5. Post-Surgery
Recovery Stage III
Settling In—Acceptance and Gaining Traction
24–48 hours post surgery
Several milestones marked the second day after surgery.
Milestone #1:
The previous day process of moving from bed to chair was repeated.
• Lying in bed to sitting on the edge of the bed and then
• Sitting on the edge of the bed to sitting on the chair
Several milestones marked the second day after surgery. I began by transitioning from using a walker to using crutches. The previous day's practice was repeated: first— from lying in bed to sitting on the edge of the bed, and then—from sitting on the edge of the bed to sitting on the chair. However, this time, rather than using a walker, the PT brought me a pair of crutches and asked if I wanted to give them a try. I did. After TKR #1, I was a bit clumsy—not because of my bandaged leg but because I had not used crutches for over 50 years and needed some time to learn how to coordinate the movements. By my second surgery, I was an expert!
This time however, rather than bringing me a walker, the PT brought me a pair of crutches and asked if I wanted to give them a try. After TKR #1, I was a bit clumsy—not because of my bandaged leg but because I had not used crutches for over 50 years and needed to relearn how to coordinate the movements. By my second surgery, I was an expert.
Tips for walking with crutches:
I found I preferred the “3 point sequence” approach which is done as follows:
1. Place the crutches under your arms and support your weight with your hands, not your armpits.
2. Keep your body weight on your stronger leg
3. Move the crutches a comfortable arm’s length (6-12 inches) in front of you.
4. Pushing down on your hands, move the weaker leg forward up to the crutches, as follows:
• Keep your knees straight so the heel of the operated leg touches the floor first.
• Try to bend the knee and ankle so the entire foot rests on the floor.
• Finally, as you complete your step, move your weight to the front of your foot so your heel will lift off the floor as your prepare for the next step.
5. Step past your crutches with your stronger leg.
6. Repeat the above steps, walking as smoothly as possible. Do Not Hurry!
Make adjustments in your stride as necessary to maintain an even rhythm.
Walking slowly down the hall, I re-gained my confidence in using crutches. The stairway offered another challenge. “Do you feel ready to learn how to go up and down stairs?” I did. While it might look daunting at first, there is a simple way to remember which foot leads going up stairs and which foot leads going down. One nurse suggested, “The Good leg goes to Heaven “ (i.e. leads going up the stairs) while the bad leg leads going down. Another nurse put it this way: “Up with the good and Down with the bad.” (Bad refers to the painful i.e, new surgical knee).
The first steps using crutches went well.
Soon I was ready to try the stairs.
Step #1: UP with the GOOD!
Going Upstairs:
1. Balance your weight evenly between the handrail which you are grasping with one hand, and the pair of crutches which you hold with the other.
Keep the crutches on the step where you are standing.
2. Step up with the stronger leg (up with the good) and push down on the crutches.
3. Then bring up the weaker leg.
4. Once both legs are on the same step, raise crutches to that step.
5. Check your balance and repeat.
Flexion required for climbing stairs is 90 degrees to 104 degrees.
Going Downstairs:
1. Balance your weight between the handrail and the crutches held in the opposite hand.
2. Place crutches on next step below and extend weakened leg (down with the bad).
3. Bring down stronger leg, check your balance and repeat.
Flexion required for descending stairs is 90 degrees to 97 degrees.
Step #2: DOWN with the BAD