TKR What did I get myself into?

[Flashlight]

Thank you for this information. My oncologist would not ok any Lymphatic massage until 10-12 weeks post-op.

 

[CricketHip]

@Flashlight I wonder why? Did they give any explanation? I've never heard that.

 

[Flashlight]

I think it is because of the healing process. I looked back in my notes and my OS said not to start massage before 6-7 weeks. Maybe it depends on the doctor and what you had done. Early on I just did a light massage on my lower leg to try and get the feeling back. My OS wanted me to massage my incisional line at 6-weeks a couple of times a day. Thank you for the information. It all gets confusing sometimes!

 

[CricketHip]

@Flashlight I understand why your OS would say 6-8 weeks for massage. Hopefully the therapist would know not to massage directly on the incision line or anywhere near the surgical site before that time frame.
I found in my experiences, that most surgeons don't really understand Lymphatic Drainage. Which is a real shame.
You don't need to have hands on work on the surgical area for MLD, either. Working above the site will still do it's magic.
But absolutely it's best to err on the side of caution.
Luckily, in @WillB 's case, he is approximately at 7 weeks post op. I hope you are doing well in your recovery. I'll look for your recovery thread so we don't high jack WillB's thread.

 

[WillB]

So today I finally had a lymphatic drain massage in hope of helping the continual swelling. I had watched several videos on LDM so was pretty much understanding the how and why! Well, I did receive a pretty good massage and a ton of time was spent on my leg. But, even though I was assured the therapist was “schooled” in LDM, her efforts in no way mirrowed the videos I had viewed on Youtube. And as a result my knee, now some 10 hours later is just as swollen and now stiffer than befire the appt. Still think a LDM is beneficial, but absolutely confirm the therapists qualifications. Rest easy folks

 

[CricketHip]

Oh, how I hate to read your update! That is the most annoying thing about modalities. People claim they can do it all. I kept my certifications, the important ones, framed and hanging within easy eyesight for this reason and would expect all professionals to do it also.
For starters, the total amount of hours should be more than 8-16, in other words not just a weekend class.
You actually may feel some difference by morning if the therapist did anything correctly. Some bodies respond a little more slowly than others.
I would be interested in seeing some of the videos you watched, just to see if they are on the right track.

 

[WillB]

Oh, how I hate to read your update! That is the most annoying thing about modalities. People claim they can do it all. I kept my certifications, the important ones, framed and hanging within easy eyesight for this reason and would expect all professionals to do it also.
For starters, the total amount of hours should be more than 8-16, in other words not just a weekend class.
You actually may feel some difference by morning if the therapist did anything correctly. Some bodies respond a little more slowly than others.
I would be interested in seeing some of the videos you watched, just to see if they are on the right track.

My knee is still swollen after my LDM experience Thursday. Last night was a tough sleep. Sharp pains were springing up which had pretty much gone before my massage. But I also drove my manual sports car yesterday and my wife thinks my pain may be from shifting. I tend to thinks its the former. Now 9 weeks in I anxiously await the day when pain is gone!! Am I wrong to be a little worried that I haven’t met ROM goals. I’m worrying a bit more about extension as I’m not there yet but 105 on flex.

 

[sistersinhim]

Many people have a longer time having a 0 extension than a good bend. Those tendons and muscles behind the knee are much larger than those used for a bend. It takes longer to stretch those out. What I find helpful was to walk with a much longer stride with a heel-to-toe gait. This helps to stretch out those large muscles and tendons.

 

[WillB]

Many people have a longer time having a 0 extension than a good bend. Those tendons and muscles behind the knee are much larger than those used for a bend. It takes longer to stretch those out. What I find helpful was to walk with a much longer stride with a heel-to-toe gait. This helps to stretch out those large muscles and tendons.

Good to know. Just went for a walk emphasizing heel toe. I use my outdoor walker as it helps me stay squared up and evenly balanced. I noticed a bit more discomfort on rhe lower front of my knee.

 

[CricketHip]

I can’t imagine that driving your manual car helped matters any.
Do you think you could possibly go a full week without exercising that leg?
Just do gentle walks and do gentle movements?
You might be pleasantly surprised by the end of that week.

 

[sistersinhim]

I think it's a good idea to use a walker outside. Did you walk with a longer stride to stretch out those back muscles?

 

[Jockette]

@WillB Just want to let you know I moved some of your posts and replies over to your Recovery thread, rather than @volLady ‘s thread, so you have a record of it here.

 

[LydiasMom]

I am at 6 weeks post op and my knee still has swelling and stiffness, doesn't want to bend as far as my pt wants it too. I was in a lot of pain afterwards and waited 2 weeks before going to physical therapy.
Like they said, don't push yoursefl, just do what you can tolerate. I'm excited to be off the walker and cane lol.
Lots of elevation and ice helps a lot.

 

[Darkang]

@WillB
How are you doing now? Feeling like it was worthwhile? I'm 8 weeks post op, and can definitely say it was worth going through the ups and downs. I can see the light at the end now, and its not a freight train!! haha

 

[Layla]

Just went for a walk emphasizing heel toe. I use my outdoor walker as it helps me stay squared up and evenly balanced.

