TKR Figuring things out

[GardenGram]

Hi - I had a TKR on 2/28/24 so about 8 wks out. Still trying to figure out the fine line of over doing it. My biggest problem is sleeping at night, which seems to be common. I have also just started back to work, so trying to take it easy when at home.

Yesterday at work, and then later at night I got a weird sensation that there was a band around my mid thigh and everything below it was swelling, but when you looked at it all was fine. I was able to walk it out at work, but it really hurt in the middle of the night - finally took a Tramadol and was able to kinda get back to sleep. Any ideas or suggestions on what might be going on.

 

[Jockette]

Hi and Welcome!

What you’re feeling is most likely swelling. Being back to work you are probably doing a bit more than your knee is healed to do, and this results in more pain at night. It’s good that you are trying to take it easy when you’re home.

I will leave you our Recovery Guidelines. Each article is short but very informative. Following these guidelines will help you have a less painful recovery.

Just keep in mind all people are different, as are the approaches to this recovery and rehab. The key is, “Find what works for you.“ Your doctors, PTs and BoneSmart are available to help, but you are the final judge as to the recovery approach you choose.

Knee Recovery: The Guidelines

1. Don’t worry: Your body will heal all by itself. Relax, let it, don't try and hurry it, don’t worry about any symptoms now, they are almost certainly temporary

2. Control discomfort:

rest​

elevate​

ice​

take your pain meds by prescription schedule (not when pain starts!)​

don't overwork.​

​

If you want to use something to help heal the incision, ​

BoneSmart recommends hypochlorous solution. Members in the US can purchase ACTIVE Antimicrobial Hydrogel through BoneSmart at a discount. Similar products should be available in the UK and other countries.​

3. Do what you want to do BUT

​

a. If it hurts, don't do it and don't allow anyone - especially a physical therapist - to do it to you​

b. If your leg swells more or gets stiffer in the 24 hours after doing it, don't do it again.​

​

​

4. PT or exercise can be useful BUT take note of these

​

the BoneSmart view on exercise​

BoneSmart philosophy for sensible post op therapy​

5. At week 4 and after you should follow this

Activity Progression for TKRs​

6. Access to these pages on the website

​

Oral And Intravenous Pain Medications​

Wound Closure​

The Recovery articles:
The importance of managing pain after a TKR and the pain chart
Swollen and stiff knee: what causes it?
Energy drain for TKRs
Elevation is the key
Ice to control pain and swelling
Heel slides and how to do them properly
Chart representation of TKR recovery
Healing: how long does it take?

Post op blues is a reality - be prepared for it
Sleep deprivation is pretty much inevitable - but what causes it?

There are also some cautionary articles here
Myth busting: no pain, no gain
Myth busting: the "window of opportunity" in TKR
Myth busting: on getting addicted to pain meds

We try to keep the forum a positive and safe place for our members to talk about their questions or concerns and to report successes with their joint replacement surgery.

While members may create as many threads as they like in the majority of BoneSmart’s forums, we ask that each member have only One Recovery Thread. This policy makes it easier to go back and review the member’s history before providing advice, so please post any updates or questions you have right here in this thread.

 

[GardenGram]

I have another question, like I said I am trying to figure things out. I have full extension of my knee, and my ROM is 120. I ride a recumbent bike 8 to 10 min daily, then do my 8 stretches that my PT has given me. I have been day hiker most of my life, nothing too strenuous just love walking and nature. It is camping season and we have a trip coming up in a week - what is the realistic distance I should be hiking on a fairly flat trail using walking sticks?

 

[benne68]

what is the realistic distance I should be hiking on a fairly flat trail using walking sticks?

There is no correct answer to this because every knee is unique and we all recover differently.

While it seems your recovery is going pretty well for just two months out, that's pretty early to take on a major hike. Do you get out and walk around your neighborhood now? If so, how far can you walk -- without having pain that night or the next day? If you haven't been out walking, I'd recommend trying it and see what distance is comfortable for you.

 

[GardenGram]

I walk around the yard and garden on a regular basis - we have an acreage, so not really a neighborhood to walk around in and according to my fit bit I walk approx 2 miles a day between work/home. I will use that as a base line and go from there. Thank you

 

[Steveg63]

Wow, you're doing really well, had my rtkr week before yours 8th Feb, only just managing 100 degree bend have full extension. 2 miles is a good amount of steps in a day.
Good luck with the camping trip.

