3 Ways To Help Lingering Chronic Knee Pain After Knee Replacement Surgery

In this video, I’m going to cover with you three ways to help chronic lingering knee pain. After you’ve had knee replacement surgery, sometimes the replacements don’t get rid of the knee pain 100%. And it’s very frustrating for somebody who’s gone through the knee replacement, they had the surgery and all the recovery afterwards and still be dealing with knee pain. Now, it doesn’t necessarily mean that the surgery failed, or that the surgeon did a bad job, it may just mean there’s a few things that you have left to fix that the surgeon couldn’t tell you to fix.

My name is Dr. David Middaugh. And I’m a specialist physical therapist at El Paso manual physical therapy. And this channel is dedicated to helping people stay healthy, active and mobile, while avoiding unnecessary surgery injections and pain medications. Please consider subscribing to our channel so that you don’t miss out on any of the helpful videos that we upload every single week. Let me tell you the three things.

Number one is you got to get stronger hip muscles. The muscles on the butt on the backside of the hip are specifically important for making sure that the force is going through your knee joint, your new knee joints are normal. Likely, if you’ve had a knee replacement, you went through severe knee arthritis leading up to it.

There are other reasons to have knee replacements. But I’m going to assume that if you’re watching this video and you had a knee replacement, or you’re planning on having an ear replacement sometime soon, you probably have had knee arthritis. And the arthritis has developed because of chronic excessive forces going through your knee joint and the ends of the bones.

I’ve got an example right here on the ends of the bones here in the knee of the thigh bone and the top of the shin bone, that excessive pressure as well as in the kneecap is causing the bones to change on the end of the bone the cartilage is wearing down. And that’s what ends up putting people in a bone-on-bone joint situation and eventually leads him to the point where they’re looking at getting a knee replacement or have just had one but because this thigh bone right here connects up to the hip and the hip muscles, specifically the butt muscles, the glute muscles, they help to control rotation in the knee joint.

And so if you have a certain amount of rotation a one way usually inwards that causes compression on the inside of the knee joints. It also causes you to use your quads, the front of your thigh, the muscles here, excessively, which loads the kneecap against the thigh bone and causes too much friction there. If you just had your knee joint replaced, and you haven’t addressed the strength of your glute muscles, and you’re quite quad dominant and you’ve got a serious muscle imbalance.

That’s going to now begin to bother your freshly repaired knee joint. And even though you may have gained all the motion back that you’re supposed to get and you’re up and walking again, is likely is the biggest reason that you’re facing pain afterwards. Because it’s not just the joint that gets all those forces, but the ligaments around there that you still have in your knee. That kneecap the pressures around the kneecap the tendons that connect to the kneecap and the nerves in the area as well. There are other tissues in the area that are going to be painful as a result of this muscle imbalance having weak glutes.

The second way to help lingering chronic pain in your knee after knee replacement is looking at your foot strength because on the other end of the knee joint on the shin bone right here, of course connects down to the ankle in the foot. If your foot strength is not good enough to where your ankle isn’t supported, well, your ankle will collapse your foot will collapse inwards, and it’ll cause the shin bone to tip inwards, which also changes those pressures inside the knee joint and causes you to use your muscles inappropriately.

It’s a chain reaction that leads to excessive forces at that knee joints. If you had a replacement than they look, they probably shaved off the end of the bone here and put in the artificial knee and the implant needs to properly heal so that it’s not loose. If your pressures are off, you’re not going to let that heel or again you’re going to injure the other tissues and that can be the source of pain.

But the way a quick way to tell if you have enough strength in your foot in your toes specifically, it’s a toe muscles that I pay attention to most because you can easily see motion there. If you look down at your foot, take off your shoe, maybe even your socks you can see your toes and curl your toes down as hard as you can go as hard as you can. If you got a cramp, that’s a clear sign that your foot muscles your toe muscles are too weak.

The reason for the cramp is you engage your muscles way too hard, and it did your muscles weren’t prepared for it so they started to hurt and to allow you to let go to prevent an injury from happening. Apologize if you got a cramp. I just want to show you how weak your foot muscles are. You should be able to curl your toes down all the way and bend all the knuckles in your foot without getting a cramp.

If you got to cramp doing this, then you simply have to work on your foot strength and over time You should develop enough strength to where you can keep your shin bone aligned. So it’s reducing the pressures at your knee joint. That’s the most common foot weakness that we see there’s other muscles in there that that could be weakened contributing to problems at the knee joint as well.

But I’m just going to give you an overview today of what could be contributing to your knee pain after you’ve had a knee replacement surgery. And the third way to help lingering chronic pain after knee replacement surgery is to move better, believe it or not the way that you walk, the way that you go to stand up and go to sit down to and from chairs. And even the way that you go upstairs, and downstairs causes you to move your knee joint a certain way.

And if you’ve already had weak hip muscles and weak foot muscles, and you’re going to go stand up and sit down in a way that is moving your knee joint inappropriately, it’s going to add up the cumulative effect of little bits of bad motion over time, every time you go stairs, go up and down stairs or step off a curb, or just walk in your home or walk in a store.

