Setbacks at 5 weeks tkr

Posted , 13 users are following.

After  feeling really positive and getting 2 good nights sleep on the run with leg feeling lighter and less pain I feel I have gone back 3 steps in the last 3 days.

Knee is throbbing at night with more intense hamstring and muscle pain. Sleep is down to a couple of fitful hours again.

Leg feels stiffer again and pt exercises harder to do.

Had planned to return to work next week but although in a sedentary job this regression is making me feel anxious.

I thought I had hit the' 6 week break pain 'through ' early but now feel I have stalled and even gone backwards.

Any advice ?

I had eased off my meds but thinking of going to see GP to request some strong pain killers and sleeping tablets again.

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30 Replies

  • Posted

    Hello Mike,

    ?Ah what a shame. Its very distressing and soul destroying sometimes. I had my knee replacement last year and  had to go back to work after 10 days for the very same reason. I am sitting at a computer most of the time, so had to prop my leg on top of a waste paper bin, taking my ice leg cuff to work with me.When I told the physio she went mad, but needs must, I had to.

    ?I did as many of the excersizes that I could, even though I was at work .I tried walking around in my lunchtime and took a small  floor bike into work just to keep my knee moving. I did so much of what I should have and it is really

    ?difficult to advise because everyone is so different .Lots of people were telling me that I was overdoing it,but the surgeon didn't seem to think that was a particularly important thing. He said that I should do what I can when I can

    ?attitude. I was in a lot of pain throughout the whole period .I am now 14 months after having the op and still can feel that my knee swells up and still gets hot!!!!if I walk too much or even remain on  my feet too long just around the kitchen cooking etc .I still cannot bend my knee any more than about 110 degrees, but am still working at it.

    ?I even went back into hospital to have a manipulation done three months after to get it bend more!!!

    ?I can ride my bike now ,which I am very pleased about ,but overall its not the result that I would have liked but better than if I wouldn't have had the op.

    ?People will tell you all sorts of different things, and you cant help but compare, then it makes you feel that you are not doing as well as others, but we are all very different, and my advice is listen to your body- no one else can tell you how you feel.

    ?So keep positive ,take the pain killers if and when you need them ,but remember that there is a lot of pain but just work through it .Dont give up on excersize even though it hurts like hell.

    ?Good luck to you, but don't despair, we have all been through it and know how you feel. Its only 5 weeks so its very early days yet.Lack of sleep is not helping the situation so get that sorted and all will come right in the end.


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    • Posted

      Thanks Dawn

      Really appreciate your perspective on things. Just got into work for a trial run - shattered already!

      Have my cryo cuff at the ready to use over the next 3 to 4 hours!

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  • Posted

    Hi Mike,

    I'm at 8 weeks post tkr and I feel the same.  I was doing extremely well and now I have the throbbing knee pain at night and also lower back pain.  I was given pain meds while in the hospital but now I was told to take otc Motrin IB.  I feel as if I'm backsliding.  I get about 2 hours of sleep at night and my leg feels extremely heavy.  Therapist said this is "normal" and will take about 6 months to feel better.  Only thing I can say is talk to your doctor and take one day at a time.  Good luck!

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  • Posted

    Hi there.  I am in exactly the same place as you are.  I am 5 weeks after the operation, and although started off so well 2nd and 3rd weeks, I am now getting more pain and throbbing and the  Tramadol 50 I am taking is not working so good at all.     I am going out walking and shopping 2 hours every day,  with one stick.   I do use ice packs etc. and try to rest the leg at home, but I still have to care for a bedbound husband.   I think my problem and maybe yours, is that we got too confident and are trying to do too much, too soon.  Coincidentally, I also had to cancel my physio last week as it seems to put such a strain on the knee, because we are probably trying to run before we can walk.  Its hard when you are an active person beforehand, and expected to do so much sitting around.

    I have heard this story from many people - so I guess the answer is to slow down and wait until the 6 month valhalla hits us.   Good Luck.

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  • Posted

    Thx Christine and Janet

    Appreciate your comments.

    I guess we all know what the answer is-...patience!

    It's just so hard when you are in the middle of a sleepless pain episode. You become desperate Di any easy answer or solution.

    There isn't one is there but some great tips on here about managing day to day.

    This site is great for calming you down and reaffirming a longer term perspective.

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  • Posted

    Hi Mike,

    At 2 weeks post op I was walking unassisted and at 3 I was already driving.  My therapist really pushed me but when the surgeon found this out he immediately made me change therapists!  But I continued pushing a little more each day and I thought I was doing myself a favor!  Narco and Tramadol did not help but believe it or not Motrin does lessen the pain enough to at least fall asleep for a few hours.  My doctor is very anti-pain meds and I don't think he'd even write a script for aspirin if I needed it!

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    • Posted


      Getting swelling down along and rest, along with keeping knee moving and gently nudging along the range of motion was the message I picked up from the way my rehabilitation was managed. Patience is essential from all concerned.

      I started walking unaided for very short distances, (and only sometimes) around house only, at around 5 weeks post op. Doing too much increases the pain.

      Now I am just over six months post op, it's great, and well worth it. But looking after that knee had to come first as much as possible for the first three to four months for sure. It's a major op. Leg chopped! May not like to think of it like that, but then looking after the knee with attention and care makes sense.

      Good healing!

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  • Posted

    The way people usually regress is that they push the knee beyond what it can take at that point in their recovery.  At 5 weeks, I did 8,200+ steps one day and dealt with the results for quite a few days afterward.  Learned my lesson...kept track of my steps.  You need to back off and start again slowly.  By 8 months, I was doing 11,000+ steps (5 miles).

