hello. 7 weeks ago i had a tkr. I am experiencing a major band effect and still have lots of pain as I walk. I am using a walker, attempting use with a cane but I am unable to be confident and secure with it yet. I have little flexion in my knee, maybe 80 degrees. I’m seeing my dr tomorrow and am sure he’ll suggest an MUA which i really don’t want to do. I am not using pain meds bc I am unable to get any more—the dr cuts them off after 7-8 weeks. Is it possible to get more flexion as i continue my pt exercises on my own? They seem harder to do with each day. It’s the darn band sensation that stops me from being able to walk well. I thought I’d write on a forum just for support. It seems that there are specific time frames to be able to do certain things whether it’s flexion or extension or walker vs cane and it’s hard to just let my own journey be just that.
TKR Kneecap Sensitivity during Recovery
- Thread starter Rdaleg
- Start date
Welcome to BoneSmart, @Rdaleg. I'm glad you found us.
Please give us the exact date of your TKR and which knee had the surgery.
At 7 weeks you are still very, very early days in this year-long recovery. Your lack of flexion is due to inflammation, which can be made worse the aggresive physical therapy. Are you icing and elevating frequently through out the day? That's be best way to get inflammation under control.
I will leave you are recovery guidelines -- with more details about icing, elevating and ROM below.
Please give us the exact date of your TKR and which knee had the surgery.
You do NOT need to have a MUA if you don't want to. It is your knee and you can refuse.
At 7 weeks you are still very, very early days in this year-long recovery. Your lack of flexion is due to inflammation, which can be made worse the aggresive physical therapy. Are you icing and elevating frequently through out the day? That's be best way to get inflammation under control.
I will leave you are recovery guidelines -- with more details about icing, elevating and ROM below.
Since you are still very early days in this year-long recovery, You will find the articles below in our Recovery Guidelines helpful. Following these guidelines will help you have a less painful recovery.
Just keep in mind we are all 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 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.
If you want to use something to assist with healing and scar management, BoneSmart recommends hypochlorous solution. Members in the US can purchase ACTIVE Antimicrobial Hydrogel through BoneSmart at a discount. Similar products should be available in the UK and other countries.
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
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
Good nutrition is very important during recovery:
Dietary Tips for Recovery
Nutrition Basics
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.
Just keep in mind we are all 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 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.
If you want to use something to assist with healing and scar management, BoneSmart recommends hypochlorous solution. Members in the US can purchase ACTIVE Antimicrobial Hydrogel through BoneSmart at a discount. Similar products should be available in the UK and other countries.
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
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
Good nutrition is very important during recovery:
Dietary Tips for Recovery
Nutrition Basics
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.
Many of us deal with this "tight band" sensation for months after surgery. It's common and it does improve with time.
I think you will find this article helpful: Tight Band feeling across the front of my knee
This is NOT true. We all recover differently. There is no "window of opportunity" for regaining flexion or extension. Please read the articles I shared above and you will learn more about this.
Yes, definitely! After a tough first year my ROM continued to increase well through my second year! And, I had stopped all formal exercises.
If Tylenol agrees with you, then the most effective way to take Tylenol is 2 x 500 mg tablets every 6 hours, to a total of 4,000 mg (4 doses) in 24 hours. You need to take it regularly, to keep up the levels in your bloodstream. If you just take the odd dose now and then, it's far less effective.
Check all other medications you're taking, to make sure there is no Tylenol/Acetaminophen/Paracetamol in them. If there is, scale back one or two of your regular Tylenol doses, so you stay within that safe 24 hour limit of 4,000 mg.
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Hi @Rdaleg !
A lot of our members have had aggressive PT or their own impatience create setbacks that actually interfere with healing.
I hope you're icing and elevating "toes over nose" 45 minutes at a time, several times daily.
Some of our members have shared charts of their progress regaining flexion. As you can see, for each, it returned slowly but surely.
