Unable to exercise after TKR

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I am just over 2 weeks post op having had a TKR on my my right leg. I have struggled with pain relief since day 1 and am now on a low dose slow release tramadol and also ibuprofen. My main concern is the lack of bend in my knee. i struggled to reach 80 deg before i left hospital but this has reduced greatly over the last week. My physio says i must push through the pain to see any results but i find this so hard when it hurts so much. It feels so stiff and tight like the whole thing is going to explode!! Beginning to wish I had never had this done and its really starting to drag me time - the time of year doesn't help either with everyone rushing around christmas shopping and partying! Any advice and encouragement would be appreciated.

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  • Posted

    Don't give up.I had TKR 3 years ago and my bend was poor as well.

    This is a really good exercise to try.

    Sit on the bed with your feet on the bed and  a tea tray at your feet and keep your socks on.

    Try moving your foot up the tray and closer to you.

    Mark on the tray where you get to.

    Next time try and get a bit further up the tray.

    Hope this helps

    Take care and keep in touch

    Praying for you

    Sarah xxx

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  • Posted

    Try to make sure you take your pain relief at regular intervals rather than wait until you knee starts to hurt. I was initially on codeine ibuprofen and paracetamol - a doctor at the hospital but a med pain in action for me whereby I took a pain killer every 2 hours - codeine before bed because it makes you drowsy. I started off using a dining room chair and trying to see how far past the leg I could get ... took a while but each time a tried to push my knee a little further. I had a little plastic device in which I rested my heel and pushed and pulled my knee up and down - again only small movements at first.

    Don't be too hard on yourself and little and often is better than trying to do a lot and then being in pain so you can't do anything. Persevere and don't let it beat you!! You will be able to achieve the bend but it will take a while. Just like everything else with this operation .... it's a very slow process but it does get better.

    ūüėČ

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  • Posted

    Hi Alison. You are not alone! We have all suffered the pain, frustration and depression but.......take the meds as instructed, follow the exerecise routine, this is critical. Be patient, things will improve. Your physio i right (eben though I am sure you feel like strangling him/her),

    Sarah's suggestion is good. I used a tightly rolled towel for placing under my knee for stretches and a large place mat, wore socks and used it lying on the bed and bending my knee. My wife was a great support, talking me on, sympathising but forceful to stop me simply giving up because of the pain. It took time - weeeks - but perseverance was the key. Use ice after exercising and rest with you leg up.

    Keep reading the forum, we have all been there and we are all here with you.

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  • Posted

    You being too hard on your self I am now 19 weeks and only just starting to feel my old self still take medication at night as it still aches at times .. Slowley slowely with the excercise it will come dont do it if it really hurts listen to your body ...

    It will fel stiff and also feel like its going to explode . I wll be honest you still have a long road to go !!! Kee it iced and elivated and you will get there I promise 

    Let everyone els rush around for you because you cant no rocking around the christmas tree for you this year but def next 

    Take care 

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  • Posted

    I can relate with this situation very well. I had my first TKR in 2012 and experienced the same thing. Despite going to therapy heavily medicated three times a week, I wasn't able to advance any further than where you are now. Friends that had the same surgery couldn't believe how difficult of a time I was having when they had done so well. There were days when the therapist tried to manipulate and flex my knee further and I actually yelled out in pain.

    Six weeks later, and after all this torture, I had my first follow up appointment with my surgeon. He examined me for about 2 minutes and said 'I have to put you in the hospital today, you have adhesions that will have to be broken under anesthesia". So, scar tissue had formed and they felt as hard and stiff as cement. I was put in short-stay hospital that same day, he manipulated the adhesions and 'broke' them up and when I woke up he sent me straight to physiotherapy and the next four days in a row. Finally, I was able to ride the bike and get a flexion of 100 degrees! Truthfully, I was so angry and disappointed that nobody recognized this and I went through six long weeks of pain and frustration because of it.

    I would recommend that you get to see your surgeon and let him examine you for possible adheasions of that knee. If your degree of flexion is worse now than it was in the hospital then I would be very suspicious that this is what has happened. That knee never healed right and I still have pain in it. I just had my other knee operated on six weeks ago, by a different surgeon and it's doing wonderfully compared to the first one. I'm already at 120 degrees and can walk and squat without pain or weakness. 

