TKR Week 20 update...all good and getting better

[KTO]

@ robhunt3 I commented earlier. But since I gave suggestion from my recovery that helped me the admin moved my comments to my recovery page.

I feel fortunate and benefited from PT and feel they pushed me appropriately. I had Graston technique starting at week 4 post op..which helped my muscle tightness (I still get it at PT at week 7)

 

[Jamie]

@robhunt3 .... while the Graston technique worked for KTO, I wouldn't recommend it for you. First, my friend, you are not even 2 months out from your surgery! You need to relax and let your healing come on your body's terms...not yours, not your doctor's and not your therapist's. You have had a lot of work done on that knee over the years and it is likely that your surgeon had to spend a bit of time in there getting things right for you. That extra time and manipulation of bones and tissues can result in additional swelling. And, as you know, the swelling will inhibit your flexion.

I also don't recommend that you try and spend a lot of time with your leg down. That really doesn't help your flexion (stretching/flexing every couple of hours is better) and it will also increase your swelling. Ice, elevate and if you hurt take something for your pain on a regular schedule. This is still the routine you should be following for at least another few weeks. You're an early bird in this healing process!

 

[robhunt3]

Thanks for the advice @KTO , I may well look into that although I think right now I need to let my knee settle a little.

@Jamie , I am definitely going to take it easier as it is so early on - I will fight my inner voice that wants to measure, measure, measure and compare!

I see the doc in just under two weeks, so I'm going to halt the physio unit then and see how I get on just resting, elevating and doing the exercises I have been doing. If my bend improves from around 80/90, I will know this is the way forward.

My rationale for this is that I had previously achieved 100 degrees of bend and less swelling on my own. This was before my first physio session two weeks ago, but ever since I started physio it has just gotten worse, in particular this week when the PT pushed my knee to the limit during both sessions, resulting in swelling and pain. It has also impacted my walking, which was fine until the end of last week, so enough for now.

Following the PT session on Friday, my leg was achy and swollen yesterday (Sat). This seems counter productive to me and further supports the approach advocated by BS.

Today I have rested, iced and elevated and done my basic exercise sets. Already I can feel the knee relax a bit more, with swelling staying down to my wake up morning levels and my walking back to where it was.

I'm hopeful this approach will yield a better result over the next couple of weeks. There's no hurry of course, and time will tell.

 

[KTO]

@Jamie , yes everyone is different.... Graston may not be good for some especially early the healing process. I am 52 year old female that is athletic with tight and since it appears robhunt3 is athletic and fit muscles going into surgery may sometime down his road of recovery may benefit the way I did. I just did not home to miss out.... I did not realize Graston was an option in my treatment

 

[KTO]

@robhunt3 I am so happy for that you have relief following your resting, icing and elevating and doing your basic exercise sets. Listen to your knee.

 

[kneeper]

For what it's worth, I let them talk me into Graston with my first knee and it made things worse.

 

[robhunt3]

Thanks again @kneeper and @KTO, I guess this just highlights the problem with this whole TKR business.
Something that works or worked for one person doesn't necessarily for another.
Add to that the differing opinions of PTs and OSs and it's becomes so difficult to choose the right path.
I'm glad I have my BS friends available to me to proffer those opinions/options, not sure what I'd do without!

 

[KTO]

@keeper so sorry to hear that. It made things worse !! for the record my PT used the instruments on my muscles on outside of my thigh and hamstring and not directly on my knee.... and at time of using the instruments on my muscles,,, my knee joint only had minimum swelling and my wound was healed and I was already allowed in pool to walk and swim... (in which I was swimming and walking in pool) yes we all are very different ....

 

[sistersinhim]

Something that works or worked for one person doesn't necessarily for another.

Every single knee is different. Each has had its own damage done to it through the years. This means that recovery will be different for each knee. For me, ADL healed and recovered my knees perfectly 11 times. For KTO, it might not have. That doesn't mean my pt was wrong and it doesn't mean KTO's was wrong. You need to learn your knee and its reaction. Robhunt3, you have already seen how yours reacted to the PT you were doing. Now, you're finding out your knee is getting better without that kind of PT. That's learning your knee and 'obeying' it!

