I had TKR end July 2024. 8 months on I still get deep excruciating pains at the gracilis tendon insertion. I have achieved 110 flexion only. It doesn't seem I'll get anymore despite doing all the exercises I'm supposed to do. I've gone from being fit and active, albeit with a knee that had become increasingly unstable to, it seems to me, ruining my life as I knew it.
TKR 8 months
- Thread starter Tedi
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Hello and Welcome to BoneSmart. Thanks for joining us!
Please provide the exact date of your surgery along with identifying which knee you had replaced. This info will be used to create a signature for you making it easier for those that stop by to advise to see exactly how far along you are in your recovery.
I am wondering what exercises you're doing daily and how many reps? Along with the activities of daily living, you may be overdoing it and that's what contributing to the ongoing pain. Have you tried to step away from exercising or therapy for any length of time to see if the pain eased? If you're willing to give us a better idea of what a normal day looks like for you, hopefully we will have some advice.
I am sorry you're hurting and understand that's not what you expected at 8 months post op.
@Tedi
Please provide the exact date of your surgery along with identifying which knee you had replaced. This info will be used to create a signature for you making it easier for those that stop by to advise to see exactly how far along you are in your recovery.
I am wondering what exercises you're doing daily and how many reps? Along with the activities of daily living, you may be overdoing it and that's what contributing to the ongoing pain. Have you tried to step away from exercising or therapy for any length of time to see if the pain eased? If you're willing to give us a better idea of what a normal day looks like for you, hopefully we will have some advice.
I am sorry you're hurting and understand that's not what you expected at 8 months post op.
@Tedi
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I agree that at eight months we aren't done healing and overdoing exercises, even prescribed ones, can easily lead to pain and to tendon issues that often respond to rest and ice.
If your orthopedic surgeon hasn't been responsive to your concerns, you might ask for a referral to a physician who works with soft tissue issues, such as a sports medicine doctor or a physiatrist (physical medicine doctor) for evaluation and diagnosis and a path forward.
If your orthopedic surgeon hasn't been responsive to your concerns, you might ask for a referral to a physician who works with soft tissue issues, such as a sports medicine doctor or a physiatrist (physical medicine doctor) for evaluation and diagnosis and a path forward.
Welcome to BoneSmart! I’m glad you found us and decided to join as an Insider Club member so we can fully support you as you continue to recover from your knee replacement. You may want to spend some time reading some of the recovery threads of other members to see what they have gone through. I will also post our recovery guidelines for you so that you can see the entire healing process. It does take time for everything to settle, which is why surgeons will tell you that recovery takes a full year or more.
Knee Recovery: The Guidelines
(Administrative Note: For those reading this thread, please be aware that these links are a premium service and only available to Insiders Club Members).
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
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
Under the NHS, you’re probably not going to get your surgeon interested in resolving the pain you describe. I do think if you haven’t done so, a trip to your primary physician for a diagnosis or referral would be a good step. I don’t know if the UK has “sports medicine doctors” or not, but the suggestion of a physiatrist is a good recommendation. You also may need some physical therapy to help with soft tissue issues.
Try not to worry about your ROM. Many of our BoneSmarties have been known to increase their range of motion well beyond a year out from surgery. It’s all a factor of what you have going on. If you have inflammation in the tissue around your knee, you likely have some internal swelling that you may not see from the outside. Just be sure you’re are doing stretches on a daily basis to continue to challenge your knee’s flexion and extension. This means you bend or stretch to the point of feeling mild discomfort, but not so far as to have pain. If you have access to an exercise bike, that will help you. Just be sure to set the seat in position so your pedaling is a little of a challenge and no resistance.
Knee Recovery: The Guidelines
(Administrative Note: For those reading this thread, please be aware that these links are a premium service and only available to Insiders Club Members).
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
elevate (we are working on repairing the images in this link)
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
Under the NHS, you’re probably not going to get your surgeon interested in resolving the pain you describe. I do think if you haven’t done so, a trip to your primary physician for a diagnosis or referral would be a good step. I don’t know if the UK has “sports medicine doctors” or not, but the suggestion of a physiatrist is a good recommendation. You also may need some physical therapy to help with soft tissue issues.
Try not to worry about your ROM. Many of our BoneSmarties have been known to increase their range of motion well beyond a year out from surgery. It’s all a factor of what you have going on. If you have inflammation in the tissue around your knee, you likely have some internal swelling that you may not see from the outside. Just be sure you’re are doing stretches on a daily basis to continue to challenge your knee’s flexion and extension. This means you bend or stretch to the point of feeling mild discomfort, but not so far as to have pain. If you have access to an exercise bike, that will help you. Just be sure to set the seat in position so your pedaling is a little of a challenge and no resistance.
Hello Tedi! Everyone of us heal so differently that there is not one thing that you can look to or read to tell you how long it will take for you but I had always been told it can take up to two years. I like you had pain ongoing for so long and I was obsessed with my ROM thinking if I don’t get it right now, I will never get it. But early on it is a game of balance. Exercise enough, but not too much. When you do more than you should, it hurts and you create swelling. With swelling comes pain and lack of ROM..kind of like a dog chasing its tail. You need to find of balance of how much is enough, but not too much.
Anyway, like others suggested once we know more about your routine then we can advise you even more. Hang in there…eventually it does get better!!
Anyway, like others suggested once we know more about your routine then we can advise you even more. Hang in there…eventually it does get better!!
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I am sorry that you are still in such pain.
Is it constant or triggered by certain movements?
As @mendogal suggested it may be more useful at this stage to find an expert in soft tissue injury to help you explore the causes and remedies for your ongoing issues. I had some ongoing problems after my PKR due to an overstretched MCL. I found an excellent Pilates teacher who helped me to strengthen my medial quads to prevent pain on stairs. You need someone with really good anatomical knowledge who is prepared to work with your body rather than just pushing a standard exercise regime.
You might also want to have a look at my pilates teacher's free classes on YouTube ( Google Katja pilates and they come up).
Her side lying squats free glute strengthening one was my go-to regime for rehab. There are also gentle stretches.
It is not true that you can't get more flexibility months after TKR- but it needs to be done gently.