     

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  • Posted

    Do you have a lot of swelling? Swelling makes it VERY HARD to get a good bend! It feels like you are trying to fold a stiff PILLOW! Ibuprofen helped me with the swelling and inflammation which in turn helped me with my BEND.

    Two weeks in is still quite early in the game. You body has been through a LOT and is responding to it!

    Rest is very helpful as is icing the knee and ELEVATING the leg above your heart. My physical therapist had me stop an exercise if I experienced pain. She then gave me a different exercise or stretch to build up the muscle so that I could eventually do the original exercise. I progressed well with her gentle approach.

    I had my left TKR in June, and my right TKR done in October. There was more SWELLING with my left than my right. Less swelling makes physical therapy a lot easier. You just have to go with what is happening in your specific knee, though! Each surgery, even on the same person is different, and the body reacts differently. No two knees are the same, and no two people have the same experience. Knees are very complicated!

    Sending lots of encouragement and prayers for you as you continue your journey! It will get better. Be patient, and give yourself time to heal.

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    • Posted

      Thank you for your encouragement Cheryl. Ive been in tears most of the day but couldnt help but laugh at your comment about your knee being like a stiff pillow - it is just like that. Thank you
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  • Posted

    Alison, I am also two weeks post op. Yes there is constant pain and of course it's worse when you do PT. The best advice I have seen is to take your pain meds about an hour before PT so that they are working during the PT. It really helps. Also once the post-op swelling goes down some it makes it easier to bend.

    Hang in there, we hear all the time that it does get better!

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  • Posted

    Take heart.......90% of the people who have gone through this had/have the same thoughts. You are still in the infancy stages and are yet to have the stitches/staples removed. Just keep doing the best you can with the excercises, drink plenty of water as dehydration is really a huge detriment to healing, elevate the leg and above all.......rest.......rest every chance you get. I'm not sure what the therapist means by working through the pain. I've had to rehab my leg 5 times and found that if i work up to pain but not into pain I'm much better off and heal faster. Take pain meds by the clock and not when the pain hits. Try to time it so that you take them an hour before starting excercising. Ice for 20 min time periods and as often as you want. This will rep the swelling down. Always ice immediately after finishing excercise. Be patient.....6 weeks is really the first benchmark and then 3 months. Just keep reminding yourself this is a marathon not a sprint. Sleep will be difficult for some time to come so don't push yourself. Exhaustion comes quickly and recovery slowly. Stay with this group. Everyone has been through it and come out the other side. If anything highly unusual occurs......unusual drainage, extreme burning in the calf.....call your Dr immediately. You have a long way to go but suddenly you turn a corner and you are There. BTW....its Christmas time......well meaning friends and family will want you to get involved in activities that will punish rather than refresh the body. Feel free to say thanks.....I'll take a rain check.
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  • Posted

     I had home health therapy for the first 2 weeks then out patient therapy now. No matter what though, it is going to take a while. This is all new to me but I am so thankful I found this discussion group.  The most important thing I have learned is exercise and patience from everyone. You will have an excellent group to ask questions to as you go along.  So many different experiences with the same surgeries. God bless all of these people willing to share and help all us newbies along.
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  • Posted

    Thank you to everyone who has commented. Its a great refief to know that i'm not alone. I think i just hugely underestimated the impact it would have. I just need to keep focused on the positives and work on the excercises. I think I may be trying to do too much too soon. Patience isnt one of my strong points! And to the person who likened their knee to a stiff pillow - what a perfect description, couldnt have put it better myself lol. 
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  • Posted

    Hi,

    I had a partial knee replacement 5 and half weeks ago.

