Difficulty walking one week after knee replacement - NRAS

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Difficulty walking one week after knee replacement

ZibZeb profile image
24 Replies

Hi all, never posted before but in need of some reassurance and you guys always seem such a kind and supportive community. Have had RA for 25 years and taken most of the drugs and many of the biologics over that time and had my left shoulder replaced. Fairly well controlled under abatacept and finally took the plunge and had my left knee replaced (TKR) last Saturday. Felt fairly nimble on just two sticks when I came home but since then have found it difficult to walk very far at all - just up and down the landing a couple of times really tires me out ( and it’s not a big landing). Pain is largely well controlled. Due to inadequate/conflicting advice from physiotherapists I wasn’t doing enough or the right exercises for the first couple of days and started to become unstable, had to change one of the sticks for a four footed walker but now back on track with the exercises and can see the difference in terms of strength and range of movement in my leg already, but walking not getting any easier. I know it’s early days but I read literature suggesting people are back to work and doing gardening etc in six weeks which makes me think I must still be doing something wrong here or maybe I just need to walk more despite the extreme difficulty in doing so and it will eventually start to get easier. I did fall down the stairs in December and fracture both my Humerus and pelvis so I haven’t been all that active for a good few months so maybe I’m just a bit weak. Saw physio on Saturday when we sorted out the walker to help with stability and got me on track with the right exercises and frequency of doing them. Seeing him again next week. Would appreciate hearing any experiences of recovery from this op please. Thanks in anticipation and sorry for such a long note.

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ZibZeb
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24 Replies
Kags1068 profile image
Kags1068

Hi ZibZeb

Nice to meet you and welcome!

Firstly, I want to say wow, as it sounds like you are doing remarkably well following your TKR! From what I can gather, you must only be about 9 or 10 days post op? On that basis, I imagine you haven’t even had your clips removed yet?!

As a comparison, I had both knees replaced in 2005 (about 5 months apart) when I was 36. For the first I was in hospital for 16 days and the second 10 days. The first one was very difficult initially - unbelievably stiff. I spent at least a week on one of those knee bending machines (don’t know the technical term), and thought it would never ease! The physio was re-assuring and said not to worry as the bend would improve over time (it did). I was told the most important thing initially was being able to fully straighten it, which thankfully I could. When I had the second one done, It was more painful to begin with - especially to walk on, but it recovered quicker and had better movement. Both times exactly the same op, but quite different experiences!

I have long-term RA/JIA too - 38 years now. I think the 6 week recovery time is very optimistic for most people! I did see some patients at my physio class who seemed to improve very quickly, but they were mainly people with OA who had no other joint problems. For most of us, it took a little longer!

I think I started to really feel things getting easier around weeks 3 to 4. After that, things gradually improved until I got back to my “normal.”

I really hope this offers you some re-assurance. As I said in the beginning, I think you are coping amazingly well - especially after your recent accident and resulting fractures! I fell down the last 3 stairs in January and ended up in hospital with a broken femur, so you have my sympathies! Thankfully, my hip and knee replacements remained intact. I’m now 10 weeks into 12 weeks of toe-touch weight bearing using a gutter frame. As such, I really can understand the frustration of thinking things aren’t progressing. I don’t know your age, but you may still be a little weak from the op too - I know I was for a while. Also, you probably are a little weaker after your recent immobility.

Keep up your quad strengthening exercises (straight leg raises etc), and you will improve. A lot of my post-op pain was muscle related. Those poor muscles have had a bit of a battering during surgery!! So, please try not to worry, and give yourself a big pat on the back! Don’t try to overdo it - little and often is usually best, and try and put your leg up at times to rest it. Sorry it’s such a long reply - I wanted to re-assure as best I can. Any queries/worries - please feel free to ask!

Keep up the good work - you are doing great👍

Best wishes X😊

ZibZeb profile image
ZibZeb in reply to Kags1068

Thanks for your post Kags, that’s really helpful. I’m 59, I haven’t had my clips out yet and yes I’m 9 days post op. Once the walking gets easier I’ll be happier I know - at present it’s just so difficult and scarey compared to how relatively easy it felt when I left hospital - I just don’t understand why it’s got so much worse since then. Poor you with falling down the stairs and those injuries - I hope you’re fit and well as soon as possible. we really do have to have such gargantuan reserves of courage to get through these things.

Kags1068 profile image
Kags1068 in reply to ZibZeb

Yes, it's always scary for a while once you get home and don't have the security of the hospital setting around you. If it's any consolation, whenever I have an op, I always feel I take a couple of steps backwards when I first get home. I sometimes think it's because in hosp everything is set up reasonably conveniently for you, you've got used to the surrounding (even in a short time) and there's usually people around. However lovely it is to get home, suddenly everything probably isn't as conveniently placed, etc and it's back to reality! I think that can feel like hard work for a start.

