Recovery and Rehab Update (Weeks 4 to 8)…Feeling Pretty "Swell"

I'm nearly 8 weeks out from surgery now and my progress and recovery really seems to have slowed down. The thrice daily exercise sessions and constant battle against swelling are becoming quite "the grind" at this time.

I was prescribed meloxicam for the first 30 days after surgery and that appeared to be doing a great job of keeping my pain down. After withdrawing from meloxicam I started getting migraine-like headaches every other day or so for about 10 days. However, I continued to make progress on my exercises, cycling, and range of motion (ROM) taking the occasional dose of acetaminophen or ibuprofen as necessary.

The period from 4 to 6 weeks after surgery I appeared to make some nice progress. I worked my way up to cycling (easily) about 45 minutes per day. I was doing a little bit of walking (just around the house) before each of my 3 daily exercise sessions and worked up to about 10 minutes per walk. Unfortunately, 45 minutes of cycling and 30 minutes of walking per day (along with other exercises of increasing intensity) seems to have been too much too soon. I experienced an increase in swelling and stiffness just in time for my 6-week follow up visit with my orthopedist.

Needless to say the orthopedist was not thrilled with the swelling and lack of kneecap mobility (although my ROM (about 125-130⁰) and quad strength were okay for this stage). He observed that my enlarged knee was "boggy"...not filled with loose fluid that could easily be drained. This implied a problem with inflamed tissue. I was prescribed a 1-week course of indomethacin. He also ordered me to stop cycling and "loaded" exercises for 4 days.

By around day 5 of the indomethacin and reduced exercise intensity, my swelling improved and my ROM improved to beyond 130⁰. There was a bit of a rebound from the indomethacin including a massive headache and an increase in swelling the day after I stopped indomethacin. However, I have been diligent in using ice, elevation, and a bit of compression to keep the swelling within reason. I have returned to cycling very easy for 20 minutes at a time every other day. My new schedule is to alternate harder and easier days where the hard days include cycling and loaded exercises and the easy days are restricted to quad sets, SLRs, ROM, and stretching.

When I "zoom out" and look at my overall progress versus where I want to get to...it's easy to get bummed out right now. Progress seems to be really slow and in some ways I've gone backwards. However when I feel this way, I try to "zoom in" and keep my focus on getting through the next exercise session, or the next ice application.