Tag: knee replacement

fitness

A six month journey recovering from total knee replacement

Sam B1 Comment

I thought it would help me, and maybe help others going through this, or contemplating going through knee replacement surgery, to see what the six month journey after knee replacement surgery looks like. For me, it’s to remind me–as much as anything–how far I’ve come, but also to think about what’s next as I gear up for surgery on my right knee.

In the draft of this blog post I was referring to my new knee as 26 weeks old, but I have decided that new knees are like babies. At a certain point, you stop the weeks talk and move to to months

If you’re reading this and thinking about knee replacement surgery, pls know that your mileage may vary. I’ve gotten to know a group of people who’ve had this surgery and our recoveries all looked different. I had the advantage of going into surgery in pretty good shape. I did the Friends for Life bike rally, riding Toronto to Montreal, the week before knee surgery. The downside of the state I was in prior to knee surgery is that my right knee also needs replacing and it’s slowing down my progress.

These days I’m not needing the cane as much for walking. I keep leaving it places which is a pretty good clue that I don’t depend on it the way I did. I’m riding my bike on the trainer on Zwift. Today was an hour and 26 km.

Sam and Zwift

Here are some milestones along the way:

My surgery was supposed to be day surgery but my blood pressure had other ideas.

Day two I came home with a walker, lots of at home physio instructions, and all the drugs. Really there were enough drugs–not just pain meds– that it required another adult to keep track of all of them.

Day Four I switched to crutches, went to my first physio session in person. It’s lucky I like Estee, my physiotherapist. I’m still there twice a week, now in the evenings.

Day Five I made it upstairs to sleep in my own bed, rather than the fold out sofa on our main floor, and managed to have a shower! I felt human again.

A week after surgery, Sarah returned to working some of the time from her office, and I was getting around reasonably well on crutches. Still, the first two weeks really were a blur of pain meds, physio, icing, elevation and napping. I couldn’t really read or watch complicated television. Thankfully there was SheHulk!

I was only able to sleep a few hours at a stretch and kept the ice machine on my knee pretty much constantly.

Week Two, I got my staples out and had a follow up appointment with the surgeon. Still no driving (because pain meds) so Sarah had to take me. I was able to start taking tiny walks down the street each day and could manage basic household tasks such as unloading the dishwasher, sorting laundry, and making lunch. I got back on the bike (with a stepladder, lol) and started to work on range of motion. I couldn’t do a complete rotation of the pedals yet. I also managed to attend a friend’s wedding. I was likely the only guest there with her own ice supply. We didn’t stick around for dinner and dancing but it felt so good to be out in the world.

Sam on the trainer bike

Week Three I started small outings and we even made it to the farm in Prince Edward County. Still no hot tub for me but it was nice to have change of scenery for physio. I was no longer taking the serious pain medication except occasionally at night. I went to a Tafelmusik concert and saw a movie.

Week Four Finally, I could manage a complete pedal stroke on the bike, backwards but not forwards, but still it was progress. Throughout all this I’m doing physio exercises four times a day and still there’s lots of icing, and elevation, napping and TV. I moved on to binging Better Call Saul and Breaking Bad, shows I never watched back in the day. I also started to drive again.

Week Five I discovered that I could pedal forwards on a recumbent bike at the gym, even if I couldn’t manage forwards on my trainer bike just yet.

Week Six I started aquafit and I returned to work. I had the option of staying off for 12 weeks but there’s only so much TV a person can watch. I started using the cane instead of crutches–leaving the all-important coffee-carrying hand free!

Week Seven I discovered that if I raised the seat on the trainer bike I could pedal forwards and I started riding a few minutes each day. For the first few times I didn’t even turn Zwift on. I just watched TV and tried not to tink about how far or how fast I was going.

Two months, I flew to the Dominican Republic for a short vacation in the sun. I did an underwater spin class! When we got back I started personal training again and started to focus on strength and balance as well as range of motion.

Three months, I started to see a massage therapist as well as a physiotherapist to help with range of motion and getting rid of the last of the swelling. Check out my fancy physio tape!