 

[Jamie]

Good for you, @robhunt3 .... you're learning that many times "less is more" with a TKR recovery! We've seen this proven out time and time again. If you can hold your passion and eagerness to get back to normal a bit longer and let your knee settle, I think you'll find your ROM begins to improve! Hang in there!!!

 

[robhunt3]

Intereferential machine for swelling reduction???

Josephine, Jamie, SusieShoes, sistersinhim, KarriB, Roy Gardiner and anyone else who might be able to help.

I've had one electrotherapy session with my physio since my surgery, but wondered whether it would be worth getting my own machine to use daily with a view to trying to reduce swelling inside the joint, which is largely where I think mine seems to be.

These are available on Amazon - OK they aren't cheap at about £160, but are supposed to help with pain and swelling. I am thinking about an intereferential machine rather than a TENS unit as I don't really have any pain, just internal swelling, and a small bit externally that seems to be holding back my ROM. And yes, I know I'm lacking in patience .

Does anyone have a view on this? I assume these are perfectly OK to use with a TKR (given that my Physio has been using one on me)? I am elevating and icing, but am willing to try anything to help improve my flexion (extension is fine) - I know it will come with time of course, but would this make any difference?

Sorry to bother all you kind admins at once, but would be interested if you have any knowledge/experience/opinion on this.

Many thanks,
Rob

 

[SusieShoes]

I am thinking about an intereferential machine rather than a TENS unit as I don't really have any pain, just internal swelling, and a small bit externally that seems to be holding back my ROM. And yes, I know I'm lacking in patience

Well, you did say it yourself, about being impatient. So there's that. You are being impatient.

You mention swelling inside the joint and that this "is largely where mine seems to be." That's true, because everyone has swelling inside the joint after a TKR. It's inevitable, given what has been done (inside the joint is where the bones and many other disrupted tissues reside). This swelling is what has to resolve for full recovery to occur. The tissues inside the knee have to heal for the swelling to subside.

You don't need to spend this kind of money (I looked up interferential machines, their uses, and studies as to their benefits) for something you don't really need. Maybe you want it, which is another bag of peas, but you don't need it. You say yourself that you are not in pain. You just want to hurry up on regaining ROM. Only there's no need to hurry. Seriously, even if this machine did reduce your swelling by a little, and you gained a fraction of ROM thereby... what do you really gain? You would have gotten the same fraction of ROM by icing, elevating, and waiting an extra... couple of days? A week? And the swelling isn't gone permanently with this machine. It just goes away for a little while (thanks to increased blood flow, which is debatable depending on the study), but then returns if the underlying damage is still present.

I dunno, Rob. If the machine was inexpensive, I'd say go for it. It doesn't sound like it would hurt you in any way (unless you are pregnant or have a pacemaker). It's a lot like a TENS unit, and we know those can sometimes be helpful for pain. But it is really, really expensive and you can get to the same results without it. Frugal me thinks you need not waste your money.

 

[Jockette]

And yes, I know I'm lacking in patience .

We ALL wanted our swelling to go down faster than it did!

Also, don’t fully believe the sales pitch from a company that wants your money. They promise the world that their product/service/technique will fix your problem.

I believed the “sales pitch” about my partial. When my surgeon said I needed a partial I trusted him that it was the right decision. I googled information about partials that all gave glowing reports about how much less invasive it was, quicker recovery, more natural feel, some back to work in a few weeks, blah, blah, blah. None of that has been true for me. When I found Bonesmart at 4 weeks post op I was shocked to learn recovery takes a year, for partial or a total.
That was the first I’d heard that!

So recently I googled partial vs total and got a whole different report. Some of the links were to threads here on Bonesmart. Others were Orthopaedic sites which said some surgeons won’t even perform partials because they don’t think it’s worth it.

