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TKR Severe deep calf pain'^

I think you should quit pt and let your knee rest. The swelling will go down and then your ROM will increase. You can bend well if it's swollen. If you're doing pt, it's going to swell. It's a no-win situation. Read the articles that have been left for you. Less exercise is more ROM. Try it for just a month. You will see a huge improvement. There are numerous threads that have had the same experience. Some of us even do no formal pt. I am one of them and I'm doing great! I let my live rehab my knee and ride my recumbent bike and do extension stretches. That's all! The only time I have a lot of swelling is after I've been on my feet too long or sat without elevating for a few hours. My daily living is meshes in with elevating and icing. Try it!
 
Hi i can relate Ive had that calf pain off and on since my TKR 4 years ago. I haven't really gotten an answer Ive had more ultrasounds for DVT than i can remember. I did get relief after my first revision I'm still waiting after my second revision 2 weeks ago. And I am not saying you will need a revision at all I just want to let you know someone else out there has had it.
also it seems like when i get the calf pain i have a pain on the outside of my knee i suspect inflammation in that area of my knee is pinching something. In fact i did have a Dr. or PT tell me i have radiating pain. But they never said how to get rid of it:shrug:. Don't give up! and if you find out let me know too lol.. I have a new OS for this surgery who i will see in 2 weeks if he tells me anything helpful i will pass it on
 
I would first try lots of icing and elevating. Usually most OS won't do manipulations one you can flex to 90 degrees or more. If after a couple of weeks of icing, elevating and taking pain meds you feel like you aren't progressing then if might be the time to discuss a MUA with your OS. Did your OS tell you how far he was able to flex your knee during your surgery?
 
@kneewords I have pain on the outside of my calf. It can feel like sunburn at times or strong tingling at other times. According to my chiropractor it was being caused by some lower back problems that he has been helping me with. My calf has been starting to feel much better.
 
How is your calf pain? I hope your can get an answer. I wish I was more demanding when it first started. I feel like mine might be chronic now. It seems like when I overdo and if my knee swells that is the place it shows up. And on the outside of my knee about in the middle I think where a nerve could be going through. Don't give up:old:
 
I saw the os and he agreed no manipulation but no answers for my calf pain At times it radiates to my foot I take neurontin 300mg 3x day.Med to slight swelling and Yes I get that outer knee pain too.Still only at 90 flex ion but based on all I hear more will come.The stiffness and pain hits me middle of the nite and I must get up and walk.I also use the heating pad to releive pain in my calf.Ice just makes it hurt more.Dr thinks most of my
Pain is from my fibromyalgia but I disagree,when I get that pain it is almost always bilateral
 
Is it long lasting pain or is it cramps/Charley horse in the shin? I get those sometimes, usually at night, sometimes on both legs.shins but I had then prior to my TKR...they are very painful and hard to find relief.
 
Scares me that advice on here is do nothing and in a year you will be OK. As soon as I don't exercise for a day or even overnight my knee feels like there is a tourniquet on it. I really want to believe it's going to get better and better but I see no proof if that in my knee.
 
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You'll feel better well before a year, but it can take up to a year to feel 100% recovered. I heard this from my OS before ever coming to BoneSmart. I felt well enough to go back to teaching part time at 3 months and I had complications.

I suspect your tight feeling is a result of the exercise you're doing, not the lack of exercise overnight. Too much activity will lead to angry soft tissue that reacts by swelling. That tight feeling is from swelling which keeps your knee from bending. Try taking a week off of exercises, ice and elevate your knee as much as possible. Chances are you'll have a decrease in that tight feeling and be able to bend your knee better.

I'm going to leave you with BoneSmart readings that may explain things better than I did. So glad you found us!

First are the BoneSmart mantras ....
- rest, elevate, ice and take your pain meds by the clock
- if it hurts, don't do it and don't allow anyone - especially a physiotherapist - to do it to you
- if your leg swells more or gets stiffer in the 24 hours after doing it, don't do it again
- if you won't die if it's not done, don't do it
- never stand when you can sit, never sit when you can lie down, never stay awake when you can go to sleep!
- be active as much as you need to be but not more than is necessary, meaning so much that you end up being in pain, exhausted or desperate to sit down or lay down!

