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

Posted by pgcdds @pgcdds, Sep 4, 2021

Does anyone else feel a “ stabbing “ pain in the back of their knee when flexing it with slight resistance ? For example, when trying to rise from a chair and you bring your feet close to the chair’s base to stand up or just even standing and you flex your leg by raising your foot behind yourself ?

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@flaredhead

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?

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You asked, "If so, does it go away when PT is finally over?" Any pain that gets worse after PT should be addressed with the therapist. There may be some adjustments that can be made to your exercises to help you - just like shoes and pants, PT should not be "one size fits all."
A couple of other considerations - the TKR will have changed your movement as you learn to walk with the implant, and with less pain. Ask the therapist to evaluate your gait and see if you need "gait training". Others here have mentioned needing orthotics because the position of their leg & foot has changed. Check out this ongoing discussion to connect with others: https://connect.mayoclinic.org/discussion/posterior-pain-9-weeks-after-total-knee-replacement-surgery/

Ten weeks out is early days - hang in there and it will get better. You are well on your way by keeping up the therapy!
Sue

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@sueinmn

You asked, "If so, does it go away when PT is finally over?" Any pain that gets worse after PT should be addressed with the therapist. There may be some adjustments that can be made to your exercises to help you - just like shoes and pants, PT should not be "one size fits all."
A couple of other considerations - the TKR will have changed your movement as you learn to walk with the implant, and with less pain. Ask the therapist to evaluate your gait and see if you need "gait training". Others here have mentioned needing orthotics because the position of their leg & foot has changed. Check out this ongoing discussion to connect with others: https://connect.mayoclinic.org/discussion/posterior-pain-9-weeks-after-total-knee-replacement-surgery/

Ten weeks out is early days - hang in there and it will get better. You are well on your way by keeping up the therapy!
Sue

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I have discussed this pain with PT and we have adjusted my exercise routine. But the pain is still there off and on. I will ask about assessment of my gait. Thanks!

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@sr108

I have been doing pretty good the first couple of weeks and stopped taking pain meds per doctors advice. Taking ESTylenol and Ibuprofen for management. I went to therapy yesterday afternoon and am having a lot of trouble with pain on the outside of my leg - especially when I try bending it since that therapy session. I was not experiencing this before yesterday. The therapist did massage my kneecap and out some pressure on top of my shin. I hardly slept at all last night ( that’s how I found this site) and taking it pretty easy today. Therapist also had me try a couple of new exercises so maybe that is what’s different. Hoping someone else has had this experience or maybe there are good days and not so good days? I feel as though I’m going backwards instead of forwards.

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Good evening, @sr108. You are doing very well if you have progressed beyond pain meds and are now introducing new therapy moves and exercises. I am familiar with those sleepless nights. My PT at the orthopedic center worked out a "deal" with my MFR (myofascial release) therapist. With the introduction of new PT "moves", they worked it out so that I went right to MFR therapy after PT and she took care of the pain.

Everyone has different surgery issues with lots of healing strategies. You are using ice and elevation, right? There are many different body structures, e.g. bone, muscle, ligaments, tendons, and the fascia. There will also be fluid build-up or swelling when the work begins on new areas or to increase the strength and resilience of other areas. I am going to attach a video that shows you what it might look like around your knee if you could look "under the skin". As you will see, the restrictions that have been created with a new therapy effort, e.g. rising out of a chair without your hands for support. As that chair gets lower and lower your knee needs to be carefully treated and given time to settle down.

https://www.youtube.com/watch?v=eW0lvOVKDxE&t=86s. (Don't forget to skip the ads).

If you have questions or concerns please fire them back at me. Keep up the good work and someday soon you will have all good days. Those not-so-good days will have disappeared. I had my second TKR one year ago and I am just amazed at how great that knee feels.

May you have comfort and ease.
Chris

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@flaredhead

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.

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Good evening @flaredhead, I see you are a new member and I want to make sure you are welcomed appropriately. So congratulations on that new knee. You seem to feel like your pain is due to the intense PT. With just 10 weeks in recovery, you are doing well. Please remember that pain of any source and at any level can be exhausting. Why do I know so much about pain? Well, I have had at least 14 orthopedic surgeries and a few years ago developed SFN (small fiber neuropathy). It has been a long time since I have had a day without pain. This morning I played Mahjongg with my friends for a couple of hours. I was exhausted by the time I got home and actually just woke up a few minutes ago......feeling better and in less pain.

