Having knee replacement: how to prepare and questions about PT

I'm 5weeks since TKR (L) , working still on range of motion. My legs naturally hyper-exte nded and I naturally stood that way, right leg flexs at 145. Now my left is 4 at rest before pt stretches (to 0) and 2 after, when can barely move it. Flex is better...117 unassisted, 130 assisted. I know will never be equal at 145.
I'm still struggling with extension...prefer things to do at home, I cannot wait to be done with PT painful assisted stretches.
Yesterday was relearning how to walk, my gait and balance is off, it takes so much effort and focus right now, still stuck with a cane. (I was a runner this doesn't work for me, maybe Judy need more patience).
I've got this tight feeling all around lower thigh, knee, upper calf, assuming that will go away when swelling finally goes away someday.
Similar experiences, normal..

Hello @coffeecraz, welcome to Connect. I merged your discussion with another one titled, "Having knee replacement: how to prepare and questions about PT." I did this because some of the conversation is relevant to the issues you are having and so the members in this discussion would see your post and have a chance to share their experiences. You may also find the following knee replacement discussions relevant as well:

- After knee replacement surgery, https://connect.mayoclinic.org/discussion/after-knee-replacement-surgery/
- Limited ROM after knee replacement, https://connect.mayoclinic.org/discussion/limited-rom-after-total-knee-replacement/
- Gait after TKR, https://connect.mayoclinic.org/discussion/gait-after-tkr/

@coffeecraz, many members talk about how they have issues with flexion (I am in that camp), so it is great to hear that you are doing well in that area. Does your knee being at 4 when resting for extension cause any issues with you? I am curious if that is enough to concern your surgeon in regards to your gait? 5 weeks is pretty fresh still and it sounds like you are making progress early on. Walking was difficult for me as well and took some time to get used to.

@coffeecraz - I've had two TKR's. Although you cannot believe it now because it seems like FOREVER... 5 weeks is pretty early. You will definitely continue to improve. In my experience, 8 weeks was a real milestone. Things got much more "normal". I understand you are still doing PT. I'm sorry they are being so aggressive with assisted stretches. My physical therapist was more focused on helping me develop my own abilities. Also, congrats on you ROM. I think you are doing great. Not sure I completely understand. Your ROM is great - so the reason you need a cane is balance?

For me I think I naturally hyper-extended while standing, and the other leg being at 4, I just can't do it with the left leg anymore (at least right now) and I seem to sometimes have it bend unexpectedly - maybe it's more time rebuilding strength and re-learning or un-learning. I see my surgeon first week of August. I want to get back to sports - at least low impact, I"m 52 need to stay active and maintain my weight which finally is normal. Walking takes so much concentration right now, still not steady - I'm planning a 5k in October and really want to finish under time limit. How much time before became 'normal' again?

5 weeks so far seems like eternity, especially when used to being at work - need that reminder that it's still early in recovery, and I have more improvements to see. I'm talking with the physical therapist next week, I need to be able to handle the pain on the stretches, and I need to know and be able to trust they will stop when I can't take more.
The cane - for balance, never had perfect balance - I use a cane, or need one before the TKR, but at three weeks transitioned from walker to cane (re: balance), so far PT watches me walk without and says keep it. Focused more on gait at the last session, mechanics of walking - it definitely did not come back naturally so far. Wish there was a video that showed the ABC's of walking. I've been going to the local track where there is a flat, straight area with railing to practice and focus on gait - before doing slow laps.

I want to echo what others have said—5 weeks is early and many things seem positive for you like a great ROM! I stopped PT at about 10 weeks when my OS gave me the green light to return to Pilates. I meet with my instructor (who in a prior life was a PT but became frustrated with the system—too many patients, too little time, and a growing belief she wasn’t able to truly help people) twice a week and for those 50 minute sessions I have her undivided attention. Every session is tailored to my knee on that day. I was at 107/0 when I resumed Pilates and now I’m at about 112/0. Extension never an issue but flexion coming back slowly but steadily. I no longer use a cane but if I’m on my feet a lot, and knee stiffens, I fall back into pre-surgery “limp.” I use Exerstrider poles and walk on our high school track so I can focus on my gait. Hopefully this gives you and others a chuckle since you mention a 5K: about three weeks ago it took my 9.5 minutes to walk a 1/4 mile lap. Today it was ONLY 9 minutes. But I do not have knee pain and at almost 15 weeks post-op I am grateful that I’ve experienced steady gains in flexion, strength, and a return to walking, biking (stationary bike), and swimming (my preferred sport). Keep fighting the good fight and be as patient as possible with your new knee!

Oh @coffeecraz - It IS hard. I can just feel what you are going through. Trust that everything you are doing is having a positive impact on your recovery. Keep it up. Will you let me know what the surgeon says when you see him/her in August?

@coffeecraz You are putting a lot of pressure on yourself, but sometimes that strong motivation is the key to success. Just be very careful that you don’t overdo it. Overdoing it could set you back rather than move you forward.
That’s good that you are seeing the therapist, maybe he or she can advise you if you are expecting more than can be accomplished.
JK

Just saw this. I hope you started PT as soon as you got home from hospital. I found that I wasn't given enough info, despite the class and the booklet they gave me!

The better shape you are in BEFORE the operation, the easier will be your recovery. Get a list or picture of the post-op exercises and do as many of them as you possibly can. Naturally you should not hurt yourself or torture yourself, just do everything you gently can. This, and have a good attitude. Make up your mind that you will recover quickly, it helps.