Opinions on Step Up exercise on TKR and partial.

Exercise is good 2021 TKR still doing squats ankle weights and exercise like u describe as well as endurance exercises stationary bike and water aerobics
From talking with people time for a replacement varies have a friend with original shoulder replacement in 20 plus years

Maybe the partial knee replacement itself is not what fails, but that the human parts of the knee that were healthy at the time of partial replacement eventually wear down to no longer being able to comfortably support heavy movement. That type of cartilage deterioration would be very individual and the timeline hard to predict, but could eventually predictably happen to many.

Very interesting! Especially considering my age. Thank you.

For some reason twice my reply to you hasn’t posted. Trying again.
That is very encouraging! It’s painful sometimes but I make myself do weights and walk briskly. Thank you.

Note the attached photo of a knee lift machine. My first doc opined that this machine results in many injuries, I should avoid it with both knees (TKR and arthritic), but my sports specialist doc (told me yesterday) that, in moderation, I should be using this machine. He also advocated knee straightening exercises that vary in tension from 10% to 100%, twice per day, to elongate the patellar tendon the surgeon attached too short limiting my ROM.

How does a non doc like me know how much is too much? How do we differentiate between contradictory opinions presented by PAs and docs? I'm desperate to regain ROM past 90 degrees and conclude that both opinions are right. Excess invites damage. Find a happy place that gradually allows the tendon to strengthen and lengthen. Allow the healing process to absorb the scar tissue that the sports doc "abrides" every month in a painful Ultrasound needle procedure which breaks up scar tissue. Heed his words which emphatically claim that "inflammation breeds scar tissue". Exercise, but not to excess in my desperate attempt to return to the highly active life I lead before TKR ended it.

In hindsight, I should have recognized this TKR technology is far from perfect, the docs vary in skill, and a smarter choice would have been to stick with cortisone and Hyaluronic Acid. However, I cannot go back in time and "couch potato" is not an option.

@zoobird1 I just noticed you question and thought I would relate this story: I am in PT for pain management, and am seen in a tiny side practice of a major PT provider in our area. The 3 therapists are specialists in difficult cases, and both leads are doctors of physical therapy. There are no "scripted" routines here, everything is designed for the individual.
This morning in the waiting room, I met a woman with an obviously new knee scar. I asked, she had a total knee replacement of her former (25 year old) original knee replacement - four weeks ago. As a person with RA, and having had the complicated surgery to remove all the old hardware, she was sent to the specialty therapists. Imagine my surprise when I came out of my session to find her in the gym doing step-up exercises on her new knee! Already. I hears the therapist explaining that by doing this with your own body strength, there is little risk of injury. And that it is the best exercise for safely strengthening the quads to support the knee.

So, if it is safe for someone 4 weeks after surgery, I would say it is probably safe for you. Have you asked the PA or PT?
Sue

Your question, "How does a non doc like me know how much is too much?" is a constant puzzle to those of us trying to maintain or regain health, strength or flexibility. As a veteran of ortho surgeries in the double digits, as well as assorted injuries over many years, I think I have found my personal "sweet spot." I am currently also receiving PT for chronic pain, and it also aligns with what we are trying to accomplish.

I try to work hard enough to know I am pushing myself, but not as hard as I would have in my younger days when I was focused on impressing someone or trying to meet some arbitrary number goal.

In terms of machines, today I set them so the first five reps feel almost easy, then focus on form and breathing, and continue until fatigue hits. Rest a minute or two then repeat. I know I have done enough if I can't do quite as many on the second set. Doing this consistently results in slow but apparent progress without injury.

28 years ago, when I was in my 40's, I had a full ACL/MCL repair & graft after a sports injury. 3 weeks later, I was SURE it was a bad mistake. But 6 months of diligent therapy, and I could go back to everything I used to do - even court sports (where I was injured) - this would not have happened in the "metal monster" I had to wear before surgery to stabilize the joint. I can assure you I don't regret it - and now I know when the time comes, it will be replaced.

Remember, most joint replacements are done on people who have been limited by pain and a failing joint for a long time, and the ortho surgeon's goal is to get them back on their feet. Many have little experience with those of us who are eager to get back to being really active. In your place, once the surgeon said the joint is healed, I would rely on the sports doc and PT to guide my exercise regimen.

Sue

Thank you for your helpful note and your experience today is so interesting and encouraging.
My surgery and PT was in St Augustine, Florida and we’re no longer in the area. My husband and I live in a small motor home and travel every few months to volunteer at state parks in SC, GA, and FL so I don’t have access to therapy equipment. I do the step ups on a stool and am blessed to have beautiful surroundings on my walks.
I so appreciate your input!

I'm glad you are able to travel again. The best therapy equipment is what's on hand. I finished rehab on my last hip replacement while living for the winter in a camper in South Texas. I used sturdy straps, the steps on the camper, ankle weights, resistance bands and the walking paths and (swimming pools) where we stayed. My current (pain) PT makes sure all of my exercises can be done just as simply. No fancy equipment for this girl.
Sue

Yes, no fancy equipment for me either. So interesting that you also rehabbed in a camper. We live full time in our RV and decided to do the TKR as we had four months in St Augustine to rehab. It was also a plus that all facilities were close to the campground.
I wish you the best and sympathize with you as I have chronic pain in both feet. Thank you for all your words of wisdom.