TKR Knee pain after 4 weeks post op.

hwhcarol

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I had my knee replaced on June 9. Right now I am at 100 degrees of flexion when the therapist pushes. I have been having more pain than usual the last few days. I am now able to sleep on both sides and am taking the pain medication every 4 hours, doing the exercises daily and getting therapy 3 times a week. Why is it hurting more?
 

Pumpkln

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@hwcarol,
Welcome back to BoneSmart! :welome:
Right now I am at 100 degrees of flexion when the therapist pushes. I have been having more pain than usual the last few days.
Best guess is because the PT is pushing on your knee too hard, causing pain and increased inflammation.
Your knee is letting your know this is too much with increased pain.
Let your PT know they can no longer push and shove on your knee.
Ask your PT to help you with finding ways to reduce pain with ice, elevation, and TENS, gait training, gentle exercises, balance and how to pace yourself so you do not cause additional irritation to your knee while it is still healing.

Swelling is what is blocking your ROM, as it goes down your ROM will be there, as it has been from the beginning.
The only ROM that counts is the ROM you get on your own.
You are still very early in this yearlong+ recovery, though most start feeling much better around 3-4 months.

Here are some gentle activities we recommend to improve 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:
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 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 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.
 

Pumpkln

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Please let us know which hip you had replaced in 2011 and the exact date if you can recall at this late date! Having that information will help us advise you knowing your complete joint replacement history.
Thanks!
 
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hwhcarol

hwhcarol

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Hi,
I am concerned because I am taking a nap mid morning and mid afternoon every day. Has anyone else experienced this?
 

Layla

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Hello Carol,
Energy Drain is common after joint replacement, which as you know is a major surgery. Our body does it’s best healing while we’re asleep. Your thread title states you’re sleeping most of the day. Could you please break that down into how many hours you’re sleeping during the day? Wondering if you’re still on meds and that’s contributing to your sleepiness? If so, you may want to talk to your surgeon or a member of his care team about adjusting meds.

While fatigue is considered normal after surgery, it usually improves as your recovery progresses. Week to week there should be some progress back to your normal energy level.

Hope you’re feeling more like your old self soon. :) Happy Monday!
@hwcarol
 

Roy Gardiner

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You'll notice that I have merged your newest thread with your original recovery thread. For several reasons, we prefer that you only have one recovery thread:
  • That way, we have all your information in one place. This makes it easier to go back and review your history before providing advice.
  • If you start new threads, you miss the posts and advice others have left for you in the old threads, and some information may be unnecessarily repeated
  • Having only one thread will act as a diary of your progress that you can look back on.
So please post any updates, questions or concerns about your recovery here.
 

sistersinhim

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Being able to sleep so well is a huge blessing. I took many naps for the first couple of months. As Layla said, while you're sleeping, your body is in increased healing mode. Many are envious of you.
 

kneeper

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Hi,
I am concerned because I am taking a nap mid morning and mid afternoon every day. Has anyone else experienced this?
I did that regularly, particularly in the first month. :sleep:
 

Jockette

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I took a lot of naps, too. I was exhausted!
 

Wolvesfan

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@hwhcarol ... In the first 4-6 weeks after my surgery, I was stunned by how tired I felt and how little energy I had for anything. I thought maybe something was wrong, but then a friend sent the attached quote to me. It helped me listen to my body and acknowledge the fact that rest/sleep was an essential part of healing. Best wishes to you!
 

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Rick951

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@hwhcarol Sleep is great as everyone else has said. I am 2 weeks post OP on my 2nd PKR. When I got home from the hospital. My plan was to sleep, Ice, and Elevate as much as possible. Mission accomplished! I suspect I slept 18 hours the first few days home. I was only awake to go to the bathroom, add ice to my Ice machine, and eat. The other thing that a lot of rest does for you, the time passes quickly. The first week or so after a knee replacement is no fun any way.
As for your PT, I am amazed the draconian practices and attitudes of years past still exist.. Think of it this way. If you ran into some on the street, and they assaulted you the way the PT did. You would have them arrested for assault and battery...
 

Toyon

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Today is four weeks since my total knee replacement, and I enjoy a rest in bed at least once each day. It really helps me make it through the day.
 
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hwhcarol

hwhcarol

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I am so grateful for everyone's responses. I cut back on the hydrocodone to 1 every 6 hours and have a lot more energy now. However, this is week 5 and I am still using a cane because it hurts too stand on it. My flexion has gotten so much better! I am now at 105 degrees, so that is a real accomplishment.
 

Jockette

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It’s fine to be still using a cane at 5 weeks. I used mine for months. There is no time by which you should give it up. Use it as long as you want to.
 

Celle

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@hwhcarol
Recovery from a knee replacement can take as long as a full year, although you will be able to do most things long before that. It's not the sort of recovery you can bounce back from in 6 weeks or so.

Like most orthopaedic surgery, nothing happens fast. It takes time for your bones and tissues to heal from this major surgery and you can't speed it up, no matter how much you'd like to.
If you think of it in terms of a race, it's a marathon, not a sprint, so you need to pace yourself.

The energy drain will probably linger for several more weeks - maybe even months. You see, most of your body's energy is being directed towards healing your knee, so there isn't much left for anything else.

Don't worry about still needing to use a cane this early in recovery. It's just a tool, to take some of the strain off your healing knee. As Jockette said, some people need it for months.
There are no prizes for giving it up early, so keep using it. It's much better to keep using the cane than it is to risk having a fall.

You will know yourself when it's all right to give up the cane. Your knee will feel stronger and more reliable. You won't feel as if your knee could give way, and you'll begin to accidentally leave the cane behind when you start to walk.
 

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