Total Knee Replacement: Swelling

Hello, I am sorry to hear that you are having a lot of swelling, but wow, 10 days is really early in the recovery process.

You have a wise therapist. I wish all of them would acknowledge that every body is different, and entitled to individual an individual treatment schedule. Ask the PT to show you strategies for increasing range of motion without their equipment. Most are very willing to show you how to improvise.

The hardest thing for me to believe, when I had my first hip replacement, was how many things were affected by "one little incision" - then I realized that my bones had been cut and hammered, muscles and ligaments moved and bruised, nerves cut and damaged, and blood lost - my body was in distress. For some people there is pain, swelling, numbness, weakness, muscle spasms, or all of these.
Everyone heals at their own rate, and it can be different with every surgery.

Apparently, your body has decided to slow you down by swelling, you just have to respect that and keep doing what you can. Just find that fine line between exercise/rest/ice and overdoing it.

One of the beautiful things about connect is that we are all walking the path back to health, and can encourage one another.

I'm wishing you lessmswelling and more range of motion in the coming week.
Sue

Jump to this post

Much like The first reply to my post yours is very encouraging and thoughtful and I do appreciate it. I guess my ultimate concern is scar tissue. I have read stories suggesting that if you do not get your range of motion back relatively early in the recovery process scar tissue can form and it tends to be very difficult to break down and regain full range of motion. In other words, is there a time frame for getting back range of motion after which it becomes very difficult? Thoughts?

I have always been in tune with my body and it’s abilities and limits. Your comment that my swelling may be my body slowing me down is not unreasonable. I’m not interested in punishing myself for no reason. If however, there is a limited window for each of us to regain motion then I would be inclined to push my limits a bit.

Thanks,
Gordy

Jump to this post

Good afternoon @ginzy53. Welcome to Connect. I am just one of a group of mentors who share their experiences with members. We are all patients or former patients and caregivers or providers. We believe that knowledge is power and will try our best to understand your concerns and respond appropriately so that you can make informed choices.

First of all....I think that for 10 days. you are right where you should be in terms of the road to recovery from a TKR. Swelling is a build-up of fluids that your body creates to help you heal. And I believe there is some inflammation going on.

Do you use a wedge to elevate your knee? I looked at some of the NICE machines and didn't see an "elevator" for that knee.

Have you started Physical Therapy at a special Orthopedic facility? I have been very impressed with the attention given to me and the manner in which they PTs reassure me that I am on the right path to recovery. They facilitate healing and increased use of the knee by changing up the difficulty, e.g. learning to get out of a chair without holding on. You first start with a seat at 16 inches. When you master that, they move the seat down to 12 inches which makes your knee work harder and get stronger. They ask you to learn balance and strength by standing on your surgery leg for 20 seconds at first. Now I do 3 sets of 20 seconds. This really improves the security I feel. Squats both in repose and from a standing position are also very helpful.

In reference to the angle measurements and your knee being too swollen...the PT folks understand. I have a set of 6 exercises that I do at home to keep the leg stretched out so that I can reach the extension goal of "0". Currently, I am at 137 ROM and I owe that success to this set of exercises. It's a lot.....30 repetitions twice a day. They also had me do the same exercises twice a day starting one month before surgery and they began post-surgery exercises 1 day after. Of course, they didn't expect me to do very many at that time. I graduated back up to 30.

And finally, have you heard of or tried MFR, Myofascial Release Therapy. I go for two sessions a week. They work on the swelling and any pain you may be experiencing. The swelling is reduced by moving the fluid up your leg where it can find its way to your bladder and be released when you urinate.

So at 5 weeks or 35 days, I am working on stairs. Last week, I just climbed up the stairs one foot after another. This week, I start going down the stairs one foot after the other. That requires more stability. I do this 3 times a day. And this was the week I started driving after passing my life partner's driving test. I practiced on our frontage road until I felt secure.

One of the things they don't encourage is moving too fast. They yanked me back from walking more than 1/2 mile at this point. And they said no Yoga practice yet because some of the poses may not be knee-friendly.

Please relax and do only what is appropriate for your recovery stage at this time. Be grateful for and excited about your new knee.

May you have happiness and the causes of happiness.
Chris

Jump to this post

Gordy - The formation of scar tissue can be a problem, and like everything else in surgery, it is very individual. As is when it is time to push limits and when to listen to your body. Perhaps it is time for a talk with your surgeon about your concerns?

You mentioned lack of specialized equipment at home - your PT can work with you on using common items in your home to substitute. After one knee repair surgery, I was taught to use a webbing strap around my ankle to gently pull my knee into a deeper bend. All I remember of the exercise after 25 years it how much it hurt - but it worked. (Just one of many tricks learned over the years.)

Also Chris (@artscaping) has talked a lot here about MFR (myofascial release) therapy, which keeps the fascia loose. I believe that process, with massage will help as far as preventing scar tissue formation. Also, lymphatic drainage massage, which can be done by you at home, can help move the fluid to reduce swelling. A good PT or massage therapist can show you how to use it in your specific case.

Those are my thoughts for the day - anything give you ideas?
Hang in there - this is a road race, not a sprint.
Sue

Jump to this post

Much like The first reply to my post yours is very encouraging and thoughtful and I do appreciate it. I guess my ultimate concern is scar tissue. I have read stories suggesting that if you do not get your range of motion back relatively early in the recovery process scar tissue can form and it tends to be very difficult to break down and regain full range of motion. In other words, is there a time frame for getting back range of motion after which it becomes very difficult? Thoughts?

I have always been in tune with my body and it’s abilities and limits. Your comment that my swelling may be my body slowing me down is not unreasonable. I’m not interested in punishing myself for no reason. If however, there is a limited window for each of us to regain motion then I would be inclined to push my limits a bit.

Thanks,
Gordy

Jump to this post

Gordy I will share my experience with swelling. Be patient.
While essentially pain free and mobile at 4 weeks I still had A lot of swelling despite regular icing and elevating. My flexibility was only 65 deg despite regular PT.
At that point my surgeon prescribed a course of prednisone and it made all the difference - dramatically reduced the swelling.
Over the next 4 weeks I gained an additional 50 - 55 deg of ROM. I think stretching with heat followed by MFR was the most helpful.
Now 5 months out and enjoying my new knee while gradually increasing endurance.

Jump to this post

I sure appreciate your sharing your experience with swelling. I have read other instances of people using prednisone. Can you tell me at what point you started switching over to Heat and when you got MFR treatment?

I know it is early in my recovery I am just trying to stay ahead of the game when and where possible. I find it interesting that so many different types of treatments work for different situations and people.

I have a feeling that once my swelling goes down my pain level will go down as well. That will be a welcome relief and make PT and recovery much more bearable.

Jump to this post

I sure appreciate your sharing your experience with swelling. I have read other instances of people using prednisone. Can you tell me at what point you started switching over to Heat and when you got MFR treatment?

I know it is early in my recovery I am just trying to stay ahead of the game when and where possible. I find it interesting that so many different types of treatments work for different situations and people.

I have a feeling that once my swelling goes down my pain level will go down as well. That will be a welcome relief and make PT and recovery much more bearable.

Jump to this post

I sure appreciate your sharing your experience with swelling. I have read other instances of people using prednisone. Can you tell me at what point you started switching over to Heat and when you got MFR treatment?

I know it is early in my recovery I am just trying to stay ahead of the game when and where possible. I find it interesting that so many different types of treatments work for different situations and people.

I have a feeling that once my swelling goes down my pain level will go down as well. That will be a welcome relief and make PT and recovery much more bearable.

Jump to this post