I am going into my 7th week post LTKR. My flexion is 115-120 yet my extension is -5. I try my best to do the exercises given to me by PT. But still my knee feels like a cement block & can never straighten it even after stretching. I’m concerned that it is “locked” in place & will never straighten at this point. Will it improve in time? It definitely doesn’t feel like it will. :(
TKR Bilateral hip & ankle pain post LTKR
- Thread starter Terese
- Start date
@Terese please don't worry about any timeline for ROM. Your ROM sounds great for just 7 weeks. Relax - ice and elevate and gentle stretches. Your ROM will continue to improve. This process can take up to one year or more.
What was the exact date of your surgery. We will put the information in your signature for you.
Meanwhile, here are some recovery guidelines for you:
Knee Recovery: The Guidelines
1. Don’t worry: Your body will heal all by itself. Relax, let it, don't try and hurry it, don’t worry about any symptoms now, they are almost certainly temporary
2. Control discomfort:
3. Do what you want to do BUT
4. PT or exercise can be useful BUT take note of these
5. At week 4 and after you should follow this Activity progression for TKRs
6. Access these pages on the website
The Recovery articles:
The importance of managing pain after a TKR and the pain chart
Swollen and stiff knee: what causes it?
Energy drain for TKRs
Elevation is the key
Ice to control pain and swelling
Heel slides and how to do them properly
Chart representation of TKR recovery
Healing: how long does it take?
Post op blues is a reality - be prepared for it
Sleep deprivation is pretty much inevitable - but what causes it?
There are also some cautionary articles here
Myth busting: no pain, no gain
Myth busting: the "window of opportunity" in TKR
Myth busting: on getting addicted to pain meds
We try to keep the forum a positive and safe place for our members to talk about their questions or concerns and to report successes with their joint replacement surgery.
While members may create as many threads as they like in a majority of BoneSmart's forums, we ask that each member have only one recovery thread. This policy makes it easier to go back and review history before providing advice.
What was the exact date of your surgery. We will put the information in your signature for you.
Meanwhile, here are some recovery guidelines for you:
Knee Recovery: The Guidelines
1. Don’t worry: Your body will heal all by itself. Relax, let it, don't try and hurry it, don’t worry about any symptoms now, they are almost certainly temporary
2. Control discomfort:
rest
ice
take your pain meds by prescription schedule (not when pain starts!)
3. Do what you want to do BUT
a. If it hurts, don't do it and don't allow anyone - especially a physical therapist - to do it to you
b. If your leg swells more or gets stiffer in the 24 hours after doing it, don't do it again.
4. PT or exercise can be useful BUT take note of these
5. At week 4 and after you should follow this Activity progression for TKRs
6. Access these pages on the website
The Recovery articles:
The importance of managing pain after a TKR and the pain chart
Swollen and stiff knee: what causes it?
Energy drain for TKRs
Elevation is the key
Ice to control pain and swelling
Heel slides and how to do them properly
Chart representation of TKR recovery
Healing: how long does it take?
Post op blues is a reality - be prepared for it
Sleep deprivation is pretty much inevitable - but what causes it?
There are also some cautionary articles here
Myth busting: no pain, no gain
Myth busting: the "window of opportunity" in TKR
Myth busting: on getting addicted to pain meds
We try to keep the forum a positive and safe place for our members to talk about their questions or concerns and to report successes with their joint replacement surgery.
While members may create as many threads as they like in a majority of BoneSmart's forums, we ask that each member have only one recovery thread. This policy makes it easier to go back and review history before providing advice.
Hello @Terese - and 
Please will you tell us the full date of your knee replacement and which knee it is, so we can make a signature for you? Knowing the exact date will help us to advise you appropriately in the future.
Don't worry about your extension. It often takes longer to achieve than flexion does. It will continue to improve gradually.
