TKR Zena831’s Road to Recovery

[benne68]

Oh, @Zena831! I am so sorry the PT did that to you. It is unacceptable and you've done the right thing by reporting it.

As others have said, you flexion is really very good for just 5 weeks in this recovery.

Since you are curious about where others are/were in regaining ROM, I will share the following charts of progress made by some of our members whose ROM returned slowly but surely.

Campervan’s ROM history
92 - 8 weeks post op
105 - 10 weeks
107 - 5 months
110 - 6 months
112 - 7 months
116 - 9 months
119 - 11 months
118 - 1 yr
120 - 1yr 2 months
125 - 1 yr 8 months and still this now at 1yr 10 months

Bertschb’s ROM history
1 month - 60 degrees
2 months - 80 degrees
3 months - 85 degrees
4 months - 90 degrees
5 months - 90 degrees
6 months - 110 degrees
7 months - 120 degrees
8 months - 125 degrees
9 months - 130 degrees
10 months - 135 degrees
11 months - 140 degrees
12 months - 140 degrees

TortiTabby's ROM
3.5 wks: 75
6 wks: 85
7 wks: 90
10.5 wks: 95
14 wks: 100
17 wks: 105
20 weeks: 110
26 weeks: 120

You are doing great. Slow and steady!

 

[Layla]

No apologies necessary, Zena. I hope things have settled with your MIL.

I am so very sorry to read of the insensitive behavior of the PT and that the pain was intense enough to bring on tears. Given that incident and the fact that she offered no apology would be enough for me to cancel any further appointments with her and find another therapist to work with. It sounds like your surgeon is happy with your progress and his is the opinion that would matter most to me.
Hopefully the swelling is easing and you'll be feeling better soon. Only 6 more days of the immobilizer...Yay!

Thanks for stopping by to update.
@Zena831

 

[Zena831]

Thank you all for the feedback. You are right, no one will be touching my leg again. I don’t even ice it there because I like my ice at home and I live 5 minutes away.

I know my exercises and are doing them there and at home. I plan to speak with the main owner tomorrow. He was there on Monday and heard me yell. However, didn’t really ask what happened which I thought was weird. He was leaving for the day so maybe that’s why.

@AnnYo thank you for input and you are right, PT is rough enough mentally and physically before any trust is lost. I honestly feel she not only broke trust but burnt down the entire village.

My reminder text that I received tonight for tomorrow’s appointment has me with someone else. So maybe I can stick with him moving forward. He’s the one who did my original eval anyway. I do know that I will not be seeing her anymore, even if I use less convenient times for myself and my husband.

@mendogal thank you, as my MIL is starting to mend. We had to place her in inpatient rehab and she will most likely have to end up in a Skilled Nursing Facility. However, she is better than a couple of weeks ago for certain.

My offices are closed Friday, so the only thing I have planned is PT. I do need to do a few things around the house but not much.

I am truly glad I found you all. I cannot thank you enough!

 

[dotski]

I’m sorry you went through that, and at only 3 weeks, and on top of the other things you are needing to worry about besides your knee. The PT’s lack of empathetic reaction to your pain is something that would have bothered me enough to find another. I’ve had some very painful pushing from my chiropractor in the past but it was 100% ok with me as I knew I had to catch up and he is a kind man with a lot of TKR experience.

Looking back I wish I had worked harder at extension earlier days. (I’m glad I got the flexion though). It will be such a relief to not wear the immobilizer…but I suspect an even bigger relief down the road to have a knee that fully straightens and allows the muscles to then work in a normal alignment. It may save you grief down the road with soft tissue pain issues or other body part issues that can stem from walking with one leg bent more than the other.

 

[Zena831]

Wow, it’s hard to believe I am 6 weeks post-op. I still have really hard days where I am so stiff and feel my knee is going to fall off.

I am a little concerned that I cannot straighten my leg 100%. When I walk it looks like a natural bend in my knee, we’re my other one is straight. I know these things take time but I feel I’ve gotten to a point and just stalled. To be honest, I feel like my new knee is so large. I can only guess I still have swelling inside the knee. When I’m walking I try to push that knee back as far as I can to get it to look straight.