Heel-toe walking does take a concentrated effort. At least it felt that way to me. I hope its working well for you and you're noticing that it does make a difference. Happy Two Month Anniversary, Will!
@WillB

 

[WillB]

Layla, my knee is still swollen, though less than a month ago, and I still have some pain which seems more noticeable at bedtime. Wondering if I should still have sharp pain at 2 months vs just dull pain? Seems each week there is slight improvement and I know I’m doing too much sometimes, ie playing a little pickleball. And would you venture a guess as tor minimum ROM you need to have a somewhat normal gait.
Also, my MLD was a total waste as therapist was not truly qualified. Frustrating as I know that would have been beneficial

 

[Flashlight]

Wait until 4 months and see how you feel. Is May a nice month in Arizona? I don't see how massage would help swelling at 2-months because you are still healing. Elevating, ice, and rest will help more. Even though you had a therapist that was not qualified MLD takes more than one visit. Lymphedema doesn't resolve that fast. I think you are doing great. If you can walk behind a grocery cart or at a home improvement store and practice your gait it really does help. Someone else suggested it to me and I was able to start this around 10-weeks.

 

[WillB]

So I did play a little pickleball yesterday being careful not to do too much. I was using one of my pre surgery compression sleeves. It was very tight and while my knee felt pretty good, I’m afrsid I may have cut off a bit of circulation to my lower leg, specifically my calf. About 15 mins after removing my sleeve I got the worst charlie horse in my calf I’ve ever had. I could barely walk because of the pain. I became a little concerned about a blood clot but 24 hours later I just have a knotted painful calf muscle which feels a bit better than yesterday. And of course after playing a little PB my knee is a little worse today! Oh well, at least I have a PT session tomorrow. What an interesting journey!!!

 

[Can can girl]

After suffering with left knee pain for some years, I finally bit the bullet and agreed to a TKR proceedure at 75. I am currently on day 19 with my first post op appt scheduled for Feb 1, which will be day 21. I totally underestimated the initial pain which was excruciating even with doses of Percocet. Sleeping still is difficult. I had several in home PT sessions where I embraced the “no pain no gain” mantra! Boy, that didn’t work as the day after PT was definitely a step back. I’ve been using a CM machine and am at 0 and 95 which I guess is acceptable at this point. But here’s whats frustrating. At day 16 I ventured out with my walker and rather comfortably walked about 1,000’. All in all, I felt pretty good. BUT, the next morning my knee was stiff, swollen and painful. Definitely moving in the wrong direction! And sleep is really tough even with 300mg of Gabapentin and a Tylenol PM. I know things will get better but my impatient nature makes all of this a little tougher than I would have imagined! So glad I’ve found this site!! Will update after my appt on the 1st.

I’m five weeks post and find that I have to do the exercises gently. Too much walking stops me sleeping at night and then next day is awful. I didn’t walk far anyway but I’ve realised now what causes stiffness and exhaustion so I don’t do too much.

Having a shower and washing my hair tired me out. So I rest for a while after doing that.

I suppose didn’t sleep properly until about a week ago, once I could sleep on my side. I have no pain now and I am on no pain medication.

I have a knee buddy and she is struggling to sleep at all. But she realised she is doing too much in the day.

You really need to rest to heal.

I have my post op appt with the surgeon in the 24th March.

I have tried driving my car today and it was fine (driving a car with a clutch in the UK).

It does improve a tiny bit each day. I think once you get to 3.5 weeks you will feel the difference. But keep going as I’m starting to feel like ‘me’ again.

 

[Can can girl]

Unfortunately, at 24 days in a recovery that lasts an average of a year, that light at the end of the tunnel is still a ways off.

My therapist is concerned that I’m not fully extended at 24 days and mentioned the “window” which seems to be every therapists concern as if you don’t hit full extention within a month of surgery you are doomed to a permanent limp.

Reread this:

Myth busting: "window of opportunity" in TKR

This "six week window of opportunity" surgeons often speak about is little more than a myth. It presupposes that all patients have the ability to create adhesions which is far from the truth. It also ignores the simple fact that in the first 3-4 weeks after surgery, swelling reactive to the...

bonesmart.org

Personally, I haven’t felt that elevation and icing are doing much

It’s going to take more than 24 days to see a difference. A lot of it has to do with your body’s healing rate.

But then I was told that the exercises will help reduce swelling.

A list of exercises probably won’t do this and can actually increase your swelling. Moderate activity and balance with rest is what will help.

I almost wish I could just do my daily activities, a little walking and a few easy exercises and let my knee continue to heal.

You don’t have to wish this, you can do this type of rehab if you choose. It’s your decision how you rehab your recovery. Doing “just” this has been successful for many, along with lots of patience.

Was walking today without asssistance, which I thought was positive.

Yes, this is very positive! ROM numbers are not the only sign of improvement. There are lots of “milestones” that indicate that you are coming along well, and you are!

Im five weeks post op. I cut my exercises right down. Still do the stretching. But if I did what the physio wanted I couldn’t sleep at night and the next day I felt awful.

I have good bend and my leg is as flat as the other one.

So I experimented and once I cut the exercises down I slept all night and felt good next day. Also I don’t walk far and sometimes not every day.
I also accepted that if I’m tired in the day I sleep (I still sleep at night now). Interesting that the physio said don’t nap in the day. I suppose I can understand stand why he said it but it’s just not possible as we get so tired, exhausted in my case on occasion, that we have to sleep.

I don’t seem to get much out of icing or elevating. But the UK doctors say elevating is not necessary as long as you are resting. I’m better lying in bed and that helps any swelling or tightness.

But we have to be patient and let it heal. Also let our minds adjust to letting our body heal in its own time. Frustrating though when you want to be getting back out there