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

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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Excellent news Melinda. Yeah rehab can hurt but it beats scar tissue developing. Good for you.

Joe

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I had TKR exactly two years ago. I had a very rough healing. This was for my right knee. My left knee is just as bad but I cannot imagine putting myself through another knee surgery! I was given pain meds, but each one caused some sort of allergic reaction. I was then told to take Tylenol Extra Strengh. This did not help the pain AT ALL!!! I was in agony with pain for at least 8-10 weeks, and I became very discouraged with the healing process. I couldn’t sleep and I couldn’t eat because the pain was so intense. PT was coming into my home but I had such a hard time with any exercises that they gave me just due to pain. When I could finally get to an outside PT, she began to give me encouragement and exercises (which I faithfully did with her and at home) and the pain began to diminish. I was back and forth to my surgeon for visits because I was so discouraged and he told me that it takes a full two years for the knee to feel recovered. However, he did say that it will never be the same knee that I was born with. It has been two years now, and it is better, but my left knee (that needs the next surgery) is truly better than the knee that was replaced! Continuing to take Advil and Tylenol for the left knee. I think that the right knee (the surgical knee) will never be the same. However, I encourage you to do exercises for your knee every day to strengthen your quads. I do this and I think that it is helpful. So sorry for your pain!!!

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@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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@ddsack: I saw that heyjoe addressed the strength aspect of knee replacement recovery. You mentioned that you had trouble to get the flexion to improve. I did my own little twist on the heel slide exercise: once you did a few of them to loosen up the knee, keep your knee at the most “bent” position, as in pulled all the way up on the floor/surface, LIFT the leg, keep the bend, point the toe, and put it down. Toe first. Sort of where your heel was. Then gently lower the heel. It will give you a good stretch, and will get you used to that increased angle of flexion. Hold that position for a while, and repeat. It does really help to increase the flexibility of the post TKR knee. Better than pulling it in with straps etc.

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@ellerbracke

@ddsack: I saw that heyjoe addressed the strength aspect of knee replacement recovery. You mentioned that you had trouble to get the flexion to improve. I did my own little twist on the heel slide exercise: once you did a few of them to loosen up the knee, keep your knee at the most “bent” position, as in pulled all the way up on the floor/surface, LIFT the leg, keep the bend, point the toe, and put it down. Toe first. Sort of where your heel was. Then gently lower the heel. It will give you a good stretch, and will get you used to that increased angle of flexion. Hold that position for a while, and repeat. It does really help to increase the flexibility of the post TKR knee. Better than pulling it in with straps etc.

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Thank you for the tip will try today …. The sheet I find to be very difficult ….. I have hip issue that makes it so much worse than I know it has to be … so thank you I think this tweek will definitely be most helpful….

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@ellerbracke

@ddsack: I saw that heyjoe addressed the strength aspect of knee replacement recovery. You mentioned that you had trouble to get the flexion to improve. I did my own little twist on the heel slide exercise: once you did a few of them to loosen up the knee, keep your knee at the most “bent” position, as in pulled all the way up on the floor/surface, LIFT the leg, keep the bend, point the toe, and put it down. Toe first. Sort of where your heel was. Then gently lower the heel. It will give you a good stretch, and will get you used to that increased angle of flexion. Hold that position for a while, and repeat. It does really help to increase the flexibility of the post TKR knee. Better than pulling it in with straps etc.

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That's an interesting take on the foot slide exercise. I'm curious, when I got to that point where I had slid my foot/bent my knee as far as it could go, that is, I felt the strain of the stretch, does this push it further than that, or just lengthen the time you're actually at the max stretch?

These flexion exercises should be done for the first few weeks, until flexion is well over 100 degrees, or whatever your Dr. and PT feels is right. Then you can start working more on strengthening the quads. Finally, strengthening the quads takes time, even if you were in shape prior to surgery. The reason is that the surgeon has to make a slight cut in the quad to release the patella and move it to the side. While that is healing (about two months) the quad will be slightly weaker.

As always, if you experience sharp pain, stop what you're doing.

Thanks eller.

Joe

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@heyjoe415

That's an interesting take on the foot slide exercise. I'm curious, when I got to that point where I had slid my foot/bent my knee as far as it could go, that is, I felt the strain of the stretch, does this push it further than that, or just lengthen the time you're actually at the max stretch?

These flexion exercises should be done for the first few weeks, until flexion is well over 100 degrees, or whatever your Dr. and PT feels is right. Then you can start working more on strengthening the quads. Finally, strengthening the quads takes time, even if you were in shape prior to surgery. The reason is that the surgeon has to make a slight cut in the quad to release the patella and move it to the side. While that is healing (about two months) the quad will be slightly weaker.

As always, if you experience sharp pain, stop what you're doing.

Thanks eller.

Joe

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@heyjoe: My reason for doing this twist on the standard heel slide was to get the muscles and ligaments used to the increased bend. When using the other leg, or some type of band to force the TKR knee to bend more, my muscles (or mind?) always resisted that. But with the self-imposed, gentle (!!) enforced bend it felt more natural, and after a week or 2 the TKR knee seemed looser, more relaxed, and capable of increased flex. May not work for everyone, but for me - ok. And one more general advice: if possible, post TKR patients would benefit tremendously from having access to a pool. A trained attendant can develop specific exercises for TKR rehab (did for me), and those are sooooooo much less painful to do under water than they are “on land”.

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@heyjoe415

That's an interesting take on the foot slide exercise. I'm curious, when I got to that point where I had slid my foot/bent my knee as far as it could go, that is, I felt the strain of the stretch, does this push it further than that, or just lengthen the time you're actually at the max stretch?

These flexion exercises should be done for the first few weeks, until flexion is well over 100 degrees, or whatever your Dr. and PT feels is right. Then you can start working more on strengthening the quads. Finally, strengthening the quads takes time, even if you were in shape prior to surgery. The reason is that the surgeon has to make a slight cut in the quad to release the patella and move it to the side. While that is healing (about two months) the quad will be slightly weaker.

As always, if you experience sharp pain, stop what you're doing.

Thanks eller.

Joe

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@heyjoe415 : I forgot to mention: once I got the heel down at the max point, I would hold that position for 10+ seconds. I could feel the knee gradually relax and accept that tight bend. Over time, as the standard heel slides gradually increase your flex, by doing this same toe-point move it keeps challenging the knee in a good way.

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@ellerbracke

@heyjoe: My reason for doing this twist on the standard heel slide was to get the muscles and ligaments used to the increased bend. When using the other leg, or some type of band to force the TKR knee to bend more, my muscles (or mind?) always resisted that. But with the self-imposed, gentle (!!) enforced bend it felt more natural, and after a week or 2 the TKR knee seemed looser, more relaxed, and capable of increased flex. May not work for everyone, but for me - ok. And one more general advice: if possible, post TKR patients would benefit tremendously from having access to a pool. A trained attendant can develop specific exercises for TKR rehab (did for me), and those are sooooooo much less painful to do under water than they are “on land”.

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That's a great recommendation on using a pool. I do suggest that people clear this with their surgeon. It should only be done once the incision is completely healed.

Joe

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I’ve got pain in my knee cap which I’m concerned about . I didn’t have this with my other knee?

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@noodles2

I’ve got pain in my knee cap which I’m concerned about . I didn’t have this with my other knee?

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Hi @noodles2, There is another discussion on knee cap pain that might provide more help.
--- Knee cap pain after knee replacement surgery: https://connect.mayoclinic.org/discussion/knee-cap-pain-after-knee-replacement-surgery-7-week-post-op/

Have you talked to your doctor or surgeon about the pain in the knee cap?

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