In spite of what you've probably been told, there's no need to rush to get ROM (Range of Motion) because it can continue to improve for a year, or even much longer, after a knee replacement. There isn't any deadline you have to meet:
Myth busting: the "window of opportunity" in TKR
This article may help:
Extension: how to estimate it and ways to improve it
In spite of the article I've just left you, it's not exercising that gets you your ROM - it's time. Time to recover, time for swelling and pain to settle, and time to heal. Your knee has the potential to achieve good ROM right from the start, but it's prevented from doing so by swelling and pain. As it heals and the swelling goes down, your ROM (both flexion and extension) will increase spontaneously, whether you do formal PT or just let your normal Activities of Daily Living (ADLs) be your exercise.
Please will you tell us the full date of your knee replacement and which knee it is, so we can make a signature for you? Knowing the exact date will help us to advise you appropriately in the future.
Don't worry about your extension. It often takes longer to achieve than flexion does. It will continue to improve gradually.
In spite of what you've probably been told, there's no need to rush to get ROM (Range of Motion) because it can continue to improve for a year, or even much longer, after a knee replacement. There isn't any deadline you have to meet:
Myth busting: the "window of opportunity" in TKR
This article may help:
Extension: how to estimate it and ways to improve it
In spite of the article I've just left you, it's not exercising that gets you your ROM - it's time. Time to recover, time for swelling and pain to settle, and time to heal. Your knee has the potential to achieve good ROM right from the start, but it's prevented from doing so by swelling and pain. As it heals and the swelling goes down, your ROM (both flexion and extension) will increase spontaneously, whether you do formal PT or just let your normal Activities of Daily Living (ADLs) be your exercise.
Thank you! My total knee replacement surgery date was 11/11/2020 on the Left knee. I found this website & I am so glad I did. Every article online I have been reading states once you reach 6-8 weeks postop your are stuck with that ROM, and it scares the heck out of me. So thank you for easing my fear & stress!!!
Welcome to the forum @Terese. 
Your extension will continue to improve for quite a while. My knee was still 4 degrees from zero at one year, now at almost two years it actually will go 2 degrees past zero and my flexion has improved to 140 from 120. All it takes is time and activities of daily living. You will find many recoveries like mine here on BoneSmart, wonderful outcomes with no PT.
Your extension will continue to improve for quite a while. My knee was still 4 degrees from zero at one year, now at almost two years it actually will go 2 degrees past zero and my flexion has improved to 140 from 120. All it takes is time and activities of daily living. You will find many recoveries like mine here on BoneSmart, wonderful outcomes with no PT.Oh that is so reassuring to hear! It truly frightening to read & hear PT’s talks about 6-8 wk of ROM limit. It really scares you. I also have Rheumatoid arthritis past 35yrs which also plays a huge part of my healing process. Thank you so much for letting me know your progression over time. I am going to stop worrying & focus on healing with self care!
I, too, had an increase in ROM in my second year. And, to be honest, 5 degrees really isn’t that far away from 0, in the grand scheme of things. Try to relax and let your body heal, it’s going to be fine. 
This is my favorite member ROM experience:
This is what @TortiTabby experienced. (Just so you know, ADL means Activities of Daily Living, which means just go about the normal things you do in the course of your day, and not doing a “list of exercises.”)
This is what @TortiTabby experienced. (Just so you know, ADL means Activities of Daily Living, which means just go about the normal things you do in the course of your day, and not doing a “list of exercises.”)
Just an update for those who are apprehensive about gaining ROM:
It has now been 26 weeks and all I do is ADL and this is what my ROM has done:
3.5 wks: 75
6 wks: 85
7 wks: 90
10.5 wks: 95
14 wks: 100
17 wks: 105
20 weeks: 110
26 weeks (where I am today): 120!!!
I did it! My goal of 120! No "pushing through pain", no PT after the first 3 visits, and most importantly to me: No MUA! My surgeon who said I would never get beyond 85 ROM without pushing through pain was wrong, wrong, wrong. I'm excited to see if it gets even better.
Wow! Unbelievable! Why do ortho surgeons & PT’s stress so much on a patient to push through pain or scar tissue will build up preventing ROM to ever improve! This is horrible! I’m so glad to see all this proof of just ADL & time to heal is what it takes! Thank you!!!
