Serious overnight pain after resuming light work.

Posted by zoobird1 @zoobird1, Apr 14, 2023

I had a really terrible time overnight. I had my TKR February 16, and graduated from Physical Therapy two weeks ago with my ROM being 130. I’ve been faithful to do my exercises at home, walking for twenty minutes or so and have very little swelling. I still have a lot of tenderness from my thigh to my ankle but it is lessening and pain where the muscles, etc were cut. I’m alternating ES Tylenol and 600 mg ibuprofen and taking 5 mg of Oxycodone near bedtime and phasing that out.
My husband and I live in a motorhome and volunteer at State Parks in Florida, Georgia, and South Carolina. Our job is to pick up debris at campsites and clear out the fire ring if need be. We also lightly rake over any tire tread marks . This is very easy work but we do have to be very careful not to trip over exposed tree roots. Yesterday was my first day back helping out and I lightly raked about ten total sites in two thirty minute blocks and sat in the golf cart part of that time. Well I was up all night and had the worst pain from my ankle to thigh top in many weeks in spite of meds. Being wakeful overnight has happened several times but nothing like this.
Could it be that little bit of raking? The different movements?
I’m considering a sleep aid but am hesitant to try one. I'm also concerned about even walking for exercise.
Any thoughts are so appreciated!
Beth, age 70 in September

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@zoobird1 Ouch! I can really sympathize and feel your pain. I have had knee reconstruction and 5 hip replacements, all before I was 62. Let me assure you that I was not raking anything 56 days after surgery. Many of my friends and neighbors are work campers, and they would not be out doing it either.
Let's look at the difference between your therapy & walking and handling a rake, broom or mop.
All of the therapy exercises are designed to work on strengthening your muscles and increasing range of motion WITHOUT twisting or turning your knee in an y direction. Walking is a slow deliberate motion without and twisting. Not sure about you, but I turn my body when I rake - even carefully. So you were placing a brand new stress on that healing joint and the weakened muscles that support twisting motions. Ouch!
I know orthopedic surgeons tell us we will be "back to normal in 6-8 weeks." But, that just means the wound has healed and the appliance is beginning to be stable. And it might be true if you were 25 years old and a top-condition athlete with an injury. But as an older person whose body is worn and torn by a lifetime of work and small injuries, and probably having other issues, 6 weeks is silly.
Three current point of reference in my life - all healthy and 70+, all doing therapy diligently:
A partial hip replacement 4 months ago after a femur fracture, just strong enough in the past 2 weeks to clean out her shed & reorganize, but still unable to get down and garden on her knees.
A hip 7 weeks ago - did his pre-op exercises, walking up to 4 miles a day - just yesterday hit his first bucket of balls on the driving range - and said last night "it might be too soon"
A full knee replacement 6 months ago - an Energizer Bunny - only began raking and gardening a month ago, finds she can do physical work for 2 hours, then needs a nap.

By the way, when you said "light work" I thought maybe office work, or cashiering while sitting on a stool. I think what you did was "too much, too soon" Any way they can find something easier for another 6 weeks? Or can hubby pick up the slack? Maybe in a week or two, try one 15 minute session, then a few days later add a second? And maybe call the physical therapist and ask, if it is safe, to get some exercises that will mimic the raking & bending/picking motions?

Hang in there, you are doing great. Your body is just telling you it's a little behind your brain on how ready you are to go again!
Sue

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Thank you so very much! I’m so encouraged now and will follow your advice about easing back in to work. I really do enjoy it - it’s so beautiful here in St Augustine, Florida. I may pull out the Voltaren gel that helped so much prior to my right knee partial replacement.
My husband, David, does so much at home and has been so protective of me - I literally badgered him to help yesterday. To his credit, today he’s refrained from saying “I told you so” lol.
I so appreciate your words of wisdom and your time to respond so thoroughly.
You perform a great service here and I so hope you and your health are doing well now.
Beth

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@zoobird1

Thank you so very much! I’m so encouraged now and will follow your advice about easing back in to work. I really do enjoy it - it’s so beautiful here in St Augustine, Florida. I may pull out the Voltaren gel that helped so much prior to my right knee partial replacement.
My husband, David, does so much at home and has been so protective of me - I literally badgered him to help yesterday. To his credit, today he’s refrained from saying “I told you so” lol.
I so appreciate your words of wisdom and your time to respond so thoroughly.
You perform a great service here and I so hope you and your health are doing well now.
Beth

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I learned (again) this week that I am no longer and Energizer Bunny. I had meetings and errands Monday, then did over 5 hours of fairly heavy yard work on Tuesday & Wednesday along with miscellaneous chores. Yesterday way an 11 hour marathon - 2 groups of indigo dyers, and a dye bath to manage - the first group just needed mentoring, but the second was hands-on for four hours. Extremely satisfying, but also tiring. Used to be able to go like that for weeks on end, with only Sunday for rest.
Umm... today I took a day off - breakfast out and errands with my husband, steak fry (by him) and now crashed into my recliner for the night. My body says tomorrow will be another light day.

Sue
Used to be able to go like that for weeks on end, with only Sunday for rest.

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@sueinmn

I learned (again) this week that I am no longer and Energizer Bunny. I had meetings and errands Monday, then did over 5 hours of fairly heavy yard work on Tuesday & Wednesday along with miscellaneous chores. Yesterday way an 11 hour marathon - 2 groups of indigo dyers, and a dye bath to manage - the first group just needed mentoring, but the second was hands-on for four hours. Extremely satisfying, but also tiring. Used to be able to go like that for weeks on end, with only Sunday for rest.
Umm... today I took a day off - breakfast out and errands with my husband, steak fry (by him) and now crashed into my recliner for the night. My body says tomorrow will be another light day.

