The Rehabilitation Process for a TKR

Posted by dkapustin @dkapustin, Sat, Mar 9 9:07am

Hi everyone,

I’ll be 7 weeks from a TKR (right knee) on Thursday and am curious about the rehab process regarding soreness. I go to outpatient rehab 3/week and do my exercises at home 2/day along with stretches 3-4 times per day. This program was designed by my PT team and they considered the fact that I had a lot of swelling still and did not want me to do too much per day because that would increasing swelling and pain, while decreasing ROM. With that said (I just wanted to be clear because many people would suggest that I increase my exercise routine per day and for me, that’s not recommended.) After each session, I am always sore so I elevate and ice. I take my pain meds and then, I start it all over again and it’s basically rinse and repeat. Day after day. Week after week. For those of you who have this procedure done, when does the soreness start to ease off after excreting? I realize that everyone is different but it’s maddening to want to crush your physical therapy and move on with your life only to find your so sore its disheartening. I know it takes a year to heal, etc etc but this soreness is driving me nuts. I’m probably being impatient but I feel like a hamster on a wheel. Help!

Hi @dkapustin! I had a TKR in May and to be completely honest, it sounds like you are doing great. I also agree with not doing more than they suggest. I got frustrated because I couldn't straighten my leg completely about 2 and half months into my recovery. I pushed it and ended up with a pulled hamstring. I had to go back to using my cane for about a week because I could hardly walk. The soreness will last for awhile, but will ease up. One of the things that I found helpful was Water Therapy. If that is an option, consider looking into it. When you exercise in a therapy pool, it takes most of the pressure off your joints and I found that it helped me get my ROM back a bit quicker. Do you take your pain meds about an hour before you exercise? It also helped me to use heat before I exercised. The heat loosened up the knee some and helped with the soreness. Then use ice afterwards. Recovering from a TKR is a full time job for about 4 months. I was in Physical therapy from May until October. Even though it is really sore, it is worth it. My right knee is a lot more stable. Sometime in the near future, I will be having the left knee done as well. Good luck with your recovery!

REPLY

Hi @dkapustin you may have noticed I moved your post from the Bones, Joints & Muscles group, to the Joint Replacement group (https://connect.mayoclinic.org/group/joint-replacements/) so that your post will be seen by others who have experienced a total knee replacement.

I wanted to thank @ssbionicknee for responding to your post, and also wanted to ask, how long does your physical therapist say your rehab will take?

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@ssbionicknee

Hi @dkapustin! I had a TKR in May and to be completely honest, it sounds like you are doing great. I also agree with not doing more than they suggest. I got frustrated because I couldn't straighten my leg completely about 2 and half months into my recovery. I pushed it and ended up with a pulled hamstring. I had to go back to using my cane for about a week because I could hardly walk. The soreness will last for awhile, but will ease up. One of the things that I found helpful was Water Therapy. If that is an option, consider looking into it. When you exercise in a therapy pool, it takes most of the pressure off your joints and I found that it helped me get my ROM back a bit quicker. Do you take your pain meds about an hour before you exercise? It also helped me to use heat before I exercised. The heat loosened up the knee some and helped with the soreness. Then use ice afterwards. Recovering from a TKR is a full time job for about 4 months. I was in Physical therapy from May until October. Even though it is really sore, it is worth it. My right knee is a lot more stable. Sometime in the near future, I will be having the left knee done as well. Good luck with your recovery!

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Thank you so much for your response. I do take my pain medication an hour before therapy and every 6 hours actually. I still have those stubborn steri strips clining for dear life, but as soon as my surgeon clears me for aqua therapy, that will be on the top of my list! I’m glad you’re doing better and I’m grateful for your encouraging words. Thanks again!

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@ethanmcconkey

Hi @dkapustin you may have noticed I moved your post from the Bones, Joints & Muscles group, to the Joint Replacement group (https://connect.mayoclinic.org/group/joint-replacements/) so that your post will be seen by others who have experienced a total knee replacement.

I wanted to thank @ssbionicknee for responding to your post, and also wanted to ask, how long does your physical therapist say your rehab will take?

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Thank you and I appreciated the response to! I haven’t been told how long I can expect to be in PT but my insurance gives me 30 outpatient sessions per calendar year and I suspect I’ll use a majority of them since I’m not one of those remarkable success stories. ( shoveling snow 5 weeks PO, etc). I do know that they want to see me with at least a 120 bend and walking device free.

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@dkapustin I think you're doing great, as others have said. With my second TKR I was in considerable pain for about 6 or 7 weeks but it pretty much lifted, almost overnight! I don't know if that will happen to you, but I was pretty darned discouraged when I had that pain, and my doctor was seeing me regularly. I think he was a bit concerned too.
I do water aerobics and water jogging, and resumed it as soon as my doctor said I could go in the pool again. He is also a big proponent of the exercise bike. He wanted me to ride my recumbent bike for a half hour, 5 days a week and then take two consecutive days off for recovery. I never did get quite to what they all want, 120 flex. I am at around 118 I believe. I have considered having a lysis, but do I really want to do something else to this knee? I am not sure. I think I might be able to be satisfied with what I have.
JK

