TKR Increasing pain at 7 weeks

Bonnielassie53

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Hi all,
I had a TKR on May 9th. I came home the next day and was doing very well. At 40 hrs post op I tried to get up from my chair and fell twice on my knee. I went in to see Dr the next day and everything looked good on X-ray. Of course I was now using a walker. At 2 weeks I was 110 and 0. Another X-ray showed everything with the implant was normal. But I was so swollen and bruised, probably more so from the falls. I transitioned to a cane but had medial pain when weight bearing. At 6 weeks I started having more medial pain especially when raising my leg. I went for 6 week check up and the Dr said it is normal to have pain at 6 weeks and to do 8 more weeks of PT. He said to come back if I still had pain in two more months. It seems like the pain is getting worse. I have also had some wobbling but it seems to be the back of my knee and from the beginning every time I bend my knee it clicks. I am really worried that something is wrong.
 

ski_bum

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Hi all,
I had a TKR on May 9th. I came home the next day and was doing very well. At 40 hrs post op I tried to get up from my chair and fell twice on my knee. I went in to see Dr the next day and everything looked good on X-ray. Of course I was now using a walker. At 2 weeks I was 110 and 0. Another X-ray showed everything with the implant was normal. But I was so swollen and bruised, probably more so from the falls. I transitioned to a cane but had medial pain when weight bearing. At 6 weeks I started having more medial pain especially when raising my leg. I went for 6 week check up and the Dr said it is normal to have pain at 6 weeks and to do 8 more weeks of PT. He said to come back if I still had pain in two more months. It seems like the pain is getting worse. I have also had some wobbling but it seems to be the back of my knee and from the beginning every time I bend my knee it clicks. I am really worried that something is wrong.
I'm not a Dr. but 8 more weeks of PT? I knew better from my first knee and Bonesmart but after 6 weeks I went for PT twice. Not only did my new knee hurt like hell, my 11 month old knew hurt again. No PT for 5 weeks and just starting to recover to what would be normal for a 3 month old & 1 year old knee might be. I'm 131 & 135, 1 finger flat knee and that's good enough for me. Now to just be pain free. Good luck with recovery.
 
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Bonnielassie53

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Thanks. Actually I am now starting to have trouble with my other knee as well. I was thinking it was the Pt. It is in bad shape but wasn’t really hurting much before.
 

Jockette

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Hi and Welcome!

You are very early in this year long recovery, and the pain you are feeling is partially par for the course, and as you suspect, you may be getting more pain due to the PT you are doing. Not all PTs really know how to rehab a TKR and give us things to do that we are not healed enough to do. This may be the type of PT you are getting. What do you do there?

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. Especially read the article about PT.

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.
 

Jockette

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But I was so swollen and bruised, probably more so from the falls.
I’m sorry you fell so soon after surgery. :console2:

Swelling and bruising is very common after this surgery, even if you don’t fall.
 
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Bonnielassie53

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Thanks Jockette,
It was my Right knee BTW. I am doing many different exercises in PT. Balance, leg lifts, step ups and modified lunges, toe lifts. They have me riding the bike for 15 minutes. PT didn’t hurt until a week ago. It seems the pain intensifies when I try walking around the house without a cane. I’m not doing that again for awhile.
 

Jockette

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That is a lot of PT activity for only 7 weeks post op, and the pain could be because it’s catching up with you, and you feel it more without the support of a cane. I think if you cut back on the PT you could lessen your pain. They have you in “training mode” and you are still “healing mode.“
 
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Bonnielassie53

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I will talk to them about cutting back tomorrow. I was thinking of doing just a few more weeks instead of the 8 the Dr wants.
I am 120 now. I think the Pt is aggravating my other arthritic joints.
 

InkedMarie

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@Bonnielassie53 120 is fantastic! I’m 9.5 weeks post op, still going to PT but am thinking of stopping. My other knee is almost 4yrs old and that is starting to hurt.

I think you’re doing great!

Marie
 
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Bonnielassie53

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I went to PT today and could not do the exercises. All of a sudden I am in excruciating pain when I lift my leg. It was very painful to drive and I won’t be doing that again until this is resolved. The therapist was great. He tried message, ice, nerve stimulation but nothing really helped. He thinks it is a problem with a muscle. I haven’t been on pain meds since week 2 but I am going to call IS office tomorrow for refill. I am going to rest my leg and ice and see if that helps.
 

sistersinhim

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It sounds like your knee needs rest and healing, not PT right now. Quit PT and rest your knee for at least a month and see how much you'll improve. Your knee is still a baby and needs to be treated as such.
 
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Bonnielassie53

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Actually, I am taking a break from Pt. The last time I went my therapist gave my knee a message. He said it felt like there was hard scar tissue right where the pain is. He thinks if I message this area frequently I might be able to break up the scar tissue.
Does this sound feasible? In the meantime my Dr gave me some Tramadol for when the pain is really bad.
 

Jockette

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There isn’t always something we can “do” to fix every pain. 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.
 
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Bonnielassie53

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I am now at 8 weeks post RTKR. I was in excruciating pain at week 6 and 7, particularity when lifting and lowering my leg. Due to the long holiday weekend I was able to rest and ice my leg for 4 days. What an improvement! With my Drs approval I quit PT today. I will test my knee for another week and we will see how it goes. If I am still having problems in 2 weeks, they will see me and do an evaluation and more imaging. So glad I didn’t keep pushing myself.
 

CricketHip

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I am so glad you didn't continue to push yourself, either!! I am guessing that another 2 weeks of resting and icing will bring more continued healing. Did the surgeon suggest doing some minimal exercises or activities to help keep your body heading in the right direction? Or just rest and ice.

So pleased to read your update and see you getting around that PG roadblock.
 
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Bonnielassie53

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He wanted me to totally rest it for the rest of this week. I am 120 ROM and my extension is fine. Then he said I could do my own exercises at home and walk around in the pool if I wanted. I would much rather do it this way. The day when the pain intensified they had me doing squats and step ups and standing leg raises. I already had pain in the medial area of my knee when bearing weight and I think these exercises are what sent me over the edge.
 

CricketHip

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Okay great! You know what? I was afraid you would think icing and resting meant to not do anything.. :snork:
But you know better.. thanks for clarifying.

Medial aspect of the knee has several muscles inserting there. When they get angry, it's no fun..am so relieved that your surgeon wants you to rest and ice..
I agree that the squats didn't agree with your very new knee!

My knees are my own, I have THR's but have noticed as my age creeps up, doing squats really irritate my knees.
 
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Bonnielassie53

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I had a THR 11 years ago. It was so much easier! I am pretty sure there is another knee and hip replacement in my future.
 

kneeper

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I'm very anti-squats (even the mini ones) for a healing knee. With my first knee I tried to be "compliant" with the PT and against my better judgment I tried the squats despite the pain. I wound up with tendonitis.

With knee 2 I said no to squats. It's just too stressful on the tissues for most people. In my experience you can strengthen more naturally with daily activities in the early weeks and months. No unnecessary lingering pain issues with knee #2 by listening to my knee.
 

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