Sue
Used to be able to go like that for weeks on end, with only Sunday for rest.

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For the first 75 years of my life, I was the ENERGIZER BUNNY. From dawn's early light till evening I was on the go but the 76th year was devasted by a TKR and suddenly everything changed. Claiming recovery in 6-8 weeks is terribly misleading (IMO). Short story: A massive low pressure storm raged thru town and ripped the shade screens off. No problem for the E Bunny, or so I thought. After 2 hours of screen repair, the TKR racked with pain. It simply didn't like being twisted into all of the contortions required to rebuild screens. The exact same thing happened last week while I was crawling on the ground, repairing a refrigerator. I can no longer get into many positions w/o great discomfort & swelling in the TKR.

I learned to compensate for the deficiency caused by my TKR by building other muscles. Intentionally, I built my calves with exercises like the attached photo. Ditto for my arms and stomach muscles to help me get off the ground using collateral muscles. I set a mental timer when performing awkward tasks so I don't push the knee beyond its capability. Keep/get the weight off. Ask someone whose capable to carry any heavy loads because they transfer onto the knee which is no longer able. Once upon a time a heavy compressor presented no problem for me, but now it does, so I use a dolly to move it. Fortunately, my wife is "three of the most wonderful people on Planet Earth" and has been very helpful after I mistakenly agreed to this procedure. Adapt and make the best of it. U r not alone.

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@mrnomad

For the first 75 years of my life, I was the ENERGIZER BUNNY. From dawn's early light till evening I was on the go but the 76th year was devasted by a TKR and suddenly everything changed. Claiming recovery in 6-8 weeks is terribly misleading (IMO). Short story: A massive low pressure storm raged thru town and ripped the shade screens off. No problem for the E Bunny, or so I thought. After 2 hours of screen repair, the TKR racked with pain. It simply didn't like being twisted into all of the contortions required to rebuild screens. The exact same thing happened last week while I was crawling on the ground, repairing a refrigerator. I can no longer get into many positions w/o great discomfort & swelling in the TKR.

I learned to compensate for the deficiency caused by my TKR by building other muscles. Intentionally, I built my calves with exercises like the attached photo. Ditto for my arms and stomach muscles to help me get off the ground using collateral muscles. I set a mental timer when performing awkward tasks so I don't push the knee beyond its capability. Keep/get the weight off. Ask someone whose capable to carry any heavy loads because they transfer onto the knee which is no longer able. Once upon a time a heavy compressor presented no problem for me, but now it does, so I use a dolly to move it. Fortunately, my wife is "three of the most wonderful people on Planet Earth" and has been very helpful after I mistakenly agreed to this procedure. Adapt and make the best of it. U r not alone.

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Thank you for your advice. Funny - I too called myself the Energizer Bunny. I’m an active retired kindergarten teacher and had to quit running due to bursitis and neuromas in my feet. Three surgeries. For years I’ve walked and worked out with weights and my doctor and PT are impressed with my progress. I thought I’d be able to lightly rake/smooth packed sand for really just a few minutes here and there over an hour. My mistake. My discharge nurse warned me I’d find muscles and hurt in places I didn’t even know I had lol. In my doctor’s defense, he told me to expect nine months to a year to recover.
It’s good to know I’m not alone. I appreciate your input and that of @sueinmn
Beth

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You said: "My discharge nurse warned me I’d find muscles and hurt in places I didn’t even know I had lol." Funny, my discharge nurse told me.... after the TKR.... "I would feel like a Mack Truck hit me once the pain deadener wears off. " She was right. Oxy barely made a dent in the unrelenting pain which lasted 2-3 weeks. Dropped 15 lbs and barely slept for that period of time.

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@sueinmn

I learned (again) this week that I am no longer and Energizer Bunny. I had meetings and errands Monday, then did over 5 hours of fairly heavy yard work on Tuesday & Wednesday along with miscellaneous chores. Yesterday way an 11 hour marathon - 2 groups of indigo dyers, and a dye bath to manage - the first group just needed mentoring, but the second was hands-on for four hours. Extremely satisfying, but also tiring. Used to be able to go like that for weeks on end, with only Sunday for rest.
Umm... today I took a day off - breakfast out and errands with my husband, steak fry (by him) and now crashed into my recliner for the night. My body says tomorrow will be another light day.

Sue
Used to be able to go like that for weeks on end, with only Sunday for rest.

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You’re amazing!

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@mrnomad

You said: "My discharge nurse warned me I’d find muscles and hurt in places I didn’t even know I had lol." Funny, my discharge nurse told me.... after the TKR.... "I would feel like a Mack Truck hit me once the pain deadener wears off. " She was right. Oxy barely made a dent in the unrelenting pain which lasted 2-3 weeks. Dropped 15 lbs and barely slept for that period of time.

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Interesting as the oxy just reduces my pain about half. I’ve lost four pounds and am on the way to 1/2 a day ( at night) from three a day in February.

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Have you checked out your back? Iv have a TKR but also suffer with sciatica and sounds like sciatica pain you are having also. Keep up your excerises and stretching but take it easy when you are in pain. Sending you hugs x

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Can someone tell me how long the stiffness lasts? I had bilateral knee replacement in Feb and I’m suppose to return to work as a nurse but the stiffness is unbearable at times.

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