Liked by amytro

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@contentandwell

@dkapustin I think you're doing great, as others have said. With my second TKR I was in considerable pain for about 6 or 7 weeks but it pretty much lifted, almost overnight! I don't know if that will happen to you, but I was pretty darned discouraged when I had that pain, and my doctor was seeing me regularly. I think he was a bit concerned too.
I do water aerobics and water jogging, and resumed it as soon as my doctor said I could go in the pool again. He is also a big proponent of the exercise bike. He wanted me to ride my recumbent bike for a half hour, 5 days a week and then take two consecutive days off for recovery. I never did get quite to what they all want, 120 flex. I am at around 118 I believe. I have considered having a lysis, but do I really want to do something else to this knee? I am not sure. I think I might be able to be satisfied with what I have.
JK

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Hi there,

Thanks for replying. I’m waiting for that turning point I’ve heard so many others talk about and know that the time frame differs for everyone. I agree that if your ROM allows you to live your life, why get anything else done? I have gotten to 118 with a forced bend but I intend on taking the exercise route as long as there is slow and steady progress. I want to avoid anything else bring done to this darn knee! I’ll be honest and say that this surgery has been the hardest thing I’ve ever done. I will definitely put off getting the other knee done. I’ve never had a cortisone shot in that knee and hope those will buy me some time!

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@dkapustin

Hi there,

Thanks for replying. I’m waiting for that turning point I’ve heard so many others talk about and know that the time frame differs for everyone. I agree that if your ROM allows you to live your life, why get anything else done? I have gotten to 118 with a forced bend but I intend on taking the exercise route as long as there is slow and steady progress. I want to avoid anything else bring done to this darn knee! I’ll be honest and say that this surgery has been the hardest thing I’ve ever done. I will definitely put off getting the other knee done. I’ve never had a cortisone shot in that knee and hope those will buy me some time!

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@dkapustin I found the cortisone shots helped a lot, and when they stopped helping they started injecting me with synvisc, three times per treatment was my preferred way. That helped tremendously also.
I have terrible bursitis in both hips right now that I am getting cortisone shots in next week. If the doctor sends me for PT for it I will have my therapist check my knee flex too when I am there. I think the knee I had done in 2017 is better than the one I had done in 2012 (I think 2012, sometime around then).
Making sure you exercise the knee really helps too. It strengthens the supporting muscles which helps greatly in recovery. There was a big delay in my second TKR due to other health problems. During that time I exercised a lot and by the time I was finally able to have the TKR my knee was feeling significantly better than it had when I originally planned to have it done!
JK

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@ssbionicknee

Hi @dkapustin! I had a TKR in May and to be completely honest, it sounds like you are doing great. I also agree with not doing more than they suggest. I got frustrated because I couldn't straighten my leg completely about 2 and half months into my recovery. I pushed it and ended up with a pulled hamstring. I had to go back to using my cane for about a week because I could hardly walk. The soreness will last for awhile, but will ease up. One of the things that I found helpful was Water Therapy. If that is an option, consider looking into it. When you exercise in a therapy pool, it takes most of the pressure off your joints and I found that it helped me get my ROM back a bit quicker. Do you take your pain meds about an hour before you exercise? It also helped me to use heat before I exercised. The heat loosened up the knee some and helped with the soreness. Then use ice afterwards. Recovering from a TKR is a full time job for about 4 months. I was in Physical therapy from May until October. Even though it is really sore, it is worth it. My right knee is a lot more stable. Sometime in the near future, I will be having the left knee done as well. Good luck with your recovery!

Jump to this post

@ssbionicknee : nice to know you also had more trouble to get the knee to be straight, as opposed to bending. It took me almost 4 months (!!) to finally get there. With lots, and lots, and lots of excercising. Never thought it would be so difficult. Seems most people have problems with the opposite range of motion. Given a choice – not really – I am ok with delayed extension, and really good ROM. Last measured (while sore, stiff, and borderline cramping from yard work, and at PT for hip pain) at 132 degrees.

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@ellerbracke

@ssbionicknee : nice to know you also had more trouble to get the knee to be straight, as opposed to bending. It took me almost 4 months (!!) to finally get there. With lots, and lots, and lots of excercising. Never thought it would be so difficult. Seems most people have problems with the opposite range of motion. Given a choice – not really – I am ok with delayed extension, and really good ROM. Last measured (while sore, stiff, and borderline cramping from yard work, and at PT for hip pain) at 132 degrees.

Jump to this post

@contentandwell : just saw your post about bilateral hip bursitis. From previous posts, you certainly had more than your share of problems. I really hope that cortisone shots will help you, especially since you seem to be the poster child (woman) of really successful TKR’s,
with an impressive exercise routine (at any age)!.

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@ellerbracke

@contentandwell : just saw your post about bilateral hip bursitis. From previous posts, you certainly had more than your share of problems. I really hope that cortisone shots will help you, especially since you seem to be the poster child (woman) of really successful TKR’s,
with an impressive exercise routine (at any age)!.

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Thanks @ellerbracke My big concern now is what am I doing at the gym that is probably the cause of this. I am fearful it might be the elliptical, which I think is such great exercise. I had been doing the treadmill but I can't get my heart rate up where I want it to be on that and I can on the elliptical. The other gym things I do on equipment are primarily upper body so I am sure they are not the problem, and I have been doing my water aerobics and jogging for years at this point so I doubt that is the problem.

I must admit, I do feel extremely fortunate that my TKRs were both as successful as they were, even though the flex is not where I would like it. I think if I had read all I have read since my last TKR I may have been much more apprehensive about it, but sometimes ignorance is bliss.

It's funny you comment on my share of problems because I considered myself to be pretty darned healthy but these days seeing how many problems I can relate to on Connect I realize I have more problems than I thought! I do not have any of the problems though that some people have that give them pain daily, so I am very thankful about that.
JK

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