What about knees?

by MG

Now that I've had bilateral unicompartmental knee replacements, I am aware of tendonitis all around my knees!

Anserine bursitis has been diagnosed and I suspect pain behind the knees is also tendonitis. I also have pain at the tops of my shins.

I expected some disruptions due to the knee surgeries, but it's been 8 months. I WALK just fine now, but climbing stairs up or down hurts (in a much different way than before surgery and much LESS) and getting up from sitting or out of bed.

I can't kneel back on my heels because of the pain at the back of the knees and haven't been able to Google the reasons for that. Got any information for me?

Thank you so much.


Joshua Answers:

Hi MG.

No fears, I always have a lot to say:)

And then I'll ask some questions to get more and more accurate, as I don't know your pre-surgery situation.

-Maybe- you have tendonitis all around the knee.

Definitely you have Pain Enhancing Chemical flooded into all the tissue around the knee, muscles getting even tighter than they were pre-surgery, and a nervous system that is very concerned for your safety.

This may not be the whole truth, but it accounts for all your pain.

It's great that you can walk fine now. That's a good thing.

As far as lasting complications from surgery...that is to be expected. Knee replacement is a major intrusion into the body, and the body generally doesn't like that. It makes sense to not yet be fully healed after 8 months.

It's more the repercussions of knee replacement surgery that you are experiencing and 'need' to worry about.

Also, I doubt that you were given an effective post-surgery self-care routine that would help get you back to full and happy mobility.

We tend to think that surgery is a fix for our problems and that we -should- heal back to 100%.

It rarely works out that way. It takes the RIGHT kind of rehab and self-care to help our bodies back to full functionality.


1. How old are you?

2. Why specifically did you get surgery in the first place? What was the situation that had you go that route?

3. Did you have knee tendonitis before the surgery?

4. What post-surgery rehab or self care have you done?

5. What is your general state of health?

Answer those questions to give me more clues, and we'll get a better idea of where you are at and what would be best to do next.

Joshua Tucker, B.A., C.M.T.
The Tendonitis Expert

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May 01, 2009
PART 2 -- What About Knees?
by: MG Severance

1. How old are you?

60-yr old female

2. Why specifically did you get surgery in the first place? What was the situation that had you go that route?

Osteoarthritis after the typical routine of cortisone shots over 12 month period and 2 rounds of Synvisc in 2 years.

3. Did you have knee tendonitis before the surgery?

Hard to say because of my limitations and OA pain. I believe the back of knee pain has been there for a long time. I have fallen on my knees twice in the last 10 yrs.

4. What post-surgery rehab or self care have you done?

Good rehabilitation therapy for 2 months. I used an ice machine for a few weeks immediately after surgery.

5. What is your general state of health?

Excellent except for being obese. And, yes, I know that contributes to these problems.

May 01, 2009
PART 3 -- What About Knees?
by: The Tendonitis Expert

Thanks for the answers MG.

What are the chances that you still have, or have access to, that ice machine?

If we're talking about the same thing, the ice machine is GREAT. And it is my opinion you should have stayed on it as long as possible.

Knee joint replacement is MAJOR trauma to the area. The body responds with an Inflammation Process. As long as you feel any pain (you are still feeling all sorts of pain) the body continues to keep the Inflammation Process in process.

I often say, the body's response to injury can be worse than the injury. That may or may not be the case with knee replacement surgery, but it's safe to say that your body is still responding to the surgery and aftereffects of knee surgery.

I'm guessing that you don't have Tendonitis per se. You for sure have a The Pain Causing Dynamic that is a prime factor of the Tendonitis dynamic. Actual tendon wear and tear damage....maybe or maybe not. I can't tell from here.

I'm guessing you weren't active enough to cause Tendonitis. And you have had a variety of strain and wear and tear forces on the knee, so you could be having pain from a variety of directions, both joint pain, ligament irritation, tendon irritation, etc.

I think the first thing to deal with is getting the Pain Enhancing Chemical released by the Inflammation Process out of the area.

So, in short, and I'm happy to say more in more detail if you're interested, ice machine or ice pack (the bigger and heaver the better) as often as you can for the next 7 days.

10 minutes on, 10 minutes off. Repeat as often as possible throughout the day.

As your body feels less pain due to less inflammation in the area, it will stop responding with a process that creates more pain.

1. Ice as much as possible.

2. Start going for short walks, whatever the knees can handle. Take as long a stride as possible. Your muscles haven't really been moving as you've been recovering, and that in itself can cause pain and problem.

That back of the leg pain could be one particular muscle that just hurts when a long enough stride isn't taken for long enough. The way to fix that one is to start taking longer strides.

You may not be up for that at the moment, and I can show you other ways of getting at it.

3. Increase your protein and calcium intake.

4. Depending on your interest and motivation, check out Kerri's work at www.Easy-Immune-Health.com

I deal with the very physical mechanical level of tendonitis and pain, she works with the deeper systemic health aspects and could be of benefit to you for whatever is causing the extra weight and osteoarthritis.

Again, primarily we need to deal with your body's response to the surgery, which is inflammation and extra pain, and the pain that comes from not using your muscles for too long.

Ask me questions, keep me updated, etc.


May 02, 2009
PART 4 -- What about knees?
by: MG

Thank you, Joshua. You have the most sane answers I have seen!

Yes, I still have the ice machine.

And you are right about my not being active enough to have actual tendonitis. As a matter of fact, I became programmed to walk in short waddling steps due to the OA and your suggestion to take long strides is a very simple action I can start right away.

Also, I am taking a Yoga class that features gentle stretching. I learned from Kerri's site about the benefits of Vitamin D and probiotics.

Those plus the increased protein and Calcium you suggest make a plan I can manage.

Yes, I will keep you updated!


Joshua Answers:

You are welcome!

Vit D and probiotics on Kerri's site. GREAT!

You still have the ice machine. GREAT!

Yoga for recovering from knee replacement surgery. GREAT!

Longer strides. GREAT! (And gentle stretching of the back of the leg and knee. Talk to the yoga instructor about that specific behind the knee pain.)

I submit to you that is is a VERY good idea for you to start using that ice machine again.

If you can do 10-15 minutes on, 15-30 minutes off, as often as you can throughout the day you will be very pleased with the results.

You want the cumulative effect of -repeated- application of cold. Short repeated bits is more effective than keeping it on for 30+ minutes at a time.

It sounds like you're on the right track. It's the perfect time to start doing all the right things to start feeling better.

I'm more than happy to help you fine tune and add in anything that's missing. Do keep me updated.

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