TKR Surprised and a bit confuse...from looking around, that makes me normal - I guess!

[Jamie]

It’s never a good idea to compare your knee to anyone else’s … including your own “other” knee. Each surgery and recovery are unique and your recovery can be quite different with each surgery, Does the therapist have you doing the squats actually sitting and rising from a chair? Or are you doing them in a standing position?

 

[mendogal]

I continue to be confused. You do squats because you're told to, and you're doing "the usual 12 exercises"?

I never did that many exercises.

Honestly, as fit as I was pre-op, I can't even imagine doing a 12 exercise regimen even now on my very nicely recovered ten month old knee, much less my progressing five month old knee.

I suspect your overworking your knee and so it never has an opportunity to have less swelling.

 

[EalingGran]

Doing sit squats because my therapists ask me to do them during our sessions. Getting up or lowering myself from a chair hurts while sitting or rising.

Agree with others like @mendogal to be very careful about doing anything that hurts as it will increase the inflammation and swelling.
I used to get medial twinges getting up and down from chairs. I was told in my case it was due to my chronically overstretched MCL. What helped was these.
1. Making sure my knee stayed directly over my foot as I pushed up- and didn't go too far forward or twist inward. I used to use my hand to gently push my knee out slightly as I got up- to prevent it turning inwards.
2. Working on my quads- especially the medial quad ( vastus medialis). This is apparently a generally underused muscle.It only engages at the last 10 degrees of extension. My pilates teacher taught me an exercise to strengthen it. It's a bit complicated.
It involves lying on your back with thick rolled towels under the knee. Then doing a straight leg raise and turning the foot out and bringing it across the midline. Hope that description is reasonably clear. But if you think it might help - it could be worth getting your PT to show you this type of exercise.
Strengthening my quads really helped to cure my medial pain when pushing up on the bent knee and enabled me to do stairs easily again.

 

[sistersinhim]

Doing sit squats because my therapists ask me to do them during our sessions.

Just because your therapist asks you to do them doesn't mean you have to. One-size-fits-all recovery does not work for everyone, especially for joint replacements. It sounds like all the exercising you are doing is keeping your knee inflamed and it hasn't had a chance to get rid of the inflammation, swelling, and pain and get on with its healing. How about stopping all these extra exercises and letting your daily activities be your rehab? You should see a vast improvement in a few weeks.

 

[socman]

I feel the wisdom of your words! I will try taking it a bit easier on my knee...and really cut back on those exercises. The way I feel, I think you are all correct! I suspected overworking my knee was not great, but my therapist was encouraging me...not do things that really hurt, but work things enough to get a painless stretch. Thanks to all of you. You guys really do help. Roger

 

[Jamie]

@socman … obviously being able to sit in a chair and rise again to get up are important aspects of daily living. So I understand your therapist’s desire to help you with those movements. When a person is new in recovery, we’ll recommend they use a chair with arms so they can use the arms to assist and lessen any pain or strain on the new joint tissues when attempting to sit or rise from a seated position.

So, if a patient has pain with using this method to rise from and lower to a seated position, usually any squat exercises are done while standing (maybe even with the support of your walker) where you begin the squat movement slowly and lower just slightly to where you feel mild discomfort. Then you stand back up again. This type of squat exercise can be done fairly early in recovery because you aren’t really lowering yourself to the point of pain (which might increase your inflammation and swelling). Over time, doing the squats in this way, a person usually can increase the depth of the standing squat until they are at the “fully seated” level.

However, if the squat exercises involved you going from standing to sitting in a chair and then back up again, and especially if this is causing pain, then it’s likely you’re doing too aggressive an exercise for this point in your recovery.

I’m glad you’re going to scale it back for a bit to see how things go. It’s important to listen carefully to the messages your body sends you.

 

[Layla]

Happy Two Month Anniversary!
I do hope you're able to cut back on the exercises and soon realize you're better off for it.
Best Wishes, socman!
@socman

 

[socman]

Hi Everyone,

Well, I "graduated" from therapy yesterday. I ended up with measurements of 4 and 114...not great after eight weeks following surgery, but I am sure things will get better. The one thing I came away from therapy hating were those darn lunges and squats! Pretty painful and my knees hurt for a couple of days following days when those exercises were included.

The one concern that I have is that I now find that after sitting at my office desk for an hour or so that standing up is extremely painful...holy cow is that painful. Beyond that, both of my knees still swell a bit.

My plan includes continuing with my exercises, but never going to a place where pain is experienced. Start walking more...up to a half mile on my local nature trail. Will continue with daily elevation and with icing when required. Losing weight will be focus during 2024 which should help reduce stress on knees. Funny...I think that I can sense when unsettled weather is going to arrive - my right knee internally aches a lot...like today when that West Coast system is about to hit our area over the holiday.

So...looking forward to moving on with this period of my transition with a positive attitude and high hopes for my ongoing, albeit slower than I desire, recovery!

 

[Jamie]

Congratulations on your progress. Actually, you’re doing just great! The lunges and squats can be a bit hard on new knees (as you noticed), so I’m glad to know you’ll take any future exercising in that way with more care. They should never be done to the point of pain … just pushing to the discomfort point, hold slightly, then release. If you find yourself hurting after any activity or exercise in the day or two afterwards, that’s your body telling you it’s a bit too soon for that level. Scale back, let the inflammation resolve and then try again at a slower pace until you can do them with no lasting pain.