Fancy physio tape

Four months, annoyingly my right knee started to bug me as I did all the physio for the left knee that’s recovering from surgery. I was fitted for a right knee brace so hopefully the right knee won’t slow down my recovery from surgery too much.

Knee brace

Five months, I rode an actual bike again, outside, in Arizona and went on some desert hikes. Read about it here. Our longest ride was 25 km and I struggled a bit with the mechanics of riding–clipping and unclipping, and getting on and off the bike, but it felt so good to be riding again.

Sam on her road bike in Arizona

Six months, I’m back at hot yoga (yin) and lifting weights, as well as riding my bike on the trainer, going for dog walks, and doing physio and personal training two days a week each. I’m doing group rides in Zwift–The Thundering Turtles and Seattle Baby Steps and Ride On For Health –as well as rides with the slowest of the virtual pace partners. The thing I’m working on now is cadence.

At six months it isn’t over. It’s still an all on thing recovering from knee surgery. There is still a lot of physio. There’s still some knee pain (though frankly the right knee is worse than the left). Some days I hop up and forget about my knee altogether and other days it’s a struggle getting around. That’s the weirdest thing, how much it varies from day to day. I know movement helps and the days where I ride my bike and lift weights are the best. I think this would be very hard and extra challenging if you weren’t already an active person for whom physical activity is a large part of your day.

Today I’m seeing the surgeon about my right knee. Wish me luck!

Any questions? Send them my way!

fitness · strength training

Checking in after total knee replacement surgery, 7 weeks out: Sam is returning to her Activities of Daily Living

Sam B2 Comments

First, I had my six week follow up with the surgeon last week. Everything looks good. Next check up is by phone at 3 months and we’ll talk then about the schedule for my right knee.

Second, the physio recommendation from the surgeon says to focus on five things: extension and flexion (bending and straightening of the operated knee), strength training, balance, gait, and a return to the Activities of Daily Living. It actually said “return to ADL” and I had the look up what that meant.

I think that means stairs, dishes, laundry, etc. I’m walking about the house now loudly proclaiming, look at me doing an activity of daily living. The thrill will wear off I’m sure.

Third, in addition to physio and my daily living activities, I’m busy with aquafit two or three times a week. I’m also riding my bike on the trainer 15-20 minutes a day. Cheddar and I are walking again. He’s such a patient lovely dog and great walking at my speed, whatever that speed is, and not taking off after squirrels.

Chase and Cheddar. My mum’s other dog Charlie is a little camera shy.

Fourth, I’m back at work and feeling happy to be re-engaged with the wider world outside my house, my left knee, and physio. The trick will be not over extending myself. I had the option of staying off work for 12 weeks, rather than 6, and so I am thinking of the first 6 weeks back as a chance to say no to some of the weekend and evening dean stuff and involve other people.

Sam in her office

I’m trying not to fret about late fall, and dark November days. I’m going to all the holiday parties this year, no matter how early. I’m going to enjoy the hot tub and sauna at my fancy new gym. It also feels good to be back in my office clothes and not just wearing shorts, t-shirts, sneakers, and hoodies. I’m also very much looking forward to extending my time on the bike. Right now, I’m spinning most evenings for 20 min or so, while watching campy movies with my son Gavin. But soon I’ll back on Zwift doing some of the slow social rides.

The tree in my front yard that’s gloriously red in October, stick like in November.

Here’s me checking in after Week 1, Week 2, Week 3, Week Four, Week Five and Week 6.

cycling · fitness · injury

Happy Thanksgiving!

Sam BLeave a comment

I’ve got lots to be thankful this year for but here’s what’s most on my mind right now, I mean aside from loved ones, our dogs, and beautiful fall colours…

I just posted this to Twitter but I want to share it here too…

“I did it! 15 minutes on a regular spin bike, not a recumbent, forwards not backwards. I grinned the entire time. Tomorrow will be 6 weeks since total knee replacement surgery. I’m giving thanks.”