Also, I had days when it seemed fairly easy, and then I might have a few when it wasn't and my knee was more painful - my recovery wasn't a straight line upwards. It doesn't help either as sometimes when we get home, we do worry about anything going wrong (I know I do), so little blips can seem much worse because we're so focused on how it feels and desperately wanting everything to be ok and to get better (if that makes sense).

I'm sure your walking will get easier. Try and hold your nerve and don't be too hard on yourself. As I said, it does sound like you are doing remarkably well.

You are dead right - we do have to have some serious reserves to get through these things. Thankfully though, we seem to plod on and somehow manage it - although I often look back and think how on earth did I get through that?!? I guess we all do .....😉😊

ZibZeb profile image
ZibZeb in reply to Kags1068

You are right, I definitely feel I’ve taken several steps back. On top of it all I do worry about all the work my husband’s having to do whilst I’m like this, having already done it for 3 months or so following my fall and only having a few weeks brief respite when I was well enough to share the load for a while before my op.

Kags1068 profile image
Kags1068 in reply to ZibZeb

I really do know what you mean about the added guilt and worry that your partner is shouldering the burden of everything. On the day I had my recent accident, I'd collected my husband from the hospital following an emergency admission and a week's stay (including a minor op) for a sudden and still unexplained tummy problem. He had barely been back home an hour before I fell down those bloomin stairs and he was calling an ambulance for me! I just couldn't believe it. He was in complete shock. Since then, like your hubby he has been doing everything (thankfully only 2 of us and 2 cats)! I feel so guilty. He has Ehlers Danlos Syndrome and I can see he is shattered. He has seen me through a number of ops in the same way. I feel worse this time as it wasn't a 'planned op, it was a silly accident that shouldn't have happened. He just says he knows i would (and have) tried to do the same for him, and that above all, to be careful and not try and push things or take any silly risks. Does your husband know this is a worry for you? I'm sure he would say the same thing as mine does if he did. It could be that you are putting a bit of extra pressure on yourself to get better quicker because you feel worried about him and guilty?

Please don't do too much too soon. As blue-sky very sensibly said - while exercise is very important, it is also important not to overdo them. Give you leg a bit of time to heal. Try doing just a bit less, and if the knee hurts to put your full weight through it, then don't. I'm pretty sure I didn't straightaway. Take some of it through your sticks/frame and gradually go to full weight bearing.

I honestly think in a couple of weeks or so you will look back and wonder why you were worried. The first couple of weeks are definitely the hardest.

Do keep in touch and let us know how you get on and if you want any more re-assurance. 😊

ZibZeb profile image
ZibZeb in reply to Kags1068

Gosh kags what an awful experience for you and your husband, and what fortitude it must have taken to come through it - I do hope you are both in a better place now. I do hope these are the dark hours before the dawn and I will look back as you say and wonder what all the fuss was about. Everyone’s comments have been so helpful and reassuring.

Kags1068 profile image
Kags1068 in reply to ZibZeb

Thanks for your kind message. It was a bit of a nightmare at the time, but it's fading now and I'm starting to joke about it which is always a good sign!!

I'm so glad you have found people's comments re-assuring- it can feel very isolating going through it alone.

I do think this difficult phase will pass and I think it's a normal reaction too. Just try and keep in mind how recent the op was, how amazingly well you're managing, and to allow yourself time to heal.

Again, any more worries, get in touch.

Take care

😊

Oshgosh profile image
Oshgosh

I think you are doing ok. Apparently the key to good recovery after knee replacement is keeping mobile.I have a few friends who had it done.

They adhered to the rules,took pain relief and did well.

Another friend said she couldn’t walk ,do exercise because of the pain. She now only really goes out in the car,can’t walk any distance.

I do think you need to ignore how others say they do.you haveRA and are on serious medication,so don’t expect miracles from your body.

Hope you feel better soon ,keep taking the tablets.xx

ZibZeb profile image
ZibZeb in reply to Oshgosh

Thanks Oshgosh x

Blueskysunshine profile image
Blueskysunshine

Hello ZibZeb, I’d like you to take a deep breath, smile, and then congratulate yourself on being 9 days post op.

10 years ago, I had a TKR, and was in hospital for a week as Easter weekend meant so few staff on Friday, Sunday and Monday. Coming home was an exhausting experience and in the mornings, just getting washed and dressed would take me ages and tire me out.

Be gentle with yourself, we all recover at different rates. Do your physio exercises, eat any drink as well as you can, and I’m sure the walking will get easier.

In what way do you find walking difficult?

Do keep in touch and let us know how you’re getting on.