    Must say I feel for your emotions - I felt the same way - wish I'd not had it done, and I hated the whole world. Very angry with Physio staff - well meaning though they were, there was this constant pressure to drug yourself stupid and push the exercises so you were in total pain. I believe in listening to my body AND over the years have learned that any sort of pain is the body's cry for help saying - pain is  the body in a state of dis- ease. I agree with oldfatguy - I take my exercises to the point of pain then back off and I've made great progress. I also find the after hospital physio care very basic. I was discharged with a NHS publication showing the exercises I had to do, as good as useless. I've got more info looking at various Physio videos on Youtube. I had to go back for a Physio review after 2 weeks which was on 24th Nov. and they declared I was about where I should be given the timeline. My next medical appointment is with the surgeon on 29 Dec. I was told to phone in if I had problems. I thought this was shabby treatment. I have a heart arrythmia and am on warfarin so I cannot take all the standard pain killers - I'm limited to co-codomol 30/50 but now 5 and half weeks later I'm down to 1 or 2 a day, some days nothing at all. The only thing I complain of now is slight swelling around the knee and tightness from the centre of the knee cap to just a few inches down. But I still keep on with the exercises, I also do others which I've found on Youtube.

    But I repeat, in my view, push yourself to pain but not into it - then back off. Rest and repeat it.

    Whilst there is plenty of information online about the surgical aspects of a partial knee replacement or TKR there is nothing that adequately prepares the patient for the rehab process. So Rehab/Physio as far as I'm concerned is barely fit for purpose.

    Good luck.

    John

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    • Posted

      You are so very right. People are always more organized for the surgical procedure and least prepared for the arduous journey of rehabilitation. The only honest and concise information regarding rehab comes from sites such as this, where others share their experiences including the moments that nearly defeat their spirit. Perhaps the medical community doesn't really want to discourage people from moving forward with surgery by giving them honest information about what a long and painful struggle complete healing will be. A handbook called "Healing After TKR for Dummies" would be very helpful.
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    • Posted

      Surgeons live in the moment of their expertise because they know they are going to dump the patient back in the lap of the primary care Dr as soon as possible. My surgeon is axfreat guy and works closely with me because he knows what I've been through but he gets me back in the hands of my primary care guy for pain relief, bp control, etc. As with most specialist, they are assuming everything will be a text book case.
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    • Posted

      It's a little different in the US, my orthopaedic surgeon is the one that will follow up with me regarding physical therapy, pain management and any surgically related issues until he discharges me after six-eight weeks. It's only after that when my primary care physicial takes over. I think it's only logical that the surgeon follows their patient from pre-surgery, surgery and through the rehab and recovery phase. My primary physican doesn't know a thing that has happened to me since I had to visit her for my pre-surgical clearance and I probably won't see her again until it's time for my annual physical.
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    • Posted

      Well said Jemma - there you go - thats your project for 2016 - 'Healing after TKR for Dummies'. I'm a simple soul really, and need to have it explained to me why I am doing something. So if I'm doing an exercise, say, heel slides - I want to know the exact impact it is having and on what part of my body, and MOST importantly how I can expect my body to respond to a given exercise. For me the Rehab process is just about meaningless for that reason.
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    • Posted

      I'm in the county of Cornwall, in Britain and that is how my local health care trust operates here. And incidently when my heart arrythmia was found I was living in the county of Surrey thats how the system operated there. Once my heart 'wobbly' was identified and treatment started after some 6 days of tests thats again what happened with me.
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    • Posted

      I'm in the state's as well and my surgical center is @ the university of Kansas medical center but my primary care is at another medical center. My surgeon advised my primary care of all pertinent activities as well as all the pre op data. Sometimes medical records isnt all that speedy getting stuff moved around but with these new information systems its a lot quicker. I'm on medicare so PT has to tranmit certain data for Dr's signature So they can go further. My wife has Parkinson's disease and has 5 different Dr's with 4 different hospital association. Because the disease affects so many different areas 4 of them prescribe meds pertaining to their discipline and really work well to make sure there is no negative interaction. Unfortunately with her its just a matter of keeping her comfortable physically and mentally as there is no cure and eventually one of the side effects will take her. I feel pretty comfortable they are all On the same page and communicating. 10-15 years it would have been pure chaos trying to mange this stuff. The other aspect, billing, is so much more effecent than it used to be as long as the correct diagnostic code are entered.
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