Foot problems after TKR

Posted by topdog11 @topdog11, Apr 1, 2018

Hey guys, I am new here and have had some of my concerns answered just by reading your questions and peoples replies. I see my PT tomorrow and will be asking him, but thought I would ask this of others who have had TKR. I am 2 1/2 weeks out. The next day after surgery I pulled my calf muscle. It has slowed me down with my straightening of my leg. But I am still progressing. But my question is. I have been walking basically straight leg and flat footed on my left leg for at least 20 years. Now I am trying to relearn how to walk heel-toe. My ankle is swollen, just a little and across the top of the foot it almost feels like I sprained it. Plus, when I hang it down it almost feels numb. I think this might be because I am now using my foot in a whole new way. Walking heel to toe and bending the foot. Any one else have any foot problems on the leg they had surgery, and did it turn out to be anything to worry about. Thanks everyone.

Interested in more discussions like this? Go to the Bones, Joints & Muscles group.

Hello @topdog11, and welcome to Connect.

I had my knee replaced in 2006. Like you, I had not had full function of my leg for many years prior to the replacement. I was a tad different in that I was unable to straighten my leg until after the surgery. I had not had my leg straight for the better part of a decade, and when I woke up from surgery, my leg was straightened out. The pain in my ligaments, muscles, and tendons was immense because I was stretching out parts of my body that hadn't been stretched that way in years.

I am not a medical professional, so it would be best to discuss this with your surgeon or provider, but it sounds like you may be experiencing something similar. I experienced swelling due to what sounds kind of similar to you – using ligaments, muscles and joints in a way they had not been used for many years. In my non-medical expertise opinion, it sounds like you might be stretching and working things that have not been used for many years, and they are responding by swelling.

I have end-stage arthritis in my right ankle and have been trying to refocus on walking heel to toe as well… it is harder than one would think isn't it?

@topdog11, other than your concerns with feet, how is your knee doing with bend and range-of-motion?

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@JustinMcClanahan

Hello @topdog11, and welcome to Connect.

I had my knee replaced in 2006. Like you, I had not had full function of my leg for many years prior to the replacement. I was a tad different in that I was unable to straighten my leg until after the surgery. I had not had my leg straight for the better part of a decade, and when I woke up from surgery, my leg was straightened out. The pain in my ligaments, muscles, and tendons was immense because I was stretching out parts of my body that hadn't been stretched that way in years.

I am not a medical professional, so it would be best to discuss this with your surgeon or provider, but it sounds like you may be experiencing something similar. I experienced swelling due to what sounds kind of similar to you – using ligaments, muscles and joints in a way they had not been used for many years. In my non-medical expertise opinion, it sounds like you might be stretching and working things that have not been used for many years, and they are responding by swelling.

I have end-stage arthritis in my right ankle and have been trying to refocus on walking heel to toe as well… it is harder than one would think isn't it?

@topdog11, other than your concerns with feet, how is your knee doing with bend and range-of-motion?

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@topdog11

Here a few other discussions you may want to check out. Each has many members discussing all things knee replacements:
– Scar tissue after knee replacement, https://connect.mayoclinic.org/discussion/scar-tissue-after-knee-replacement/
– Limited ROM after total knee replacement, https://connect.mayoclinic.org/discussion/limited-rom-after-total-knee-replacement/

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@JustinMcClanahan

Hello @topdog11, and welcome to Connect.

I had my knee replaced in 2006. Like you, I had not had full function of my leg for many years prior to the replacement. I was a tad different in that I was unable to straighten my leg until after the surgery. I had not had my leg straight for the better part of a decade, and when I woke up from surgery, my leg was straightened out. The pain in my ligaments, muscles, and tendons was immense because I was stretching out parts of my body that hadn't been stretched that way in years.

I am not a medical professional, so it would be best to discuss this with your surgeon or provider, but it sounds like you may be experiencing something similar. I experienced swelling due to what sounds kind of similar to you – using ligaments, muscles and joints in a way they had not been used for many years. In my non-medical expertise opinion, it sounds like you might be stretching and working things that have not been used for many years, and they are responding by swelling.

