Pain after recent Knee Replacement. What is normal? For how long?

My PT guy also was big on making sure my knee was elevated at or above heart level. I used two or three firm couch throw pillows stacked below my knee on the recliner while watching TV. I had to use my leg-lifter strap to raise and place the leg on the stack of cushions. I experimented with a few different combinations of pillows to try to make the pile as high and stable as possible. I don't remember how many minutes I elevated (and iced) each time, but watching TV took my mind away from it, so it was anywhere from 20 min to an hour. I hope everyone having a TKR goes home from surgery with a leg lifter, it makes getting in and out of beds and recliners so much easier, plus is needed for help with exercises.

HI Joe and others. Each TKR is different, even when done by the same surgeon. Even when done robotic assisted or or not. How much arthritis did a person have? How much were their legs bowed because of the arthritis? How far did the surgeon go to straighten the leg out during surgery? Did your foot or ankle supinate or pronate before surgery? What are your feet doing now. Besides the low hemoglobin, all of these items affected me and rehab pain and getting back into my pace and continuation of mild to moderate pain in the knee that was in the worst pre-op condition. All of these affected my gait. In my case one leg is shorter than the other 1/2 inch. Some therapists will say that 1/2 inch is not significant. It was with me After a put a 1/2 heel lift in my right shoe my gait changed and my balance exercises became easier to do successfully. Which by the way, anyone with TKR especially if both are done, need to do balance exercises. Most people I have met after TKR can't stand on one leg for thirty seconds. Forget about doing it and closing their eyes. Joe where is your pain. The bio-mechanics from your waste down to your toes can all affect knee pain, especially after TKR. Is it mostly on the anterior side just above, at, or just below the knee at the top of the tibia? If any of the pain areas I mentioned are where your pain is at, talk to your therapist about your IT band and the Tensor Fascia Latae muscle which has an unbelievably complex anatomical relationship with the IT band and the stability of your knee. It plays an important part on your posture and one legged stance, which basically happens at every step we take. Think about it. The full weight of your body is on one leg or the other withe each step we take. The TFL muscle plays a super important role stabilizing all of that, even though it is at the upper end of your femur. Often times this muscle is in an over tensioned condition due to our not being in shape, over use or change of gait to to injury or surgery. The tense or weak TFL will cause the IT band to be in tension and that will cause mild to sever pain along the anterior side of your knee. Your therapist hopefully can explain more about the relationship, and show you one of the simple yoga exercises to stretch or loosen the tension of the TFL muscle
It is often called "the standing TFL stretch". I am not a therapist, but have gained an enormous amount of knowledge from the therapists and Doctors I have relationships with. It is simple to do and I have seen it work with eight individuals that I work out with that have had persistent IT band pain. The following technique may sound silly, but I have found that if I walk forward on my tippy toes in my athletic shoes for about 30 to 40 feet and then walk backward the same distance for about three reps, much of the mild to medium pain in my left knee is reduced. I hope some of this info helps you as well others. As Always, Stay Strong-Stay Safe!

Wow thanks. As a former marathoner, I thought I knew a lot about anatomy, especially as it affects gait. I didn't know about the TFL.

Another large muscle that requires stretching but is hard to do is the psoas. The psoas is a thick muscle that attaches the lumbar spine to the femur. An expert massage therapist can loosen this muscle, but they must be experts on anatomy because they have to go through the stomach and probably other organs to reach it.

And a 1/2 inch leg-length discrepancy is significant. Wearing the lifts in one shoe is a great idea.

Joe

I sure appreciate all the responses, advice, and support. I have tried several suggestions and things are going much better. Thanks you all so much:)

Hi all, Please note that I have merged a few recent discussions dealing with the same topic into one discussion called:
Pain after recent Knee Replacement. What is normal? For how long?

Here's the link if you want to read the group's wisdom all in one place 🙂
https://connect.mayoclinic.org/discussion/posterior-pain-9-weeks-after-total-knee-replacement-surgery/
Any updates from anyone? How's your recovery going? What tip would you give someone about to get a TKR?

I am 8 weeks out and while I was doing great at first, I'm now experiencing the same thing you are. I also have pain on my inner knee, which Dr. said is my bursa and it will get better "in time". My PT said to continue all exercises but maybe cut back a little and let the knee/leg rest more. I admit I have probably been more active than I should at this time .. lots of exercise, walking, shopping, etc. I find at the end of the day I suffer from it. So I think it's time to start pampering myself again! R.I.C.E.works well and I need to be patient. I'm guessing the pain in the back of your leg is from over-exerting it too. Let us know how it goes.

Every knee is different. My first TKR and recovery could not have gone better. My 2nd TKR 4 months later went well to start, then slight swelling would come and go depending on my activity level. And I was over-doing it too. So good advice, especially after a month when you've done most of the therapy for motion, just slow down. I took two days off to start (5 weeks post-op) and then worked on my legs every other day.

Joe

Does the pain on the inner knee come mostly from the patella, especially when going up and down steps? It could be a strength issue with your quads. Rest is a good idea to get things settled down. You might check in with your surgeon or your PT to find exercises to strengthen the quad without stressing the knee too much. And of course ice and elevate after every therapy session.

I'm at eight weeks as well and while all pain is gone, still have slight swelling. That can take a while to go down.

Joe

I had TKR on my right knee 10 weeks ago. My knee is recovering well, still some pain due to the intense PT. But yes, I feel tired every day. After doing a daily task like making breakfast or taking a shower I am exhausted. Have to sit down and rest. I understand fatigue is common after surgery, so I am not worried. But it is so frustrating to have limited energy. We must have patience and give ourself permission to rest so the body can heal.

I'm just tired of being in pain and am looking for answers. I had TKR about 10 weeks ago and am still doing outpatient physical therapy. I understand that PT can cause pain in your muscles as you try to rebuild them and regain strength. But over the last three weeks I have started experiencing aching in the middle of my back and sciatic pain after my therapy sessions. I am addressing this with OTC pain relievers and heat, but am wondering if other TKR patients have experienced this as the result of PT. If so, does it go away when PT is finally over?