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Help Preparing for Knee Replacement

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Help Preparing for Knee Replacement

Old 12-05-23, 12:19 AM
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Now at six weeks post-op, on my ride today I experienced what I had hoped would be one of the positive outcomes from the knee replacement…being able to pedal while out of the saddle. Because of the bone-on-bone situation I had, pedaling out of the saddle was just too painful. Although just spinning while seated wasn’t at all a problem. But any sprinting, or climbing had to be done seated. So today I tried getting out of the saddle on inclines and it wasn’t painful. I hadn’t done it in so long that it was a bit awkward, and I’ll need to work on regaining some strength there. But it’s nice to again experience that aspect of riding. — Dan
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Old 12-06-23, 09:20 AM
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Originally Posted by _ForceD_
Now at six weeks post-op, on my ride today I experienced what I had hoped would be one of the positive outcomes from the knee replacement…being able to pedal while out of the saddle. Because of the bone-on-bone situation I had, pedaling out of the saddle was just too painful. Although just spinning while seated wasn’t at all a problem. But any sprinting, or climbing had to be done seated. So today I tried getting out of the saddle on inclines and it wasn’t painful. I hadn’t done it in so long that it was a bit awkward, and I’ll need to work on regaining some strength there. But it’s nice to again experience that aspect of riding. — Dan
Glad to hear you are starting to reap a benefit from all the work and pain. I looking forward to the same.
Tailwinds,
Charlie
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Old 12-06-23, 09:58 AM
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Originally Posted by _ForceD_
Now at six weeks post-op, on my ride today I experienced what I had hoped would be one of the positive outcomes from the knee replacement…being able to pedal while out of the saddle. Because of the bone-on-bone situation I had, pedaling out of the saddle was just too painful. Although just spinning while seated wasn’t at all a problem. But any sprinting, or climbing had to be done seated. So today I tried getting out of the saddle on inclines and it wasn’t painful. I hadn’t done it in so long that it was a bit awkward, and I’ll need to work on regaining some strength there. But it’s nice to again experience that aspect of riding. — Dan
That is HUGE! I'm at 5 weeks and still spinning. Trying to find a balance between weight bearing exercise/training and inflammation. I tend to overdo the weight lifting and walking. Generally having a little less pain and marginal improvement in the sleep I've been able to get.
Congratulations!
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Old 12-06-23, 10:18 AM
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Originally Posted by laxpatrick
That is HUGE! I'm at 5 weeks and still spinning. Trying to find a balance between weight bearing exercise/training and inflammation. I tend to overdo the weight lifting and walking. Generally having a little less pain and marginal improvement in the sleep I've been able to get.
Congratulations!
The swelling-sleep situation continues to vex me. It seems to be wavering. Actually, weeks 4 and 5 after surgery was some of my best sleeping in recent years. I had post-surgical ache and discomfort…but once I’d fall asleep I was actually sleeping through the night. This week the aching is back somewhat (last night was notably difficult sleeping). Slowly, it’ll all normalize (hopefully). But with regard to the swelling and riding…I’m just resolved that the swelling is gonna have to run its course and there doesn’t seem to be much I can do. So, I’m riding and exercising in spite of it. I figure the more active I am, the more my circulation in the surgical area will improve, and help to reduce the swelling. — Dan
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Old 12-24-23, 02:09 PM
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Caveat to my 10/23/2023 TKR. With just a pedestrian 15 more miles before the end of the year…I will achieve my highest mileage year since I began cycling in 1984.

Dan
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Old 12-24-23, 09:37 PM
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Originally Posted by _ForceD_
Caveat to my 10/23/2023 TKR. With just a pedestrian 15 more miles before the end of the year…I will achieve my highest mileage year since I began cycling in 1984.

Dan
Wow Dan, Have a total knee replacement and still beat you your yearly mileage record! I suspect with the bum knee fixed you'll probably exceed 2023's mileage next year. Way to go!
Tailwinds,
Charlie
P.S. I am recovering a little slower, took forever to get good full revolutions on the stationary bike at PT and my Physical Therapist, who rides a little also has been wanting me to wait to ride. But know at 7 weeks post TKR I think I'll go out tomorrow and see if I can ride on the rode (with flat pedals of course).
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Old 01-10-24, 09:17 AM
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Update at 9 weeks post TKR... Finally sleeping pretty well, just the "usual" constitutional at 4am. Still on about 1800mg+ of ibuprofen and using AdvilPM most nights.
Knee is often stiff, still doing PT - the quad rebuilding continues to be a slooooow road. Brutal. I'm pretty much pain free just sitting still, going up stairs only a little pain but going down still some pain. That is, going up and down like a normal person.
Definitely annoyance at the "play" in the joint. I get a click or pop (not painful) with most movement. Spinning (not pushing watts) also causes it on each revolution until I do push up the effort (watts).
PT is primarily strengthening - leg press, curl, extensions, squat wall sits and the like.