Is there anything I can do to help with this? My PT has me lay on my stomach an places small weights on my ankle to try and get it straight. I feel like I have been doing everything they ask of me but it’s just not enough.

There is a guy who is in PT and we have spoken. He had the same surgeon as me and is 4 days behind me. This is his 2nd TKR on that knee but he was walking out of therapy on Wednesday with no cane and as straight as could be. My PT says she doesn’t think my muscles are firing like they should in my quad. Could this be true?

No more TEDs or immobilizer

 

[Jockette]

Many of us were not 100% straight at 6 weeks. In this recovery that takes an average of a year, 6 weeks is still considered “early days”. If it was me I would not allow a weight to “help” straighten my leg, it will happen in time, as you heal.

 

[mendogal]

I agree that trying to force a newly healing post-op knee with suspended weights is counter productive. It risks creating new problems and is 100% uneccessary.

Yes your "big" new knee still has swelling, and yes it's the swelling restricting your extension. It will come naturally as you heal and practice good heel-toe walking plus gentle stretching.

Stiffness (,especially after sitting, standing, or sleeping) is a universal problem after TKR - for many of us it continues for months, though if we don't aggravate the knee it improves and the ability to sit, stand, etc improves . My own one best therapy for it is short walks.

 

[MSuki]

If you want to do something more gentle you can just put your ankle on something like a pillow or anything that holds it up a little - the weight of your leg is enough to naturally stretch you a little toward better extension. PT had me doing this for 5 minutes a day.

 

[benne68]

I didn't get to full extension with my first knee until I was about 3 months post-op, @Zena831. For many of us, extension comes more slowly than flexion -- but it does come eventually.

Every recovery is different because every knee is different -- even two knees in the same person (as I am learning firsthand in my second TKR recovery!) -- so please, please don't compare yourself with anyone else.
You are doing just fine!

 

[sistersinhim]

My extension took a lot longer to come in than my extension did. I did no exercises or PT to try and force it, but did it the natural way. I walked with a longer stride, with a heel-to-toes stride. This helps to stretch out those big muscles and tendons in the back of the knee. It didn't happen overnight for me, but it worked after a month or so and my leg was then straight. If you try this way of walking, make sure you have something to hold on to or grab if you lose you balance.

 

[Layla]

No more TEDs or immobilizer

Woohoo! That’s fantastic news.
The rest will come, Zena. Give it time.
Wishing you all things good in the New Year!

 

[Zena831]

Thank y’all for the feedback on PT using a weight to try and straighten my leg. I have been trying to extend, tighten and bend to best I can wit’s each step. I’m really putting a lot of thought into my walking which is something we take for granted.

At PT Friday, I was measured at negative 5 for my straightening. I was at a 115 bend and that’s when I started to hurt. I head back to my doctor on Friday, Jan 5th. I’ll see what he has to say.

Wishing each of you a very Happy New Year!

 

[benne68]

I’m really putting a lot of thought into my walking which is something we take for granted.

Good for you! It will make a difference. Keep practicing until it becomes second nature.

 

[Zena831]

Headed back to see my doctor tomorrow morning. I really hope he is ok with me wanting to stop PT. I am totally over it and them. I feel that if I use the time and start walking more and longer, as well as getting on my stationary bike that I get to full extension and bend. of course, nothing crazy but building up.

I was at a negative 3 earlier this week and my bends were at 115 before it started hurting. I know progress is slow but I just want to finish the way I want to finish and start doing things my way.

Hoping y’all had a great holiday.

 

[mendogal]

You're doing so well! Your ROM numbers are really fine for how soon after post you are.

Two points that may help tomorrow....

One, some othopedists don't take measurements and don't ask what they are. Mine will ask about functional status and watch from a few feet away while I swing my leg, bending and straightening it. So.... don't volunteer any numbers; focus on functional status and any concerns or questions you have.