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100% yes. It's just soft tissue and will react to stretching exercises as any other part of the body would
Stop worrying, the BoneSmart view is that this is quite wrong. It does not stand to reason.
Goodness knows. Everyone has scar tissue, it's not that which prevents ROM improving, it's muscles and tendons being overworked, becoming dry and sticking together - 'adhesions'. They are not common.
Oh my gosh...I came here looking for the answer for that very same question and I see that we have the same surgery date, Terese! Mine was a revision from a partial, though.
My pt people aren't pushing it a lot but I was also told by the main guy that there was a"window of time" around 8 weeks and that if I don't get it straight it will throw off my gait like...forever and I will ruin my hips and other knee.
I went back to work too early and it seems like I am going backwards as far as ROM and pain. I vary between absolute panic that I'm not doing enough and anger at pt for not doing more, and then thinking I'll just stop it all and let the poor hot swelled joint be.. blah!!!
My pt people aren't pushing it a lot but I was also told by the main guy that there was a"window of time" around 8 weeks and that if I don't get it straight it will throw off my gait like...forever and I will ruin my hips and other knee.
I went back to work too early and it seems like I am going backwards as far as ROM and pain. I vary between absolute panic that I'm not doing enough and anger at pt for not doing more, and then thinking I'll just stop it all and let the poor hot swelled joint be.. blah!!!
@Scouty - Hi, and .
Please will you start a recovery thread of your own, so we can address your recovery without disrupting Terese's thread?
Starting a new thread and posting
. Please will you start a recovery thread of your own, so we can address your recovery without disrupting Terese's thread?
Starting a new thread and posting
It has been going on 15weeks now from my LTKR. As far as my postop knee pain, 3 months was a huge turning point with postop pain lessening despite extension still at +5 & flexion ~115.
However, the new debilitating problem is that both my hips & ankles have burning aching pain everyday increasing at night. I’ve been taking it easy everyday with only doing ADL’s *the bonesmart way* & never pushing myself with exercising. I do the exercise bike on low resistance every morning to loosen up fir a few minutes.
Now it seems that I totally forget about my knee surgery since these other joints have flared. I often wonder if it’s the overall stress of possibly off gait walking with new knee & being unable to fully flex & extend!? I do focus on properly heel/toe walking but this has only worsened.
Has anyone else experienced this & what treatment/s worked for you.
However, the new debilitating problem is that both my hips & ankles have burning aching pain everyday increasing at night. I’ve been taking it easy everyday with only doing ADL’s *the bonesmart way* & never pushing myself with exercising. I do the exercise bike on low resistance every morning to loosen up fir a few minutes.
Now it seems that I totally forget about my knee surgery since these other joints have flared. I often wonder if it’s the overall stress of possibly off gait walking with new knee & being unable to fully flex & extend!? I do focus on properly heel/toe walking but this has only worsened.
Has anyone else experienced this & what treatment/s worked for you.
Hi again, @Terese -
You'll notice that I have merged your two threads together as it's best if members in recovery only have one thread.
This is because:
Please keep all your questions and updates on this thread. We won't miss your new question as, between us, the staff read all new posts each day.
If you need an urgent response to a question, tag a member of staff.
Tagging other members and answering tags
If you prefer a different thread title, just post what you want and we'll get it changed for you.
Here are the instructions on finding your thread, How can I find my threads and posts?
A helpful hint - Many members have found it useful to bookmark their thread so they don't lose it.
Best wishes,
Celle
You'll notice that I have merged your two threads together as it's best if members in recovery only have one thread.
This is because:
- That way, you have all your information in one place. This makes it easier for others to go back and review your history before providing advice.
- If you start new threads, you miss the posts and advice others have left for you in the old threads, and some information may be unnecessarily repeated
- Having only one thread will act as a diary of your progress that you can look back on.