I’m now home icing and elevating and excited about getting back into cycling shape. Next time I’ll bring music. I can do 15 minutes without tunes but longer will take my Zwift playlists.

My spin bike
Grinning!
Spin bike
Chase and Cheddar
Fall colours
fitness · shoes

Recovery shoes? Really?

Sam B2 Comments

So as regular blog readers know, I’m on a year of not buying clothes, shoes and jewelry that began July 1.

All is going well so far except for the exceptions. They were bras, a dress to wear to a friend’s wedding, and running shoes.

The bras were bought in July. I now have non under wire options for work. The dress I bought in August. (I bought one with a slit up the left side so I could ice my knee during the event, cute and practical.)

Now I’m looking for running shoes. My exception was new shoes after knee replacement because when I started the year of no shopping I had no idea when that would be.

I say running shoes but there’s no actual running in my life these days. Lots of walking with crutches and likely I’ll still have crutches when I’m back at work.

I laughed because a few manufacturers of running shoes have a new name for shoes that aren’t actually for running. They’re “recovery shoes.” On your non running days, you’re recovering.

Here’s what’s being replaced:

Sam’s orange shoes

And to be clear I bought the orange running shoes back when I was actually running. That’s seven years ago. Yikes.

What am I looking for?

They need to be comfortable and sturdy and good for walking with crutches. No flip flopping around, reasonable foot support.

They need to be suitable for work, but that does not preclude sporty-looking. Paired with crutches I think people will understand.

Some of the time I can wear my short leather boots that also fit my orthotics so they won’t be the only shoes that I wear.

Reasonably easy on and off. While I was thinking slip-ons, they could have laces if they don’t make a whole production getting them on and off.

I’m Googling “best shoes to wear after total knee replacement” and they’re pretty much all running/athletic shoes.

Here’s one person’s explanation, “Now that my knee requires more support, I find that using a walking or running shoe gives me a little extra padding to take the pressure off my joint. Think of your shoe as the shock absorbers on your car. Remember, you can also add shoe inserts that help even more with cushion.  Also read my article about the best shoe inserts after TKR. It’s not fun riding in a car with bad shock absorbers because it makes for a rough ride. Our bodies are the same way. However, because it’s so subtle we may not realize the extra “shock absorbing” we get from our shoes. Even if I’m not a runner, I usually gravitate toward running shoes for comfort and daily use. Why, you ask? Because running shoes are made to reduce the repetitive impact caused by running and they are made with more cushion technology in the heel (air, gel etc.). They also have good arch support to enhance the position on the foot.”

Also remember I have two knees, both of which were in need of replacement so my right knee will still require lots of extra attention until its also been replaced.

So far people have suggested All Birds

All Bird slip ons

Also Hokas

Hoka
No Bulls

My son thinks Ons might be good shoes for me.

On, Cloud go

Sarah suggests these New Balance shoes.

Black new balance shoes with rainbow sole

I also like the sound of the Canadian brand Vessi

Vessi slip on

And finally, there’s Danskos. I wear their clogs a lot but haven’t tried their walking shoes.

Danskos

Probably I need to go out shoe shopping and try things on. But the whole idea is off putting. I’m still very tired. If I only have so much energy during the day I don’t want to use it shopping.

I’m tempted to order my favorite 3 and return 2.

All of the above are available in bright colours as well as black. I haven’t decided which way to go yet. They are also all in the $100-200 price range as are the pair they’re replacing.

Welcome your suggestions!

fitness · injury

Sam is checking in three weeks after knee replacement, CW: contains photo of operated on knee after staples removed

Sam B5 Comments

Knee replacement isn’t easy. It’s been 21 days now. I checked in after one week and again after two weeks and I’m checking in again now.

Even though I’m making progress, it’s still a slog. The big issues are physio–so much physio!–and also pain management. It feels like alternating between physio and icing and elevation is still pretty much a full-time job.

The hardest and most important exercises are focused on range of motion, making sure my knee can bend and straighten. But I’m also doing some balance work, standing one legged with the operated leg doing the work. The other focus is strength, lots of sit to stands, and leg raises.

