TKR Bending knee issues

Marge#

new member
Joined
Sep 13, 2023
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Hi everyone this is the first time I have posted but I need some guidance. I have had a TKR of my right knee nearly 4 weeks ago. I am struggling to get my knee to bend I am trying to do the exercises but it just won't budge. It feels like my new knee is blocking me bending it I can feel my new knee moving a bit wierdly in my knee joint not sure if this normal. As anyone else encountered this issue and if so will it just release eventually or is there anything I can do to get this knee's bending. It is worrying me as I am not sure if this normal or something is wrong with my new knee. Any help would me much appreciated many thanks M
 
Please tell us the exact date of your TKR and which knee it was. We will add this information to your signature for you. Seeing this information after each of your posts will aid us in advising you and also let other members see your surgical date and relate to you.

What is keeping your knee from bending is swelling outside and inside your knee capsule. This is very normal for one month out. Most knees take an average of 1 year to heal and you are only 1/12 of the way through your recovery. Ice and elevate, toes above the nose, as long and often as you can. This will help to lower that swelling, improving your bend. Don't worry, that bend will come naturally as you heal and the swelling goes down.
 
Each person is different as is their recovery. Most find that the Bonesmart approach works best for them, some others find that a more aggressive therapy helps them more. It's your recovery and your choice on how you recover. As you read more on other members' recovery threads, you’ll get a better perspective of what to expect. The following are our basic guidelines and should help get you started.

If you want to use something to assist with healing and scar management, BoneSmart recommends a hypochlorous solution. Members in the US can purchase ACTIVE Antimicrobial Hydrogel through BoneSmart at a discount. Similar products should be available in the UK and other countries.

KNEE RECOVERY GUIDELINES

1. Don’t worry: Your body will heal all by itself. Relax, let it, don't try and hurry it, and don’t worry about any symptoms now, they are almost certainly temporary

2. Control discomfort:
rest
elevate
ice
take your pain meds by prescription schedule (not when the pain starts!)
don't overwork.

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 for a few weeks.

4. PT or exercise can be useful BUT take note of these:
the BoneSmart view on exercise
BoneSmart philosophy for sensible post-op therapy

5. At week 4 and after you should follow this
Activity progression for TKRs

6. Access these pages on the website
Oral And Intravenous Pain Medications
Wound Care In Hospital

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.
 
Thank you for your replies it is my right knee which I have had replaced on the 8th September 2023. My knee does have swelling it has gone down a lot through icing and elevation. It just feels like it is hard at the front of the knee when I am trying to bend it and has no give in it. I am just concerned that it is not healing correctly which worries me as I am not sure what is classed as normal I have physio next week and I feel they are going to think that I have not been exercising properly
 
Hi and Welcome!

Please don’t worry about your bend. Your knee is naturally swollen from all the trauma of the surgery. It can take weeks for it to settle down some, and then it can reappear easily of you overdo your activities, and that can happen for months. Your bend will return to normal as your swelling goes down and as you heal. And, just in case your doctor hasn’t told you, this recovery does take an average of a full year, for complete healing! So, at 4 weeks, you are very early in the process.

Please also don’t worry about what your physio thinks. Too often some physios have unreasonable expectations for this recovery because they haven’t been trained properly. Your knee will heal fine, it knows naturally what it’s doing. Trust it and be patient with it.


Regaining our ROM does not require forceful bending or painful exercises. That is counterproductive.

Regaining our ROM is more about Time than repetitions of a list of exercises.

Time to recover.
Time for pain and swelling to settle.
Time to heal.

Our range of motion is right there all along just waiting for that to happen so it can show itself.

In the general run of things, it doesn't need to be fought for, worked hard for or worried about. It will happen. Normal activity is the key to success.


