TKR Tight Band

Brenda Joyce

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I am 7 weeks post op TKR.I have been working with a therapist for 6 weeks and now my bend is at 132 and my knee goes flat when extended. With all that hood news when I try to walk feels like a clamp on both sides if my kneecap and sometimes in the back of my knee. I still have pain off and on and get a lot of zapping and tingling pain. I was taking tramadol but stopped due to fear of addiction. I went to see my OS he and my therapist can not explain what this is. The OS wants me to take Epsom salt baths daily and see him in 6 weeks. I am getting very scared and walking pegged leg is getting me very down. Anyone else have this and please let me know if it will pass Thank you!
 
I have similar pains at 7 weeks. I have been told it is the nerves reattaching. Are you walking peg leg because of the pain?
 
No mostly due to tightness on both sides of the kneecap kerp from bending.
 
I went to see my OS he and my therapist can not explain what this is.
I’m really surprised that your medical team doesn’t realize that this kind of tightness is a normal occurrence after this kind of major surgery. Your surgeon did major carpentry work and disturbed every millimeter of soft tissue in this area. You aren't tight because your muscle is underused and needs to be stretched and rehabbed. You're tight because your tissue is healing...and full healing takes a full year or more.


I will leave you our Recovery Guidelines. Each article is short but very informative. Following these guidelines will help you have a less painful recovery.

Just keep in mind all people are different, as are the approaches to this recovery and rehab. The key is, “Find what works for you.“ Your doctors, PTs and BoneSmart are available to help, but you are the final judge as to the recovery approach you choose.

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

6. Access to 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 the 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 the member’s history before providing advice, so please post any updates or questions you have right here in this thread.
 
Please tell us the date of your surgery and we’ll make a signature for you. :flwrysmile:
 
No mostly due to tightness on both sides of the kneecap kerp from bending.

I just wanted to add that my gait was getting very poor prior to surgery. I was bow legged and the surgeon had to straighten my leg. Also my ankles are weak; so I struggle with balance, et
 
I am 9 weeks tomorrow still have pain and tightness to the point of walking pegged leg very depressed and I too did everything I was told to do by the book but now I am so afraid I will be stuck with this pegged leg and tightness my PT or OS do not have any answers for me...
We each heal at different rates and you are still in early weeks in this year long recovery. You will improve as you heal.

As I’ve posted before, tightness is par for the course while we are healing.

Are you icing and elevating your leg? Are you having rest periods during the day? Are you still doing PT/exercises? Are you taking any over the counter pain relief?
 
Yes icing 2x day, riding recumbent bike 10 minutes a day. Doing stretching exercises while sitting in my recliner. I am up on the knee most of the day doing housework, laundry and making meals. I did PT for 5 weeks 2x week in home but thought maybe I should try another therapist went to see him twice but basically told me the stiffness is due to my nerves and brain and I should try and ignore the stiffness and make myself walk through the pain. I went home and tried to make myself walk without the pegged leg motion and have been in more pain ever since I did that so cancelled my upcoming appointments with this therspist.I take 1000 tylenol not much relief so taking 25 mg tramadol but just at night due to pain otherwise I can't sleep due to the pain. I am a little afraid to take the tramadol so much. Had surgery May 19 so it seems like a long time to be taking opioid medication.
 
I am 7 weeks post op TKR.I have been working with a therapist for 6 weeks and now my bend is at 132 and my knee goes flat when extended.
riding recumbent bike 10 minutes a day. Doing stretching exercises while sitting in my recliner. I am up on the knee most of the day doing housework, laundry and making meals.

You are actually doing a lot of activity for 9 weeks post op. Your ROM is awesome, for so early in recovery, so you really could stop doing all that exercise activity. The housework, laundry and making meals, which we call ADLs ( activities of daily living) gives your knee all the exercise it needs. And if possible, it might be a good idea to cut back on some of these activities, too. You are still healing and your knee still needs a lot of rest time.
I take 1000 tylenol not much relief so taking 25 mg tramadol but just at night due to pain otherwise I can't sleep due to the pain. I am a little afraid to take the tramadol so much. Had surgery May 19 so it seems like a long time to be taking opioid medication.

The most effective way to take Tylenol is 2 x 500 mg tablets every 6 hours, to a total of 4,000 mg (4 doses) in 24 hours. You need to take it regularly, to keep up the levels in your bloodstream. If you just take the odd dose now and then, it's far less effective.

Check all other medications you're taking, to make sure there is no Tylenol/Acetaminophen/Paracetamol in them. If there is, scale back one or two of your regular doses, so you stay within that safe 24 hour limit of 4,000 mg.
thought maybe I should try another therapist went to see him twice but basically told me the stiffness is due to my nerves and brain and I should try and ignore the stiffness and make myself walk through the pain. I went home and tried to make myself walk without the pegged leg motion and have been in more pain ever since I did that so cancelled my upcoming appointments with this therspist.
I’m glad you cancelled the upcoming appointments, as that is a example of bad PT. You’ll do fine on your own from this point on, as I said, your ROM is already really good.