    You have to be prepared for advances, setbacks and plateaus...the worst.  You think you're stuck permanently but you're not.  Your PT will help break through that scar tissue but it takes time and work.

    Speaking of work...  Going back only 6 weeks post-op without encountering any consequences is virtually unheard of.  Yes, there are some exceptions but the vast majority of us return to work in the 4-9 MONTH range...even for sedentary jobs.  Most of those attempting it earlier report experiencing, swelling, pain, sleepless nights and more...and then they have to get up the next morning and repeat the cycle.  Sets their recovery back.  Your choice.

    Before returning back to work, the recommended course of action is: 1. getting your scar tissue broken down by PT and achieving at least 0 / +120 ROM; and 2. doing strengthening exercises to rebuild your atrophied quads, glutes and core to support the knee.  Then you have to be off all the opioid meds...can't work or drive taking them.

    A "six-week breakthrough" may not be very realistic since everyone is different.  Most of us finish up on the huge pain meds in the 2-3 month range and then taper down to something like Tramadol (still an opioid) for a while...but again, that's very individual.  I'm 18-months post-op and I don't know of very many contributors who were past their pain in just six weeks.  For me, I started outside PT at 3 weeks and I then did 10 weeks of PT @ 2X/week to get from -14 / +84 down to -1 / +123.  So I was still dealing with the pain at the 3-month mark.  What's your ROM now?  Have you achieved 0 / +120?  That's critical.

    Plus, some of your pain can be caused by a change in your gait.  Very normal as we limp to compensate for the knee pain.  This will affect the alignment of your hips, pelvis, SI joints, lower back and lumbar spine.  I got sciatica from locked SI joints...took a chiropractor a month to fix it.

    Pain, depression, lack of sleep and so much more are all normal.  It takes time for your body to heal from this most brutal of all surgeries.  You need to eat healthy, hydrate a lot, take your meds on schedule and rest.  All of the energy of your body is being directed to healing your knee.  At 2+ months, I was still sleeping 16 hours a day...normal.  

    And you want to return to work in just 6 weeks?  I'd seriously reconsider that choice.  Your body will tell you when it's ready.  There's a big price to pay by not listening.  If you can do it, God bless.  All of us hoped for it but it took way longer.

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  • Posted

    Dont underestimate importance of sleep and rest. I did not have a tkr but my injury was severe so it was close to it. I went to work right away but payed for it later. I suffered from sleepless nights for 2 month. Going to work made it even harder. I was so depressed that i did not want to live. The pain started to go away when i addressed my artrophy. Pool really helped. Oh, it was great for my muscles and great for my mind. I started to listen to my body and see what helped even a little bit. Hope you will find your way of dealing with it. Good luck.
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  • Posted

    Hi Mike - sorry to hear that  your knee was feeling better and now is hurting and swollen. My experience -- it happens a lot. You got great advice from the group. I am 11 months and still dealing with the ROM and pain. Everyone is different and the healing timeframe totally different. Take every ones advice sort through it and apply what you think might work for you. Jenny and Chico are great. They always respond with great advice. They have helped  me a lot along with Laurel. You take care and let us know how your knee is doing while you went back to work. Best of luck J-21370
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  • Posted

    Hi mike,I'm coming up 5weeks into recovery,although my physio says I'm ahead of schedule I suffer from lack of sleep too,if I get 2-3 hours split sleep a night I've had a good night,I tried over the counter sleep remedies with no joy at all,so I'm now trying to get an appointment to get prescription sleeping pills of the doctor ( zolpidem).its not a pain issue with me just discomfort i.e. Swollen and numb feeling knee and it still feels pressurised the only ache is at the back of the knee if I have a straight leg.So your not alone on the sleep issue it's common on TKR.

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  • Posted

    Hi Mike. Just wondered how you were getting on now. I am interested as we are the same age and had our op at similar times and in the UK. I think I am doing OK. Managing 110 bend, although see what I achieve tomorrow at physio and today managed about 3500 - 4000 steps, although quite slowly. I have however suffered terrible low mood which i think maybe because I thought this would be easy for me at my age and being reasonably fit. It has been a long slog to get here and still not back at work even though I am admin as don't feel physically or mentally ready just yet. I am exactly two months post op tomorrow. Would be nice for an update on your progress. Kind regards. Sue

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    • Posted

      Hi Sue

      Thanks for your interest.

      Yes 7 weeks post op now. Beginning to feel more positive and pain less of an issue at night- sleep back up to 5 to 6 hours.

      Unfortunately being self employed has  meant this is my second week back at work.

      Whilst I hoped to take it slowly the reality is the world of work doesn't operate like that.

      Consequently as predicted by Chico I have spent the weekends recovering from the build up of tension and discomfort gathering up in my legs from being on my feet all week. Finding it hard to get the required exercises in and then in free time finding it too sore to do very much.

      So whilst I will argue I didn't have any choice if you do have the latitude to have more time off from work then definitely take it. Your knee demands your complete focus and time.

      Still not walking independently of my crutches yet but can get round the house now without them.

      Hamstrings still very sore and still suffering mood swings and some depression but feel there is more light at the end of the tunnel.

      My leg feels stronger too as my body begins to recover  from the trauma.

      So a mixed bag really but if I measure progress on a monthly rather than weekly basis  then definite progression but day to day it doesn't feel like that.

      Good luck with your recovery sounds like you are doing really well.

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    • Posted

      Thanks for your update. Can fully understand your need to return to work bring self employed. Sounds like you are making progress but perhaps a little slower as on your feet all day. Good luck. We will get there in the end. This forum has been fabulous though for all of us.
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