Muscular Pain in Thighs

[marennorge]

Hi Folks,

I have enjoyed reading this forum, and I am so glad I found it. I am 12 weeks out on the right knee, 21 on the left. I am currently undergoing some aggressive PT for both knees at a rehab facility. It's going well, but I am frustrated by the muscular pain I have in both thighs when I walk or stand for any length of time. As soon as I sit for a while, the pain goes away. It doesn't seem particularly related to the PT, although they are working on those muscles to make them stronger. I hate to think I traded achy knees for achy muscles. Anybody else have this, and does it go away with time and exercise?

Thanks.

 

[dw6928]

Where on your thighs does it hurt? Above the knee cap is the quad tendon which is cut and resewn and hurts everybody during rehab. On the outer side of the quads is the IT band which runs from the hip down past the knee and is notorious for post-surgical TKR pain. You are at 12 weeks and in PT at rehab?
Is this outpatient rehab? I had my first TKR in Jan 08 and the 2nd one month ago. I have both the quad tendon and the IT band pain. ICE, ICE ICE and elevation after PT.

 

[Doug]

There's also a good possibility that prior to the surgeries, due to the pain in the joints, your thigh muscles weakened. Just keep up the good workouts and it will all come around.

 

[marennorge]

I am an outpatient at a rehab center. I had 5 weeks of inhome PT for both knees, but waited until I had the second knee done before going for the outpatient PT. Yes, I have the band pain just above the knees but wondered about the soreness for the rest of the thigh muscles. Since my health insurance will cover me (with a co-pay) until the end of October, I am taking advantage of it as I really want to get back to 100%.

Thanks for your reply.

 

[RickB]

I have been out now from BTKR for 31 days on the right and 21 days on the left and I have pain in my thighs and caves in both legs. This is due to my muscles adjusting to my new legs. Like Doug said, keep up the work in PT and before you know it, it will be only memories.

God Bless,
Rick

 

[AlaskanTKR]

I am a bit over 8 weeks on a rtkr. I can remember the calf pain and hated it soooo bad when we first started the aggressive pt. On occassion I have thigh pain that I knpw is related due to strain on sleeping muscles. Like the others say - rest ice and elevation really help. I am working through hip and lower back pain now because of all the "waddling" over the past 8 weeks. I was told to ice the hip - it seems to be working. The back gets a ton better when I just stop and rest. Today was a rough day - Drove 100 miles round trip (first time since surgery) to the OS and actually walked through OLD NAVY ( alright - so I sort of walked in and walked out in 10 minutes - but I did manage to buy a shirt). Man o man my knee, quad, hip and back are ugly - ice and rest will do the trick and off to school i go tomorrow - hang in there. REST REST REST!
MArianne

 

[Josephine]

Where on your thighs does it hurt? Above the knee cap is the quad tendon which is cut and resewn and hurts everybody during rehab.

Never heard of the quads tendon being cut during a TKR, dw. You wouldn't be able to use it afterwards if it was.

Sometimes it does get interfered with for a whole other variety of conditions but then the patient has to spend a few weeks in a cast while it heals.

 

[dw6928]

Perhaps I misspoke: there is an incision in the quad tendon and the quad itself so that it may be 'maneuvered' so the surgeon may gain access to the knee itself. Is that correct Josephine?

 

[Josephine]

Well, to my knowledge the quads never seems to be much of a problem being moved aside. Mind you, I have heard of US surgeons do some bizarre things so I may not be as well informed as you on that point. I just know that in my experience any cut in that structure would be something to be avoided.

 

[ship4]

According to my book on TKR:
As part of the surgical procedure, the quadriceps tendon , located just above the kneecap, is divided longitudinally (lengthwise) in order to gain access to the knee joint. Because it is cut, it is painful postoperatively. The quadricpets tendons and muscle receive the most stress during walking and knee-flexion exercises. The stress from these activities on the repaired tendon and muscle results in a significant amount of pain. This is normal and will subside over the next few weeks.
Best,
Crystal

 

[Josephine]

Jeepers! Think I'd avoid a surgeon who does that.

 

[ship4]

I think most of us in the States have it done this way. Both of mine were done this way. My scar is 6 inches long on each leg. Apparently it is the norm here. That is why it takes a long time to build up the quads again. I also had a lateral release of both patella tendons during my BTKR surgery.
Best,
Crystal

 

[dw6928]

Mine was done the same way as Crystal's. I believe it has become the norm in the US these days Josephine. I had a discussion w/ my OS about the pain above the kneecap that everyone complains about. Reason: surgically "attacked" quad tendon. Bottom line: I have no knee pain for the first time in 35 years!

 

[nin]

I have to say I am just over 2 weeks past my RTKR,and the pain in the back of the calf is just beginning to subside a little,had my 2nd session of physio yesterday it went well but ice and elavate were the key words last night...;]but the good news was my knee bend sat and laying is now 125 degree's as it was 95 last week physio are really pleased as am I.
And to be able to lay it down flat on a bed without pain is sheer joy,okay its still swollen and uncomfortabe but as all you guys on here said,"its so worth while doing"..I am still taking the odd Tramadol for night time sleeping,as they seem to work for that,so if the second knee does need a tkr as was suggested after this op,it wont seem so daunting.
Nin

 

[ship4]

Nin,
Wonderful ROM results! Congrats to you! I am looking forward to my 4 month office visit with the OS. I would like to know what my ROM is currently. I keep working on keeping my foot flat and bending my knee with it on a stair that is about 16 inches off the floor. I am hoping I have a 135 or more ROM. I only had 9 home PT sessions post op following 6 days in a rehab hospital. When I was released I too was @ 125 and 0. I am working hard at gaining my strength back in my muscles and working them evenly as I over compensated with my right side for over 12 years. I have been diligent about working both legs evenly. (I had BTKR in mid June).
I do believe it will take me a full year before I fell better and can confidently participate in walking, hiking, and skiing again. Good Luck to you!
Best,
Crystal

 

[nin]

Many thanks Crystal
At the moment it seems to be getting better every day and long may it continue.
Now after hearing the news the other knee also wil need attention as it was hurt in the accident but I thought not as badly,I will not face it with so much trepidation.
It is just so wonderful to be with out the "toothache" in the knee,
Its stiff today but the sun is shining so off to the garden to have a wee sit and enjoy
Nin

 

[AlaskanTKR]

Crystal -
I too have had the quad tendon cut - I have a 9 1/2 inch scar to prove it - I too think it is standard for most - unless they are doing the minimmally invasive type of surgery. We really worked on strengthening that tendon at pt!

Marianne