TKR Intense Medial Pain - 8 weeks after RTKR

[Trapper4ever]

RTKR - I am currently 8 weeks post op and have intense pain about the size of a golf ball or a bit larger on the medial side of my knee cap. It only hurts when I am doing my stretching exercises for ROM. Unfortunately, this sharp intense pain is interfering with any gains in my ROM. (Currently at 0 - 103 degrees on my own up to 110 with PT push.) I have been stuck in my current ROM for three weeks now and I am getting very frustrated. I think my PT is also at a bit of a loss as to what to do. I am working hard at my recovery, 3 PT sessions per day at home as I am a very active person and want to get back to my workouts. I am massaging the knee and especially the medial area 2X per day and have even have a professional massage therapist helping. I've tried ice, heat, Biofreeze, without any luck at all. The pain is just so intense in that area that when the PT pushes my stretching, it brings me to tears. I'd like to believe I can take a fair amount of pain, but this is awful. Currently on 2400 mg. of Ibuprofen per day (per OS for swelling) and 1 Tramadol before a PT session. A friend who had a TKR approximately a year ago was put on muscle relaxants and used Voltaren for a similar issue. Is this something I should ask for or are there other options? Really struggling as to what to do.....any input/advice would be much appreciated.

My surgical date for my RTKR was 05/12/2020 - added as requested. Thank you!

 

[Pumpkin]

@Trapper4ever
Welcome to BoneSmart, glad you joined us.

Please post your surgery date, a moderator will add it to your signature for you. Having the exact date will help us properly advise you. Thanks!

Unfortunately, this sharp intense pain is interfering with any gains in my ROM. (Currently at 0 - 103 degrees on my own up to 110 with PT push.)

Your ROM is great for 8 weeks, your knee just needs some TLC and time to heal. Your ROM is there waiting for the swelling and inflammation to resolve so your ROM can reveal itself.

All the pushing and focus to gain ROM is too much for your knee, and may be causing the pain on the medial side of your knee.

Ask your PT to help you with finding ways to reduce pain and swelling with ice, elevation, and TENS, also ask about gait training, balance training, and gentle exercises. Your knee ROM will increase as you heal, trying to push it may set your recovery back.

We recommend theses two gentle activities for ROM.
Heel slides and how to do them and Extension: how to estimate it and ways to improve it .

Here is your copy of the Knee Recovery Guidelines, the articles are short and will not take long to read.

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:

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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

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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

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the BoneSmart view on exercise​

BoneSmart philosophy for sensible post op therapy​

5. At week 4 and after you should follow this

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Activity progression for TKRs​

6. Access these pages on the website

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Oral And Intravenous Pain Medications​

Wound Closure​

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.

 

[sistersinhim]

@Trapper4ever, please give us the date of your TKR and tell us which knee it was. Knowing this helps us to advise you better. We'll add this to your signature for you.

Your ROM is really good for only 8 weeks out. I think your pain is coming from doing way too much for your baby knee. All it needs is gentle movements, not aggressive PT. Try icing and elevating more and exercising less. This should lessen your pain and swelling.

 

[Trapper4ever]

My surgical date for my right knee TKR was 05/12/2020. Thank you!

 

[Pumpkin]

Thank you for your date. I’ve added your surgery date to your signature and added you to the May Marvels. You will find other members in the May Marvels who had surgery around the same time as you.