I’m excited to say that I’m making progress. This isn’t a particularly flattering photo but it does demonstrate that I’m getting better at bending my knee. A lot of physio went into getting there!

Sam with crutches getting into the car

Also othe bright side I’m off the serious pain medication.

I feel more like myself

I can read again. Phew.

After four weeks, I can drive again. It’ll feel better not needing Sarah or my mum to take me to physio.

I’m getting around pretty well on crutches and in the house, within a room, I don’t really need them. I’m still struggling with carrying stuff. I need a coffee and book carrying robot to follow me around the house. I can do basic household chores like dealing with the dishwasher and cooking and sorting clothes but I can’t do things that require carrying stuff, like setting the table.

I also had the surgical staples removed and check in with the surgeon in London

No more staples

I think it looks pretty good. I’m impressed with their needlework/stapler skills. What I can’t do, until that heals completely, is immerse myself in water. I can shower, yes, but no swimming pools, hot tubs, or baths just yet.

I can now look forward to short outings.

This past weekend we had breakfast with a friend.

Sarah and I made also it to the farm. For me there’s no swimming, no hot tubbing, no bike riding. There’s still lots of physio and icing but with different scenery. It’s lovely.

Hoping to go out to the movies next week.

I’m also looking forward to getting back to work. Medical leave for knee replacement is 6-12 weeks and I’m hoping for the short end of that range.

Have you had a surgery with a long recovery period like this? Any advice you have to offer?

fitness

Sam is checking in two weeks after knee replacement surgery

Sam B4 Comments

After a rocky start and an additional night in the hospital, things have been progressing pretty well with the total replacement of my left knee.

Here’s a few milestones on my road to recovery:

I’m sleeping in my own bed and the stairs, with crutches, seem pretty manageable. I’m still only doing them once a day though.

I’m also going on tiny walks down the street each day.

For better or worse, lol, I can now manage basic household tasks such as unloading the dishwasher, sorting laundry, and making lunch.

Physio tells me I’m going well at both ends of the range of motion, getting the knee to lay flat and bend. Physio is so hard!

I got back on the bike on the trainer just to work on range of motion. That felt both inspirational and humbling. I know it will take time.

Friends warned me about out of character things they’ve said and done, wild emails sent, while on pain medication for knee replacement.. So far so good for me. Except I might have gone on a middle of the night pillow shopping spree after googling “best pillows for sleeping after knee replacement.” They keep arriving.

Yay for tonight body pillow

And speaking of pain medication, I’m just taking the heavy duty stuff now for night time and after physio.

We also went to the wedding of dear friends on the weekend. So much joy! I wasn’t sure if I’d be able to do it and I wasn’t sure how I’d feel just being there for the ceremony, but thanks to pain medication, ice, and Sarah’s help it went perfectly. It was lovely to see friends and to be there to celebrate with Jenn and Annada and their friends and families. I promised them we’ll dance next year for their anniversary.

What’s not going as well as I’d hoped? I’m still struggling with attention span and reading. I was hoping to enjoy having time to read but it turns out physio and recovery is pretty much a full-time job. So far I’m sticking mostly to tv and audiobooks.

Enjoying She-Hulk, for example, but the Booker prize winning novels will have to wait.

She Hulk

What’s up this week? Staples removal and follow up appointment with the surgeon. Stay tuned.

cycling · fitness

First time back on the bike

Sam B1 Comment

It’s baby steps but I’ve been given the okay to get back on my bike on the trainer.

The goal isn’t some number of kilometres, a given amount of time, or to reach a certain power level

Instead, it’s something much more basic and fundamental. It’s all about regaining enough mobility so that I can make a full rotation of the pedals. It’s range of motion time, baby!

Various guides to knee replacement say to expect a 5 degree improvement in the angle possible for your new knee each week. You need 90 degrees to ride a bike. A goal is 120 if your leg size permits that. Not sure mine does. I was at 52 degrees last week, a few days after surgery, and 67 today eight days after replacement.