I have end-stage arthritis in my right ankle and have been trying to refocus on walking heel to toe as well… it is harder than one would think isn't it?

@topdog11, other than your concerns with feet, how is your knee doing with bend and range-of-motion?

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After talking with my PT, he agrees my foot is swollen and causing me problems because I am using muscles, joints, etc in ways I haven't in many years. Also since I pulled that calf muscle I am not completely walking correctly cause of the pain in my calf. I am in a bit of a catch 22. I need to stretch my leg so I can get it to lay flat but I am not suppose to stretch my calf muscle so it can heal. I also judge myself by how well my husband did with his TKR. He was at 115 bend and -1 straight the day after surgery. I am 2 and 1/2 weeks and have 95 bend and 14 straight, which is just about how it was before surgery. I can tell I am bending it a little easier everyday so there is some improvement.

REPLY
@JustinMcClanahan

Hello @topdog11, and welcome to Connect.

I had my knee replaced in 2006. Like you, I had not had full function of my leg for many years prior to the replacement. I was a tad different in that I was unable to straighten my leg until after the surgery. I had not had my leg straight for the better part of a decade, and when I woke up from surgery, my leg was straightened out. The pain in my ligaments, muscles, and tendons was immense because I was stretching out parts of my body that hadn't been stretched that way in years.

I am not a medical professional, so it would be best to discuss this with your surgeon or provider, but it sounds like you may be experiencing something similar. I experienced swelling due to what sounds kind of similar to you – using ligaments, muscles and joints in a way they had not been used for many years. In my non-medical expertise opinion, it sounds like you might be stretching and working things that have not been used for many years, and they are responding by swelling.

I have end-stage arthritis in my right ankle and have been trying to refocus on walking heel to toe as well… it is harder than one would think isn't it?

@topdog11, other than your concerns with feet, how is your knee doing with bend and range-of-motion?

Jump to this post

I can relate completely. I wouldn't worry about comparisons, my recovery was long and painful. It took me well over a year to find my new normal, which ended up being 0-105 degrees. I had to have two manipulations along the way because of aggressive scar tissue formation. But, in the end, I am pain free and my flexion and extension is enough that it does not prevent me from any activities (except using a trampoline!). You will get there, even if it takes more time than others you know.

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My ankle was swollen for few weeks after the surgery. Few days after the surgery I forgot to use the compression sleeves, on the operated leg and it really swelled up. I called my doctors office to see if it was normal. They ignored my question completely and asked my about my calf instead. She told me if it’s tight and hurting go to the ER and get checked for a possible blood clot. Luckily, it only cost me the ER fees, and no clot. So please make sure that you rule out the blood clot.

As for as walking is considered, just watch any 4 year old kid to see how they walk. They don’t use heel to toe, instead it’s the whole foot forward and they never straighten their knees. Following that method I was able to walk few miles a day before my tkr, instead of few hundred feet with a bone on bone knee which was completely worn out. This is also called CHI walking. I tried to find a good link for chi walking but unfortunately couldn’t do so. There are too many people pretending to be the experts on the topic with crazy videos.

I’ve told by some serious marathon runners at the gym that they use the whole foot, not the heel to toe.

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My R foot is deformed since birth; it rolls inward (no arch) and I use a custom orthotic. Now I need TKR on the right knee, and the leg will of course be perfectly straight afterwards. What will the effect be on my foot, and how severe will it be? Can it prevent the healing of the TKR? Suggestions very much appreciated.

