TKR 9 weeks and my biggest complaint is muscle soreness>

[chsed]

Hi all! I'm 49 years old, 48 at the time of my TKR, and beginning to see a light at the end of this tunnel. Surgeons sure don't tell you everything, do they? ;)

I had TKR of my right knee on July 18, 2016. Stayed overnight in the hospital and went home the next day. I had lots of help at home plus home therapy for the first couple weeks. Achieved 92 degrees flexion at my first out-of-the-house therapy visit. Extension was about 8-10. Everything has been slow going, but improving nonetheless. Now at 9 weeks, I am almost done with outside PT (having exhausted my benefit). I have 120 degrees, and extension is about 3.

The knee itself only hurts after physical therapy, but my biggest pain comes from muscles soreness in my hamstrings and calf muscles, with accompanying tightness. I'm assuming this is from the tourniquet applied during surgery? How much longer should I expect it to continue?

I also have what feels like bone pain in my thigh just above the knee. Anyone else have this issue, and what do you do that helps? I have had a couple sessions of deep tissue massage, which has helped to loosen some of the knots in my leg muscles and has helped me feel that I can move better.

 

[BBCG]

Hi chsed, my TKR was just a week before yours. I also have very tight quadriceps muscles above my knee although I have more pain in areas on the outside of my knee. I have had a lymphatic massage which helped some, which was very gentle and which involved holding the sore areas to help relieve the tight muscles. I do self massage on my leg, too, especially as I'm applying my pain cream. I do anything I can to move the skin and fascial layers separately, too, massaging in diagonal directions away from each other... Just whatever I can do to loosen that area!
Do respond to Josephine's questions, too, as doing so helps the moderators help you! I answered them, too, but it helped me discover some really helpful suggestions that worked! I was extremely frustrated at not being heard by my ortho center when my pain was intense, and everyone here was so supportive and helpful. I followed suggestions I heard here and it did work; I got heard and helped!
I;m sure you'll get some good suggestions; everyone here is really supportive!

 

[skigirl]

Welcome to Bonesmart and I will give you the recovery articles from our library that we recommend to new Bone Smarties!! The articles are all short and very informative.

First are the BoneSmart Recovery Philosophy. . .

- rest, elevate, ice and take your pain meds according to your prescription, don't wait for pain to occur, don't overwork.
- If it hurts, don't do it and don't allow anyone - especially a physical therapist - to do it to you
- If your leg swells more or gets stiffer in the 24 hours after doing it, don't do it.
- If you won't die if it's not done, don't do it; if you must do it, short and sweet, not hours on your feet.
- Don't stand if you can sit; don't sit if you can lie down, don't stay awake when you can go to sleep
- be active as much as you need to be but not more than is necessary, meaning so much that you end up being in pain, exhausted or desperate to sit down or lay down!

Next is a FAQ (Frequently Asked Questions) thread.

The importance of managing pain after a TKR and the pain chart
Swollen and stiff knee: what causes it?
Energy drain for TKRs

Myth busting: no pain, no gain
Activity progression for TKRs
Heel slides and how to do them

Extension: how to estimate it and ways to improve it
Elevation is the key
Ice to control pain and swelling

Healing: how long does it take?
Chart representation of TKR recovery
Myth busting: the "window of opportunity" in TKR

Myth busting: on getting addicted to pain meds
Post op blues is a reality - be prepared for it
Sleep deprivation is pretty much inevitable - but what causes it?

 

[Roy Gardiner]

The knee itself only hurts after physical therapy

Don't do anything that causes pain either when doing it or in the hours afterwards, it's counter productive. As you've stopped PT now that should be OK.

but my biggest pain comes from muscles soreness in my hamstrings and calf muscles, with accompanying tightness.

Your leg is now moving more than it did before surgery, and the tissues were traumatised during surgery. Stretching exercises and massage, plus rest, are what's needed.

How much longer should I expect it to continue?

Should gradually decline. But it won't be quick, sorry. and you can't hasten it.

 

[chsed]

Thank you for the replies! I apologize for not getting back here sooner.

It is now 4 months since my TKR, and the pain in my leg has diminished by quite a lot. It will ache sometimes at the end of the day, mostly on days when I have been busy, but it is much better. It continues to improve little by little.

My ROM is now 120+ flexion, and 0-2 on extension. This seems to depend on the time of day and whether I've done my extension stretches, but I'm very close to straight, and I can now make it straight on my own by tightening the muscles.

I continue to ride a recumbent bike for 25-30 minutes daily, and do extension stretches 2-3 times daily. It is working! (This is my PT now, as graduated from actually going in to the therapists' office).

Basically, TKR is no joke! But 4 months out, I can now say I am glad I did it. I can walk down hill with no pain, something I couldn't do for years!

