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TKR Worried about ROM, swelling, and general lack of progress

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One little exercise that I did was to sit on the office chair in front of my computer with my feet flat on the floor (I had a BTKR)---I would then slowly move the chair gently back and forth to the point of discomfort---you can also do this with a rocking chair, too. take the movement to the point of tension---that is it.

Afterwards, ice and elevate.
 
referee54 said:
One little exercise that I did was to sit on the office chair in front of my computer with my feet flat on the floor (I had a BTKR)---I would then slowly move the chair gently back and forth to the point of discomfort---you can also do this with a rocking chair, too. take the movement to the point of tension---that is it.

Afterwards, ice and elevate.
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I'll give that a try, thanks. I still take three or four pain pills in a 24 hr period and that seems to work just fine.
Josephine said:
The pressure and stiffness is the swelling building up. Did you read the article on the Swollen Leg?
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Can't remember if I read it. I'll look it up.
 
I had my two week post op doctor appointment yesterday and it went well. He was pretty positive. He said he would have liked for me to have 90 rom but I wasn't too far off. I was able to sleep some last night without icing. It's hard to get the leg comfortable with the ice pack on. When I woke this morning the knee felt the best it's felt since the operation.
I went to a PT session this morning and was able to complete all the reps and sets. I'm a little concerned that my therapist wants to apply some pressure to my leg to get the rom when I go next time unless I have improved by then. The next session is Wednesday. I'm gonna have to decide if I'll let him do that but in the meantime I'm gonna do as much as I can before then without hurting myself. It seems to be such a fine line between pushing to the limit and causing more pain and swelling.
 
DsFan5163 said:
I'm a little concerned that my therapist wants to apply some pressure to my leg to get the rom when I go next time unless I have improved by then. The next session is Wednesday. I'm gonna have to decide if I'll let him do that but in the meantime I'm gonna do as much as I can before then without hurting myself.
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Why would you let somebody hurt you? Pushing will cause inflammation, whihc will not only cause pain, it will negatively impact your search for ROM. Keep taking it gently and slowly, and you will get to where you want to be---and without the pain and frustration, to boot.,
 
I probably won't allow him to do it. But I'am gonna use that as a little extra motivation for me to push. I'm being very careful and methodical about it. I'm gonna make a tool so I can measure how high I can get my knee when doing heel slides. I mean heel slides without a strap to pull or any other type of extra pressure, just raising up my knee with my foot sliding back. I'm hoping to see the knee get a little bit higher as I go. I'm also gonna tell him he has to measure my rom again before I'll agree to any extra push. There may be some unnoticed improvement.
referee54 said:
One little exercise that I did was to sit on the office chair in front of my computer with my feet flat on the floor (I had a BTKR)---I would then slowly move the chair gently back and forth to the point of discomfort-
Click to expand...

I'm also gonna start trying to do something like what you have described here.
 
Thanks for the nice encouraging response Josephine. I read your latest recovery thread. I'm envious of your rom but don't think I would trade all the other difficulties you've had to get the rom. You're a tough cookie.
My knee felt good yesterday and I did way too much. I have to learn to be cautious about what I do. I haven't' had the sharp pain today like last time I over did it but my quads are very stiff. I massaged them and used a heating pad on them for a few minutes which helped. I'm taking it very easy today.
My swelling is pretty minimal. I have a little swelling on the outside of the knee just below the knee cap and it's warm and the skin is very tight. The inside of the knee is very stiff when I bend it but not swollen or warm. I think these two issues are keeping it from bending more. I have started massaging those areas. It's a shame there isn't something more that can be done.
Josephine said:
Don't obsess about exercises.
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I'm really trying to remember this. I'm going easier with those that I do.
 
Remember that you can have internal swelling that isn't obvious. Keep up with the ice and elevation.
 
kneeper said:
Remember that you can have internal swelling that isn't obvious. Keep up with the ice and elevation
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I think that's what I have. Is there anything else to do besides ice and elevate? Also, my quads are very tight. Does anyone have any tips for reducing that tension?
 
You can use a heating pad on low on the muscles--not the knee itself. The quad tightness is very normal. Your pain meds should help a little with the quads too.
 
