TKR IT tendonitis pain

Sosazzy6362

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Hello. .new to doing this so apologies if I misstep...thus? I am 59, 5' 9, 135 pounds. Very athletic and osteoarthritis made me do it. Anyway 5 weeks out from RTKR...recovery for the knee has been awesome. My issues have been with lateral hamstring pain and outside IT band pain. I am 120 with ROM but at a 6 for extention. My knee doesn't hurt the tendons hurt. Plus I still have swelling. I am doing all my strength exercises and stretching but can't seem to get rid if the pain. Has anybody else experienced this? Thanks!
 

ski_bum

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Hello. .new to doing this so apologies if I misstep...thus? I am 59, 5' 9, 135 pounds. Very athletic and osteoarthritis made me do it. Anyway 5 weeks out from RTKR...recovery for the knee has been awesome. My issues have been with lateral hamstring pain and outside IT band pain. I am 120 with ROM but at a 6 for extention. My knee doesn't hurt the tendons hurt. Plus I still have swelling. I am doing all my strength exercises and stretching but can't seem to get rid if the pain. Has anybody else experienced this? Thanks!
June 10, 2021 RTKR, still some pain in the Knee But Have IT Band issues. Issues were from begin when walking it felt like my knee was pushing out the side which turned out to be IT Band. Pain from middle of knee up to my hip. After doing exercises and using a Roller pain stopped to the hip but went to below knee. Pain has almost stopped but when walking IT Band pops out.
March 31, 2022 second knee replacement. Knee cap area is extremely swollen and thinking IT Band is going to be an issue again. I get staples out April 11, 2022. So time will tell. Would love to follow your recovery. Good Luck.
 

Layla

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Hello and Welcome to BoneSmart. Thanks for joining us!
I’m sorry you’re dealing with pain. I don’t have much advice since I had a hip replaced, not a knee, but I‘m sure you’ll receive a lot of feedback here. Please leave the exact date of your surgery below so we’re able to create a signature for you.
Thanks in advance.

I will leave the BoneSmart Recovery Guidelines for you with wishes for speedy relief from the pain your dealing with.
Wishing you comfort and a nice weekend.

Knee Recovery: The Guidelines

As you begin healing, please keep in mind that each recovery is unique. While the BoneSmart philosophy successfully works for many, there will be exceptions. Between the recommendations found here, your surgeon's recovery protocol and any physical therapy you may engage in, the key is to find what works best for you.


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. 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.
 

Layla

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If you could share a bit more info, it may be helpful for those stopping by with comments or advice -

Are you attending PT and if so, how often, and for how long have you been attending?
What types of exercises are you engaging in?
Also…are you icing for pain? If not it may bring you some relief. Check out the article on ICE in the Recovery Guidelines. :)

Here is an article from the BoneSmart Library that May be of interest -http://bonesmart.org/forum/threads/itb-ilio-tibial-band-issues-and-treatments.18936/
 

Jockette

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Hi and Welcome!

5 weeks is still very early days in this year long recovery. It‘s a bit early to be working on strengthening, your whole leg, not just the actual knee area, has been affected by this surgery and needs time to heal.

You will have pain and swelling for a while yet, especially if you do something your body doesn’t like. You may have to cut your exercises back a bit and give yourself more healing time. Don’t look at this as doing nothing, look at it as giving your body the best opportunity in which to heal. Recovery is temporary, so give it the time it needs. Doing more than it is ready for causes setbacks which can lengthen the recovery.
 
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Sosazzy6362

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Thanks everyone for input. I had surgery 3/3/22. I had a block and released the same day. Was in horrible pain 12 hours later as block wore off too quickly. Was in ER because my quad and hamstring seized. Was the most horrific pain...Since then that seems to be the pain more than the knee. I use a trigger gun for hamstring and quad and massage. I am still in PT...session 8 coming up. Just doing what PT recommends. I ice 6 to 7 x a day especially after exercise or if I just start to ache. I use Biofreeze on the hammy and the IT band. My PT thinks it is IT tendinitis maybe the tourniquet was too tight..I don't know. Just trying to do what I am told...without over doing it.
 

benne68

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Hi @Sosazzy6362 and welcome to BoneSmart.

Like you, I had severe IT band issues following my TKR. For me, what helped was backing off the "strengthening" exercises and focusing on walking plus massage and simple stretching. My PT showed me some self-massage techniques and as well as the areas to target.

I agree that some of your pain may be caused by doing to much at this stage of your recovery. As @Jockette said, you are still very early days and your body may be telling you it needs more time to heal from the trauma of surgery.

Try backing off for a few days and see if things improve. There is no reason to push yourself to pain. Your flexion is well ahead of where most people are at 5 weeks post-op and your extension is fine -- it usually takes a bit longer to regain.
 
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Sosazzy6362

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Thank you @benne68 ...I had a terrible night because I really over did it. I am going to focus on just stretching and massaging....icing...and Advil and hope that the swelling and pain subsides. I don't have PT until Tuesday so I think that will help as well. Appreciate the feedback!!
 

sistersinhim

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What we do during the day can sure catch up with us at night, can't it? That's why we need to take things slowly and then see how the knee reacts that night.

If you can take it, Tylenol is a better pain reliever after surgery than Advil. You can take up to 4000mg of Tylenol, (acetaminophen), a day, counting everything that has it in it. Being an NSAID, Advil, (ibuprofen), is good for arthritic pain but can be rough on the tummy.
 