You have the answers.......patience and modest tolerance. On Tuesdays I have an hour of stretchy yoga........in the morning, followed by a resting, rebuilding nap. Oh.....and you didn't mention your age. I am 80 and have noticed that exhaustion arrives more rapidly at this age.

Keep up the good work and positive attitude. Very, very helpful.

May you have happiness and the causes of happiness.
Chris

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@flaredhead

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.

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Sounds like my experience. you don't have a choice if you want a functional knee but to hit the PT hard the first 4 or 5 weeks. That establishes flexion (bending your knee) and extension (locking your knee so the leg is straight).

After that you can focus on strengthening the quad. All of the work is necessary, hurts a bit, and keeps the swelling - so you have to ice and elevate.

And then, as you describe, daily activities become hard. I can't get down on my knees to et my cat from under the bed. She's happy!

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@flaredhead

I have discussed this pain with PT and we have adjusted my exercise routine. But the pain is still there off and on. I will ask about assessment of my gait. Thanks!

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Good evening @flaredhead, I see that @sueinmn has presented you with some important responses to your post. I just wanted to note one comment of yours and that is you are using heat for pain relief after therapy. I have had two TKR surgeries and I was strongly reminded to use ice as needed for pain. You can get special forms for knees that can be kept in the freezer so they are ready when you need them. I think Amazon has numerous options. I also like Vive health. http://www.vivehealth.com.

Please try some ice and let me know how it works for you. You can also use a wedge to elevate your knee. And every morning during my simple stretch Yoga, I do "Legs up the wall". You can find that Yoga pose online. It certainly helps me.

May you be safe, protected, and free of inner and outer harm.
Chris

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@artscaping

Good evening @flaredhead, I see you are a new member and I want to make sure you are welcomed appropriately. So congratulations on that new knee. You seem to feel like your pain is due to the intense PT. With just 10 weeks in recovery, you are doing well. Please remember that pain of any source and at any level can be exhausting. Why do I know so much about pain? Well, I have had at least 14 orthopedic surgeries and a few years ago developed SFN (small fiber neuropathy). It has been a long time since I have had a day without pain. This morning I played Mahjongg with my friends for a couple of hours. I was exhausted by the time I got home and actually just woke up a few minutes ago......feeling better and in less pain.

You have the answers.......patience and modest tolerance. On Tuesdays I have an hour of stretchy yoga........in the morning, followed by a resting, rebuilding nap. Oh.....and you didn't mention your age. I am 80 and have noticed that exhaustion arrives more rapidly at this age.

Keep up the good work and positive attitude. Very, very helpful.

May you have happiness and the causes of happiness.
Chris

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Thanks, Chris! I am 65 years old. When I retired at the end of 2021, I didn't even know I had a problem with my knee, it was just stiff and a little sore. I went to see an orthopedics doctor in February and he took an xray that showed bone-on-bone arthritis in my right knee. The joint was so damaged it had turned my right leg inward and I was walking knock-kneed.
It took me a couple of months to decide to have the TKR. I just couldn't believe it was true. My surgeon not only replaced the joint but also straightened my leg. This added a risk of nerve damage and paralysis. Thank God, no damage occurred. I appreciate your encouragement. Knee surgery recovery is one of the hardest physical things I've ever endured.

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@artscaping

Good evening @flaredhead, I see that @sueinmn has presented you with some important responses to your post. I just wanted to note one comment of yours and that is you are using heat for pain relief after therapy. I have had two TKR surgeries and I was strongly reminded to use ice as needed for pain. You can get special forms for knees that can be kept in the freezer so they are ready when you need them. I think Amazon has numerous options. I also like Vive health. http://www.vivehealth.com.

Please try some ice and let me know how it works for you. You can also use a wedge to elevate your knee. And every morning during my simple stretch Yoga, I do "Legs up the wall". You can find that Yoga pose online. It certainly helps me.

May you be safe, protected, and free of inner and outer harm.
Chris

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To clarify, I use heat for the back pain; ice packs for the knee pain.

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@flaredhead

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.

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It is annoying to be unable to do why I want to do! Im sure we’ll have more energy in time.
The sooner the better.

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@eurekahayley

It is annoying to be unable to do why I want to do! Im sure we’ll have more energy in time.
The sooner the better.

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Also, I’m glad to know I’m not the only one!

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