← Return to PT for TKR - Pain from stretching & Other rehab questions

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@topdog11

I am about 4 months PO and have a pain like a tendon or ligament pulling and then snapping back of my knee. It started about 6-7 weeks, happens every time I go from sitting to standing, and starts about 10-15 minutes when I walk. Is this anything like you have? My OS doesn't seem concerned either, but by the end of the day it really is hurting. It seems like I traded one pain for another. I have really been working on strength exercises thinking maybe if I build my muscles up more it will stop. When I suggested to my OS that I see a different kind of doctor for it, he out and out told me no one's touches my knee except him. I politely as possible told him if it still hurts like it does at my 6 month checkup either he addresses it or I will be seeing another doctor. He believes by 6 months I shouldn't be having this problem. We shall is.

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Replies to "I am about 4 months PO and have a pain like a tendon or ligament pulling..."

Hello @topdog11. You may noticed I edited the title of your discussion so that it is a bit more descriptive. This should help bring other members in to the discussion. If you don't mind sharing, did you have issues with straightening your leg before your replacement? I had my knee replaced when I was 19, but due to severe arthritis and deformity in my knee, I hadn't had my leg straight at that point for what was probably close to 9 years. When I woke up from surgery, they had my knee in a brace and pulled straight. It was 9 years of atrophy pulled straight in a matter of hours. As you can imagine, the pain was unbearable. It felt like my ligaments and the back of my knee were going to snap loose. However, over the course of a year (and two manipulations later) my knee began to bend and straighten more and more each day and eventually became pain free. We are all so different in how we heal and recuperate, but I found that time, patience, and persistence are the ultimate deciders in the end.

@JustinMcClanahan that must have been so painful ,strength and endurance ,you,ve got it. When I hyperextend my leg it hurts just to bend again Can't imagine the pain you went through.

I was diagnosed with osteoarthritis in 2009 because my kneecap kept sliding out of place. I went to physical therapy for a while and as long as my hamstring was stretched out I was fine, In Feb. of 2018, my knee started locking up. At that point I was no longer able to straighten it completely.The doctor compared my 2 x-rays and I was bone on bone. I wanted to try the orthovisc shot. Insurance had still not approved it and in the beginning of May it became evident that a TKR was my only option.I had the surgery. I have been to PT 3 times a week faithfully and have done my exercises at home just about every day. 2 weeks ago I was at a -10 flex and I kept getting threatened with having to use a brace. So, I began to stretch out my hamstring as much as I could. This past Tuesday I could hardly walk. I had a follow up appointment Thursday and the doctor said that I have a severely strained my hamstring because I was pushing myself so hard. She said I was at a 5 flex and was not going to give me a brace.She told me to go to PT and do my exercises at home, but other than that prop up my leg and ice the back of my knee. I have a high tolerance for pain and am determined. So when they kept saying I was going to need a brace I was determined that I was going to straighten it myself. The cost was a severely pulled hamstring. I go back in 2 weeks to make sure it is ok. You are so right when you say we all heal differently and the level of pain we can tolerate. I am frustrated that no one recognized how hard I was pushing. I also began aqua therapy on Friday, I am scheduled for once a week, but I think I am going to try and see if I can go 2 times and once with my regular PT because I feel like I will benefit more from the aqua therapy. Right now I am waiting for the hamstring to calm down so I can work a little harder.

I agree that it is important to keep this discussion going. I hope that the discussion of scar tissue issues (arthrofibrosis) expands to include information on any new approaches to treatment. I am three years post TKR and not a good candidate for scar tissue removal so hearing of any advances in non-surgical treatment would be most helpful.

Dr. seems pretty arrogant – see another Dr. and don't tell him. Mayb you won't need him at the 6 month mark?

@marram, if you don't mind me asking, what is your range-of-motion? Do you also suffer from scar tissue as a result of your knee replacement? I am also not a candidate for scar tissue removal as they worry about infection. I suppose I am happy enough with my 0-110 or so (depending on weather!).

Ask Away! 3 days after, it was 100. don't know now? Will get PT in 6 days – then I'll know. I'm 2 weeks out from surgery, nurse and PT think scar looks great- I will have to see? When everyone talks about scars – do they mean on top of skin or something that goes deep.

Hello Justin. My flexion is only 70 on a good day. My surface scar has always been clean. I’ve had tests that confirm that the implant is well placed, solid and free of infection. It just is blocked with scar tissue that would likely recur after open surgery. Infection, of course is a concern.

@mari, from my own experience, I am talking about the internal scar tissue that prevents flexion of the knee. Mine was so aggressive that initially, I only had about 15-45 degrees of range-of-motion! It took two manipulations and about 18 months of work until I finally got to 0-110 or so. It was ultimately less than I wanted, but I am pain free on most days so it has been worth it. I also have to admit that when I was 19, I don't think I was as motivated as I would be now to push through the pain to complete my PT more thoroughly.

Being at 100 three days after the surgery is great Mari!

@marram, that is frustrating and I can relate to a certain degree. I did ultimately end up getting to 110, but it was not the conventional route. After surgery and no progress with range-of-motion I had to try all sorts of things. I had a full leg cast made that had hand cranks in it to force my knee to bend. It was the middle of the summer and this was so unbearable, I had to have it removed. I had two manipulations, but each time the scar tissue came back aggressively. It honestly wasn't until I was playing catch football with my friends that I jumped up for the ball, landed, heard a pop, and within the next few days was able to bend my knee to about 90. Weeks past after that pop and I eventually got myself to 110. As I mentioned to @mari, at 19, I don't think I was as aggressive with my PT and stretches as I should be, despite my dad's best efforts. 70 is functional, but not ideal. I am guessing that 2 years post-op you are not a candidate for manipulation anymore either. Have any possible solutions been proposed marram?

Thanks for your input Justin. I must press my OS on why he doesn’t recommend surgery for me. He thought an open procedure wasn’t a good idea. I’m going to ask home about arthroscopic procedures. From what I’ve read, there aren’t a lot of surgeons who are experts in this particular procedure but he might know of someone in my region who has done a lot of them. In the meantime I will continue to remain active and strive to remain fit.

That should read “him” not “home “ in line 3.