I’ve also looked at some physical therapy websites who promise they can fix your pain. And yet I’ve read countless posts on here about how physical therapists have done more harm than good. My PT experience was not as bad as some, but they did and said things that Bonesmart says not to.

I’m a much harder sell these days if the person I’m listening to wants my money.

So, I wouldn’t bother even thinking about that machine.

 

[Josephine]

whether it would be worth getting my own machine to use daily with a view to trying to reduce swelling inside the joint, which is largely where I think mine seems to be.

You can't get swelling inside the joint! Just not possible. I think what you are referring to is internal swelling in and around the ligaments and other soft tissues and no machine is going to affect that.

I don't really have any pain, just internal swelling

Well swelling is pain, you know. So if you have any kind of swelling then you have pain!

Plus you're only 5 weeks out which is a) in the middle of the 'angry tissue' phase and b) you can hurry up swelling only to make it worse!

I say don't waste your money!

 

[KarriB]

I think slowing things down a bit will in the end give you an easier recovery. There really is nothing you can do to speed things up. A body needs time to heal and from my OS, about 12 weeks is normal. My PTs used electric stimulation on me and it still took the full 3 months before I felt ready to go back to work.

This is a tricky time during recovery because you’re beginning to feel a bit better and think the knee should be feeling better as well. However the knee just needs more time after surgery and swelling will go away with time.

 

[Jamie]

I'm going to have to join in the chorus here. Don't waste your money on this. You're really just barely out of your surgery!! You just need to let yourself heal. There are no "magic devices or pills or activity" that hurry things up. You are having a perfectly normal recovery. Try to relax and convince yourself of that....it really is the best way to get where you want to be.

 

[Snoosie]

Ahhh...another Type A demanding "bend...bend...BEND!"

robhunt3 - I remember week 6 and literally screaming at the leg to get your dang ROM already! Patience? Pssff. I convinced myself that this was the worst decision I had every made. I decided I'd never do a second TKR. I compared myself to those who walked out of surgery with ROM 110 and wondered why not me. I determined I was going to obtain great ROM by MNotUA through PT.

By the end of wk 7 , I was dealing with a leg which was severely swollen, too stiff to push bend past 80 degrees, continually buckling unexpectedly, and keeping me up at night with horrid muscle contractions and pain. I don't know how my brain switched from seeing 'the crappy leg' as 'my good leg'. But I regrouped and noted everything I could physically do. I paused PT. I rested, elevated, iced and did things my leg asked me - heel slides to just uncomfortable point, resistance free recumbent, gentle rocking bends. I just had to listen to it and it told me what to do and when to do it.

Now at wk 11, I've gained back 10 degrees. Not a great bend, but my bend, and it will come. More importantly, I function better- walk without a limp, go up and down 11 stairs with rail and stand and balance on my leg to put on pants, etc. I wasn't doing that 3 weeks ago. And I haven't decided about PT yet.

Yesterday, I booked my LTKR!

From one Type A to another, true reflection can put things into perspective. Take care.

 

[kneeper]

The human body has miraculous healing ability--but it's not instantaneous and you need to let it do its work.

 

[sistersinhim]

I loved it when I was finally able to put my pants on without sitting down. Now, you are already there! Doesn't it feel great! Things will just be getting better and better as time goes on!

 

[Suzette]

Hi..just a little bit from me...i found from week 4 to about week 7 was my worse knee time, mine also felt 'swollen' and sore inside.

I felt on the up mentally, my knee did not, so I immediately went on the downer because I was beginning to feel a failure. I didn't think I was healing fast enough and my pain was awful.

I had put pressure on myself to be back at work by week 6! Wrong.

I agree with the others and give your self time without pushing your knee to bend. It will improve.

The most improvement I experienced in the bend was around week 8 then another improvement around week 10.
This happened once I had accepted my knee was going to do its own thing and that I was not going back to work at week 6. All I then did was a lot of lying down and elevating.

See how things go x