Walking after a TKR

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OK...so here's another post since, like I've said before, I keep writing the same stuff over and over again.  This one's about walking...

You all know that they get you out of bed IMMEDIATELY at the hospital to get you walking again.  This makes walking the #1 exercise you can do post-TKR.  Great way to get your life back and start to break down that scar tissue.

So walking is of the most recommended activities but you have to avoid any impact...no running, jogging, etc.  Most docs will suggest an elliptical machine or bike which have zero knee impact.  If on a treadmill, you walk slowly, heel to toe.  On hard concrete, get fitted for a fantastic, cushy pair of walking shoes (treat yourself!).  It's all about keeping pressure and impact off the knee.  A great pair of shoes is essential.

How often you walk is measured in steps...NOT MILES or KMs.  Push the knee too far and it swells..period.  Then it's back to rest, ice, elevate.  The idea is to avoid that completely.  To do that, you need to TRACK YOUR STEPS!!!  

Get a pedometer (Fit Bit, Smart Watch, etc.) and track every step.  Find your "pain point" (swelling baseline)...back off...ice...elevate...increase gradually.  I did 8,200+ steps at 5 weeks and ended up with a hot-air balloon for a knee.  Never did that again.  Slow and steady increases.  By 8 months, I was doing 11,000+ steps (5 miles) with zero swelling or pain.

There is no set of guidelines on how many steps you can/should do in a day/week/month.  Everyone is different. You have to find your own limits and proceed from there.  Believe me...your knee will yell at you when you've exceeded your current limit.  So again...it's not miles...it's the steps that matter.  You can walk every day if you like...just watch the steps.  Take a day off here and there when you are tired or are experiencing pain or swelling.  It's all very personal.  Listen to your knee!

Any electronic pedometer will hook to your computer so you can actually see a graph of your progress.  This is not only helpful in planning your recovery but inspirational because you can actually see your improvement right on the screen.

Also, know that this is NOT a linear process.  There will be advances, setbacks and plateaus...be prepared for all of them.  If you have a bad day or two, forget it and get back on track.

Lastly, you will literally have to learn how to walk again...HEEL, TOE.  This is usually done with your PT and takes a few weeks to get your rhythm down again.  Very normal.  Do NOT get down on yourself and become discouraged.  It's all completely normal.  You have a 2 1/2 pound mechanical device implanted in your body...what do you expect?  This takes time and work.  Never give up on yourself...it all comes back to you in time.

I'm writing this at almost 15 months post-op.  Some minor warmth from time to time...feel the pins and needles from the nerves only when I kneel down...zero pain, band feeling or swelling.  Clunking sound?  I think that will last forever.  The biggest problem is strengthening and balance but that's all in another discussion on Post-TKR Exercising.

So get to walking.  Crutches, cane walker at the beginning...no problem...even if it's for just 5 minutes.  You'll be walking normally in time with zero assistance...just give yourself the space to get there with no expectations or mind games.  It all works out.

Stairs?  That's in another post.  Pretty much the last big thing you have to conquer.  For now, just walk until you feel normal again.

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  • Posted

    Very helpful 😊

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  • Posted

    Good point!  After I'd been walking with crutches for about 6 or 7 days, as taught in hospital - crutches, operated leg then bringing up the non operated leg to be level with the operated one, I gradually started bringing up the non operated leg and taking it past the operated one, to get a more normal gait.  This is something no-one mentioned about doing in hospital and not having a physio, it was rather left to us to sort out for ourselves.  I don't know when others did that?

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    • Posted

      If you're not doing PT, you'd better be doing these...

      https://patient.info/forums/discuss/tkr-heel-slide-exercises-526213

      And then have someone gently push down on your knee to straighten it out.  A weight on your knee would help too.  However...

      I don't recommend ANY of this (except for the heel slides).  Breaking down that scar tissue is a job for PROFESSIONAL physical therapists.  You really need to see one.  Twice a week for 10 weeks worked for me.  Doing this on your own is not recommended...

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    • Posted

      I'm the one with 137 bend at 10 weeks (not doing any more slides now) and 0 extension from the start.  Our hospital never gave us a physio therapist, but just a sheet of exercises and instructions - no numbers were mentioned, but a picture of a man sitting first in a chair with knees bent so the stick he held out in front of him was parallel to the lower leg and about six inches out from the stick at the knee as it touched the toe, and then the same man, sitting the same, but with the foot back far enough so the stick was still upright but touched the toe and the knee.  My worry always was over extension but as it all healed it's stable.  Not had any problem with scar tissue, but just put a bit of emu oil on it ever day.  So our hospital DID recocmmend just getting on with it on our own, but it's been absolutely fine for me and they were amazed at my progress at 6 weeks.  It's a wonderful hospital - very patient orientated and they were keen to know if there was ANYTHING I could suggest they did differently to help patients.  I can't fault them!   But I apprecite that we are all different:-))))  Just hoping my next knee goes like the first - pretty much pain free and I did everything in my own time and it went very well!

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    • Posted

      You are one of the lucky ones to have that ROM so quickly.  Not common at all.  Now it's time to get your strength back.  Hope that goes well for you.  Finally found someone on the far left side of the bell curve...

      Caution:  There are many stories on the forum where people's second knee recovery turned out to be completely different (better or worse) from their first one.  Just sayin'...

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    • Posted

      Yes, Ali on here had a similar recovery to me, with a fast ROM, but we both tend to be very flexible.  Yes, I am aware that the second knee doesn't always go the same as the first, but I'm going into this with the same positivity as I did the first.  Having done a bit of walking (not a huge amount compared to what some do) today and left with a searing pain in the unoperated knee I'm looking forward to it!

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  • Posted

    Chico,I never cease to be amazed at how comprehensive your brilliant retorts can be.

    Just where do you find the time?

    Well done.

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  • Posted

    Besides for ice and elevation, is there any

    Other input for severe swollen ankles?

    All advise helpful.

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    • Posted

      I have heard very little of that happening.  Create a new discussion: "TKR Swollen Ankles".  That title should attract people who have had the problem and are able to give you some advice.

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