Two, you don't need a physician's permission to stop PT (you should tell the PT at last planned visit though. ). At some point PT will probably send some kind of discharge summary to the physician's office; whether it's read or simply placed in your file varies from practice to practice.

 

[sistersinhim]

I really hope he is ok with me wanting to stop PT

PT is up to you. I chose not to take formal PT and did it on my own. My OS was happy with my function and never mentioned me not taking it.

I know progress is slow but I just want to finish the way I want to finish and start doing things my way.

You will be fine doing it your way. Progress is slow for everyone. That is just the nature of this recovery.

 

[Jockette]

I never asked my surgeon if I could stop PT. I had a short discussion with my PT the last day I went there, he wanted one more appointment and I asked (to be polite, but I wasn’t really asking) “can this just be our last appointment?” and he easily agreed. I mentally floated out of the building knowing I’d never be back! (I had a bad PT experience, especially early on, which totally betrayed my trust in them)

I feel that if I use the time and start walking more and longer, as well as getting on my stationary bike that I get to full extension and bend. of course, nothing crazy but building up.

This is a wonderful plan. You’ll do fine!

 

[Layla]

Best Wishes for your appointment today, Zena. Please let us know how it goes. Hopefully you'll receive a nod from your surgeon to continue recovery your way. Obviously the choice is up to you, but it is always nice to feel supported by our surgeon.
Have a wonderful weekend and many blessings to you in this new year!
@Zena831

 

[Zena831]

You're doing so well! Your ROM numbers are really fine for how soon after post you are.

Two points that may help tomorrow....

One, some othopedists don't take measurements and don't ask what they are. Mine will ask about functional status and watch from a few feet away while I swing my leg, bending and straightening it. So.... don't volunteer any numbers; focus on functional status and any concerns or questions you have.

Two, you don't need a physician's permission to stop PT (you should tell the PT at last planned visit though. ). At some point PT will probably send some kind of discharge summary to the physician's office; whether it's read or simply placed in your file varies from practice to practice.

Thank you for the information. I do appreciate you.

Well, for the visit today I’m not sure it went too well. Keeping in mind Wednesday was 7 weeks post-op.

They asked to see my incision area and were very pleased with how everything looks from that perspective. They asked me how I felt and I was honest…I cannot sleep because I cannot get comfortable and I constantly hurt.

They asked me to straighten my leg and looked at both side by side. My left leg is actually hyperextended by 3-5 degrees so it looks like a huge difference when my right is negative 3-5 degrees.

After pressing, wiggling and jiggling my knee, we had the discussion of how much inflammation is in it causing the issue of not being able to get completely straight. I cannot be on NSAIDs for a long period of due to having Factor V Leiden and being on blood thinners but I was prescribed methylprednisolone in a different regiment to try and get some of the inflammation out. I have taken this before for inflammation caused by my arthritis. It seemed to help in that aspect.

They were going to put me back in my immobilizer but as we talked through it, I am already as straight as it takes me. It does have a slight bend in the brace. So, I am back in my TEDs for another month to get that swelling down and try to keep it down. I’m back on my wedge (best purchase ever). Plus, I am living with ice even more than I was.

I know everyone heals differently but I’m not sure how I feel about the visit today. The conversation was very much around how every time I try to extend/bend my knee it just gets angry and continues to get angrier.

The positive note was they are truly happy with the flexion and we know that will get even better when the inflammation dies down.

Final result: a round of steroids, another month of TEDs and another month at least of PT with icing, icing, icing.

 

[mendogal]

Working on the inflammation sounds like a good plan. At under 8 weeks, yours isn't necessarily unusual, but given your history it totally makes sense.

I'm glad you've had the experience of being on steroids before, so you know how your body responds to them!

May I respectfully ask what you hope to gain in PT vs walking and using the stationary bike?

We support all our members' decisions regarding their very individual recovery paths, so this question isn't meant as a challenge, just as a question for you to clarify your goals and methods.