Next is a FAQ (Frequently Asked Questions) thread.

And here are some very crucial articles
The importance of managing pain after a TKR and the pain chart
Swollen and stiff knee: what causes it?
Energy drain for TKRs

Myth busting: no pain, no gain
Activity progression for TKRs
Heel slides and how to do them

Extension: how to estimate it and ways to improve it
Elevation is the key
Ice to control pain and swelling

Healing: how long does it take?
Chart representation of TKR recovery
Myth busting: the "window of opportunity" in TKR

Myth busting: on getting addicted to pain meds
Post op blues is a reality - be prepared for it
Sleep deprivation is pretty much inevitable - but what causes it?
 
Sebelsak,
Welcome to BoneSmart glad you joined us!
Sbelsak said:
that advice on here is do nothing and in a yr you will be ok.
Click to expand...
We recommend in the early days that your let your knee heal, that less is more, the activity you do around your home, along with a few Heel slides and how to do them properly and Extension: how to estimate it and ways to improve it is plenty. At about 3 months most feel much better, and can increase their exercise and activity. It usually takes a full year to feel 100%, some slower some faster.
"Tight band" feeling across the front of my knee
BoneSmart philosophy for sensible post op therapy


I am going to tag @Josephine our forum nurse for advice.

 
I merged your two recovery threads as per forum protocol. By having only one thread in recovery, we can quickly and efficiently see where you are in recovery and better keep track of your issues and questions---it also helps eliminate duplicate posts.
 
I was instructed by my PT's to more or less follow the Bonesmart approach during my recovery from my BTKR. It was not about doing nothing, but, rather, taking a gentler approach to recovery, and understanding that hard work will merely cause the knee joint or joints to become more inflamed and swell---and become painful.

There were actually times when I wanted to work had, but my PT's intervened and instructed me to scale my effort back.

We also have to understand---myself included, as I went through some very troubling times, that recovery can indeed take longer than we would like it to be, and there are times that it seems that we are not making any progress at all---we have hit a "plateau." Patience is the key, and by taking it slowly and gently, one can slowly see progress---all the while reminding oneself that there are peaks and valleys in this TKR recovery---it is very much like a roller coaster.
 
I'm going to tag @Josephine to come back and ask her questions about your pain again. It's been some time since you first posted. You're almost 5 months out from surgery now. You will need to be very detailed in your answers for Jo to help you. Please don't get discouraged.
 
Hi sbelsak, as others have said, I'm so sorry the pain isn't resolving for you yet! I had a really tough time getting my medications figured out in order to get the relief I needed to get the early healing done...an especially challenging task it seemed to me.

My initial prescriptions were not successful at calming my pain either, but after following guidelines suggested here, I finally found the right combo and found relief!

I take Tramadol still (at 13 weeks out) with 2 Extra Strength Tylenol 4x a day, every 6 hours. I wasn't able to get by on that amount of space between, though, until about at 10 weeks. Earlier, I took OxyContin as well as a muscle relaxer (Methocarbamol) at night, then Oxy every 4 hours. I gradually spaced the doses further apart to taper off then moved to the newer routine between 8-10 weeks.

I also do some self-body therapy called Melt, too, which involves routines done using a soft foam 4' long, 6" diam. roller, similar to those they might use in PT offices. It always lessens swelling, relieves tension in body parts I'm working on. Is done in a class with other folks who share the camaraderie of fellow relief-seekers.

I had twitching/muscle spasms but mine were along the inner thigh area down into my inner calf into the foot, and the muscle relaxer made that better, and although painful early on, when it occurs now, it's more of a simple annoyance that I can chuckle about.. Gives massage therapists a scare, though, if I forget to mention it! Massage tends to trigger the twitchy spasms...

My calves are also tight at times so I'll do massage on them, sometimes use a homeopathic gel called Arnica that seems to help pain some, and I also have a PT recommendation to roll my calves on a pink ball (about 3" diam, soft) too. It does ease the tension there some.