Still not past the hump - so more painful than before the surgery. I'm up to 1hour plus rides on the trainer nearing my FTP on Zwift. Some mild swelling and stiffness post-exercise.

Still unable to stand up out of the saddle - granted it was at the end of a 30 min interval workout but... one more thing to work towards!

Last edited by laxpatrick; 01-10-24 at 05:35 PM.
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Old 01-11-24, 09:59 AM
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Originally Posted by laxpatrick
Definitely annoyance at the "play" in the joint. I get a click or pop (not painful) with most movement. Spinning (not pushing watts) also causes it on each revolution until I do push up the effort (watts).

Still unable to stand up out of the saddle - granted it was at the end of a 30 min interval workout but... one more thing to work towards!
lax — In regard to the “click or pop” that you’re experiencing…I think that’s normal at the post-op stage you’re at currently. I’m not quite three months post-op (10/24/2024), and mine was doing that around the same point. The PT checked with the surgeon and he said that was normal, and would/should go away with PT strengthening. As far as pedaling out of the saddle…I had that issue too. Probably like you, before my TKR, I had bone-on-bone going on. Just regular spinning wasn’t painful at all. Even climbing hills was OK. But anything out of the saddle was painful. Once I got back on the road after the surgery, I was reluctant to try peddling out of the saddle. What I realized, is that getting out of the saddle wasn’t really “painful” but more awkward because I hadn’t done it in so long. And, of course there was/is a strength issue in that knee to overcome. So, I began making myself purposely get out of the saddle, at least for a few revolutions, at every incline I encounter. Slowly, but definitely, it’s getting normal again and strength is returning. Good luck.

Dan
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Old 01-17-24, 10:11 AM
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Thanks, Dan.

I'm done with "going to" PT - now doing exercises in my home gym. Squat sits, partial squats, leg extensions/curls and leg presses. Hoping I'll be up and out of the saddle as my strength sloooooooowly builds in the new knee leg. Trying to do those exercises every other day and ride at least 3-4 times per week on Zwift (-12 this morning here in WI).
Knee is still stiff, still have some swelling and going down stairs is still worse than up.

Patrick
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Old 01-22-24, 03:22 PM
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Have added some additional elastic band exercises, hoping to get past the tipping point on standing up out of the saddle. The "stall" in my rotation is frustrating but focusing on exercising my way out of it...
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Old 01-23-24, 09:13 AM
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Originally Posted by laxpatrick
Have added some additional elastic band exercises, hoping to get past the tipping point on standing up out of the saddle. The "stall" in my rotation is frustrating but focusing on exercising my way out of it...
Stay with it. It’ll come. Just imagine where you’d be if you weren’t in good physical condition going into the surgery.

Dan
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Old 01-24-24, 12:50 PM
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Originally Posted by Speedskater
My wife has a toenail that looks like that. She went to a Dermatologist, because it might be cancer. (Subungual melanoma)
Just to follow up on the picture I posted above, and what was believed to possibly be a melanoma under my toenail. I just got back from the 6-week follow-up with dermatology. It’s determined that it’s a blood blister. And, it’s moving toward the end of my toe. But…thanks for the heads up. And the doctor also said it was good for me to go in.

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Old 01-25-24, 01:05 AM
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I'm 68 and just had my right TKR on 1/16/24. My plan was to go in as fit as possible so I was doing prehab PT streches/exercises, riding 70-80 miles a week, walking a mile or two, and the secret ingredient--going to the yoga class my gf teaches.. As stated above, I tried to stay seated as much as possible because it was painful to get out of the saddle. So far, it seems like it's been a good plan.

My Doc prescribed a ROM stationary bike for the first 3 weeks of rehab. Thanks to this, I've been cycling starting a day and a half after surgery! The pedaling circumferance electronically adjusts as you progress through the riding programs and provide feedback via a touch screen. Each session is about 12 minutes and you can do up to 5 sessions a day. So in a way, I've been cycling an hour a day almost immediately after the operation!!!

My pain has been pretty minimal, thanks to the painkillers that I take 100% as prescribed. I've weaned myself down to a level that I expect to be off them in a few days. My recovery seems to be ahead of the game by every measure! Very grateful as I have read many stories on the internet about people experiencing problems recovering from this surgery.
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Old 01-26-24, 12:09 PM
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Sounds like you're on your way! Do whatever you need to do in order to get good sleep - that affects everything and was the biggest challenge other than having to completely rebuild the quad on the affected side (10/30 TKR). Wish you a fast, good recovery.
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Old 01-27-24, 06:57 PM
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Originally Posted by raceboy
I'm 68 and just had my right TKR on 1/16/24.