But all of these guides to knee replacement say don’t compare your progress to the progress of others. Different people take a different amount of time to get there.

It’s unlikely I’ll be able to that the first few times I try I’ve been told. So no expectations.

Also, even once I can I’m to use the trainer in a very spinny gear, no pressure at all on the pedals.

Whether or not you’re a cyclist the bike trainer is a basic rehab tool after knee replacement surgery. Surgeons and physiotherapists have to talk people who aren’t cyclists to give it a go. It’s easy when the patient’s first question is how soon can I get back on the bike (on the trainer to start.)

It’s all about passive range of motion. Here we go!

Sam on her trainer
accessibility · fitness · habits · injury · stretching

Recovery and why physio is so hard!

Sam B1 Comment

So I am the sort of person who is good at following the advice of physiotherapists. I’ve successfully rehabbed some serious injuries and I trust the professional advice of physiotherapists. I do what I’m told.

It’s also worth noting that I have exceptionally good benefits and they cover almost all of my physio costs. And yet, even for me, physio after knee replacement is tough and I thought I’d explore why.

First, advice about recovering from knee surgery can sound contradictory. The take home sheets from the hospital say to use your new knee as much as possible each day. It will help you heal faster from surgery and improve your chances of long-term success. But also it says to avoid pushing yourself too far too soon. So as much as possible but not too much. Yep.

And practically it feels like that too.

The knee feels good and so I go for a short walk. After that it swells up and is painful so it’s time for ice and elevation. I’m constantly moving between making the knee work and then helping it recover.

After I posted about going for a very short walk this morning, friends commented, great, now rest!

What’s as much as possible but not too much? There’s not really good intuitive measure at this stage since everything hurts a lot of the time.

Second, unlike other physio I’ve done this is really painful. It’s the kind of painful where you ice before and after and take pain medication around your pt sessions. Since you’ve just undergone surgery and things still hurt from that, you feel a bit like hiding on the sofa, covering yourself in blankets, and waiting until the pain goes away.

Third, it’s pretty time consuming.

Here’s a rough schedule of my days this week. Next week I’m hoping to be able to get on the bike trainer to help with my range of motion.

6 am breakfast, drugs, ice and elevation in bed

630 physio round one, basic stretching and mobility

700 more elevation and icing and getting ready for the day

Tiny walk

800 Breakfast round two, more pain meds, more elevation and icing

900 Physio round 2 mobility and stretching plus regaining strength

930 ice and elevation

10-12 free time for reading possibly napping

12-1 lunch

100 ice and elevation, more pain meds

130 Physio round 3, mobility and stretching and regaining strength

200 ice and elevation

230-4 free time for reading and napping etc

4-6 dinner etc

7 last round, 4, of basic mobility physio

Tiny walk #2

Bed with all the ice and more pain meds


That’s me on the deck post tiny walk, resting and icing, as friends and physio advised.

Patience my friends is going to be key.

accessibility · equipment · fitness

Knee replacement surgery and recovery: Some reflections after week 1

Sam B9 Comments

Day 1 Surgery

Surgery was Monday, August 29th. It was supposed to be day surgery but my blood pressure wasn’t fond of the spinal so I kept flunking the physio exam to leave hospital. Each time I stood up my blood pressure sank drastically and I had to sit back down. That was frustrating, especially since the surgery itself went well, but I was happy to see they were obviously okay keeping you if you’re not well enough to leave. Yes, here in Ontario our hospitals are stressed but I felt very well cared for. The nurses and physios and the whole surgical team were lovely.

Day 2 Home!

Tuesday’s big adventure was making it from London to Guelph. Getting in and out of the car was the biggest challenge. I was happy to be home and settled into our ground floor back room with the fold out sofa. Usually it’s our Zwifting studio but no one is Zwifting right now. We have a main floor washroom and so I was saved the need to handle the stairs with crutches until I was a little bit more stable. For the first few days I relied upon a walker.