Walking is very good, but be sure to also do plenty of bending and stretching with your knee. You can place your foot on a step and lean into the bend to stretch things. With extension, lying tummy down on the bed with my knee right at the edge and letting my lower leg hang (no weights) worked wonders. If you try this, it may be uncomfortable at first, so start with very brief periods and work up slowly to around 15-20 minutes.

 

[mendogal]

Your ROM at eight weeks is quite good!

Sitting upright at a desk or table (or couch) was problematic for me and I had to patiently increase my sitting time over a period of months from five or ten minutes to an hour - despite good ROM and walking.
I think at three months I still had to take three walking breaks when watching a movie at home. I still always take one!
Yes, the pain on first rising to standing could be momentarily breathtakingly severe! Now it's just a very annoying ache. A five minute walk truly is my best therapy for it.

 

[Layla]

Funny...I think that I can sense when unsettled weather is going to arrive - my right knee internally aches a lot...like today when that West Coast system is about to hit our area over the holiday.

I'll bet you do sense it! I did a little research on this a while ago.
Is It True You Can Feel Weather Changes In Your Joint?

For some people, yes. It's especially true for patients with arthritic joints who have not had a joint replacement, but also the case even after you have a new prosthetic in place.

Weather changes are predicted by changes in barometric pressure, which is the weight of the air pressing against the earth's surface. These changes can trigger pain and stiffness in the area of the prosthesis. The activity of bone adapting and growing around the metal leads to the sensitivity felt during weather and pressure changes. These sensations normally disappear within one to two years following surgery.

I like your positive attitude, socman. Keep up the good work!

 

[MSuki]

Sounds like this is the perfect time to start a good habit of getting up more frequently!

 

[EalingGran]

Sitting upright at a desk or table (or couch) was problematic for me and I had to patiently increase my sitting time over a period of months from five or ten minutes to an hour - despite good ROM and walking.
I think at three months I still had to take three walking breaks when watching a movie at home. I still always take one!

Agree. Sitting or standing in one position is really tough.
I was very lucky, as my daughter left a rocking stool ( part of a rocking chair nursing mother set) at our house. It was wonderful and I still rest my feet on it whilst watching TV. Your feet move enough to avoid the immobility/stiffness that the post op knee hates.

 

[socman]

So thankful for all the good advice and constant encouragement. It all works to the good! For two weeks now I have gone very easy on my exercising at home. However, starting January 1 (just sounds right), I will be beginning more of a daily routine - light strength work out, moderate ROM exercises (nothing painful), and good stretching before and after! I have come to the point where I embrace the pain in a positive kind of way...better to befriend it than fight it. Again...so grateful for all of the help I get from you sages and gurus of all things knee! May the force be in my knees in 2024 .

 

[Layla]

Happy Three Month Anniversary on your Right TKR!
An early Happy One Year Anniversary, Lefty!
I hope the year is off to a good start for you. Stay in touch.
@socman

 

[socman]

Question: My knees seem to be healing well, but almost two months after therapy ended, I am still experience intense pain upon standing after sitting for a while. The pain leaves within five to ten seconds, and then I can walk with very little discomfort. Is this the kind of pain one should expect to experience for a while...knowing everyone is a bit different.

I also have a lot of pain around right hip when I try to lift my left into pants or shorts. Left knee...left hip....nothing. Right hip area gets really painful when I lift my right leg...even just a little. Again, I attribute this to possibly not walking quite right for almost a year!

I am hoping that after bike season starts up here that riding will eliminate a lot of what I am experiencing.

Man...I sound like a cry-baby! Sorry about that.

Roger

 

[sistersinhim]

No, you don't sound like a crybaby, you sound like someone who is frustrated with how long this recovery takes. As long as your pain is going away after standing up, I think you are okay. If you are concerned you can always call your doctor.

 

[mendogal]

I had intense but transitory pain when standing after sitting, plus the first several steps, for several months post op on my newer June knee. Once I got past those first few steps and continued walking it out, it was fine.
If that's what you're describing, your sitting tolerance should continue to improve.
Until two months ago I couldn't watch a full two hour movie at home without one or two breaks to walk. It's only in the last week I realized I'd watched a whole movie without thinking about getting up.
If you're prone to getting lost in whatever you're doing while seated - as I am - it's worth setting a timer for 30 min or an hour to remind you to get up and walk five minutes BEFORE it's too painful.

 

[socman]

Hi Everyone,

Well...I have been given one more month of physical therapy - Oh Joy! Knee, quad, and hip/hip flexors are all at play here. I sure hope it helps since the pain level remains pretty high after my October surgery. I am a little concerned. Can't even walk any kind of distance without hip and lower back pain is causing me to stop.

Take care,

Roger

 

[mendogal]

Oh I'm sorry you're feeling stuck. Yes pain in other areas can pose a real challenge in our recovery and I hope PT can assess your gait and structure to address possible causes of (and perhaps also suggest therapy or self care for) the hip and back.