I had a good day yesterday. The knee felt pretty decent all day. I was able to eat out for lunch although I did take the ice pack along and wore it while at the restaurant. Also wore it for the ride to the restaurant. Then we went to Target where I rode around in one of their handicap carts, a first for me. I was really trying to go easy. I made it through a morning and evening set of exercises just fine. Again, I went easy with it and felt fine during and after the exercises. I felt good all evening. Then during the night I woke up with a sharp pain on the outside of the knee just below the knee cap. It did not go away in a few minutes so I took a pain pill and of course renewed the ice pack as I do several times throughout each night. My knee was very stiff and swollen at the same spot where the pain came from when I woke this morning. I have taken it very very easy today icing all day and it's just not making much difference. I guess I overdid it yesterday but I really thought I wasn't. It's a constant source of amazement to me how long, slow, and difficult this is. Oh and by the way I had mentioned in a previous post that my PT wanted to push my knee to get ROM, that ain't happening! I can see that even pushing things when I don't think I'am causes me a setback so no one else will be pushing my knee. Thanks to the folks on this site for common sense infused personal stories about regaining rom.
 
So you went out for lunch, then to Target, and then did exercises in the evening. And the you were surprised you had pain in your knee? I think you'd have been better to either go out and to Target or do the exercises but not both! THAT'S over doing it!

Did you read my recovery threads and see how much exercising I did? Like ZERO!
 
Thanks Josephine. I did read your latest recovery threads and you certainly had a rough time. I've also spent the last two days reading many other recovery threads. My knee feels a little better this afternoon but is still stiff and swollen. I took it very easy again today and cancelled my PT for tomorrow with hopes of making the Friday appointment. I have to remember that even a minor increase in exercise and activity may be too much. I have to remember to be very careful. I'm not as worried about my rom after reading threads about other's rom. It's really been a blessing to have this site to go to. BTW, tomorrow will be three weeks since surgery.
 
I had the same problem with my first knee---I was always pushing the limits. Finally my doc told me that I needed to elevate for two hours after one hour of activity. That brought it home to me and showed me how much I was overdoing it.
 
Josephine was right that I should have chosen one activity or the other, not both. That's a lesson I think I have learned.
skigirl said:
I had the same problem with my first knee---I was always pushing the limits. Finally my doc told me that I needed to elevate for two hours after one hour of activity. That brought it home to me and showed me how much I was overdoing it.
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I'm also learning that I wasn't icing and elevating enough. I would ice less on days when it felt better but now I realize that at this early stage I need to ice more consistently regardless of how it feels. I have also found that sometimes elevating alone helps me too just as you indicated.
 
One of the things I did when my knee was swollen was a type of "lymphatic massage" where you gently rub your leg from about mid calf up to the thigh. I used short circular movements with both hands. The idea is that you are physically encouraging the fluid in your leg to move up to the abdomen where your lymph system is more likely to be able to remove it. The movement of my hands on my skin was soothing. Once the incision is healed, you can use some lotion or cream to make it feel even better. Or just keep any lotion away from your incision if it's not quite closed up.
 
Thanks Jamie. I'm gonna give that a try.
I looked at the elevating illustrations, Skigirl. I'm gonna work more on perfecting that. I'm becoming habitual, almost obsessive about icing and elevating after being up for a while. it has felt better today. I did an easy morning PT and it stiffened up a bit but not too much.
 
When do physicians and therapists typically measure ROM? I've noticed mine is better after exercise and wondered if there is any certain system to their timing in measuring it. Since mine is better after warm up I'm thinking of asking that it be measured then.
 
@DsFan5163 my therapist measures after I've warmed up on the bike and wall slides, which is the one that increased my rom.....I do the wall slides at home often, as the other exercises are easy to me. I read somewhere "don't waste time doing the easy ones" so I do the exercises that aren't easy, and for me that's the wall slides and I hold it for a good long minute or so then release. Texastee gave me the tip on the wall slides. You can watch a demonstration on YouTube if you're not sure how to do them. They will surely increase your rom, but you have to hold the uncomfortable position longer than 10 sec. I hope this helps
 
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