ZibZeb profile image
ZibZeb in reply to Blueskysunshine

Hi Blueskysunshine, thanks for your reply which was very comforting. I find putting all my weight on my leg difficult and painful. I keep telling myself the knee is strong and stable , to be calm and confident, and putting my heel down first and bending my leg as I go through the step and putting the weight through the leg rather than through the walker, but it doesn’t get any easier. I did do 20 reps of 5 different exercises this morning so may have overdone it, I don’t know. Maybe one set of 10 of each would have been better. I am icing with a cryocuff four times a day, taking all my meds and elevating so not sure what else I can do. I’ll try some more exercises a bit later once my latest painkiller has kicked in and perhaps be a little gentler. I know you’ve got to listen to your body and maybe I’m not doing that enough - it’s so hard to get the balance between physio and rest right.

Blueskysunshine profile image
Blueskysunshine in reply to ZibZeb

Your leg will be painful to walk on, you’ve had major surgery on it, and it’s going to take time to heal. Keep up your pain relief, which will help you do your exercises and walk.Did the physios advise 20 reps of 5 exercises all in one session?

You will get there. Trust those of us who have been through it, and like others, I wasn’t running a marathon or back to work after 6 weeks. I worked part time at a desk job and still had a phased return to work - I can’t remember if that was after 2 months or 3 months.

Go gently x

ZibZeb profile image
ZibZeb in reply to Blueskysunshine

Thanks Bluesky. The one I saw Saturday said two sets of 10 for each one and to exercise every two hours but I think this might just be too much for me. Maybe I should space them out more. But The physio I spoke to the day before this one just said to do two different types of exercise only and do them once in the morning, once at lunch time and once in the evening, so conflicting advice.

sylvi profile image
sylvi

Right ZibZeb, take no notice of what the books say about going back to work or walking a marathon it doesn't happen. You only had it done at the weekend, your lucky to be home. When i had my knee replaced i had four days in hospital. So your doing really well. As long as you keep doing the exercises then you will be fine. It took me three month before i was sully back to work and then that was a desk job. So listen to your body and keep doing the exercises and you will get there i promise you that.xxx

ZibZeb profile image
ZibZeb

Thanks Sylvi xx

Judyloo profile image
Judyloo

Hi ZibZeb

I had a knee replacement four years ago, and like you I have had RA for just over thirty years,, since my mid thirties. I expected to be bouncing around as soon as I came home!! But I found I was pushing myself too hard. I was lucky in that we were able to use BUPA which we had kept up for just these eventualities. I found having five nights in hospital a great help. I was able to practice stairs, and do some physio before coming home. However it did take some time before I felt able to really function. It took me months to risk a bath rather than shower, and four years on my knee is still weirdly numb. I know I will need my right knee replacing soon too.

As regards pain I was quite lucky, however for several weeks sitting in our car with my leg extended was very uncomfortable but it did ease. We planned a holiday 3 months after my replacement, my husband had also had a hip done that year, and that was a great help. Sadly fir you this year is not the best one for such an operation.

I do hope you recover soon. With hindsight for me it's the best thing I ever did.

ZibZeb profile image
ZibZeb in reply to Judyloo

Thanks judyloo- really good to know you feel that way about your op now. I also had my op done privately and had a chance to practice stairs but they felt I was ok to leave after 3.5 days - I felt much more nimble on my feet when I left hospital than I do now but hope it will come back again.

magliona profile image
magliona

4 weeks is the magic number. Like most I’ve had both knees done and on my second one 2 years ago I was getting frustrated as I was trying to hurry it along and was very impatient. My first knee I was up and about after 24 hrs and thought the same would happen with this one but then again I was 20 years younger. This time I like you I didn’t find it as easy but turned a corner at 4 weeks. Once the clips and swelling go down it’s a lot easier. I used the ice pak the hospital gave me and along with painkillers everything eventually got back to normal. Slow and steady and ask friends to help out. Not only did they help it was nice to have a chat and cup of tea but I suppose this time it would have to be socially distanced and lots of washing hands etc. Be patient you are early days still. I am 62 and become very impatient with my body who at times acts like an old lady but my mind is still 21. Good luck

ZibZeb profile image
ZibZeb in reply to magliona

Thanks magnolia - clips are out tomorrow and I’m icing religiously so hopefully will see a difference soon.

Kags1068 profile image
Kags1068 in reply to magliona

Excellent advice Magliona I honestly felt 3-4 weeks was a turning point too when it all started to feel that bit better. Hope you are well.

Mumcon profile image
Mumcon

I think you’re doing really well Once you get the clips out you will feel so much better I had my left knee done 7 years ago I’m sure you will feel the benefits soon xx

ZibZeb profile image
ZibZeb in reply to Mumcon

Thanks mumcon- really helps to know that things will improve.

magliona profile image
magliona

A tip from someone who knows. When the clips are out, soak in a bath and massage your knee with liquid soap or something like it and massage the skin around the knee and this will help with the tightness you feel in your knee.

ZibZeb profile image
ZibZeb in reply to magliona

Thanks Magnolia- can’t get in or out of a bath but will see what I can simulate xx

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