Beyond discouraged - 9 wks Post TKR

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At 9 wks Post TKR, I know I am getting better. But pain is still a constant.  Trying to work because I must. Still using one crutch most of the time because if I don’t, pain and swelling increases. Doing my exercises, especially exercise bike, religiously. Struggling to sleep. Just worn to a frazzle trying to keep on ‘til things get better. People at work think I ought to be better and show little mercy for me not quite being up to par on the job. I think I ought to be better! 

Help!

0 likes, 16 replies

16 Replies

  • Posted

    Hi you are very early returning to work, I know everyone is different but it takes a good year to get back to some sort of normality, I'm 9 months post TKR and being referred back as the pain is still horrendous, I was off crutches by about 8 weeks, maybe you are doing to much which is why the swelling and pain is still bothering you. X

  • Posted

    Hi AliMarie, I think a 9 week return to work is really pushing it. You have to remember you've had massive surgery to your knee. At 9 weeks you'll still have scar tissue which , as you exercise, keeps tearing and repairing. Also the nerves around the knee are growing back and, as you can feel, it's not a pain free procedure. I'm not sure were you live but I do wonder why you were given a crutch to help you move about. I'd think a crutch, because of the pain, could be encouraging you to not put full

    pressure on your knee. This would possibly cause your scar tissue and repairing nerves to stretch causing pain. When I came to after the op, UK, I was given walking sticks. I believe this is to get you to put pressure on the new knee as you move. Myself, after 4 weeks I was able to get around with minimum use of one stick. As for the pain and swelling there's only one really good easy fix, ICE, ICE, and more ICE. Yes painkillers have their place at night but during the day you need ICE. So having to return to work must prohibit the use of ice. As for not sleeping, I think it was around the 7 month post TKR before I woke one morning and realised I'd slept all night. I found the lack of sleep really affected me more than the pain. So please don't beat yourself up over your work colleagues crass comments. Don't put yourself under undue pressure forcing yourself to exercise more than your body can take. Try listening to your body and take it one day at a time. It will get better but only if you don't push yourself too hard, undoing all the good work done on your knee. Best wishes for the next few months and do look after yourself.

    • Posted

      Hi David - I was initially given a walker, but it was so limiting that I transitioned to a single crutch (with my therapist’s approval).  I don’t even really know what walking sticks are in regard to knee rehab. ?? I live in the U.S. in Texas. All I see are walkers, crutches, and canes. ? I have tried a cane, but my knee still occasionally feels unstable, and the cane offers little in the way of support. I try to walk as straight up as possible, not leaning on the crutch unless I’m really hurting. At home, I walk a good deal without the crutch, and I do manage to hobble around the library without it. But it seems the more I do that, the more pain I have. So I felt like my knee wasn’t quite ready.? (My husband did purchase a mobility scooter for me to go long distances at work since our school is all concrete floors and is quite large.)

      When I returned to have my staples removed, two weeks following surgery, the nurse asked if I’d be returning to work the following week. I thought this must be customary since she asked, but I initially begged off to not return until 4 weeks. When that time arrived, I put it off another two weeks. I am typically a very active school librarian (not the old stereotypical role of sitting and shushing everyone). School started in August, and I had already missed the first weeks, using up all of my paid sick time. Each day I miss now deducts $300 from my monthly income. 

      I have three large ice packs that strap to the leg, and I have one of those at work. They are wonderful, and I manage to ice at least once during the workday, and then a couple more times in the evening.

      I’d like to know more about the walking sticks.? Thanks for responding.

    • Posted

      Hi AliMarie, Ouch, your loss of wages must really hurt. Here walking sticks would be your 'canes', a crutch or walking frame was not an option. Second day after the OP I was shown to the stair well and had to do 2 flights with just one cane to be allowed home. There's NO WAY you would be expected to return to work sooner than 8 weeks. I believe most people, if financialy possible, put off till they've had their first checkup with their Surgeon or 6 months. At most firms you would normally start back with a reduced work plan. Slowly building up to full time. The instability feeling in your new knee will probably be more to the loss of strength in the muscles around the knee. Remember the pain in the knee joint is gone. What you are feeling is the pain from the scar tissue as it keeps stretching, breaking and repairing. The nerves that have been cut and are regrowing are adding their bit. Unfortunately it takes a LOT of exercise, specifically to tighten up the tendons supporting the knee. At first I would be doing exercising, leg lifts,  2 hourly during the day. Slowly at first and with lots and lots of ice. Looking on YouTube there's lots of advice on the exercises needed to strengthen those muscles. Hopefully in the near future as the strength in your leg recovers you'll feel less pain.