That cumulative small amount of motion over time begins to affect your knee joint inappropriately, you start to get pain as a result of it. It’s because you’re tensioning the tendons too much, you’re compressing the joint itself, you’re irritating nerves in the area, there’s all kinds of reasons that your knee joint could hurt. And it’s besides the knee replacement itself, I’m talking about other things besides the joint replacement.

So the solution here is to take a good look at your walk. And we’ve got videos to talk about how to walk how to go up and down stairs. And we talk at length about how to squat appropriately so that he can sit down and stand up better. Now simply fixing those three things should allow you to take your knee pain after knee surgery down a bit.

I’m not talking about those of you that have just had a knee surgery, because if you just had a knee replacement surgery, within the past few months, you’re expected to have some pain, just from the operation itself. It’s a serious procedure, they’re cutting open your knee, they’re shaving the ends of the bone off, they’re there, there’s things that are being reattached and detached, and then they’re putting implants in there.

So you’re expected to have pain for a while afterwards. Of course, you should be on pain medication if you had any replacement surgery. But it is not, I’m not talking about helping you in this stage. If we’re talking six months or farther out, like 12 months really is probably the best point to look at this information. If you’re having knee pain after knee replacement surgery 12 months out, then this will apply to you the best.

If you’re just out of any replacement surgery within a few months, then you should be going to physical therapy should be doing certain rehabilitation afterwards to make sure that your pain levels are going down and you’re maximizing your motion and your strength. But if you’re six to 12 months out or later, chances are you’re probably more active now, especially if you’re moving better and you’re feeling better.

But if you’re still having some pain, I’m going to give you a bonus tip. Now, you might be doing too much. You might need more strength than you had before going into the surgery or even since you’ve gained since the surgery to do what you’re doing. And that could be the reason that you’re having pain. Just like with the foot thing if you don’t have enough strength to curl your toes all the way and you start getting a cramp.

Or you can even bend your toes all the way, you know just a second little tip to that. If you take your foot and force those toes down, without trying to fire your toe muscle just with your hand, curl your toes down, and then hold your toes down and let them go. And if your toes pop up, that means you don’t have enough strength to bend your toes all the way, because they pop up.

You should have the strength to calm down without you assisting them with your hand, your toes should stay down. And if you let go, they should stay right there. If you with most people weak toe muscles, their toe starts to do that as soon as you let go. They pop up even though you’re trying to hold them down. If you’ve got this kind of weakness, if you’ve got weakness up in your glutes, that might be why you’re having pain right now. And so you might be walking too much even if the surgeon told you go off to your heart’s content.

Go ahead and do all the chores you were doing before go back to exercise your physical therapist may have told you this. It may be too much right now. And that’s probably why you’re getting some pain. And here’s kind of another tip, a bonus tip, but it’s not really for people that have had a knee replacement. If you’re looking at getting in the replacement. If you haven’t yet had one and you’re considering getting a new replacement, then what I highly recommend to you is doing something called pre-habilitation. It’s kind of a play on words on rehabilitation.

The idea is to do some strengthening and some exercise before you go have the surgery so that you’re stronger going into the surgery. And we know that if you do this your chances of recovery afterwards with a good outcome improved tremendously. You’ll be able to you’ll be able to recover from the surgery a lot faster have if you’ve been doing pre-habilitation beforehand. So not all surgeons will recommend that to you, and it depends on your specific situation.

If your knee arthritis is really, really bad, it may not be possible for you to do pre-habilitation. But you should consider asking your surgeon if you’re going to go have an ear replacement, especially if there’s a delay in you getting it if it’s a month or more out, go to physical therapy and tell him that you need to get stronger to prepare for your future knee replacement surgery, that’s going to be the world of a difference.

And if for some reason you don’t have access to that, or your surgeon just kind of left you hanging on that, then what I recommend, the next best thing is consider signing up for our 28 Day New Health And Wellness Boosts Program. It’s a 100% online and on demand program. So you can do it from anywhere you have an internet connection, and anytime you choose. And all you do is you go to the link down in the description below. And once you sign up for it, you’ll get all the access codes and all your permissions. And then you start working through the strengthening and the exercises.

There’s a little bit of cardiovascular exercise in there as well. And you can adapt it all to your current situation. If you have limitations in your range of motion, you can adapt it so that you can make it doable for yourself and get the benefit of getting stronger and more mobile, going into your knee replacement surgery so that afterwards, you’re feeling better, much faster than if you had not been doing that before.

Now if you go through all the tips that we covered here, you strengthen your glutes, you strengthen your foot muscles, you start walking better, and you’re going up and down stairs better and standing and sitting better. And you’ve done everything that I’ve asked here, then I think only then can you definitively say, maybe there was something with a surgery or something with the way my body heals, maybe there was some excessive scar tissue, something that might require you having to go back to the surgeon and having something else looked at or possibly having to go in again to the knee joint.

But until you do your due diligence and make sure that you strengthen everything like I’ve discussed earlier in this video, go rewind and look back on that so you don’t miss a thing. Until you do all that only then what I would I go back to the surgeon because you don’t want to have to have two knee replacements if you can avoid it.

And surgeons are generally nice people they want to help you out in the way they can but they don’t consider this information because it’s not part of their training. So you’ve got to do your own work in strengthening the right muscles to make sure that you do everything possible to avoid a second surgery that could put you at risk for some bad stuff.

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