TKR Increase of stiffness and back of knee pain<

[roboknee]

Hello, newbie here I’ve been following for months gotten so many questions answered!
I had a right knee replacement Sept 11 2018 so I’m right at 8 weeks post op. I’ve been doing well I think? In the last few days I’ve been having much more pain behind the knee and stiffness over all. I’m so frustrated with myself about still being in pain. But now some of my regular home stretches are even back to causing pain. I go back to work soon and I’m worried about that because my job is physically demanding. But Doc says I can go back on desk duty only but she really wants me out three more weeks which I just can’t do. I’m so confused on all this!

 

[DIYSteve]

I had a bad patch of stiffness and aches at 8 weeks, followed by a big leap in improvement at 10 weeks. Of course, each of us has a unique recovery curve. Good luck to you.

 

[Jockette]

Hi and Welcome to Bonesmart!

Most of us are not painfree at 8 weeks post op. Full recovery takes an average of 52 weeks (one year) You will feel better long before that 52 weeks, but 8 weeks is still pretty early.

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.

Knee Recovery: 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
elevate
ice
take your pain meds by prescription schedule (not when 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.​

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. Here is a week-by-week guide for

Activity progression for TKRs​

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.

 

[Chemist]

Hello @roboknee :

I always ended up with stiffness and pain behind my knee whenever I over did it with exercise and stretching. Things improved when I took it easy.

Good luck on the recovery

 

[forbesy]

I have learnt so much and a knee recovery is so different from a hip much slower into week 4 and pretty sure I was nearly of the walking stick as I still feel stiff but hopefully will improve in weeks to come. Roboknee hope you improve over the next few weeks and can get back to work.

 

[Celle]

Hello @roboknee - and

I wonder if you have increased your activity lately? That can sometimes account for an increase in stiffness and pain. Increasing stiffness and pain are messages from your knee that you are doing a bit too much for it.

So we can understand how much activity you are doing, I'm going to ask @Josephine , our Nurse Director, to advise you. She has many years of experience in orthopaedics.
She'll probably ask you a lot of questions. Do try to answer them as fully as possible, so she has all the information she needs, to advise you appropriately.

Meanwhile, try cutting back your activity and spending more time resting, icing and elevating your knee. Icing the back of your knee will help, too.

We usually recommend taking about 12 weeks off work and then doing a Phased return to work
I wonder if you've been increasing your activity, hoping that will prepare you for work?
Take the time that you rinee needs. It's been through major trauma.

Did you realise that complete recovery from a knee replacement takes as long as a full year? Your knee is still a toddler, so treat it gently.

 

[Josephine]

I'd really like to offer you some structured advice but in order to do that, I also need to ask you some questions. Are you willing for me to do that?

 

[roboknee]

Josephine Yes I would like to for your input, please.
Thank you


Celle Thank you for your welcome.

I look forward to learning more about this healing process.
After I posted my pain issue I brought it up to my physical therapist as it was a few days to my appointment. He doesn’t like me to over do it and I’m so glad I was honest and upfront with how much pain I was in still. He is always asking if my knee hurts and telling me to slow down or not do what hurts. He then suggested laser therapy and gave me a free session that day. I must say by the next evening I was very much relieved. The back of knee pain I had had the evening I posted was back down to the minimal tolerable amount.

I have had to go back to work. Only desk work restricted and am graduating my hours trying for 4-5 hours a day. This week I’m only working three days. Today was my second day and I over did it for sure! I will have to really keep an eye on my days and activities!

Thank you
Roboknee

 

[Josephine]

Here y'go then! But this is for the last 6 weeks only, okay?

It would be very helpful if you would answer each one individually - numbered as I have done - in as much detail as you can then I'll come back as see where you are ....

1. what are your pain levels right now? (remember the 1-10 scale: 1 = no pain and 10 = the worst you can imagine. And don't forget to factor in other forms of pain such as soreness, burning, stabbing, throbbing, aching, swelling and stiffness).

2. what pain medications have you been prescribed, how much are you taking (in mg please) and how often?

3. how swollen is your leg compared to these?

4. what is your ROM - that's flexion (bend) and extension (straightness)

5. are you icing your knee at all? If so, how often and for how long?

6. are you elevating your leg. If so how often and for how long?

7. what is your activity level? What do you do in the way of housework, cooking, cleaning, shopping, etc., and

8. are you doing any exercises at home? If so what and how often?
This is the most crucial question so please help me by using the format I have left as an example
(which means please make a list and not an essay!)

Exercises done at home
- how many sessions you do each day
- enter exercise by name then number of repetitions of each
etc., etc.

Anything done at PT
- how many times a week
- enter exercise by name then number of repetitions of each
etc., etc.

 

[flsungirl]

Welcome! We had our surgeries a day apart. I too started back to work this week. I work in a busy medical facility and work 11 hour days. Fortunately I have half days on Thursday because there’s no way I could have done another full day! I think I’m more tired than in pain. Although pain is bad in left knee, the new one seems to be holding up. That’s not saying I’m 100%, more like 75%. I am having an easy weekend!


We both had right knee done. Can I ask how your left knee is doing? Mine needs to be replaced but I’m holding off on that!
Look forward to following your recovery!