Read the recovery guideline articles, there’s a lot of good information there about what to expect. :flwrysmile:
 
Hello Marge, :wave:
Happy One Month Anniversary! Thanks for joining us here.
Please don't be intimidated by Physio, engage in movement that causes discomfort or pain, or allow anyone to forcefully manipulate your leg. While your range of motion is currently limited, it will naturally increase as the swelling subsides and the pain eases. Try to relax, be patient and give it time. I hope you have a great week!
@Marge#
 
Hi everyone I had a RTKR on the 8/09/23 so I am 8 weeks post op. My ROM is only at 45 to 50% and although I am doing the exercises my knee does not want to budge pass this point. My surgeon is saying that they may need to put me under general anesthetic to bend it for me. For info my knee is still quite swollen so I am not sure if this is the reason why it will not bend any further or I have what they call a stiff knee. Has anyone else had this happen to them, is my recovery normal and it will bend eventually I am not sure what else I can do I am definitely anxious about going back into hospital any help would be appreciated many thanks
 
my knee is still quite swollen
This is likely the reason you're having difficulty. You have to get the swelling down before you gain the movement.
It can take months and you're not quite two months post op. Wondering if you're icing and elevating often enough and long enough when you do...You can ice as often as you're comfortable and for as long as you like, always taking care to place fabric between bare skin and the ice source. In addition to help with the swelling, I will post an exercise our colleague, CricketHip, often leaves for members with swelling issues.
She shared what you'll find below with another knee member just a coupe of weeks ago. Give it a try!

CricketHip posted this -
The key to this is to do deep breathing. As in taking your time to breathe deeply and slowly.
The second key to focus on is the groin area.. you have many lymph nodes in your abdominal area and then the lymph nodes in your inguinal areas are the second important area to help release.
Our lymph nodes are responsible for clearing the swelling and inflammation away from your surgery site. But they can get overwhelmed with so much to do and they kind of go into shock. Then add in the numbing agents and pain meds that they inject in the area and imagine how that slows down those nodes!
So simple, light to moderate massaging over the nodes in your groin can be beneficial AFTER you do the abdominal breathing and compressions.
I will leave you the article that I put together and for you, the best thing would be to lie on your back, elevate your surgical leg and then do the routine, then most importantly, stay elevated and try to nap and see if things begin to move..

I hope this helps.. it will help you to relax, too!!

****
Take deep breaths.. deep, as in breathing in to a count of 3 or 4, whatever is best for you. hold it for another count of 3-4, then blow out completely, still using the count that's comfortable for you. A series of at least 6 of these could help get your excess swelling to move. To ensure you are taking proper deep breaths, place your hand on your naval and watch while taking in your breath, if doing this properly you should see your hand move up.

Then, as you slowly breath out, to the same count of either 3, 4 or 5 gently press down and slightly upwards with the palm of your hand.
Do this whenever you feel up to it during the day or night. The more supine that you can get in the recliner or bed, the more effective this can be.. you have lymph nodes located in your groin and sitting up too much can cause a restriction of the lymph flow.

You can, after the breathing, place your hands lightly on your upper thigh, right where the crease is in your groin and lightly stroke upwards towards your naval.
I did this quite a bit post op and while it takes a while for the body to wake up and respond, it will and it will help get the swelling moving.
The reason this can help is because many of our lymph nodes are located in our abdomen. Our breathing combined with moderate pressure over our naval can help to "prime" our lymph system.

***********

Additional notes: you can reach down to your knee and lightly stroke upwards your groin after doing the steps above. Then lastly, gently pump the back of your knee in a rolling, upward motion towards the trunk of your body, using all 4 fingers of your hand and NO fingertips pressing in..

This can be effective if done daily.. use light pressure, no deep pushing. This isn't a no pain no gain thing.


Please notice that we have merged your newest thread with your original recovery thread. Having your recovery information contained in one place will make it easier for you to reflect back on. It is also helpful for those stopping by to be able to review your history before advising or commenting.
Please post any updates, questions or concerns about your recovery here. Best Wishes...stay in touch!
 
