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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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mpirruccel | @mpirruccel | Sep 18, 2022
In reply to @marc919 "Yes, when I stand and bend the knee I get sharp pain in the calf and..." + (show)
@marc919

Yes, when I stand and bend the knee I get sharp pain in the calf and outside of the knee. With all the PT it is still there. 🙁 For a while I would get pain up the back of my leg when I sat down. This is not easy.

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I still have acute pain on outside of kneecap with bending, getting up. 13 months out. Want to get focused shock therapy but was just diagnosed with stage 1 breast cancer ☹️

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1 reply
heyjoe415 | @heyjoe415 | Sep 18, 2022
In reply to @mpirruccel "I still have acute pain on outside of kneecap with bending, getting up. 13 months out...." + (show)
@mpirruccel

I still have acute pain on outside of kneecap with bending, getting up. 13 months out. Want to get focused shock therapy but was just diagnosed with stage 1 breast cancer ☹️

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I'm sorry to hear about your situation. Focus on the Stage 1 cancer. My understanding is the recovery from that is great when caught early, and you have. Joe

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flaredhead | @flaredhead | Sep 19, 2022
In reply to @ellerbracke "@heyjoe415 : I realize that most people come to this site because they have major problems..." + (show)
@ellerbracke

@heyjoe415 : I realize that most people come to this site because they have major problems with surgeries and the results. I also was grateful to find some day-to-day helpful hints to deal with issues resulting from assorted shoulder/knee surgeries. But, I’m with you that there are absolutely success stories as well. I had plain Jane, run of the mill, knee replacement in September of 2018, dumped walker within 2 days, started 1/2 mile walks around neighborhood on day 7. Biggest issue was zero straight knee - took almost 3 months. Flex topped out at 137, official measurement. Has still improved since then, I think. I can do child’s pose to the level of 95% knee bend. Yes, I am bragging. Also, extremely grateful for my surgeon. Also, I paid for all this progress in effort, pain, and tears. Many tears. And much pain. And stubborn persistence.

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Thank you for your encouragement. While it can be painful, PT has been crucial in meeting my goals for ROM and for strengthening my knee/leg to climb stairs. But PT exercises often result in knee pain (either while doing them or after you finish). That stinks, I know. I hate pain! Very depressing and yes, I have cried many a tear. The flip side is PT works. With courage and commitment to keep going, you can meet your goals. This week will mark 3 months since my TKR surgery. PT is now once a week and I do exercises at home in between therapy sessions. My knee strength has significantly improved and I am nearing my goals for recovery.

Melinda

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1 reply
firerobin | @firerobin | Sep 19, 2022

I had TKA four weeks ago. My physical therapist told me I only had 21 to 28 days after surgery to get to 105% abduction. I am currently at 101 to 103, and the exercises/manipulations the therapist does three times a week are excruciating. I actually end up just screaming. I told my therapist I need a sound proof room so I don't scare the other patients. My flexion is excellent. My question is whether after four weeks post-op, I can still increase my abduction to 105%.

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1 reply
ezas123 | @ezas123 | Sep 20, 2022
In reply to @ddsack "Hi @marc919 I hope you can get back to playing tennis, I know of people who..." + (show)
@ddsack

Hi @marc919
I hope you can get back to playing tennis, I know of people who did, and if your doctor encourages you, that is reassuring.
I'm guessing you have already done the more extreme stretching and bending exercises. The most helpful of these for me was using our stair steps several times a day to force my knee into a forward bend. Standing on the bottom, put the TKR foot two steps up and bracing your arms on the steps above, push forward into as deep a bend as you can stand, hold for 30 seconds, relaxing and sinking deeper forward as you hold. It's been 1 and 2 years since both my knees were done, but I still do this whenever I think of it.
We have a poorly designed house with a full flight of stairs up to the kitchen and living room, so I was forced to do a lot of stair climbing during recovery just for daily chores, which probably helped regain flexion.
Sounds like you are considering MUA to try to get added range, if your doctor approves, I would go for it!

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Hi I came across your post I am out of revision like 54 days now I am at 100 flexion ….. I only have like 8 more session of pt but I exercise 3 times a day at home…. I was focusing on bike thought that was main exercise but after your post I am thinking stairs need to be also … I do stairs but definitely not as focused as the rest of my exercises…. I will be changing that today thank you for the tip ….

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2 replies
heyjoe415 | @heyjoe415 | Sep 20, 2022
In reply to @firerobin "I had TKA four weeks ago. My physical therapist told me I only had 21 to..." + (show)
@firerobin

I had TKA four weeks ago. My physical therapist told me I only had 21 to 28 days after surgery to get to 105% abduction. I am currently at 101 to 103, and the exercises/manipulations the therapist does three times a week are excruciating. I actually end up just screaming. I told my therapist I need a sound proof room so I don't scare the other patients. My flexion is excellent. My question is whether after four weeks post-op, I can still increase my abduction to 105%.

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Robin,

You're talking about knee flexion, that is, how far you can bend your knee, right? You're probably doing ankle slides and pulling your surgical knee as far inward as possible with the help of your other leg, while wearing socks on a wood floor. Your therapist is probably having you raise your leg over short floor hurdles, and a lot of slow walking, assisted if necessary.

The therapist is right in that flexion is dependent on doing these exercises in the weeks immediately after surgery. Don't push it past the discomfort of a hard stretch, you may be going too far. Eventually, they'll want you at 120 degrees of flexion, and 0 degrees of extension (leg straight).

Stay with it and you will be glad you did. All the best.