 

[GardenGram]

Thank you - I feel like I should be doing more, but right now it seem to be more stamina over pain, but then I am use to pushing through things (former gymnastics coach) and have to figure out when to stop and let my body do what it needs to do. I keep saying just one day at a time.

 

[lrj]

I started with going to the zoo to work on building up distance. Our zoo has a significant hill, so it was a while before I tried that. First time, I had to stop so many times. Next, same distance only stopping once. Then I started adding distance. Then I took my 8 year old niece and that threw in a whole new element of difficulty.
I've been building on distance and difficulty. At 4 months post op, I hiked 4 miles and it didn't hurt after. This weekend, I'm going to try 7.5 miles easy. Also want to try less than a mile rugged.
I'm working up to my goal of hiking the tallest mountain in Australia.
All this to say, start with short distances and build up as you are able.

 

[mendogal]

To plan ahead.... total miles walked in a day isn't really relevant to your day hike; how far (either in distance or time) can you walk nonstop?

At eight weeks I was good for 1/2 mile on crappy uneven "sidewalk" without the walking stick. I hit one mile about 12 weeks out. 4 months, 2 miles. Now I can do over 3 miles, or if walking paved and staircased hills and stopping to birdwatch, 2.5 hours on my feet.

My goal for this year is 5 miles nonstop. Both stamina and leg muscles need to build up to it. Stamina is still a very real limitation for me but I suspect my additional years of life is contributing to that being slower to return.

You may find your excursion is exactly the tonic you need!!!!

 

[Jockette]

I feel like I should be doing more, but right now it seem to be more stamina over pain, but then I am use to pushing through things (former gymnastics coach)

TKR recovery and an analogy to athletic training

When we begin recovery, most of us cannot wait to push ourselves to show the world that we can not only beat the odds, but also regain our lives as fast as possible. We must add many PT's into this equation, as well---many feel the need to push us to the point of pain and beyond---and many of us...

bonesmart.org

 

[Layla]

Happy Two Month Anniversary, GardenGram!
Slowly but surely you'll get there. I hope you have a great week.
@GardenGram

 

[GardenGram]

Thank you - I really feels like 2 yrs not 2 months. I have to keep reminding my self that this will take a while to be back to normal. All the other surgeries I have had on joints recovery was 6 wks and I was back to most of my normal routine. Looking forward to camping this weekend, and going on some small hikes. I said no to riding the motorcycle - didn't think I could handle the vibration. At 3 wks out I was able to walk a mile with walking sticks with not problem, but we tried a 2.5 mile the next day and it was not a good choice.

I just want to be able to sleep, really hate waking up in the middle of the night - and it taking a couple hrs to get back to sleep. Unfortunately having to go back to work, does not allow any naps during the day.

 

[Layla]

Safe travels to your camp site this weekend. Enjoy the small hikes!
@GardenGram

 

[GardenGram]

Went to PT this morning and talked about my progress and even mentioned this forum to my therapist. She was right with you guys on PT - that you shouldn't go home in pain and there is a difference between pushing yourself to feel a pull, but don't push yourself to feel pain. My leg has been very tight the last couple of days, so she just had me do stretches and a massage today. Love It!!

 

[mendogal]

You've got a good PT there!!!!

 

[Layla]

Thanks for getting the word out re; BoneSmart. It its appreciated!
Sounds like you found a great match in a PT. I hope you enjoy and flourish!
Happy Wednesday!
@GardenGram

 

[sistersinhim]

what is the realistic distance I should be hiking on a fairly flat trail using walking sticks?

I was 3 months out before I tried hiking in the mountains. I was OK on the blacktop and concrete, but the trails themselves had loose rocks and tree roots, causing very uneven gait. I stopped those after about 25 steps!

All the other surgeries I have had on joints recovery was 6 wks and I was back to most of my normal routine. Looking forward to camping this weekend, and going on some small hikes.

Camping is so relaxing. Please be careful and watch your steps on any type of uneven ground. You don't want to fall!

I said no to riding the motorcycle - didn't think I could handle the vibration.

I couldn't do my riding lawn mower until the fall because the bumps and vibrations hurts so much. You're smart not trying the motorcycle yet.