I'm sorry you feel discouraged and not yet helped, but hang in there! We've all been in that same frame of mind too, while allowing our healing bodies the space and time to get stronger... I check here each evening, so if you have questions, am happy to answer... I just felt you might like to know how at least one other of us had to ferret out help here to get the right pain relief... I found Bonesmart on those sleepless nights, when researching pain relief! Lots of really amazing people here REALLY want to help, so hang in here and just keep providing info. so they can help you! This is a really caring group of people!
 
The Bonesmart plan is not to do nothing!! Really, why would we go through this surgery to do nothing? It is to take it easy the first few weeks, to slowly rehab the knee over the course of six months so that you regain your full strength.

I ride a bike for 30 min a day which does keep my knee limber and moving. I am sure it is frustrating for you. I tried to push my first knee---exercise every day, pool at night, etc. But, when I finally stopped all my frantic extra activity and just began to live my normal, active life with the addition of 30 min of bike riding, most of my issues resolved themselves.
 
Sbelsak said:
Scares me that advice on here is do nothing and in a year you will be OK
Click to expand...
You misunderstand - nobody has ever said that! What we DO say is 'no intensive exercising'. You still need to be active and follow this advice Activity progression for TKRs.

I'd like to ask you some questions if you don't mind, and it would be very helpful if you would answer each one individually - numbered as I have done - in as much detail as you can then I'll come back as see where you are ....

1. what are your pain levels right now? (remember the 1-10 scale: 1 = no pain and 10 = the worst you can imagine)

2. what pain medications have you been prescribed, how much are you taking (in mg please) and how often?

3. how swollen is your leg compared to these?
[Bonesmart.org] Severe deep calf pain'^


4. What is your ROM - that's flexion (bend) and extension (straightness)

5. are you icing your knee at all? If so, how often and for how long?

6. are you elevating your leg. If so how often and for how long?

7. what is your activity level? What do you do in the way of housework, cooking, cleaning, shopping, etc., and

8. what kind of PT exercises and exercises at home are you doing? How much and how often?
This is the most crucial question so please help me by using the format I have left as an example
(which means please make a list and not an essay!)

Exercises done at home: (how many sessions each day)
enter exercise then enter number of reps and sets
etc., etc.

At PT (how many times a week)
enter exercise then enter number of reps and sets
etc., etc.
 
There is a balance you must find between doing too much or too little. Doing no activity will make you stiff and increase your pain, doing too much activity will do the same.
 
I hear you.

I know I saw a post saying they did no pt. I would never do that. I had 4 months of pt and continue to do my exercises at home. I am still at 90 flexion and 0 extension.

I have some swelling and a tight band feeling around knee all the time. I can't do steps normally and definitely can't ride a bike. I continue to walk about ½ mile a day but I have a strange gait and it's painful. My pt has tried everything. I just can't get that normal gait. Bought all new shoes too. To say I am extremely frustrated and still wish I never would have had the surgery. I'm at 5 months post op. Thanks for having this site
 
@Sbelsak I believe you are experiencing swelling due to all the PT you're doing. It hasn't moved your flexion in the months since your surgery. I strongly suggest you take a week or two away from PT and concentrate on elevating and icing. Chances are you'll see a difference in flexion and gait.

I hope you answer Jo's questions. She can then give you some advice to help you. I understand why you must be frustrated, but what you've been doing hasn't worked thus far.
 
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Sbelsak, I also have the tight band across my knee and some pain still and am 3 months out, too. But, I think my pain and stiffness is due to going back to work and needing to be a bit too active too soon. There's not much I can do about it as I own a store...which kinda involves standing! So, I'm doing Pilates, a thing called Melt and massage, gentle...to help decrease the stiffness and work on increasing my ROM, too. The ideas here have helped me, too, even though I'm still not where I want to be yet. I'm improving every week a bit at least, and weeks where I'm not on my feet so much find me with less swelling and smaller ROM. So, the Bonesmart way has been working, and I've not been quite able to limit my activity quite enough.

I would heartily recommend answering the questions you were given, too, as I did, as it may help you see ways to help yourself get closer to here you want to be, too!
 
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