EXERCISE
Is there a preferred time of day to exercise?, ie before or after meals, early morning or late evening before going to bed, or any time you feel like it.
At 3 weeks PO my PT told me to raise myself off a chair to a standing position then lower myself again without any kind of support ten times daily.
I found that quite hard compared to any other form of exercise including stretching and bending my knee 100 degrees with the aid of a rowing machine.
Since week 3 my lower leg muscle developed a tightness and is very sensitive to the touch, it feels like the nerve ends are on fire.
At week 4 because of this tightness it has reached the point where some of my exercises are now restricted.
The chair exercise has now become very difficult but I can still climb the stairs normally and unaided.
I was concerned this stinging nerve sensation could be the start of a blood clot, but a friend who did actually suffer a DVT following a TKR told me he pain is excruciating and I'd certainly know it if I did have a DVT.
Just wondered if anyone else has these symptoms?
ICE AND ELEVATION
How often should you apply ice, my PT says 20mins on and 20mins off but over what period of time ?
Its recommended elevating the foot above the heart helps the circulation, but again how long for ?
Oh dear David?? How long is a piece of string??
I was told to do the exercises 2to 3 times a day, but do the ankle pumps more frequently.
I was never told when to do them, what time of day! I just do when I feel I can, at 15 days po that isn't that often to be fair! Most of the time just the act of washing & dressing in the morning exhausts me! So I leave a couple of hours after that to start! Or sometimes I find it good to do the exercises before I get up when at my most refreshed! Most can be done on or near the bed & that seems to work.
My physio from last year (I don't start this years until 11th Jan!) said to ice for about 20 mins but with at least an hour between icing. I admit to icing 3 times a day but not more as I found no relief & it's really boring, never found it enjoyable in the least. In a much as we should own our own recoveries/rehabs on the icing scale I stopped by about 6 weeks!
I think it's one of those things that differs between different Physios?? Maybe even between the uk & USA?? I'm in the uk.
It really is more a question of being sensible. Exercise is most important but so is REST. Leave plenty of time to just rest & put your leg up. If you have a lot of swelling then don't forget to make sure the knee is raised higher than your heart, you can ice then too.
Just remember this is a rehab not a race to get back to 'normal' it takes as long as it takes & one way of setting things back is to do too much too soon.
Pace yourself!! This a marathon not a sprint.
If you feel you are ok & can do it all just do it! You know your own body, listen to it.
The knee is in charge not you not your physio!
I wish you a good recovery.
Marilyn
XX
Excercising at or near bedtime isn't good. It only stimulates the pain and makes sleep more difficult.
As far as the chair exercises....start with a pillow or two on the chair a d as you gain strength decrease the number of pillows. Never allow anyone or yourself to put you in extreme pain, it will only cause you to take a backward step. Icing is an option that only you can judge. Some use the cyrocuff which has a continual flow of ice cold water and its on all the time. I always found it to be too confining so I purchased the gel pack through a local pharmacy. The gel packs ate flexible and you can wrap the knee. They also have a quick recovery in the freezer. I used it anytime I wanted relief. Everyone has their own tolerance for pain and exercise. For me I concentrated on heel slides and leg lifts to build quad strength. I also did a couple of things to work on straightening the leg. One thing to remember, its the straight leg that will prevent the permanent limp. As far as the other exercises, once a day was plenty. Age can make a difference. I was 66 when I had my 1st tkr but I had already had 4 surgeries and radiation (I have a rare tumor). 9 years later I had a revision, broken femur and 2 bouts of staph infection over 3 years so I've seen a different side of textbook surgery. If you are younger you can handle things differently. Rehab isn't lineal, you will have ups and downs. S roll through and find the musings of Chico Marx. He has written several great articles on the rehab process and it is truly a process. Good luck k. Sounds like you are in your way to a speedy recovery.
My PT advised me to do my home exercises 3-4 times a day. Here are some extras...
https://patient.info/forums/discuss/tkr-rom-work-at-home-620053
I did PT sessions weeks 3 through 12. Went from -14 / +84 to -1 / +123 with all the work. Once you finish PT, your dead quads, glutes and core will have to be rebuilt to support the knee. Here's the program...
https://patient.info/forums/discuss/post-tkr-exercising-565527
Once you have the strength back in your legs, you can do the last thing on the list...master stairs...
https://patient.info/forums/discuss/mastering-post-tkr-stairs-552728
You can start the stairs at any time but won't get far without stronger muscles. PT had me try this at 9 weeks and I just couldn't do it without dragging myself to the next step. It's all about leg strength and those muscles have all atrophied. This will take months and months to achieve. However...at 14 months, I was able to go up two steps at a time without holding onto anything. Gotta get strong again...takes work...
You must keep in mind that a TKR recovery is NOT linear...there are advances, setbacks and plateaus. This one picture says it all...
https://patient.info/forums/discuss/the-reality-of-a-tkr-recovery-in-one-picture-626038