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Sosazzy6362

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Thank you @sistersinhim you are so right....at night is the absolute worst...1.5 is about my limit before I wake up from stiffness or pain. I have done no strength training just stretching since I over did it on Sat. I go to PT today and hope that she can guide me as to what I can do to help the tendonitis improve. We are going on a 13 day road trip starting tomorrow...so any words of wisdom would be helpful. We are not planning on driving more than 5 hours a day and I will be able to plug in my ice machine and heating pad. I told my husband we will probably have to stop every hour just so I can walk a bit. We are driving to Boston as our daughter will be running in the Boston Marathon. We have plenty of time to get there. Of course I am nervous because I won't be able to do my regular PT...but maybe that will be a blessing? I have learned my lesson...hopefully I haven't done too much damage.
 

FourCats

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One suggestion for your trip is to sit in the back seat so you can elevate your leg. I find even a 1-2 hour trip with my leg down causes swelling. Glad you’ll be able to use your ice machine.

Good luck to your daughter!
 

sistersinhim

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Your knee is awfully young to be taking a trip like that. If there was a way, I'd suggest that you not go. I'm afraid you'll be miserable. You have gotten some good advice about sitting in the back with your knee elevated. You can use the chemical ice packs while traveling and then the ice machine at the hotel. Don't plan on doing a lot of walking or your knee will rebel. I hope your trip is enjoyable.
 
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Sosazzy6362

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I am one week of road trip. Our truck as a plug in so I am able to elevate and ice all day. We only do about 6 hours a day which includes plenty of stretch stops. It has actually been the best thing I could have done fo4 the tendonitis as I can't walk and so things around the house because sitting is hard for me. Anyway...my last PT..before my trip. My extention is now 12...as my PT says very bad....I am scared now that I will never be able to straighten out my leg to a 3 or 4. I don't want to push it but any suggestions on what I can do to help with extention? I don't want to do anything aggressive right now as to aggravate the tendonitis. I have been stretching while in the truck...just hoping I haven't passed the window of opportunity. Thanks!
 

FCBayern

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I have been stretching while in the truck...just hoping I haven't passed the window of opportunity. Thanks!
You haven't missed the "window of opportunity" because there is no such thing! I was still at 4 degrees a year out from TKR, but during my second year of recovery I progressed past 0. The main thing I did when my knee felt well enough was to walk with as long a stride as possible to slowly stretch things naturally. I too was told about my "window of opportunity", but after my own experience, and those of many many BoneSmarties I know that's a bunch of hooey! You might want to revisit this article:
 

sistersinhim

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am scared now that I will never be able to straighten out my leg to a 3 or 4.
It is quite common for the extension to take longer than the bend to come in. You are only 6 weeks out, which is way too early to be worried about ROM. You have years for your ROM to improve. Swelling also affects the extension, so getting that down should help, but don't expect it to come fast. Those huge muscles and tendons behind the knee take a while to stretch.
 
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Sosazzy6362

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Thank you...it helps hearing that. I am so afraid that the set back will totally mess up my recovery and progression.
 

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Hi, Sosazzy6362!

Hope your trip went well.

I wanted to chime in on tendinitis. I ended up with quadriceps tendinitis at about 4 weeks after my TKR, after a PT overworked me. A new PT and my own research confirmed that tendons take a long time to heal- way longer than you might imagine! So, pushing strengthening while it’s still pretty painful may be counterproductive. My tendon STILL hurts sometimes when I rise from sitting and I’m almost 6 months out from surgery and 5 months from that injury- though it seems to be 90% healed now. It took me a long time to stop worrying so much about what other people think about my recovery, and about what my final outcome might be. Learned some self talk to nip in the bud those negative thoughts.
So, slow and steady will be the way to go and you’ll get there!

Best of luck,
:puppysmooze::console2:
 
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Sosazzy6362

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Thank you @Lovebugs for input. I am back from trip and went for my follow up with dr. because I still have so much inflammation and swelling he put me on meloxicam. Then I went to PT and had another session of just massaging and trying to work through all the knots in my piriformis, hamstring and IT band. We finally decided to try dry needling which I have had in the past with success. We got the okay from my dr as I am 8 weeks out. The process is painful (like deep tissue massage) they try to work through the knots. She did 10 of them with many more to go but I don't think I could have managed it. That was Friday...Sat. I felt like someone beat me with a bat...but today I am feeling better. I am taking it easy and not doing any strength training...just stretching and spinning which feels so much better. I go again tomorrow for more...and really feeling very optimistic that will help. I am lucky that I have a wonderful PT who I had when I had my left knee done 3 years ago. She listens and is very good at being supportive. I have been trying to remain positive but honestly between the gray skies and no sunshine it has been hard. I know I am making progress ...but like everyone else...IMPATIENT!!! Thanks again!!!
 

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@Sosazzy6362 I am five months ahead of you and a member of the ''hammy gang''. I too have a wonderful physio and basically, it's all about time.
I do my hamstring stretches [no hamstring curls involved at ALL] whan I think about it but the good news is, the tightness is gradually releasing.
No longer do I have to look for raised loos or grab handles to get off the loo, hamstring not replaced knee issue, and I no longer, on the whole, have to push the car seat back to get in/out.
Coming down stairs is still a little bit grin and bear it at times, again, hamstring and not the knee, but it's getting better all the time.
My physio said don't be alarmed if this still takes months to resolve. She reckons I'm doing REALLY well, and I agree. It worried me like mad at first but everything she's said and done for me, has been spot on, including occasional acupuncture on these knots. Ouch! :)
You sound as if you have a similar relationship with your physio. Be guided by her, don't worry about the time scale and just go with it. It gets better. It really does.
 

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