Posted , 6 users are following.
First time I have ever posted... I am 5 weeks TKR I have 3 sets of exercises every day. The last few days after completing 2 sets my leg swells and becomes very stiff. I elevate, medicate, and rest should I complete the last set? thank you.
0 likes, 16 replies
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jackierae davina63546
Posted
Yes. It took me 8 weeks before I felt better. Its hard but don't give up.
davina63546 jackierae
Posted
Thank you
CHICO_MARX davina63546
Posted
Agreed. Five weeks is VERY early and it is VERY important to break down the scar tissue to achieve your goal of 0 / +120 ROM. Here's some other work you can do at home...
ROM at Home
Your PT "dungeon master" should be evaluating you constantly, increasing your flexion and working directly on the knee to address the scar tissue. There are also devices you can buy to help...
Remember that there are advances, setbacks and plateaus in the recovery. I got stuck at -4 for weeks before breaking through. To get you past the first 12, usually horrible weeks, remember to stay on your med schedule religiously to keep the proper level of the drug (s) in your blood stream at all times. Titrate down as per your doc's instructions. Typically, people are off the "hard stuff" in 30-60 days.
A great topical anti-inflammatory is Voltaren Gel (RX in the US, generic diclofenac elsewhere...check for interactions). You can use it 4X/day...great at bedtime. You just can't use it directly on your incision until it is fully healed and your doc approves but it can be applied to the rest of the knee and surrounding area. Helps a lot.
Once you get past this first stage and you start walking for real again, note that time and distance are irrelevant...it's the number of STEPS that matter since that's when pressure to the knee is applied. Get a fit bit or smart watch. The software will automatically graph your progress. If you do too much in one day, you will get a "balloon knee". Back off, recover and resume gradually...and don't do that again. We all had to learn that lesson the hard way. A full recovery takes time, work and patience...you cannot push a knee.
Click on my name, then Discussions, then View All. The Post-TKR Exercising discussion will be very important after the ROM work. There's lots of stuff out there on sleeping, depression, etc. Welcome to the club...
davina63546 CHICO_MARX
Posted
thank you this has been very helpful.
CHICO_MARX davina63546
Posted
I agree with lyn32416... I am also 3+ years post op. After the ROM work, you have to do the muscle rebuild to get back all of the strength in your quads, glutes, core and more...
Post-TKR Exercising
This will enable you to walk correctly, regain your balance and allow you to do stairs again like a normal person. The ROM work will give you the flexion to bend the knee properly on stairs while the exercising will give you the quad strength to go up and down stairs without holding on to anything. The muscle work will take months so be patient, focused and determined. It all comes back in time.
Then, as Lyn says, you have to KEEP the muscles strong and this means continuous use of the knee and supporting muscles. This is a LIFELONG recovery. Sit around and you will lose that muscle strength and knee flexion. Sucks, right? Actually, it's a great incentive to lead an activity-filled life. I see it more as a blessing than a curse. Gotta keep movin' or stiffness and limited motion will return. Avoid that at all cost.
Also, kneeling will be an issue long-term...not because of the knee but because of the damaged nerves. Sure, you can kneel down with zero pain...just not on hard surfaces like cement, tile, hardwood floors, etc. The pain you will feel is from the nerves, not the knee itself. Always use a 4" foam pad or pillow indoors and a set of padded tactical knee pads outside for gardening work. Avoid the pain. Long-term TKR-ers relate that this nerve pain may never go away so be prepared. This is something out of our control...
PS: I also totally agree with Ann...LISTEN TO THE KNEE!!!! When it swells, you did too much. Slow and gradual...give it the time it needs to heal. You can push a shoulder or hip to recovery but not a knee. It's a completely different ball game.
davina63546 CHICO_MARX
Posted
I am definitely listening to my knee from now on. Wonderful information!
lyn32416 davina63546
Posted
HI Davina
I still do exercises for my knees after 3 years. As others have said... scar tissue must be broken. Also you will need to keep the quad muscles strong to hold the device in place. Consult with physio regularly.
Never sit for too long. Moving is good! Hope you obtain good result!
davina63546 lyn32416
Posted
Hi Lynn many thanks for your advice.
ann18637 davina63546
Posted
Hi davina it's early days I've had both mine done within a year of each other. The last one 4 months ago. If your knee swells its telling you to back off and rest. Too much excercise and walking will irritate it. I've learnt through the first one, felt great so off I'd go for a long walk and pay the price later not worth it. Excercise little and often I found the best one was my excercise bike helped me get through the second tkr much better. You'll get there But remember your body will tell you when it's had enough listen to it and rest. My point of view best thing I got done no pain now yes an odd twinge and stiffness but remember this op was a major one and can take years to recover completely. Good luck x
davina63546 ann18637
Posted
thank you much. x
lynda49844 davina63546
Posted
If you knee swells to the extent that it becomes stiff or painful then it's telling you it's not ready for whatever it is you're doing, so back off for a while. . A stiff, swollen knee won't bend. Think of a hose pipe full of water. Do what your knee is comfortable with and if your knee is happier with fewer exercises, do those and increase gradually.
I was doing really well on the exercises I was given on discharge from hospital until I tried the next stage. Just one exercise put me back and it took two weeks before my knee settled. I was advised it was ok to experience discomfort and some swelling, but not anything that caused pain or a lot of swelling. I had a lot of stiffness if I did two many heel slides in one go to begin with so broke them down to 3 or 4 every hour. You would think I would have learned my lesson, but 6 weeks ago I was given an exercise that caused another setback and it was painful just walking. It isn't a linear recovery by any means, more like being on a rollercoaster! I'm 6 months along now and my ROM is excellent. I can do most things I was doing before, although the knee still lets me know if I've been up and down too many flights of stairs, not helped by the fact that the other knee needs doing.
davina63546 lynda49844
Posted
Thank you Lynn, I think this is the problem I'm doing a set of exercises all in one go rather than a couple of different exercises every hour. (I have 3 x sets of exercises each day). Then early evening my knee is red and swollen. I will definitely change my exercise routine from tomorrow.
lynda49844 davina63546
Posted
Yes, I came out of hospital with 3 sets. It's important to keep the knee moving and exercising, but within limits. Listen to your knee. Try to move it for at least 5 minutes every hour during the day even if it's just a 5 minute walk round the house or doing normal activities such as preparing meals, loo breaks etc. In between ice and elevate toes above nose on 4 pillows, with slight bend in the knee, for at least 40 minutes 4 times a day. After all the trauma our knees have been through it takes time for those tissues around the joint to heal. Remember it's a year recovery so very early stages for you still.
davina63546 lynda49844
Posted
it's amazing all this information. in the UK physio once a week and they haven't mentioned any of this except do these exercises. Its a wonderful forum thank you.x
lynda49844 davina63546
Posted
I'm also in the UK, but didn't start formal physio until week 6. Everything else was on the hospital website and I gained a lot of information from another forum.
It does seem rather as if we're pretty much left on our own after surgery, wondering whether all our aches, pains etc are normal or something of concern. Thank goodness for forums!