My Doc prescribed a ROM stationary bike for the first 3 weeks of rehab. Thanks to this, I've been cycling starting a day and a half after surgery! The pedaling circumferance electronically adjusts as you progress through the riding programs and provide feedback via a touch screen. Each session is about 12 minutes and you can do up to 5 sessions a day. So in a way, I've been cycling an hour a day almost immediately after the operation!!!.
Raceboy,
Tell me more about the ROM stationary bike. I'm 70 yr old at 12 weeks past TKR and I've hit a plateau in my recovery from TKR. My ROM has flatlined since 7 weeks at a palltry 116/111 (passive/active). I am going to have an MUA (closed manipulation) and possibly a surgical revision to clean out scar tissue on 1/30/24. This will be a bit of a setback and I am very interested in a ROM bike. I take it that my doc would need to prescribe it, correct?
Tailwinds,
Charlie
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Old 01-27-24, 11:11 PM
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Hi Charlie,

I'm not sure about the rules around ROM bikes. For insurance to cover it, I'm pretty sure it has to be prescribed. My surgeon ordered it before my operation and the company is called ROMtech. There was a bit of a go-around initially with the billing office saying the prescription plan hadn't been approved. I had to make several phone calls before I finally got notice that all was approved. Once it got off the bean counter's desk, I have to say the company service has been amazing! My prescription was for the first 21 days after surgery so I have no idea whether they are effective for use further down the road. I'm riding it at the widest possible pedal setting on the bike as it is setup and my flexion is 113 active. I hope I don't stall out because at less than two weeks post op, I think that is a pretty good number.

All the best on your recovery!
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Old 01-28-24, 12:11 PM
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Raceboy,
Thanks for the info. I looked up the ROM bike online, it's looks promising. Now to discuss with the doctor. I am up against the clock with my procedure on Tuesday. With what I'll have done it sets the clock back to day 1, as to scar tissue and soft tissue adhesivions.
Regards,
Charlie

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Old 02-29-24, 10:19 AM
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Update at 4 months post TKR: I can FINALLY pedal standing up/out of the saddle. Still hurts but a GREAT milestone for progress.

Still doing regular wall sits, table squats, leg extensions/curls and more...

Most pain with effort is patellar.
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Old 03-10-24, 09:05 PM
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Folks,

I know a lot of people on this forum had a knee replaced and I have been wondering about knee flexion, Active vs Passive ROM. Active being how for you can bend your knee without an external force applied vs Passive (with an external force applied, usually by the therapist measuring the ROM). All the numbers I see in posts it never clarifies whether the ROM was measured actively or passively. I ask because my doctor is more interested in my active ROM, which trails behind the passive number the therapists love to tout. So are the numbers you guys quote in your posts Active or Passive?
Tailwinds,
Charlie
P.S. I am 5 1/2 weeks post Knee revision and doing better than post my initial TKR. I doing everything to get this right for I darn sure don't want another surgery!
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Old 03-11-24, 09:19 AM
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Originally Posted by Chancy
I know a lot of people on this forum had a knee replaced and I have been wondering about knee flexion, Active vs Passive ROM.
For me (approaching 5 months TKR RIGHT knee)…I can’t quote the exact numbers you’re asking about. My PT ended around two months post-op. But just standing and flexing both knees…the replaced knee passive ROM is pretty close to what I can do on the non-surgical knee. But, IMO, “it is what it is.” Since I ended PT, I do flexing and stretching on my own. I do things to strengthen it. On the bike, I’m even back to pedaling out of the saddle without pain. It’s still a bit awkward but getting better. I’m even back to jogging a bit once a week or so. I discussed that with my surgeon at a follow-up appointment. I said “I don’t want to return to running road races, but want to at least be able to run from danger, or TO it, if need be.” That sounds silly, I know. But he understood, and agreed that jogging a few miles here and there wouldn’t be anything problematic. So…just keep doing the flexing, stretching, and strengthening and I’d think you’ll be OK. — Dan
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Old 03-12-24, 10:38 AM
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Dan,
Thanks for your reply and update. I am still going to PT and intend to keep up the stretching and strengthening exercises once they kick me loose for there are still gains to be made and gains to retain for at least a year post TKR. Also I totally understand "running to danger." I am a husband, father, grandfather, thus have many reasons I would run toward danger.
My question regarding Active vs Passive ROM is , now that I am at 118° Passive ROM and 107° Active ROM am I 18° or 7° behind someone posting they are at 125°?

Tailwinds,
Charlie

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Old 03-15-24, 06:08 PM
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Folks,
I just wanted to give an update. I am 6 weeks post my Revision, which in short is starting over at Day 1 from my rt. TKR on 11/03/23. I now am have 123° passive ROM and this is a big deal for me. After the initial TKR in November I only made it to 116-118° passive ROM and stalled out there. I feel very good about this and now more confident I make all the way back. I am still lagging in active ROM. I just started riding my bike on the street (seat jacked way up, flat pedals, and only for 20 minutes max- too uncomfortable for any longer), I can’t get out of a chair using only my legs (I can’t bring my right foot under enough to contribute), and my gait while walking needs work.So, lots of work still ahead of me, yet for the first time in over 4 ½ months I feel I can see the finish line on the horizon!

Tailwinds,

Charlie
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