Please keep all your questions and updates on this thread. We won't miss your new question as, between us, the staff read all new posts each day.
If you need an urgent response to a question, tag a member of staff.
Tagging other members and answering tags
If you prefer a different thread title, just post what you want and we'll get it changed for you.
Here are the instructions on finding your thread, How can I find my threads and posts?
A helpful hint - Many members have found it useful to bookmark their thread so they don't lose it.
Best wishes,
Celle
I see you're still concerned about your ROM, when there is no need to be. A ROM of 115/5 isn't bad at all and you still have plenty of time for improvement. After all, at 15 weeks, you're still less than a third of the way to full recovery.
At that ROM, you should be able to do almost everything you need to. These are the flexion numbers needed to do many needed things:
And how long are you on the exercise bike? Just a few minutes is enough.
Something is upsetting your hip and ankle joints and it's possibly your gait. With those ROM numbers, you should be able to walk normally, but your other joints may still be adjusting to an altered gait.
5 degrees off straight is hardly anything at all and it shouldn't affect your gait.
Do you still limp at all? If you do, you still need to be using a stick, to help with proper gait.
If you're still going to PT, ask your therapist to forget about measuring numbers and, instead, to concentrate on your gait.
Finally, have you talked to your surgeon or your own doctor about your painful hips and ankles? You probably should do that.
At that ROM, you should be able to do almost everything you need to. These are the flexion numbers needed to do many needed things:
- 65° to walk
- 70° pick an object off the ground
- 85° to climb up stairs
- 95° to stand from a sitting position
- 105° to tie shoelaces
- 115° (or greater) to squat or sit cross-legged
- 125°+ covers most activities. However, squatting or sitting on your heel may always prove challenging.
When you say low resistance, do you have some resistance? No resistance at all is best.
And how long are you on the exercise bike? Just a few minutes is enough.
Something is upsetting your hip and ankle joints and it's possibly your gait. With those ROM numbers, you should be able to walk normally, but your other joints may still be adjusting to an altered gait.
5 degrees off straight is hardly anything at all and it shouldn't affect your gait.
Do you still limp at all? If you do, you still need to be using a stick, to help with proper gait.
If you're still going to PT, ask your therapist to forget about measuring numbers and, instead, to concentrate on your gait.
Finally, have you talked to your surgeon or your own doctor about your painful hips and ankles? You probably should do that.
I had surgery one week after you. My knee is great, minimal pain and rom and extension are good. No soft tissue or IT band soreness. I don't take meds or need to ice anymore. I walked with a bent leg before surgery and possibly with a hunched back. When I came off crutches I developed a sore back, tight hamstrings and a sore ankle in my unoperated leg. Even my hip started to hurt. As weeks went by these pains began to resolve although the back of my knee on my good leg is still sore and I'm getting an ultrasound next week to see what's happening back there. I think our bodies are adjusting to a new way of walking.
I agree you should talk with your surgeon or primary care doctor about your hip and ankle pain, just to be on top of things.
That said, I recall (and documented in my recovery thread) having hip and ankle pains during the first six months of my recovery. I had bilateral replacements, but had never had any hip or ankle pain whatsoever prior to that surgery. Afterward, when I started walking, my hips complained. My ankles, one or another and occasionally both, complained. They settled down though and that was that.
Consider, too, the possibility of your shoes being the problem. Did you get new shoes? That’s often the thing to do, get new shoes. The pre-surgical wear patterns on our old shoes can be all wrong for our new knee(s) and stride. Just a thought.
That said, I recall (and documented in my recovery thread) having hip and ankle pains during the first six months of my recovery. I had bilateral replacements, but had never had any hip or ankle pain whatsoever prior to that surgery. Afterward, when I started walking, my hips complained. My ankles, one or another and occasionally both, complained. They settled down though and that was that.
Consider, too, the possibility of your shoes being the problem. Did you get new shoes? That’s often the thing to do, get new shoes. The pre-surgical wear patterns on our old shoes can be all wrong for our new knee(s) and stride. Just a thought.
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