Campervan’s ROM history
92 - 8 weeks post op
105 - 10 weeks
107 - 5 months
110 - 6 months
112 - 7 months
116 - 9 months
119 - 11 months
118 - 1 yr
120 - 1yr 2 months
Bertschb’s ROM history
2 months - 80 degrees
3 months - 85 degrees
4 months - 90 degrees
5 months - 90 degrees
6 months - 110 degrees
7 months - 120 degrees
8 months - 125 degrees
9 months - 130 degrees
10 months - 135 degrees
11 months - 140 degrees
12 months - 140 degrees
A lot of our members have had aggressive PT or their own impatience create setbacks that actually interfere with healing.
I hope you're icing and elevating "toes over nose" 45 minutes at a time, several times daily.
Some of our members have shared charts of their progress regaining flexion. As you can see, for each, it returned slowly but surely.
Campervan’s ROM history
92 - 8 weeks post op
105 - 10 weeks
107 - 5 months
110 - 6 months
112 - 7 months
116 - 9 months
119 - 11 months
118 - 1 yr
120 - 1yr 2 months
Bertschb’s ROM history
2 months - 80 degrees
3 months - 85 degrees
4 months - 90 degrees
5 months - 90 degrees
6 months - 110 degrees
7 months - 120 degrees
8 months - 125 degrees
9 months - 130 degrees
10 months - 135 degrees
11 months - 140 degrees
12 months - 140 degrees
Hello again. I posted on here a couple of weeks ago about my 10/17/24 left tkr and received helpful feedback. I wanted to know if anyone is experiencing extreme sensitivity of the kneecap? If a sheet grazes my knee it is quite painful. Just sitting wearing anything over my knee causes pain. The pain is pretty intense and nothing really does anything. I was told about a topical called biofreeze professional that I might try. But i wondered if anyone else is experiencing that. My dr said that walking is the best thing to do. I continue to do my knee extension and flexion exercises as my knee is incredibly stiff and not too moveable. Thanks in advance.
Many of us have complained about this problem during recovery -- it's a common experience and indicates that the nerves are reactivating. It does improve slowly with time.
When I experienced it with my first TKR, I took the advice of another BoneSmart member and put some plastic wrap around my knee to protect it from having the sheet rub against it at night. Other suggest trying to acclimate to touch by gently pulling a piece of soft, light fabric across it.
Also, please notice that I've merged your newest thread with your original recovery thread because we prefer that members maintain just one recovery thread. This way all your information is in one place, making it easy to find and serving as a diary of your recovery. Having all your information is all in one place, also enables our staff and other members to advise you better. And you won't miss or lose relevant posts and advice.
So, please post any updates, questions or concerns here. I changed the title to reflect your newest concern, but iIf you’d like a different title, let us know.
You may want to bookmark your thread to make it easier to find. For more on how to navigate the forum, you can read through this article:
How can I find my threads and posts?
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@Rdaleg
Biofreeze professional is menthol, used in many similar OTC topicals.
It's safe to use if your incision is 100% healed.
However, it's most effective for pain from arthritis or angry muscles, not for the type of post op sensitivity you're experiencing as your tiny sensory nerves wake up and start reconnecting, but misfire. It's possible it might help, but equally possible it might trigger an exaggerated and worse sensation.
Biofreeze professional is menthol, used in many similar OTC topicals.
It's safe to use if your incision is 100% healed.
However, it's most effective for pain from arthritis or angry muscles, not for the type of post op sensitivity you're experiencing as your tiny sensory nerves wake up and start reconnecting, but misfire. It's possible it might help, but equally possible it might trigger an exaggerated and worse sensation.
I agree about the Biofreeze, and I wouldn’t use it on a 2 month old knee. The sensation it gives is quite intense. I’m currently using it for a low back/hip issue, and even after washing my hands after applying it, the sensation lingers for a while.
I never tried the Saran Wrap but I know many members like it.
This knee sensitivity will last for a while, unfortunately.
