Back in late summer, I began to think about what I would post on the second anniversary of my new knees. At the time, I was riding my bicycle, and I thought about videotaping my ride and narrating some of the highlights of my rehab in relation to the different landmarks along the way. At the end of that ride, I noticed that the ride had taken me longer than usual, but I figured it was because I was lost in my thoughts and not concentrating on pedaling in a consistent manner.
A few days later, I was using The Stick on my quads prior to my ride (a necessary part of every ride, before and after), and I accidentally went below my knee and felt exquisite tenderness. I recognized that tenderness immediately as tendinitis like I had had before in my quads. So with punchy fingers, I discovered that I had tendinitis on both lower legs from the knees to the tops of my feet on both sides of my shins! This finding explained why I had been noticing some increased stiffness in my knees. Once again, I had developed a problem while trying to do something good for my knees and muscles. I immediately began doing what I had done for the IT band tendinitis some months before--5 days of rest, using The Stick 4x/day, icing 4x/day, stretches for these specific areas found on the internet, and NSAIDS. It has been 8 or 9 weeks already, and there is improvement, but not complete healing. I'm guessing that the healing would have been quicker if I had had the different modalities used at physical therapy.
So here I am at my 2 year anniversary slowly building back up to my previous mileage. When I developed the IT band tendinitis earlier, my doctor said that this should not be a recurrent problem if I would stretch good both before and after a ride. So far that has held true for my quads, so hopefully once I get my lower legs taken care of, stretching before and after a ride will keep further tendinitis at bay.
So now, I will answer questions from 2 previous posts at 5 months and 9 months post surgery that may be helpful to someone looking to have a knee replacement or recovering from one. The answers in blue are from 9 months post surgery, and this point in time will be in red.
1. I wonder if my knees should still be this stiff? It's a different kind of stiffness than I had before surgery, but I sure would like to come out of this with none. (I am doing some serious flexion and extension stretching exercises. I have to do them every day, but I tend to have tight muscles anyway, so time will tell if I will just end up with my normal muscle tone that's a bit tight . I have minimal complaints about my right knee, but the left one still requires a good deal of work.) Stiffness, for the most part, is a thing of the past. Flexion and extension pose no or very little problem for me. I am very pleased at how much I can bend and extend my knees. Now, if I sit for longer than 20 minutes or so, I still have some stiffness when I first stand up. That will keep me from getting up and leaving during the middle of some group activity, like church, where I would be a distraction waiting for my knees to cooperate as I stumble away!
2. I wonder if there will always be some movements that will cause me pain. There are times when I move around in bed that I am very aware of my knees. ( These painful movements are fewer and certainly less noticeable than the first time I asked this. I have noticed that I no longer require a pillow between my knees to cushion those sore knees. All in all, things are looking up!) It is a rarity for some movement to cause me pain. Occasionally I might make some quick movement that is uncomfortable, but I would not attach the label of pain to it.
3. Will I be able to kneel? Will I be able to squat? Am I expecting too much? (I am amazed at the progress I have made with my yoga routine as far as getting on my hands and knees. When I first started, I had to put pillows under my knees and it was very uncomfortable. Now, I only use the yoga mat on the hard floor. I can't say that it is total comfort, but it is certainly manageable. Kneeling and squatting will come much later, if at all.) I can kneel with minimal discomfort. Getting there is not a pretty sight though. I cannot just kneel down with fluid movements that require no thought! But once I'm down, it's not too bad. Probably wouldn't want to kneel down and dig in flower beds for prolonged periods like I used to do, but I have not given up that that day will come. I will not even attempt to squat; I'm pretty sure I could not get up from that position. Maybe after a significant weight loss.
4. When will I be able to descend stairs without pain? Going up isn't always a lot of fun, but going down is definitely not without pain in one knee. (Definite progress in this area, but I am still mindful of steps, and the left knee still hurts some. Probably cannot do steps without a rail to hold.) Steps that are 4 inches or less are not a problem, but more than that is not totally comfortable. Once my tendinitis in my lower legs is healed, I hope to give more attention to stairs. Again, a significant weight loss will certainly help this issue, too.
5. When will I be able to walk without listing to one side? I really want to have a normal kind of walk. (7 1/2 months, but I'm thinking much of that was due to the problem I was having with my feet.) I no longer list to one side, but I have become painfully aware of balance problems in the past couple of months. I have started going to a seniors exercise class at my church where I am very much the youngest person there. I was shocked at the problem I was having with balance with some of the exercises they were doing. I now spend more time with my Wii Fit working on those balance activities. I know that after surgery, balance was a definite issue, and I worked on it for months, but I did not know that it was still a problem for me. My leg strength has really increased in the past couple of weeks and that cannot but help.
6. My left knee does not extend as well. Will this always be the case or can I expect both knees to be more similar? (8 months--I notice that when standing this is much less noticeable to me.) I would say that both knees are pretty equal now. My left knee is obviously the more problematic knee and is the reason that I continue to do stretches every day. I am aware that my progress and my current state is linked to mindful stretching every day.
7. Are most of my knee problems going to resolve with increased strength? ( This seems implausible, but before getting the injection in my foot, I wondered about why I bothered to get new knees if walking first thing in the morning was still really difficult. Once my feet were not hurting, I could really feel the benefits of having knee replacements.) Yes.
8. When will I have more stamina and be able to walk more than 6 laps on the track without paying for it later? (7 1/2 months--again the problem was more related to my feet) I cannot really answer this question because I still have issues with my feet. Walking does not excite me, but I can go shopping in Target or Costco without having to come home and rest like once before. Again losing 300 lbs. would probably help. (Yes, that is an exaggeration but indicates a significant problem.)
9. When will I be able to get up out of a chair and immediately start walking without having to wait for my joints to lubricate first? (8 months--the feet had much to do with this) As mentioned earlier, this is still a problem although not as significant as before. It varies, too, from day to day. It is definitely less of a problem when I am strong.
Another interesting discovery I made this fall. After my surgery, I got rid of all my shoes since they were worn in a particular way related to my bone on bone knees. Those shoes were no longer compatible with my new knees which now had space in between the bones. (check out the before and after X-rays) Right before my surgery, I had bought a pair of dress flats that I had worn only 4 or 5 times for short periods so I figured they were ok to keep. Since I wore running shoes even to church for the first year, those flats did not get any wear. After the first year, I wore the flats 4 or 5 months on Sundays, put them up for the summer, and brought them back out a couple of months ago. This time they were TOO BIG--would not stay on my feet, flopped up and down when I walked. I'm guessing all the swelling in my knees was shared with the whole lower leg via gravity. Obviously the edema problem is gone, and I now have shoes that are too big!
Now you may feel like I am insulting myself by using this animated cartoon, but I totally identify with it. As I have been riding along, I many times wonder what I look like from behind and wonder if someone is making fun of me. I must say, I no longer sway from side to side, but I know I did for a long time! I had even considered having my husband video me from behind at different intervals as a visual diary to look for change over the ensuing months. It seems like every time I get going good with a consistent exercise regimen, I get waylaid by an injury. Anyway, if you are timid about exercising in public, please read this. After reading this guy's blog post, I have chosen to think that others admire the way I haul myself through space and are quietly saying, "Atta girl!" Happy Anniversary to my new knees which have changed my life for the better! It was a scary decision, but one I am so glad I made.