 

[referee54]

Thanks for you reply and for you great report!! You have helped others who are going through the "Dark Days of Recovery" see what awaits them!

Basically, TKR is no joke! But 4 months out, I can now say I am glad I did it. I can walk down hill with no pain, something I couldn't do for years!

Absolutely correct in all regards---I would say that 99.9999% of us were unprepared for the length and for the issues that would arise during recovery---but, in the end, it is truly worth it!

 

[chsed]

In reply to Josephine:

I was still icing in the evenings at the time of my original post, but I haven't needed to ice at all for about 6 weeks.

I have almost no swelling. Just a small patch immediately above the knee cap remains.

On a normal day now, I am getting an average of 6-8,000 steps. My record is 13,000 on a very busy day (and I felt it). Before surgery, I had 15 to 20,000. So I am not back to that point but I didn't expect to be. Next spring I would like to begin hiking though!

No prescription pain meds since the end of August. I relied on Advil for awhile but my need has diminished.

 

[referee54]

My record is 13,000 on a very busy day (and I felt it). Before surgery, I had 15 to 20,000. So I am not back to that point but I didn't expect to be. Next spring I would like to begin hiking though!

It does take some time---remember that it may take upwards to a year to fully recover.

I am sure that this time next year you will be able to do anything you want---and that hiking will be oh, so much fun!!

 

[chsed]

Thanks for you reply and for you great report!! You have helped others who are going through the "Dark Days of Recovery" see what awaits them!

Referee, thanks! I hope to help others. Those were indeed "Dark Days" that I thought would never end. But they do end, and it gets so much better! My neighbor a couple of houses over is currently in those dark days, so I try to encourage him every chance I get.

 

[referee54]

I can certainly commiserate---my BTKR recovery seemed to go on forever----it took me five months to lose a little limp, and it was not until six months that I was about 80%-85%---at eight months, I was about 90%-95%---getting closer to 100%. I gained some ROM in tiny increments well after a year post-surgery.

You will continue to see progress---and those steps that you are taking---they will increase in number and decrease in swelling and stiffness. you will get back to normal---when you can go for days without thinking about the knee that is younger than you are!

 

[chsed]

You will continue to see progress---and those steps that you are taking---they will increase in number and decrease in swelling and stiffness. you will get back to normal---when you can go for days without thinking about the knee that is younger than you are!

So true! Already I am going for hours without it screaming at me. Never thought I'd see the day.

 

[Josephine]

I am getting an average of 6-8,000 steps.

Those dratted Fitbits!

 

[referee54]

Already I am going for hours without it screaming at me. Never thought I'd see the day.

My knees do not cause me any pain now---if there is some pain, it is the muscles telling me to give them a rest!!

Those dratted Fitbits!

Quite addicted to mine!!

 

[Josephine]

Well so am I! But I still think they are dreadful things!

 

[chsed]

Hi everyone!
I'm now 5 months out (technically I will hit that milestone on Sunday) and the improvements continue. I've got a question--kneeling. Is kneeling a no-no? Do some docs not care while others do? What have you been told?

I had to kneel tonight, on a padded surface, and my leg is a little sore now but not bad. Wondering what it will be feeling tomorrow.

 

[FlaGranny]

I'm a bit more than 4 months out and I tried to kneel on my sofa to reach something yesterday and quickly decided it was not a good idea yet. Some people can sooner than others but I'm not ready.

 

[Celle]

Some surgeons advise against kneeling for a while after a TKR. Others don't mention it.

There are people who can never kneel - I think Josephine is one - but I find that I can, although it feels strange and I don't really like to do it.

I started trying to kneel by doing it on a soft pillow on the bed. I gradually worked up to kneeling on harder surfaces, a cushion on the carpet, then on the carpet itself. If I have to, I can now kneel on a hard surface, but I try not to, because it doesn't feel good. It's nice to know that I could, if I had to.

 

[sistersinhim]

Those dratted Fitbits!

I'm addicted to mine, too! It's interesting how many steps a person takes just inside the house in a day!
I was told to never kneel. Of course, I have no kneecaps, so many that's why.

 

[referee54]

Is kneeling a no-no? Do some docs not care while others do? What have you been told?

Yes---some surgeons tell their patients to avoid it---mine let me kneel after six months, due to the little button inside the patella.

I have tried to kneel---and it really, really, feels weird, so I try to avoid it.

I would talk to your surgeon for his protocol on kneeling.

 

[Dancing Fool]

Interesting differences. After my first TKR I asked about kneeling at my 7 week post-op appointment and my OS said I could if I wanted. I tried that day and it was uncomfortable but not awful. By summer I was gardening on my knees, on a pad, and my knees didn't hurt any more than they did before my TKR, maybe less. I'm anticipating the same this time, but since I'm only 5 weeks out I haven't tried it yet!