    • Posted

      Hi again David - I think I must have overdone my exercise yesterday, possibly doing the "stretching, breaking, repairing" of scar tissue that you mentioned. I had much more intense knee pain all night and throughout the day today - especially about the knee cap. I've tried heat, ice, exercise, but it's still just throbbing. I can't even really see any extra swelling. Not sure what I did. ??  Did you experience anything like this? I actually think I might be walking better today, but the pain is certainly no fun.  Thanks!

    • Posted

      Hi AliMarie, it's 3 yrs for me and I still get the odd day when I'll get pain down the side of my kneecap. I usually find its when I've been on ladders or steps. I think it's the twisting of the joint as you stretch sidewards or twist on the rungs. Also when I've been on a long drive. I have a tendency to let my knee lean to the side against the door. Boy do I know about it when it comes to getting out. The pain will usually only last a few minutes till I get moving on my feet again. Wonder if the muscles have shortened and any excess or continuess sidewards movement aggravates them. If I remember rightly when I used to get that tight swelling feeling I used to slap on the Bio Oil and massage the pain away.

    • Posted

      Bio Oil? Thanks David. I just haven’t had this sharper pain in a while. And where it’s hurting is not muscular. It’s like where the new joint line is located, so I would think it would have to be scar tissue tearing and reshaping itself. ??Getting better, but wow! Kind of threw me for a loop!
  • Posted

    Hi Ali Marie I'm 5 + months after my ltkr and when I was at your stage felt I was never going to feel normal again and guess what I'm great now walking cycling no pain even contemplating getting my right knee done in the next few months. If you'd said that to me I would have said no way but like the Dr said it takes time and it's true. Sleeping was terrible for the first 3 months but to be pain free it's worth it. Keep on with the excercises ice regularly if you need meds use them but listen to your knee if it hurts rest don't overdo it. Good luck it's worth it

    • Posted

      Thank you so much! It does feel like this is a never ending road of pain and dysfunction right now. Good to hear from someone not too far ahead of me!
  • Posted

    At nine weeks, you're not out the the Pain Zone yet.  The first 12 weeks are the most challenging, especially with PT getting your ROM back.  Lots of of ups, downs and pain.  After 90 days, the bad things usually subside unless there are complications or you haven't done the ROM work for the flexion and started the exercise program to rebuild all those dead muscles that support the knee.

    Understand that the entire load of walking and moving around falls squarely on the new knee because your quads, glutes, core and more are all atrophied.  Once you get into the muscle rebuild, that pressure shifts back to your musculature taking the load off the knee thereby lessening future pain.  Gotta do the ROM work first (0 / +120) and then start the exercising.  This thing takes a year with lots of advances, setbacks and plateaus.  Your tools are time, work and patience.  Give up your "expectations"...they only screw with your head.

    • Posted

      I’ve got the range. Have for a while now. Working on muscles. Thanks so much!
    • Posted

      And that makes sense about all of the weight going onto the freshly “sawed off” bones! Ready for it to shift to musculature.
    • Posted

      Yup...it just takes time and work.  At 14 months post op, I was going up stairs two at a time without holding onto anything.  It's all about using your now-atrophied muscles again for their intended purpose and taking the pressure off the knee.  Restore the body's natural balance.  Time and work...and patience...

  • Posted

    !!  I have been an RN for 5 decades and have also worked in Orthopedics.  My TKR was exactly 2 years ago but I can still vividly remember "hitting the wall of depression" at about 8 weeks into recovery!  It's real and no one prepared me for it. Recovery is a marathon of MONTHS, not weeks. It's as much mental as it is physical. There will be many baby steps along the way and often setback that can rock your world...swelling, chronic pain, not sleeping....and people not understanding why you are not "back to your old self". Hang in there and know that it WILL get better. Count everyday that your pain is less, you can bend your knee alittle more, or that you can go the whole day without the needing a nap as a "GOLD STAR DAY". The other days...just be glad that they are over and look forward to tomorrow. We are all here for you.  God bless you and give you rest!

    • Posted

      WOW...50 years as an RN...amazing.  You are a real hero.  My wife spent 30 years as a psychiatric nurse in state mental hospitals and then had a brain aneurysm in 2010.  The resultant short term memory loss and two TIAs left her unable to complete her career as she had anticipated. It still bothers her to this day at age 69 as she expected to be nursing still and continuing to teach the psych rotation at the local community college as she had done for many years. An outstanding career stopped way too soon.  Enjoy every minute minute of yours, inspire others and leave on your own terms...wish Sage could have done the same.  Good luck...

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