 

[skigirl]

Once you start working, I would not worry about doing any exercises----instead spend any free time you have with your leg elevated and iced. You can rest which I am sure you need!

 

[traceys]

@roboknee

Surgery same day so I’m right there with you. I know the feeling you are talking about. Although my recovery is a bit more convoluted due to history with the knee we sound similar.
If I walk too much or over do any of my exercises I get a distinct tight cord in the back of my knee. I started massage 3 weeks ago and what a difference. Some people have shared their experience with that same issue on my thread too if you wanna read it and contact them.

It’s matter of being kind to the joint and finding what helps most for you!

Look forward to seeing more of you on here!

 

[roboknee]

Josephine
Ok here goes

1. my pain ranges from 0-3 most of the time. except when I’m over tired trying to sleep or when that back of knee gets to me then it can to about a 5-6.

2. I generally don’t take anything in the am. I have a prescription of Naproxen 500mg taken at bed time. Unless like two days ago at work I had to take another dose. I do supplement with two extra strength Tylenol if it is bad especially at night.

3. I’m moderate. Right in the middle

4. my ROM is 115 before stretching, 122 after stretching. My extension is 0

5. I only ice if I’m having more pain I have an ice machine maybe 2 -4 times a week.

6. I elevate while I ice and still at night my leg is up on a pillow. Not as much as I probably should I bet.

7. My activity level I do shop and cook some I light clean. I’m back at work so while I’m at a desk and try to get up every hour. But I’ve been on my feet mostly directing employees for the last few days as we are busy. Yes I over did it and I realized that I can’t stand for an 8 hour day! I’m trying for shorter days but it’s a flower shop and busy this time of year.

8 done once a day - sometimes I do part in am, part in pm except PT days.
I do my home exercises once a day
Heel slides x10 hold bent position for count of 10
ankle on rolled towel knee hanging for 15-20 minutes
knee lifts x3 sets of x10 sitting
chair slides x10 with 5 sec hold.
towel around my thigh, lift it and let my bent knee hang until I feel slight pain x3.

PT twice a week
trying lazer therapy
ride bike for 5 minute warm up
massage then lifts leg and does gentle stretches then uses rolling stick on quads.
hamstring stretch 30 second x3
up on toes, calf stretch 2 sets x10
sitting knee lifts with 4lb weight 3 sets x10
standing knee lifts to back with 4lb 3 sets x10
step up 2 sets x10
side steps with band 2 15 ft passes
knee stretches on chair hold 30 seconds one x10
wall squats with ball 2 sets x10
single leg balancing on foam x5 for 15 seconds
knee hip external 3 set x10
3 sets of 10 on quad machine. I think that’s what it is (Lay down push with feet on board)

Hope I answered everything logically!
Robo

 

[roboknee]

Flsugirl
I am back to work three days this week. I’m in flowers so I normally work 11-12 hour days. But I’m on desk only now and I’m part time on advise of my PT for a couple weeks.
I did work one 7 hour day (we were so busy)and by the end i was very stiff after being on my feet all day.

My left knee has very little damage no pain so far no replacement needed for a long while.
Your job sounds like it would be hard.
I too am just plain exhausted after work! Well I’m not sleeping very well right now!

Robo

@traceys
Hi surgery buddy!
Wow sounds like we are on some of the same levels.. I know everyone is different!

I sure can feel it if I do too much. The stiffness is the worst for me by the end of the day. It shows up right as I try to go to sleep. Which is not much!

That pain was so bad in the back. It lasted a couple days.. I didn’t do my home stuff at all.. I talked to my PT guy and he suggested lazer therapy so I tried it and it’s sure made a difference! I was back to no to little pain by the next day.

Massage sounds good too I’m going to ask my niece about it she is a massage Threapist..
Thank for the advice! I’ll check out your thread!

Robo

 

[Jockette]

What is laser therapy? I’ve never had it.

 

[flsungirl]

I’ve been taking Advil PM at night to sleep. I only take 1 but I sleep better. This weekend was a recovery one for me after working. I was just worn out! Hoping each week gets easier. Only 3 day work week because of thanksgiving I also use Voltaren gel on both knees which has helped too. I did have a few screaming zingers this weekend...arghhhhh. Can’t wait till this journey is over! Take care

 

[Josephine]

I’ve been taking Advil PM at night to sleep. I only take 1 but I sleep better.

Advil is an NSAID (Naproxen) which, while one of the better types, is still a very poor pain med. And your description here tells me that your problem is inadequately medicated pain. I suggest you at least try taking Tylenol 1,000mgs 3-4 times a day in order to prepare for the night.

 

[Josephine]

chair slides

@roboknee what are these?

 

[roboknee]

@Josephine
Sitting in a rolling chair instead of moving leg back and forth roll chair back and forth keeping foot in one position.

 

[roboknee]

@Jockette
My PT uses a laser to massage deeper into tissues all around the knee front and back. It works to increase metabolism at the cell level reducing pain and inflammation. With no side effects. It keeps working for around 18 hours warming deeper than topical heating pad. I can’t ice when I have had one until the next day. But it seems to help me with the inflammation and pain. It’s not covered by insurance yet but is an FDA approved treatment.