Day 3 My walker

Day 4

Day 5

Day 6

Also on day 6 I made it upstairs and slept in my own bed. Bonus!

Day 7

OMG Sarah installed a new handheld shower attachment and I successfully showered. The world is a better place today.


Surgical staples get removed and I have a follow up visit with the surgeon on the 15th. That’s the point at which I can ask about getting back on the bike on the trainer and maybe getting back to the gym for some gentle workouts.

Here are some of my thoughts so far about the recovery process:

It helps to have a team. Between keeping track of all the medication–pain drugs yes but also antibiotics and blood thinners and anti inflammatory drugs–and running out for ice for the ice machine, it’s a lot. Thanks Sarah, thanks mum, thanks Jeff. I can’t imagine going through this alone.

Functional fitness matters. I only needed the walker for the first couple of days and I’m pretty stable on my feet now even without the crutches. I’m using them for walking to help the joint but I feel pretty strong. The new knee is “weight bearing as tolerated” as they say. It helps too that I’ve got some upper body strength and reasonable mobility. All of a sudden when you’re trying to lower yourself into the toilet seat with one leg doing all the work and the other sticking out because it doesn’t yet bend, pistol squats start to make sense. We bought one of the raised toilet seats with handles but I really only needed it for the first couple of days. It’s packed away now.

Pain management is a thing. Part of me worries about pain meds and addiction. I also like feeling like myself. But knee surgery isn’t a time to try to soldier through. You need to keep moving and do the physio and to do that you need to keep the pain under control. There’s always some pain but I’ve been told to try not to let it get too far above 5/10. I’ve been using the heavy duty pain meds at night for sleep and before and after physio.

Physio, physio, physio. Recovery from knee surgery is a full-time job. I’m off work for at least six weeks and part of me wondered why. I could work from home and make my meetings virtual meetings. One reason is of course pain medication and judgement. There’s also time constraints. If you’re doing physio two to three times a day and you need to prepare for physio and recover after, there isn’t a lot of time to do other things.

This is also going to take a lot of patience. It’s tough work and I know it can feel like slow going. Wish me luck!

Good leg good to heaven, bad leg goes to hell. Crutches advice for the stairs.

Happy to answer any questions anyone has about my surgery experience. Ask away!

cycling · fitness · goals · injury · motivation

Letting go of yearly goals and focusing on smaller things

Sam B

Like most cyclists, I have a yearly distance goal. It’s ranged over the years from 4000-7000 km. This year it’s 5500 km.

My goals and monthly activity on Strava

I’ve got 785.5 km to go. In normal times that would be perfectly reasonably even going into the fall months because of Zwift and weekend gravel rides.

But I’ve also just had total knee replacement surgery. Another friend who also had the same surgery got back on his bike at 8 weeks. It’s never reasonable though to look at someone else’s progress and make that your own standard. Isn’t there something about comparison being the thief of joy?

I started to do the math. There’s 18 weeks left in 2022.. Suppose I’m like him and riding on Zwift at 8 weeks. That gives me ten weeks to meet my annual mileage goal. That’s about 80 km a week. Say 4 easy 20 km rides a week. I could even do that slowly, just spinning, no pressure on the pedals.

Still, though it might have doable, it also might not be.. This isn’t a year for distance goals. If it works, great. If it doesn’t, fine. I have big picture goals about mobility and long term bike fitness. That matters in ways that arbitrary numbers on the bike computer just don’t.

I do have one immediate goal though–getting upstairs on crutches to the shower! I can shower if I can keep the incision covering dry with a plastic bag taped on and use a hand held shower. Sarah just bought one to install.

That’s our weekend mission.

Next week it’s my hope to be sleeping upstairs and have the bike back on the trainer downstairs. I’ll be using the bike purely for range of motion purposes. It’s likely going to be awhile before I can make a complete rotation on the trainer.

Anyway, I’m blathering. Thanks pain drugs. The point is just to say, I’m giving up distance goals and sticking to sensible short term functional fitness while my knee heals.

Sam with crutches outside Defy physiotherapy in Guelph