I am doing the exercises my knee does not want to budge
With your knee being so swollen, you should back off doing these exercises and let your swelling go down. You can not bend a swollen knee very well because all that fluid is in the way and has nowhere to go. Concentrate on more icing and elevating and not exercising. This will help to get that fluid out of there and your bend improving.

My surgeon is saying that they may need to put me under general anesthetic to bend it for me.
This is what is called a MUA (Manipulation Under Anesthesia). Doing this now would just cause more inflammation and swelling. Your bend will improve when the swelling goes down. It's a gentle movement, time thing. Just walking around doing your daily activities is enough exercise until the swelling goes way down.
 
Hi @Marge# I’m so sorry your care team is stressing you out in regards to your flexion. The amount of pressure they put on us after this surgery is outrageous. You come out of an incredibly traumatic event (physically, but also mentally) where you’ve literally been cut apart and put back together, and rather than allow your body to recover from the shock, they treat you like a trainee in boot camp.

I really feel for you. There are so many stories here of people being threatened (with MUA for example), shamed (for not trying hard enough or being afraid of pain, etc), and pushed and pressured to the point of tears. That was my own experience. They tried to tell me if I didn’t work harder and push through the pain, I was going to be a 45 yr old cripple who would never be able to bend my knee enough to function. Luckily I found BoneSmart 4 weeks after surgery (right where you’re at!) and learned it didn’t have to be that way.

I had a LOT of swelling and my knee was very reactive to being rushed. They insisted I needed a MUA, and I said, I don’t think so. It took me months of gentle treatment to get the swelling under control, and when it did, that’s when I suddenly started seeing real progress! The swelling was preventing bend. It’s gradually increased throughout the past 14 months and I am hiking, backpacking, riding my horse, and working on my farm. I am not a 45 yr old cripple. My knee works great! And you know what? My bend keeps improving even now! Considering how reactive my knee was, I don’t believe a MUA would have sped up this process, but only caused a cycle of swelling that restricted it even more. I’m so glad I didn’t believe the threats, and here I am living my life to the fullest!

All that to say, please don’t be frightened your knee will never bend if you don’t get it immediately. Our bodies are actually very wise. They will tell us what they need if we will only listen. Sometimes they need time. Your surgeon is an expert in the mechanics of a knee joint. But YOU are an expert in YOUR very unique body. Wishing you all the best in your healing journey. You are in good company here.
 
Hi @Marge# I went through the same threats after my first replacement in 2018. The physiotherapist was the one who kept saying the surgeon would have to do a manipulation. I was pushed to try to bend my knee and I injured my patella tendon on the stairs at physio. I was 47 and looking forward to life again. I wish I had found Bonesmart before that surgery. This time, with my revision, I am following the Bonesmart way and things are going much better. Don't let anyone push you. As JusticeRider said, you know your body best.
 
Thank-you everyone your comments ans advice are very much appreciated great to know we are all not alone in our recovery many thanks x
 
Happy Three Month Anniversary, Marge.
How is your recovery going?
Please let us know how you're doing when you have time. We'd love to hear from you.
Wishing you a happy holiday season!
@Marge#
 
I have a problem bending my knee, surgery was 1st week of April 2023, over 8 months ago. I now walk ok, go up and down steps ok. bend is almost 110 degrees. I can't seem to go any farther for the last two and a half months.
I have been riding a recumbent bike at least 3 times per week for 20 minutes and I am not able to move the seat any closer, that tells me my bend has not changed. I'm okay with my new knee it's much better than my old knee less pain. The new pain is a dull pain, my leg from the knee down feels like its asleep and the skin feels dead. Saying this I'm glad I have the new knee. I believe in time the feeling in my leg will improve. Actual I think it bends almost as far as my old knee.
I had the manual manipulation; my doctor could only get it to bend to 110 while under anesthesia. I stopped rehab after 3 months. at that time the bend was at 95. My doctor told me it takes 2 years to heal completely. I'm not even halfway there, so stay positive it will improve.
 

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