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Bilateral TKR Pain behind knee when working on ROM

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DragonHeart, I would wait at least another 4 weeks and keep working slowly but steadily. Also be sure you are elevating and icing to get that swelling down and watch how much you're up and doing on those knees. And at the end of that time, if you are satisfied with your ROM and it allows you to do the things you want to do, don't have the MUA. On the other hand, if you're not satisfied, then have it---but you will be quite swollen for a time after you have it and will have to take it easy for a week or two and elevate and ice a lot.
 
There is no "window of opportunity---ROM can be gained for quite some time. Do not let any PT push you into doing exercises that cause pain---only to the point of discomfort. I was lucky---my PT's understood the difference between a TKR recovery/rehab and that of an athlete.
[Bonesmart.org] Pain behind knee when working on ROM

"Patience, Grasshopper, Patience!!"
 
Roy Gardiner said:
Do you do stretches on your own or just at PT? IMO you need to do LOTS of gentle stretching, never to the point of pain but almost, every day. This is the only way that the ligaments and tendons will stretch as you want them.
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Yep, I do my stretches several times a day every day and not to the point of pain - just slight discomfort. :thumb: I found the stretches help when I have that tight band feeling across the top of my knee. I'm still having problems with the tendons behind my knees. It doesn't take much to aggrevate them. But I had problems with those tendons even before my surgery.

I just wish my bedroom wasn't upstairs. :umm:
 
bottomshollow said:
DragonHeart, I would wait at least another 4 weeks and keep working slowly but steadily. Also be sure you are elevating and icing to get that swelling down and watch how much you're up and doing on those knees.
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My next appointment with my OS is Sept 14th. That is when he says I should have a certain ROM or he will want to do an MUA. I've been icing and elevating my knees a lot more lately and can tell the swelling is going down. My sister said she can tell the swelling has gone down more in the last week or so too. I admit though that I need to be better about not over doing it and just sit down and relax more.
 
Such good information. I had my TKR done on 6-4-12. I'm right there with you, stuck at 93 degrees, released from PT because they said there's nothing more they can do to make it bend farther. My OS wants me at 125 & I was at 73 prior to the TKR. I'm not back to school yet, so my days are spent riding the recumbent bike, hurting, walking, & not enough icing, I'm afraid. My OS appointment is on 8-31 & I wonder what he'll say. He mentioned a MUA at the last post-op appointment, but said he's only done 6 throughout his 30+ career. I understand everything you've mentioned. Tight, stiff, & stuck! :gaah:
 
Ladies, don't get disheartened with low ROM. As I said above, I got stuck at just over 100 for 6 months and then all of a sudden things moved along quickly. When surgeon measured me at 8 weeks it was 92 even though physio measure two days earlier at 102. I had to sit on a plane for 2 hours to get to him so I was stiff when I saw him. He didn't even talk about MUA.

I'm probably around 115 now at 8.5 months.
 
Lori - thank you, I'm glad I'm not alone with a slow going ROM. I don't get why OS expect us to have such a higher ROM after surgery than before surgery. I'm just happy to be able to walk without pain. I really don't care what my ROM is as long as I can get around fine, which I can.

Campervan - I'm not too worried about my low ROM. I'm sure it will get better as my swelling goes down and I get back to my regular activity level. I just wish my OS would back off and not make me feel like I have to be at a certain ROM by the end of my third month post-op. Rehabing is stressful enough. We don't need OS or PT putting more stress on us by forcing us to be at a certain ROM and holding MUA's over our heads if we're slow getting ROM back. My PT is happy with my progress and his opinion means more to me than my OS opinion.
 
I don't get what "walking without pain" is? I feel every stiff step! It feels like a rigid, metal plate is covering the knee. I go up & down stairs, but the sensation of the moving plate is always there. That's why I still take Percoset, to ease that puffy, stiff, rigid feeling. It helps but I know when it wears off because it gets super stiff. Ugh! Elevating only makes it stiffer! Day or night !!! :hairpulling:
 
Lori, would you be a dear and put your surgery date in your signature like the rest of us do?
You can find the instructions here How to create a signature
That also applies to anyone else who is reading this.
Thank you.
 