I really think if you cut back on your activity, you will see an improvement. It won’t happen quickly, this can be a very slow recovery, but doing more than our healing knee is ready for, does not improve things. In this recovery, for some of us, (and I was one!) less is more.
 
Thank you for the advise. I am trying to cut back on how long I am on my feet and see if that helps with the pain at night. My knee doesn't seem to be swollen on the outside very much but with the tightness I remember reading it can be swollen on the inside. Sometimes my foot will tingle too is that part of the healing process and my calf is very stiff in the morning. Any suggestions on what I can do for the calf muscle?
 
I tend to get tight calves and did post surgery. You might try some gentle calf stretches before you go to bed and/or when you get up in the morning. You can even do these seated in a chair or on your bed.

Like Jockette says, continue to think about how much activity you're really doing. I tended to try to split my household tasks up so that I wasn't trying to do them all in one day. Or even split tasks up.
Ex) chop vegetables ahead of time and rest before cooking the meal
 
@Brenda Joyce
I also had my LTKR on May 19th and having very similar problems like you.
I have achieved full range of motion [135] as checked by my PT on 7/7. I do exercises in morning for about 45 minutes - all lying in bed. During the day, I am not as active as you. I spend lot of time on my laptop.

When I walk for more than 10 minutes on a flat surface, my knee joint starts hurting, with tightness in front and back, and sometimes needle like pain on side. There is no pain in my calf or thigh. When I walk for longer time, the pain level is at 5-6 out of 10. The type of pain is like a hard object is pounding on my knee.

The pain situation while resting and standing hasn’t changed. Meaning, I have no pain if I am sitting or lying down for upto 30 minutes. After that, my leg becomes quite stiff and hurts. My sleep at night is constantly disturbed due to this. It also hurts if I stand for more than 5 minutes.

For pain management, I take 2x3 times Tylenol [3000 mg total].
 
@BrendaJoyce, welcome here!

It sounds like you are doing very well for 7 weeks into this year-long recovery, but that the pains you're having are somewhat normal given your level of activity. Given that your range of motion is as good as it is, doing too much activity now, will increase the internal swelling, making the leg more swollen and more painful.

For instance, I am at 12 weeks now and only at week 9 did I try to cook an entire meal from scratch, standing in the kitchen for an hour or so. I had pre-cooked foods and frozen several sets of favorite meals and warming them up for a standing total of about 10 minutes was very do-able!

In between each activity burst of about 10-20 minutes, I came back in and sat on the recliner and iced and elevated my leg until about week 10.

I also had alot of the tingling, zingers, too and last TKR (2016) I found a magnesium gel I purchased and used on the area where those nerve spasms were occurring and that really helped. the zingers seemed to happen intermittently, so having that gel handy was relieving to know I had something that worked for that type of pain! If you want em to, I can post a link to it here, but I think there may be one that helps Bone Smart, too, which I can locate and post if you wish!

Hang in there! You really are doing quite well, and I know it's tough when there are so many varied twinges in hinges (and non-hinged areas). It's all part of the healing process, because so much of your leg got pulled and messed with... consider it a new baby knee that needs your TLC...
 
I am 9 weeks post TKR and have stopped PT for now. I get zingers and an uncomfortable pain at the outside of my knee when I move too quickly or bend the knee too aggressively. My bend is good and flat so I am not concerned about that. PT said to ice as needed and I take Celebrex for other areas of arthritis and Tylenol. I have tried Silver Sneakers
Exercise Class and Tai Chi Chin. I plan to start Chair Yoga as. Well. Wish I had found this forum prior to my surgery. I also was told by my surgeon that this would be a 3 month recovery. I am leaving shortly for a beach vacation. It will be interesting to see how the sand and ocean like my baby knee.
Thank you for reading my post
 
12 weeks post op TKR still having stiffness and limping. Have pain at nightI have cut back on exercising only do recumbent bike 10 minutes a day and a little daily chores. My knee feels very tight like I am wearing a knee sleeve that is too tight. I have used ice and tried Epsom salt baths. No change in the knee as far as being stiff and tight. I have appt to talk to my surgeon next week but I am sure he will not have answers for me. I still get very tired if I try to walk through a grocery store. Getting very depressed and feeling like it is never going to let me walk normal or do anything I want to do again like hike,bike, etc very down today.
 
Things will improve as you continue to heal. Stiffness/Tightness is a normal occurrence after this kind of major surgery. Your surgeon did major carpentry work and disturbed every millimeter of soft tissue in this area. You aren't tight because your muscle is underused and needs to be stretched and rehabbed. You're tight because your tissue is healing...and full healing takes a full year or more.

I still get very tired if I try to walk through a grocery store.
This is very normal for many of us at 12 weeks.

12 weeks is only 25% healed. You have lots of time to improve, and you will, just not as fast as you’d like.
 
Should I still do stretching exercises and ice even though there doesn't seem to be much swelling. My pain seems to get worse at night and that is when my restless legs also kicks in.
 
I would certainly continue with the ice, elevation and GENTLE stretching.
 

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