Pain behind knee limits further bending

[NancyAK]

I am new to the forum. I am 14 weeks post op having had both knees replaced. My ROM as of 12 weeks was Rt 120/0 and Lt was 125/0. I was told that my ROM was ahead of "normal" but now I feel I have hit a wall.

When I first was bending my knees the pain/stiffness was in the front - now it is in the back and to the outside of my knees that is limiting my progression.

They also have a feeling of big rubber bands around them and when I push on the skin it stays in around the front areas of my knees. Before I had surgery they only bent to about the same as they are now from having frayed cartilage - OA and no cartilage behind my kneecaps.

I want to find out if anyone has had the pain behind the knee and is there a trick to getting this pain gone.

I was going to try Myofacial release and see if that will help - has anyone had experience with that?

I am only able to stand for a short amount of time before my calves and shins start to ache. Any help with that also.

I was going to try "river walking" at our water park. I am having a hard time doing my PT on my own even tho I joined my PT's Fitness Club as it can be so boring.

Any comments on what is going on with me would be great. I know this is a long and drawn out recovery and I am not at the point that "it is the best thing I have done". I am hoping that feeling comes soon.
Thanks for your help.

 

[Jamie]

Welcome to the forum, Nancy. So glad you decided to post!

You are just a little over 3 months out from surgery and that is actually fairly early in the recovery process for a TKR. I think you might be pushing just a little too hard. Your ROM sounds very good, but at this early stage it is quite normal to still have some muscle weakness and to get tired when you do things. It is possible that the pain you have is soft tissue swelling. I would suggest some icing, a little more rest and elevation and take an anti-inflammant. Doing your PT is very important, so try to keep up with what your therapist has recommended. Even walking or cycling can work. But please don't worry if you are not back to "normal" yet. It's way too soon for that!

 

[Max Wallace]

I was told at PT that depending on the size of ones calf and thigh (muscle and other) that would limit flexion.This is a tough question I am sorry you are not getting more responses. All of my pain was front and sides. Sorry I could not have been better help!

Max

 

[aussie]

Hi Nancy and welcome,

I get that tightness too, although it's not pain, just tight, so I do exercises that focus on extension, straightening the knee and it seems to stretch the tightness out. Hope that helps a little.

Chris

 

[Josephine]

Actually, you may well have some inflammation of various ligaments in your knee and the different places indicate different structures which have been aggravated by different exercises! Hope that is suitable confusing!!

But one point that you don't mention is your pain meds. See, that discomfort you are experiencing may well be a low grade, persistent pain that needs medicating. It's been quite a common problem that people interpret this as tightness or somesuch.

As for the myofascial release (myo=muscle, fascia=superficial soft tissues) who has suggested this? Is your OS planning to do this? If so, he must feel that some ligaments have tightened to the point where they won't get released by PT. Would like to hear more about this.

 

[NancyAK]

Thanks Max, Jamie, Aussie and Josephine for your replies. Aussie is right in saying that it is not a pain just tightness. Just occasionally do I get real pain anymore and then it is my shin that aches.
Josephine... lately I have not taken pain pills during the day but try to take either Advil or Aleve at night. The reason that I don't take them during the day all the time is that I never notice a difference taking them or not. It happened that way early on also. I was prescribed Oxycodone 5mg 1-2 every 4-6 hours. I could take the 2 every 4 hours and it felt the same if I took one every 6 hours. (I really didn't notice anything when I was on the Moraphine drip in the hospital either) So then I stopped taking the oxycodone during the day and took 2 Aleve which my doc told me to take instead of the Oxycodone. My PT said to not worry about taking the oxycodone and to keep taking them at night to get a good nights sleep. I was also rationing them as my doc likes you off them quickly and doesn't like to renew scripts. My last renewal was done reluctantly during my 6th week I think. I really don't like taking the Aleve or Advil as I have heartburn at night and I think that is not helping much.
The myofacial release is my idea. I had my shoulder worked on a bunch by this guy who is now my friend and we ended up trading my artwork for his services. I told him about me doing the replacements while he was working on my shoulder the last time and he said he should be able to help my knees after I had the surgery. He also does massage therapy and has also had experience working on others with knee replacements to get more ROM.
On a lighter note... I did the river walk tonight after work. It was fun but a lot of work. It really was a challenge to keep my balance with the moving water - the real test will be when I wake up in the morning. Hopefully I will be able to walk in the morning. I liked being able to do this with my friend and we also sat in a hot tub for a few minutes after we were done. That felt so good, my knees even felt pretty good walking up and down the few stairs to get out of the water park. I was shocked they felt so good. It gave me a glimpse of what the future will bring. I will be going back to walk more - I have to get my balance down good as I am going to Hawaii on vacation and want to go in the surf to snorkel.
Today my boss asked me how the new knees were doing and I said they are slowly getting better but they are still not great. He asked what type of material they were made of and I after I told him and mentioning that they were really noisy especially in the morning.. he said.. they must be like when you replace something in your car. The parts have to be worked a bunch before all the bugs and such are worked out of them. That really made me understand what is going on down there. Yeah they are stiff and make noise like new shocks on a car but after a few hundred miles you don't notice it any more. I guess I have another 175 or so miles left before all the bugs are worked out of them.
Thanks everyone. This is a really great site. I am hoping I will be able to help give someone else good information from my own experiences. Nancy

 

[aussie]

Nancy I started the exercise of laying on my tummy on the bed with weight hanging from my ankle and it really stretched out that tightness, the weight feels like it gets heavier and heavier each minute until you can't keep it on any longer, but it does help with the extension. I think it was Jamie that mentioned it in another thread. (Correct me if I'm wrong Jamie),

Chris

 

[Josephine]

Ok, you answered all my queries about your pain meds. You shouldn't need heavy duty stuff for this problem but if the NSAIDs are giving you heartburn then that's a pretty good reason for not taking them either! So the water therapy sounds like an excellent option.