Lori said:
I don't get what "walking without pain" is?
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Before my surgery I had bone on bone arthritis in both knees. I could not walk more than five minute without being in extreme pain even with a cane. By bedtime I would lay in bed a cry because my knees hurt so bad. I'd wake up in the middle of the night on the verge of tears because of the stabbing pains in my knees. They basically hurt 24/7 and nothing would ease the pain. Not even cortisone shots. Now I do not feel that bone on bone extreme pain. Yes, I feel stiffness and my muscles get sore but I am not walking in pain. Maybe slight discomfort from the swelling and stiffness but not that down right debilitating pain. I can handle the discomfort of my new knees because they are by far an improvment from my old worthless knees.
 
[Bonesmart.org] Pain behind knee when working on ROM
It appears, DragonHeart, that you have slain your dragon and are well on your way to living your new life with pain free knees! Keep up the good work, and it will continue to get better and better every week that goes by. Take care, keep us posted, we care.
 
Actually I prefer to see myself as the dragon who victoriously fought off the pesky knights and can now live in peace (or at least when my battle wounds have completely healed). :yes:
 
ROM is the primary worry of PT's and OS's---but then, they read of "where one should be" and they have, for the most part, never gone through a TKR recovery. Let them worry and obsess about the numbers---you just focus on taking it easy and knowing that ROM will show up and improve, but it will do so most likely slower than you would like it to.

ROM can indeed improve up to a year. You need to take it slowly and understand that slow and steady will prevail here. A couple of things that i did to improve ROM were to sit in a shower and let the shower massage jets hit the quads of the surgical knee (I had a BTKR). After warming up the quads, I gently did heel slides on the shower floor from the seated position.

Another activity that helped me was that, when my incisions was all healed up and I was allowed to do so, I went into a whirlpool at the gym. Again, I let the whirlpool jets massage my quads, and I would slowly and gently work my quads to the point of discomfort----NO MORE.

I would also pedal my stationary bike during the morning, afternoon, and night---and I would use a heating pad to heat up my quads before i did so.
 
I had a good talk with my PT about having an MUA and he explained to me in detail why he feels an MUA is not the right route for me to take. He also acknowledged that when measuring my ROM it's not always completely accurate because he sees that I get a better ROM when doing my exercises. Once I got through to him that he needed to be a little gentler on my knees, he's been a pretty good PT. So if my OS suggests I have an MUA I'm going to decline and I'll deal with the consequences. After all, they are my knees!

Last week my knees where angry with me for working a full 5 days (still half days though) so I took it easy and backed off my exercises. I did light stretches and iced/elevated. Today I went to ride the stationary bike for the first time in over a week and I was able to pedal better than I have been able to so far - with no pain behind my knees!:happydance:

When I get frustrated with my lack of progress or having swollen/sore muscles I remind myself what every one here says -have patience and that slow and steady will prevail. I appreciate all the support and advice given. Thanks!
 
I find that often after a particularly vigorous supine deep-tissue and tibial edema massage session (with leg stretched out, ankle on the therapist's shoulder), when I get into position to do heel slides the pain is behind my knee. My PT tells me that it's most likely the popliteal tendon. She'll have me flip over into the prone position (feet hanging off the table to avoid foot cramps) and---wince!---she uses her ELBOW to soften and stretch it. After about 30 seconds I can feel it suddenly relax and gently stretch--and then do some good heel slides.
 
It's been a while since I've posted anything. Mainly because I feel like I'm stuck in limbo and haven't had much progress. I saw my OS last Friday and he still suggested I do an MUA since my ROM has been at 85 for the past two months. :hairpulling:

Well guys this time I'm gonna do it. What do I have to lose right? At least this way I won't wonder how much more ROM I could have gotten if I had done the MUA. I'm still not all that thrilled about the procedure but I'm really bummed about my lack of ROM. I see people all around me bending their knees with ease and I get so jealous that I can't do it and will probaby never be able to bend my knees as much as I did before my surgery. So instead of wallowing in self pity, I'm gonna do something about it. I go in next Monday morning October 22nd for the manipulation and then back to P/T in the afternoon and every day for the rest of the week. Josh will be so happy to see me back in P/T. Yeah right, the other day he tried to run me over when I was walking up and down our street. That's the perks of having you physical therapist live across the street from you I guess. :rolleyes:
 
This is one of those rare occasions when I say that an MUA would appear to be the right thing to do. Are you needing both knees manipulated or just one?
 
Unfortunately I have to have both knees manipulated. Neither one wants to cooperate with me. :sigh:

I guess if I survived the surgery I can survive the manipulation. Now the physical therapy is a whole other story. That's what really has me nervous.
 
Going in tomorrow morning bright and early (6 am) for my manipulation. Let's hope something good comes of it. :)
 
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