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Oh my I can relate to that. I was so anxious to start walking and doing things like years ago before my knee got so bad. the first couple of months seemed promising. I no longer had any pain in my knee after a few months. The knee was great. Then I started to have swelling in the surgery leg in my foot. The surgeon said they had to turn my leg and that the muscles needed time to adjust. It seemed to get worse and they sent me to a ortho foot doctor who had no clue what was going on and sent me to imaging center to see if I had a blood clot. Then he fit me with a brace. Why he didn't know that this was a common thing I don't understand. To make a long boring story short…..I went to several doctors none seem to have a clue, I was given prednisone, antibiotics and many other wrong diagnosis. I started researching for myself and found out this is a common problem. plantar fasciitis and neuropathy is just one of the problems that can develop from having your leg turned in TKR surgery. So I am going to go back to a foot doctor and discuss what I found. Hopefully in time the foot problem will resolve enough to have good use of my leg again. I'm in my 8th month since my TKR. Also the foot on my surgery leg was always a flat foot, so when I discussed this fact with the doctor as an additional possibility for problems, he dismissed it saying "it just needs time"!! I find you have to be your own advocate and research as much info as you can. :[

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I’m over 5 months PO and my ankle swelled and it hurt to walk. Finally went to my foot surgeon. I’d developed Sinus Tarsi. He gave me a cortisone shot. He said with this syndrome, it should be cured with one or two shots. I think it was created by my new alignment and gait. Hope you feel better soon!

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@tani

Oh my I can relate to that. I was so anxious to start walking and doing things like years ago before my knee got so bad. the first couple of months seemed promising. I no longer had any pain in my knee after a few months. The knee was great. Then I started to have swelling in the surgery leg in my foot. The surgeon said they had to turn my leg and that the muscles needed time to adjust. It seemed to get worse and they sent me to a ortho foot doctor who had no clue what was going on and sent me to imaging center to see if I had a blood clot. Then he fit me with a brace. Why he didn't know that this was a common thing I don't understand. To make a long boring story short…..I went to several doctors none seem to have a clue, I was given prednisone, antibiotics and many other wrong diagnosis. I started researching for myself and found out this is a common problem. plantar fasciitis and neuropathy is just one of the problems that can develop from having your leg turned in TKR surgery. So I am going to go back to a foot doctor and discuss what I found. Hopefully in time the foot problem will resolve enough to have good use of my leg again. I'm in my 8th month since my TKR. Also the foot on my surgery leg was always a flat foot, so when I discussed this fact with the doctor as an additional possibility for problems, he dismissed it saying "it just needs time"!! I find you have to be your own advocate and research as much info as you can. :[

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After my second set of hip replacement surgeries, I needed "gait training" from PT, new orthotics from my foot doc, and (UGH!) to replace all my shoes that had any wear on them. My lower body alignment & foot position was so changed that wearing anything from before cause much pain. Even now, 11 years later, I must carefully test shoes at home with my orthotics, before keeping them. And NO flip-flops or slides, not even the "good ones" except for very limited use – to the mailbox, to the pool…
Written as I am trying out some new shoes I got last week – I think they are keepers.
Sue

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@sueinmn

After my second set of hip replacement surgeries, I needed "gait training" from PT, new orthotics from my foot doc, and (UGH!) to replace all my shoes that had any wear on them. My lower body alignment & foot position was so changed that wearing anything from before cause much pain. Even now, 11 years later, I must carefully test shoes at home with my orthotics, before keeping them. And NO flip-flops or slides, not even the "good ones" except for very limited use – to the mailbox, to the pool…
Written as I am trying out some new shoes I got last week – I think they are keepers.
Sue

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Thank you! Since my surgery I saw a foot doctor 2x, family physician in between. The foot doctor did not treat anything…sent me to an imaging center to make sure there was no blot clot. I had to research to find that many people with TKR where the leg had to be straighten had foot issues. Why in the world did the foot doctor not know this. I even asked him if it could be an issue because they had to turn the leg. He didn't even acknowledge it! I spent a few dollars to come full circle to absolutely nothing. And quite a few medications which didn't help the problem. No one address the "gait" problem, I had to read it online. May I ask what kind of shoes your wear (you mentioned you bought new ones) Thank you for replying and affirming I have a problem from the surgery. No one I went to would even address that. I guess they were afraid to say that…..I don't really know, but I'm not trying to point a finger I just want them to find the problem and help me recover the foot. Its so bad now I had to quit driving. So I called and they are sending me to a "foot specialist", but he is full and will call when I can get an appointment. Hope its soon. Have a good day!