I really would talk to your OS before you start getting any soft tissue releases around the new joint.

 

[beachcomber]

Nancy,
I went snorkeling 6 months after my PKR and it was great! The only hard part for me was getting back onto the boat after the beach picnic on Cozumel That first high step was a killer! (it was only 1 month after an 'scope on my other knee).
Keep up the hard work. You'll get there!
Beach

 

[Jamie]

Nancy I started the exercise of laying on my tummy on the bed with weight hanging from my ankle and it really stretched out that tightness, the weight feels like it gets heavier and heavier each minute until you can't keep it on any longer, but it does help with the extension. I think it was Jamie that mentioned it in another thread. (Correct me if I'm wrong Jamie),

Chris

I did mention the weight on the ankle lying on your tummy in bed. It worked wonders for me with extension.

 

[exjock]

I am about 6 months post LTKR and had the same pain in knee stretching past 115. PT thought I might be at end limit of new joint. I asked Dr. and he did not think 115 was a problem. That is about where the other knee is. I have large legs so this might have something to do with it. I can get in and out of car, put on shoes and socks and don't have pain so I am ok with where it is at.

Probably does not answer your question but I never really got a good answer.

 

[aussie]

Who ever thought you could exercise while laying in bed. Bonus!!!!!!

Chris

 

[NancyAK]

Too funny Chris. That was an exercise my PT had me do to get to 0 extension. I have gotten there and have kinda put that exercise on the back burner but maybe it will work to get my calves to not bark so much at me when I stand up. I had not thought of that. how long has it been since your surgery?

This forum is great. I am figuring out a bunch of things and finding out that I am probably expecting too much too soon. Hearing that people are having the same problems at 5 months and I am having at 3 makes me feel a bit better about my progress.

Thanks all.

 

[aussie]

It will be 11 weeks tomorrow, but who's counting! All seems to be going really well, I can do so many things and I'm not even worried anymore if I can't park the car directly outside the shop I need, in fact I welcome a short walk. I did swim a couple of times today so my leg is feeling a bit heavy tonight but I know it will be fine again tomorrow so all is good!

I'm still working on Flexion and Extension. I think it's going to take a while for the extension but I walk well, can go up and down stairs etc so I am not terribly worried. Also Jamie passed on some wise words, stating it's about a good life not a number so I as long as I'm progressing I'm happy.

Chris

 

[NancyAK]

Chris:
I just had 14 weeks yesterday. I am getting better talking to people when they ask how they are doing. I say it is just baby steps. Tiny things seem to improve. I am trying to be more positive but I am not at the point of being really happy about having them done yet. Tonight I did the riverwalk again. It is fun and tonight felt better than my first time on Tuesday. The riverwalk is in our waterpark that is indoors. You are enjoying summer and I am in the dead of winter living in Anchorage, Alaska. Tonight when I got out of the waterpark there was heavy blowing snow. And I learned a lesson that I put my shoes on the top of the shelf... someone had put theirs on the shelf above mine and my socks and shoes were wet from the snow melting into my shoes. it was pretty funny really.... With having snow I am glad I have a temporary handicap tag for my car so I don't have to walk on the snowy ground as much. But it expires the end of February but I should be a bunch better by then. My flexion is at a point now that i can get in and out of bed but still have a hard time if my husband's car is parked to close to my car in the garage. But you are right... as long as we are progressing we should be happy.
Enjoy the warmth.
Nancy

 

[aussie]

Yes Nancy and progression is different for everyone. I was able to walk unaided after 7 days, but my flexion and extension aren't near some of the other people on here. I could sleep in any position from early on (a few weeks after the op) but others were doing 10 mins on the exercise bike before I could do 1 forward revolution. We are all so different and probably went into the ops at different stages of Pain and disability, so I have learned to be grateful for all those baby steps, they still get you where you want to be.

Take care Nancy,

Chris

 

[Susie Mac]

I have had the pain behind my knees; hamstrings are tight and my calves are tight as well. My PT told me that my hamstrings are compensating for the lack of quad muscle and assisting in keeping me balanced. Your body has been walking for a certain way for X number of years and now your body is relearning how to walk. Your ankles and feet suffer too. If you work on walking correctly heal toe the pain does go away. I walk very slowly but correctly and I don’t have that pain. There could be swelling as well. Ibuprofen helping?? Anyway this is my 2 cents and what I was told about that particular pain. I hope you get to feeling better soon!! I am six weeks post op and I have that same pain.

 

[AlaskanTKR]

Nancy!
Hi - From a local..... Palmer.... Hang in there. I had a rtkr back in July and still have moments when I go.... huh.... Glad to see another alskan here. I am sitting at Alyeska typing while the family is skiing. Bummer this year... Next year I will be out there with them again. Anyway.... Who did your surgery. I work with Anchorage fracture. I am very pleased with them and the outcomes... even though I am not back to myself yet. I know it will take time to get muscles back to wear they were this time last year.

Anyway - If you need anything - you have a fellow Alaskan hear to chat with. We were down here at Alyeska last night and the kids were enjoying the snow... we are hopng it snowed back up in the valley -- it was pretty windblown by us!

Enjoy H2O. my kids favorite place to go!

Marianne