TKR Knee pain when getting up

Tgcmoore

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I had total right knee replacement on July 12, 2022 and knee still hurts really bad when I sit in a chair or toilet and have to stand up. It is so painful. How long does this last? I dread sitting down anyplace. I am told by my therapist I have really good range of motion. But this is not getting any better.
 

Jockette

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Hi and Welcome!

After this surgery pain can last for months. A lot was done inside your knee and complete healing can take up to a full year.

What do you do at PT? Sometimes certain exercises can cause additional pain.

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.

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.
 
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Tgcmoore

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Thank you. At PT I ride a stationary bike and do some simple exercises. The last couple times she massaged the knee sides and said I was very tight. It’s just standing up after sitting that kills me, it’s like it’s ripping my knee off. when I go watch my grandkids football game it kills me to sit down on the bleachers and to get up.
 
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Jockette

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Yes, I can understand how it would hurt a lot sitting on bleachers, there’s little room to stretch your leg out and sitting with a 90 degree bend, with feet down for a while can be very painful at only 2 months post op. When I was at that stage I had to keep my leg up on something well past 2 months.

The last couple times she massaged the knee sides and said I was very tight.
Stiffness/Tightness is a normal occurrence after this kind of major surgery. 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 has been disturbed is healing...and full healing takes a full year or more.


 
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Flashlight

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I massage my knee and leg throughout the day. This is not a deep massage, but I find it really helps and is soothing.
 
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Roy Gardiner

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At PT I ride a stationary bike and do some simple exercises
You don't have to train on a bike if gaining ROM and flexibility is your objective.Using a bike to gain ROM is pretty simple:
  • Set the bike to zero resistance
  • Set the saddle low enough so that a single rotation is a challenge; difficult but not painful. When a rotation becomes easy right from the start, lower the saddle a max of 1cm.
  • Gently turn the pedals, through discomfort but without pain.
  • Continue until the knee is 'warmed up' and the rotation is now easy, or for 2 minutes, whichever is the shorter time.
  • Repeat several/many times a day, but don't go mad. Diminishing returns will apply; my guess is that half a dozen reps would be enough
  • Do not pedal fast or for more than 2 minutes, this is a stretching exercise, not training.
  • And if you get any pain or swelling in the 24 hours after doing this, cut it down until you don't
Here is a bit more chat and some pix and how 'healing' and 'training' are different

knee still hurts really bad when I sit in a chair
The pain is caused by the soft tissue not being healed, which is itself caused (often) by overdoing things. I wonder if that's you? Do you do a lot of walking or running? Do you 'work through' knee pain?

Key is, IMO, don't do stuff that hurts, or causes swelling in the 24 hours after doing it.
 
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Cjackso21

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Hello, I have had similar problems as well but also found like others, that elevating my knee makes a big difference. I even try to passively bending the knee a bit to get stuff moving before I get up. At 2 months I was still having problems getting back to work and getting up and down. It will get better! I also iced for many months after every surgery and it always helps! Good luck!
 
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Rain Dancer

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I had total right knee replacement on July 12, 2022 and knee still hurts really bad when I sit in a chair or toilet and have to stand up. It is so painful. How long does this last? I dread sitting down anyplace. I am told by my therapist I have really good range of motion. But this is not getting any better.
What technique do you use to get up? My knee still isn’t very bendy, so I keep the operated leg in a more forward position than the other leg and push up with my arms if I am in a low seat. This helps with the pain. As my ROM improves, I bring the leg closer to the other one. As for sitting, keep the operated leg mostly straight as you bend with the good leg. This may feel like a controlled plop or fall in the beginning! As you heal, you will be able to start bending the operated leg more and more without pain.
 
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Tgcmoore

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I went on a long trip this past weekend for a wedding. My legs were aching mean but we stopped every 90 minutes or so for me to get out and stretch them. I bought a camping chair that’s a little higher than most so I can bring it to the kids games and I brought that with me which was nice because it allows me to get up without pain. The biggest problem I had was using restrooms because at home I have my toilet raised seat and without it it was so hard to sit on the toilet and get up. I feel like my knee when is about to break off
 

Jockette

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Those low toilets can be a big problem! Been there, done that! Now that you’re back home, ice and elevate a lot so your knee can recover the weekend. It may take a week or two, or maybe more.
 

sistersinhim

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I found that I can reach on the front of the toilet seat with both hands and push myself up, it really helps.
 

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