TKR Stairs and pain

[Brbmks]

My tkr on my right knee was June 24. I’ve been released from physical therapy and doing well except for stairs! I’ve been trying to go up and down reciprocally. When I step up I have quite a bit of pain in the knee. When I go down with the left leg I have a lot of pain behind the right knee and up into thigh. When I left physical therapy I measured 120 rom. Why is this still hurting so much?

 

[leejaa]

Hello and welcome to bonesmart. You are still having difficulties with stairs because you are still in recovery. It takes up to a year and for some beyond a year to be fully recovered. This does not mean that you will not be able to do things but will experience improvements as time goes on.

You are very early in your recovery and the knee is not ready. Give it time and exercise patience which is so hard to do but necessary. Do not force the actions but wait and try it again in a week. If you still cannot then wait another week before trying it out. Even then do only a few stairs each time while your leg builds up strength.

I am going to include our recovery guidelines and they will help explain more fully about recovery from this major surgery.
KNEE

Knee Recovery: The 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
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
6. Access these pages on the website

Oral And Intravenous Pain Medications
Wound Care In Hospital


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


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.

 

[Disney Mom]

I was also just released from pt and had trk on June 22 so very close to yours. I also have pain with stairs and have been working on it for a few weeks. The past few days for me have gotten better. I think taking it slow and if you have pain stop for now and try again in a day or 2. One day it will work. I am still working on it like this and it is slowly getting better. Going down stairs is harder. I think we use different muscles. One thing for me is that my knee was very bad for a long time before surgery so I babies it a lot and relied on my other knee. I think now it is kind of a habit to keep doing that and difficult for me to actually trust the knee that didn't work for so long. good luck!

 

[Roy Gardiner]

It's putting force through the traumatised tissue that causes pain. Going up stairs requires more force than walking, coming down more force still - you're stopping your full weight on each step. Just take it slowly, it'll improve over time.

 

[Jockette]

Good ROM is not the whole story in this recovery. It takes a long time for all those soft tissues inside our leg to relax and heal.

 

[Tykey]

It's not clear in your post, but just checking that you should only be doing one step at a time. Going up, left leg first. Going down, right leg first.
It normally takes several months before we are confident in trying the odd step the other way round. Starting with the bottom step, in case you go base over apex. Then 2 steps, then 3 etc etc.
Be patient, there are no prizes or medals.

 

[Sara61]

June is still early days in your recovery, I only really managed stair from about the 8th month onwards and even now nearly at my 1 year post surgery, I still have difficulty especially if the steps are high or many flights of stairs as Tykey says this takes time and eventually we'll be going up and down normally without thinking about it xxx

 

[Brbmks]

Thanks everyone. I was trying to go up and down reciprocally and feeling like there was something wrong with the knee. I’ve been making such good progress and this was stressing me out. Your replies makes me feel a lot better. I’m going to give it a rest and ease in a step or two at a time after a few days

 

[Tykey]

Realistically, it might well be Xmas, or even Easter, before you find yourself going up and down stairs normally without thinking about it. Your knee will decide when it's ready.
You might be able to do it earlier with discomfort or pain, but what's the point.

 

[judgar]

Iam at a year and I still don’t do steps very well. It hurts quite a bit. So be patient

 

[doodlebug60]

remember; up with the good leg leading. down with the bad leg leading. take baby steps; don't try to rush the foot over foot. your knee may not be ready for that yet. hope you have a great recovery; Doodlebug

 

[Muldoh]

I’m so glad you brought this up @Brbmks! I am also experiencing the same thing with the stairs. I had my surgery very close to yours, 6/30, and once or twice I’ve even forgotten and started down the steps the regular way. Boy did that hurt! Walking up seems to be a little easier, but I make sure to take it slow and am very conscious of how I step. As @Disney Mom said, because the knee was so bad before surgery, I feel like I wasn’t walking up the stairs correctly before, more like pulling myself up with the railing. So I’m trying not to fall into that habit and want to build up the other muscles in my legs before I try to take them all at once. And since I live in a colonial with about 13 steps, I only do about four or five of them one at a time so I don’t overdo it. As everyone said, I guess we’ll get there

 

[Disney Mom]

One thing I have to remind myself to do is to use my knee and not my hip! I used my hip a lot before because the knee was so bad. That isn't correct obviously so trying to do it the right way is a struggle.

 

[Schega]

These posts are encouraging. I am 13th weeks PO and I am not fluid going either up or down stairs. My mind says one thing and my knee says another. I just have to work on being patient

 

[TimeBuster]

It took me 8 months before I was able to go up and down stairs without assistance.

As long your not in pain, it's all in the mind.

 

[Brbmks]

Hi Everyone. I'll be 7 months out tomorrow and I'm doing much better. I still know the knee is there when I go up and down stairs, but I am so much better than when I first posted. I was so grateful for all the posts telling me that it would take longer and you were right. I kept thinking that there was something wrong with MY knee. I so always have to remind myself about the patience thing. Timebuster, I saw your stats and it looks like you went through some stuff with that right knee! Happy Holidays and Happy New Year.

 

[TimeBuster]

Glad to hear you're doing so much better.

Yes, it was one heck of a journey but I'm doing great now. After being homebound and in pain every day for six years, I feel blessed to have this opportunity at my age to have a second chance in life. My new knee is everything I dreamt of and more.

I couldn't agree more, patience is the keyword when it comes to our new knee/s.

Happy Holidays and Happy New Year.

 

[TKRsharon]

@TimeBuster I am so glad to hear you are happy with your new knee! I have been thinking if I will ever that to that point. Thank you for the encouragement.