Thank you so much, Layla, for asking how I am doing.
Update: I ‘graduated’ from official physical therapy just this week. I am still using a walker and practicing daily and doing much better with my cane. I can even ‘walk’ a little without anything. I do still have quite a bit of pain and also the incredible sensitivity on my kneecap. The pain is almost unbearable especially at night. I get up from time to time to see if my knee is still working. Of course I know it is but it helps to move a bit. I feel the sensitivity 100% of the day and nothing seems to relieve it. Sometimes it helps to have nothing covering the kneecap but with the cold weather that is nearly impossible. AND I keep doing my exercises. I’ve reached a 95 ° flexion after being at 70 and 80ish for so long. I am told I am making great progress. Just slow compared to others which is why this forum has been quite helpful. And i have learned that comparison is the worst thing to do after this kind of surgery!
Update: I ‘graduated’ from official physical therapy just this week. I am still using a walker and practicing daily and doing much better with my cane. I can even ‘walk’ a little without anything. I do still have quite a bit of pain and also the incredible sensitivity on my kneecap. The pain is almost unbearable especially at night. I get up from time to time to see if my knee is still working. Of course I know it is but it helps to move a bit. I feel the sensitivity 100% of the day and nothing seems to relieve it. Sometimes it helps to have nothing covering the kneecap but with the cold weather that is nearly impossible. AND I keep doing my exercises. I’ve reached a 95 ° flexion after being at 70 and 80ish for so long. I am told I am making great progress. Just slow compared to others which is why this forum has been quite helpful. And i have learned that comparison is the worst thing to do after this kind of surgery!
Hi. I had a total knee replacement on October 17. Just passed my three month anniversary yesterday. Still using a walker, practicing with a cane daily. Still have quite a bit of pain and sensitivity. I know I’ve made great progress and only wish I can ‘get rid’ of the darn band sensation that is always with me, as well as the pain. I’m at 95 degrees with flexion last measured this week. And less improvement with extension. From all I’ve read and from this forum I’ve learned that not only does each person recover on their own timeline, but recovery can continue for months and months. I’m just looking forward to less pain and being able to walk more freely! I’m grateful to the staff and folks who are here….
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Thank you for the update @Rdaleg
Slow and steady...
You might try a blanket lifter at the foot of your bed - I have used one for many years for other reasons but found it so helpful after my TKRs.
Have you spoken with your surgeon or primary care provider about possible prescription medication for nerve pain? There's one or two anti depressants that are also very effective for nerve pain at low doses, as well as a couple of meds used specifically for nerve pain. One can be quite sedating and is often taken at bedtime to also help with sleep. If you hadn't considered going this route, it's surely worth speaking with a provider early next week.
Slow and steady...
You might try a blanket lifter at the foot of your bed - I have used one for many years for other reasons but found it so helpful after my TKRs.
Have you spoken with your surgeon or primary care provider about possible prescription medication for nerve pain? There's one or two anti depressants that are also very effective for nerve pain at low doses, as well as a couple of meds used specifically for nerve pain. One can be quite sedating and is often taken at bedtime to also help with sleep. If you hadn't considered going this route, it's surely worth speaking with a provider early next week.
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Yes, you’re making progress! Because your ROM was low for so long, it will take you longer to get better numbers. As mendogal said, slow and steady is the way to go. Don’t think that the more exercises you do, the faster your ROM will improve. We each have our individual healing rates, and nothing can change that.
You have lots of time to improve in this year long recovery!
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I have taken gabapentin in the past for sciatica and it does work for nerve pain.
It can also help with sleep. I agree it would be worth discussing options with your GP
I‘ve moved your post above, #16, out of the Monthly team thread as we reserve that thread for surgery date information, and so members can see who else has surgery the same month. We prefer all other comments and discussion to take place in a pre op or recovery thread, such as this one. Enjoy interacting with others who are on the same journey, here in this thread, and Best Wishes as you continue on your healing journey. 
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