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@tani

Thank you! Since my surgery I saw a foot doctor 2x, family physician in between. The foot doctor did not treat anything…sent me to an imaging center to make sure there was no blot clot. I had to research to find that many people with TKR where the leg had to be straighten had foot issues. Why in the world did the foot doctor not know this. I even asked him if it could be an issue because they had to turn the leg. He didn't even acknowledge it! I spent a few dollars to come full circle to absolutely nothing. And quite a few medications which didn't help the problem. No one address the "gait" problem, I had to read it online. May I ask what kind of shoes your wear (you mentioned you bought new ones) Thank you for replying and affirming I have a problem from the surgery. No one I went to would even address that. I guess they were afraid to say that…..I don't really know, but I'm not trying to point a finger I just want them to find the problem and help me recover the foot. Its so bad now I had to quit driving. So I called and they are sending me to a "foot specialist", but he is full and will call when I can get an appointment. Hope its soon. Have a good day!

Jump to this post

I have found Skecher walking shoes with memory foam work pretty well, even figured out how to slide my orthotics under the insole so my foot is padded. Or Bernie Mev woven elastic shoes. Sometimes I find Alegria athletic shoes on sale. With 2-3 pairs to alternate, I get about 1 year out of each pair. For dress up I wear Naot sandals with a cork footbed and at least 3 straps, and anchor my orthotic to it with Velcro. Two pairs last me 4-5 years, wearing 9 months of the year. Or I occasionally wear Rieker shoes which are narrow enough for my foot, and deep enough for orthotics. So…I have very expensive feet, but without the good shoes, the rest of my arthritic body cannot keep moving.
Do you have a favorite?

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@tani

Oh my I can relate to that. I was so anxious to start walking and doing things like years ago before my knee got so bad. the first couple of months seemed promising. I no longer had any pain in my knee after a few months. The knee was great. Then I started to have swelling in the surgery leg in my foot. The surgeon said they had to turn my leg and that the muscles needed time to adjust. It seemed to get worse and they sent me to a ortho foot doctor who had no clue what was going on and sent me to imaging center to see if I had a blood clot. Then he fit me with a brace. Why he didn't know that this was a common thing I don't understand. To make a long boring story short…..I went to several doctors none seem to have a clue, I was given prednisone, antibiotics and many other wrong diagnosis. I started researching for myself and found out this is a common problem. plantar fasciitis and neuropathy is just one of the problems that can develop from having your leg turned in TKR surgery. So I am going to go back to a foot doctor and discuss what I found. Hopefully in time the foot problem will resolve enough to have good use of my leg again. I'm in my 8th month since my TKR. Also the foot on my surgery leg was always a flat foot, so when I discussed this fact with the doctor as an additional possibility for problems, he dismissed it saying "it just needs time"!! I find you have to be your own advocate and research as much info as you can. :[

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@tani I have been doing a lot of physical therapy because of recovering from an ankle fracture 2 years ago. The alignment of everything through the pelvis, hips, knees, and ankles is very important. I lost a bit of cartilage in my injury, and my ankle isn't as stable now. If I circle it around, it cracks a lot, and there are slight differences in alignment that cause pain and I can't step on my foot. My PT showed me how to release it when it gets locked up and push it back into better alignment. Some of it could be caused by weakness for not having normal use of muscles during recovery, or that it also is weak enough that it just gets tired and slips a bit.

The muscles can also be too tight around the pelvis, and this happens from sitting too much causing the hip flexors to be too tight. Tightness can pull on everything down the leg and cause uneven pressure on joints. My physical therapist also does myofascial release which can help balance the body and stretch out the places that are overly tight. You may be interested in our discussion on Myofascial Release.

Myofascial Release Therapy (MFR) for treating compression and pain:
https://connect.mayoclinic.org/discussion/myofascial-release-therapy-mfr-for-treating-compression-and-pain/

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