telling you that you're in the danger zone of overdoing and setting your recovery back.
 
@donnag1108 I agree. Fortunately Dr gave me another 30 today and I have lots of questions when I see him on January 2nd. I have had pain in different areas than I did with my first TKR. Sharp pains down my shin take my breath away and my hip is really sore when I sit elevating my legsso not sure what is different about this surgery. I know no two knees are ever the same but the pains are severe and I don’t remember experiencing pain like this last time. Of course first OS prescribed 10/325 and thus dr just 5/325 so that could account for it. I know it’s early days yet just 10 days post op but so ready to get on the road to recovery, love get support we get from Bonesmart. Thanks.

@Josephine I agree. I think the PT has aggravated what was an already painful area. My calves are stiff as if I ran a marathon and tomorrow I have a list of questions about over exerting the surgical knee too early. I am thinking I would rather let the knee heal some more and just do general walking etc to get mobility back. We will see what they have to say. With my first TKR I did gentle therapy and it worked just fine. Changing OS has meant a whole new approach with PT from early on And I don’t think I buy into this approach. Need to speak up tomorrow I guess.
 
@Pamjam68 I too am having a totally different time this time round and like you shin, calf and hip pain. Hope you get some relief from it soon. I haven't done any PT only walking. My knee is too sore to do the exercises and why cause more pain by doing it. I had PT appointment tomorrow but have cancelled it.
 
Pamjam68 said:
Changing OS has meant a whole new approach with PT from early on
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You have the right to go back to the PT that did the first knee. You can go anywhere you want to go. Plus, you don't even have to take PT if you don't want to. That's your right, too!
 
Pamjam, I'm wondering if part of the reason for your additional pain with the second TKR is (paradoxically) your second knee had not been in as bad of shape for as long as your first knee? I am about 6 weeks out from my TKR. I had arthritis in the knee for over 40 years, and was told by an OS over 10 years ago that I was a candidate for TKR then, but he recommended I wait as long as possible due to the limited life of the implants. So I waited over 10 years, and finally had my surgery November 15. But it wasn't severe pain that drove me to the surgery. It was the loss of functionality and the increasing deformity of my leg. And I wasn't in severe pain after the surgery either. Only took one hydrocodone a day for about 3 weeks before stopping. My family thinks I am some kind of robot, but I just wasn't in that much pain. So I'm wondering whether decades of arthritis can desensitize your joint to pain?
 
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@LarryB that's impressive just three weeks and low dose of meds. I had reached the stage where I could barely walk. It was like walking on shards of glass so was eager to get both knees done. My CT scan on second knee read “severe arthritis with obliteration of the patellofemoral compartment and extremely large osteophytes involving both patella and femoral portions of the joint”. After surgery my OS said I should have had surgery years ago but not sure whether that will impact my recovery but hoping when it’s all finished I can walk pain free. That’s the goal anyway. Fingers crossed. I am using the pain meds every six to eight hours at ten days post op and thankful to have them. You did amazing to get off the pain meds so quickly. I was off meds with first TKR by six weeks. I prefer not to take anything stronger than Tylenol but easier said than done for me right now.
 
Well two weeks post op on TKR #2 and this OS is very different. No more pain meds now. I had two weeks worth if 5/325 Hydrocodone and dr made it clear he would not be giving another script for pain meds. Interestingly enough he sent me home with a bunch of meds from gaberpentin, warfarin, methocarbonal and Celebrex. My first OS sent with home with nothing but 10/325 hydrocodone and never blinked at providing a second script for pain meds two weeks out. Very differebt approach I guess. Dr said my Bend was good but need to concentrate on getting it straight as it will help strengthen muscles and eliminate pain. We shall see. My shin and my knee cap are both really tender to the touch and sore but dontvrecall the other one being tender like this. Oh well onward I go with exercises and hope for the best. I was warned not to compare the two knee surgeries. But it’s hard not to. Be interested to hear from others who had two knees done within a few months of each other had similar experiences.
 
Pamjam68 said:
Oh well onward I go with exercises and hope for the best
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I suggest you cut the exercises right back. You know you had a good recovery with your first TKR, using only gentle PT therapy.
It's not exercising that gets you your ROM - it's time. Time to recover, time for swelling and pain to settle, and time to heal. Your ROM is there right from the start, just waiting for all that to happen, so it can show itself.
 
@Celle i think I am going to do just that. The home PT folks are gentle by comparison to what I recall at the outpatients facility and have no problem if you decide to skip an exercise. My experience with the hospital outpatients Therapists are too gong ho fir me. I see so many on BoneSmart that made a complete recovery without concentrating on PT.
 
@sistersinhim i discussed my previous OS pain management and he made it clear he would not prescribe hydrocodone for more than 3 weeks. He said he could refer me to a pain management clinic which seemed odd. My previous OS managed my pain well and when healing took place got off it no problem. I think Drs are definitely cognizant of the opioid issue these days but think they are going overboard in my opinion,
 
I think they are way too conservative with they pain meds now. I wish everyone of them would have to go through a tkr and feel what this recovery feels like!
 
@sistersinhim that is exactly what the PT said. He would not want to face PT with no meds just two weeks post op. I guess I will see how it goes. It is comforting to know my friends on here know the struggle to manage the pain just two weeks post op with no pain meds.
 
Pamjam68 said:
that is exactly what the PT said. He would not want to face PT with no meds just two weeks post op.
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Red flag right there, he seems to think you need pain meds to do PT.

Bonesmart believes PT should not hurt, and that it’s not exercising that gets our range of motion back, it’s Time:

Time to recover.
Time for pain and swelling to settle.
Time to heal.

Our range of motion is right there all
along just waiting for that to happen so it can show itself.

In the general run of things, it doesn't need to be fought for, worked hard for or worried about. It will happen. Exercise as in strength training is counter-productive and in the early weeks does more harm than good. Normal activity is the key to success.
 
I had my two TKRs 3-1/2 months apart. When I commented separately to my surgeon and my physical therapist that #2 seemed more sore and stiff in the beginning than #1, they both had this same reply. With TKR #1, I had a non-surgical knee/leg for support. Even though that knee was bone-on-bone, that knee/leg was stronger than my new surgical knee/leg. With TKR #2, even though #1 was coming along really well, it wasn't as strong as a non-surgical leg. Therefore, #2 was required to provide more support from the very beginning than #1 had to provide in the beginning. More work for #2 meant more soreness and stiffness. That made sense to me.
 
I'm on my second TKR, and this time I will only have at home PT which is very gentle. If I don't feel good enough to work the knee, I get an easy massage! No outpatient this time too much pain and anxiety.
 
@Jockette i am ready to send them all packing and deal with my GP for post op care. I have my stitches out and I think the recovery is up to me now. My first OS was more interactive asking me what I felt best with etc this one was more like this is his protocol and he doesn’t vary patient by patient. He just reminded me that TKR is an invasive procedure that comes with a fair amount of pain. It has been very interesting to see how different two OS can be.
 
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