TKR: Did I do too much too soon? I'm freaking out. Please weigh in

Posted by amytro @amytro, Sep 26, 2019

I had bilateral TKRs this year-one in February and one in May. I did well after both of them. Within the last few weeks,I've gotten back to outdoor cycling, very light aerobic workouts (i chose the "senior citizen" tapes to be sure they were gentle), and resuming normal activities. For the last week, my first knee- the one that should be better, is in serious pain when I walk. I can ascend hills, do stairs both up and down, but walking on level pavement and descending hills is excruciating. It's worse than pre-surgery. I am seeing my doctor for X-rays tomorrow but am very scared that I screwed up somehow. I did have some dental work recently but took my antibiotics. Can someone please tell me that I just did too much too fast? My bike rides ARE long (12-22 miles each) but I felt no knee pain. I am so afraid of having to have surgery again, I could just cry. It was a lot to go through two TKRs within 3 months- the thought of going under the knife again is killing me. I was just getting my life back and now this....And words of wisdom?

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@amytro - I know it must be terribly scary to have that kind of pain after doing so well for an extended period of time. If I understand correctly, you have just returned to cycling in the last few weeks and for a week you have had the serious pain with walking. The proximity in time certainly would suggest that the two are linked, but of course, I'm no doctor and I'm very glad to hear you are seeing your doctor tomorrow. I'm wishing you the best and hope you will check back in and let me know how things went. Beforehand though, I would suggest that you make a timeline including things like when you last did formal PT, when you started aerobics, when you started cycling, when the pain started, etc. etc. This would probably help the doctor pull everything together. Are you still taking any pain meds? Also, your bicycle rides do sound demanding... do you ice afterwards or do anything to help the knees recover from the stress?

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I had my right knee in in May, and I wouldn't dream of stressing it that much! Internal healing can take months. Did you check first with your physical therapist or Orthopedic doctor?

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Hi @amytro! I am amazed at all that your are able to do after 3 months. I would not "freak out." It sounds to me that you may be doing too much too soon, but you should ask your doctor about that. The one suggestion that I would make about exercising, would be to try a low impact water class. I did that after my first TKR and right before my my second one. It was much nicer because the water took the pressure off of the joints. I am hoping to be able to go back to my low impact water classes as soon as my knee is ready.

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@ssbionicknee

Hi @amytro! I am amazed at all that your are able to do after 3 months. I would not "freak out." It sounds to me that you may be doing too much too soon, but you should ask your doctor about that. The one suggestion that I would make about exercising, would be to try a low impact water class. I did that after my first TKR and right before my my second one. It was much nicer because the water took the pressure off of the joints. I am hoping to be able to go back to my low impact water classes as soon as my knee is ready.

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Thanks for your reply. I was in good shape pre-surgery and I am a long distance biker so the rides seemed comfortable.My knees still feel a little strange in water so biking is the low impact exercise of choice. I might have torqued my knee doing exercise or even a rapid movement on the bike. Ironically, biking feels better than walking to me. The X-rays didn't show any damage to the appliance- yeah- but not knowing what it is bothers me. Let's just hope it goes away. I just landed at my vacation destination with my bicycle, so we'll see how I do this week! Thank you!

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@debbraw

@amytro - I know it must be terribly scary to have that kind of pain after doing so well for an extended period of time. If I understand correctly, you have just returned to cycling in the last few weeks and for a week you have had the serious pain with walking. The proximity in time certainly would suggest that the two are linked, but of course, I'm no doctor and I'm very glad to hear you are seeing your doctor tomorrow. I'm wishing you the best and hope you will check back in and let me know how things went. Beforehand though, I would suggest that you make a timeline including things like when you last did formal PT, when you started aerobics, when you started cycling, when the pain started, etc. etc. This would probably help the doctor pull everything together. Are you still taking any pain meds? Also, your bicycle rides do sound demanding... do you ice afterwards or do anything to help the knees recover from the stress?

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Thanks, Debbra. You're always so helpful. The x-rays didn't show any damage and their is a coinciding of the increased exercise and the pain. So I do think they're related. I do ice afterward and honestly, the distance feels easy to me since cycling has been my thing for decades. I may have torqued it somehow even with gentle exercise. They put me back on tramadol as needed and I'm going back to my PT exercises for strengthening as well. It's so disheartening to have made such progress and then have a set back. I was always one to "go hard" so I think I'm going to have to temper my expectations. At least another surgery is ruled out- that was my biggest freak out!! Thank you again!

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@amytro - Thanks for the kind words. I am SO pleased that they ruled out any serious damage and you don't need another surgery. I know its disappointing not to be able to keep up the pace we used to keep - on ANY activity! I think you are right that accepting that fact and adjusting expectations is the key. I know that I have had to do that. My exercise pales in comparison to your long bike rides, I just walk in the morning and I used to do 3 miles. I've cut back to 2miles and since my 2nd TKR I'm not as fast. But I still enjoy it and it gets me out and moving, so there you go. Hoping your new PT exercises go well. Will you keep us posted?

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@amytro

Thanks, Debbra. You're always so helpful. The x-rays didn't show any damage and their is a coinciding of the increased exercise and the pain. So I do think they're related. I do ice afterward and honestly, the distance feels easy to me since cycling has been my thing for decades. I may have torqued it somehow even with gentle exercise. They put me back on tramadol as needed and I'm going back to my PT exercises for strengthening as well. It's so disheartening to have made such progress and then have a set back. I was always one to "go hard" so I think I'm going to have to temper my expectations. At least another surgery is ruled out- that was my biggest freak out!! Thank you again!

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@amytro I am not nearly at your level of exercise/biking but I too tend to overdo when I first resume exercise. I think I can go full-steam ahead and then pay for it the next day. I hope to get back to my health club this week and resume exercise (after sitting out from a fracture) but I will have to very consciously limit what I do. It feels good when I am doing it, it's just afterward that it hurts.

Have a great vacation and don't overdo! You don't mention where you are but if you are in an area with fall foliage it will be a beautiful time for biking.
JK

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Today I am having a grateful day. I am grateful I can walk 3 miles, without my cane, I am grateful I can ride 45 min. on recumbent bike. I am grateful that my pain after exercise subsides without heavy drugs, and that I can now do most of my own housework. It’s so easy to feel discouraged when a TKR did not give a pain free knee, and that it still feels very strange, but I am still grateful for the things I now can do

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