Monday, March 19, 2012

Ask Us Anything: Why Do I Still Have Pain after a Knee Replacement?

"I had total knee replacement almost three years ago and am still having discomfort and difficulty getting up from chairs and using stairs. I was recently told that the medial gastroc muscle in that knee has atrophied. Could this be a result of the surgery, and how can I rebuild it?"

Physical Therapist Richard Szabala Responds:

A total knee replacement is an extensive surgical procedure in which a metal prosthesis is placed in the knee to take the place of the worn down joint surfaces. Although there is a lot of cutting in bone and soft tissue, often times, the main muscles surrounding the knee are merely moved out of the way during the surgery.

Although it is rare to continue to have surgical soreness three years after surgery, it is not totally unheard of to have soft tissue and other joint pain.

Generally, it takes a full year for muscle strength to return to 100%.

When patients are discharged from our physical therapy clinic AthletiCare at the MACC Center, we educate them that the exercise program they were provided with is a lifelong commitment and should be continued at least every other day. Not following these instructions can cause all of the muscles to atophy and become weaker, thus making it difficult to climb stairs and rise from a sitting position. If this is the case, I would recommend making an appointment for physical therapy (click here for locations) so that you can receive a refresher course on your exercises.

Another factor that can cause difficulty climbing stairs and rising from a sitting position is the condition of the other joints in your body. If you have extensive arthritis in your hips or other knee, then climbing stairs and rising from sitting can agitate the other joints. Once again, stregthening can help in those cases.

The moral of the story is that you should continue exercising long after any surgery of the joints, as motion is lotion and keeps the joints healthy.

– Richard Szabala PT, OCS

Richard Szabala is the senior physical therapist at AthletiCare Orchard Park.

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