Joe

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ddsack | @ddsack | Sep 20, 2022
In reply to @ezas123 "Hi I came across your post I am out of revision like 54 days now I..." + (show)
@ezas123

Hi I came across your post I am out of revision like 54 days now I am at 100 flexion ….. I only have like 8 more session of pt but I exercise 3 times a day at home…. I was focusing on bike thought that was main exercise but after your post I am thinking stairs need to be also … I do stairs but definitely not as focused as the rest of my exercises…. I will be changing that today thank you for the tip ….

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I'm happy you found something useful in my post. There is another stair exercise that I just hated at first, but it was important in building strength and stability in the knee so that it can take your weight when coming down stairs. Maybe your PT has already got you started on this one.
Standing just one step up from floor level on your TKR foot, turn so you are facing the wall or the railing if you have that. Your TKR foot will be close to the edge of the step, and you will drop your good foot to the floor. You can put both palms on the wall, or hold the railing for stability at first. Dip/bend your TKR knee, and try to tap just the toe of your good foot on the ground below the step before bringing it back up next to your other foot. Do the knee bend 10-15 times. You are putting your whole body weight on your bent knee, just as you would walking down the stairs. You can put a large book or boards on the floor below at first, to make an easier goal to reach with your good toe. You don't need to put the good foot all the way down, just tap the toe. You also do a set of these facing forward looking up the stairs, and then a set facing straight down. These are hard and uncomfortable to do at first, but it gets better, and they are really good for building strength and balance on your TKR leg.
I can only say what worked for me, you may want to check with your PT person to see if they think these would benefit a person in your current phase of recovery. Someone still having a lot of daily knee pain and weakness may not be ready for them. Your PT person is your best guide.

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2 replies
heyjoe415 | @heyjoe415 | Sep 20, 2022
In reply to @ddsack "I'm happy you found something useful in my post. There is another stair exercise that I..." + (show)
@ddsack

I'm happy you found something useful in my post. There is another stair exercise that I just hated at first, but it was important in building strength and stability in the knee so that it can take your weight when coming down stairs. Maybe your PT has already got you started on this one.
Standing just one step up from floor level on your TKR foot, turn so you are facing the wall or the railing if you have that. Your TKR foot will be close to the edge of the step, and you will drop your good foot to the floor. You can put both palms on the wall, or hold the railing for stability at first. Dip/bend your TKR knee, and try to tap just the toe of your good foot on the ground below the step before bringing it back up next to your other foot. Do the knee bend 10-15 times. You are putting your whole body weight on your bent knee, just as you would walking down the stairs. You can put a large book or boards on the floor below at first, to make an easier goal to reach with your good toe. You don't need to put the good foot all the way down, just tap the toe. You also do a set of these facing forward looking up the stairs, and then a set facing straight down. These are hard and uncomfortable to do at first, but it gets better, and they are really good for building strength and balance on your TKR leg.
I can only say what worked for me, you may want to check with your PT person to see if they think these would benefit a person in your current phase of recovery. Someone still having a lot of daily knee pain and weakness may not be ready for them. Your PT person is your best guide.

Jump to this post

These simple "dip" exercises work the quad of the surgical leg and build strength. I started doing these after I had established range of motion of about 120 degrees, so around 4 weeks post-op. For some people it will take longer. You'll feel it in the patella, and if the pain is sharp, stop. But if the pain if manageable, then these are good exercises and can be done just about anywhere.

Think of recovery in two phases. The first is to get range of motion (ROM) back in your knee and to straighten your leg (extension). There are exercises, like ankle slides, to do this. Once you've reached 120 degrees ROM (or whatever your PT and Dr.recommend), then you can start to strengthen the quads, and these dip exercises are a good way to do that.

Remember, it's likely the surgeon made a small incision in your quad to weaken it enough to pull the patella to the side during surgery. So the quad on your surgical leg will be a little weak, Be patient and good things should happen.

Great advice ddsack, thanks!

Joe

REPLY
ezas123 | @ezas123 | Sep 20, 2022
In reply to @ddsack "I'm happy you found something useful in my post. There is another stair exercise that I..." + (show)
@ddsack

I'm happy you found something useful in my post. There is another stair exercise that I just hated at first, but it was important in building strength and stability in the knee so that it can take your weight when coming down stairs. Maybe your PT has already got you started on this one.
Standing just one step up from floor level on your TKR foot, turn so you are facing the wall or the railing if you have that. Your TKR foot will be close to the edge of the step, and you will drop your good foot to the floor. You can put both palms on the wall, or hold the railing for stability at first. Dip/bend your TKR knee, and try to tap just the toe of your good foot on the ground below the step before bringing it back up next to your other foot. Do the knee bend 10-15 times. You are putting your whole body weight on your bent knee, just as you would walking down the stairs. You can put a large book or boards on the floor below at first, to make an easier goal to reach with your good toe. You don't need to put the good foot all the way down, just tap the toe. You also do a set of these facing forward looking up the stairs, and then a set facing straight down. These are hard and uncomfortable to do at first, but it gets better, and they are really good for building strength and balance on your TKR leg.
I can only say what worked for me, you may want to check with your PT person to see if they think these would benefit a person in your current phase of recovery. Someone still having a lot of daily knee pain and weakness may not be ready for them. Your PT person is your best guide.

Jump to this post

Thank you I pretty sure I can do but I will ask …. It sounds very challenging…. Exactly what I need at this stage in recovery…. Thank you very much

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heyjoe415 | @heyjoe415 | Sep 21, 2022

I get pain in my patella when I get up from a couch, or any soft chair or recliner where my knees are higher than my butt. I just had both knees replaced in 2022, so I think this will get better. My pain is sharp but short and it helps if I have something to grip as I stand up.

Hope that helps.

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