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Why do I still have knee pain after knee replacement surgery?

Congratulations, you summoned up the courage and successfully completed your knee repair or replacement surgery.  You are on the road to recovery and looking forward to getting back to normal, yet you may be struggling with knee pain after your surgery?  Are you wondering why you still have pain weeks, months or even years after your surgery?  Is this pain keeping you from enjoying life (walking,golfing, hiking or playing with your kids or grandkids)?

Pain after knee surgery is common in the first few weeks as the swelling and inflammation goes down.  However, if your pain is lasting longer, something else may be occuring

Next to back pain, knee pain is the most common complaint among older adults.  Knee pain can be caused by a knee injury but it may also be caused by arthritis, repetitive movement, overuse or even osteoporosis.   There is good news here, 80% of all knee pain can be corrected without surgery or medication.  The key is finding the root cause of the pain and addressing it.  

Reasons for Knee Pain after Surgery

Knee pain following surgery is very common and is to be expected.  The first few weeks after surgery has your body recovering.  Swelling and inflammation will likely go down during your post-surgical rest.  After the 6 week mark, many patients turn the corner and start feeling much better.  However, oftentimes, many patients are still feeling pain and discomfort after 6 weeks.  Why?  What is happening?  

A few things may be occurring:

  • Development of scar tissue –  During surgery and post recovery, your body is healing and scar tissue often develops in and around the incision.  This creates tightens in the knee joint area.  This can give the feeling like your leg is “giving out” on itself.  It can also make bending or straightening your leg very difficult.  Our expert physical therapists can help with releasing and relaxing the tissue through our specialized myofascial release.  Myofascial release is a hands on treatment that pinpoints tension areas and works to release that tension.  
  • Tightening or constriction of your supportive tissue and muscles around the knee.  Your IT Band, quad and calf muscles may be weakened due to inactivity prior to and post surgery.  Limited movement due to injury or pain causes muscles and ligaments to weaken and become stationary.  This can lead to knee pain or discomfort once range of motion is increased.
  • Rest of your body may be out of alignment.  Our goal at Balance Within is to look at the site of your pain along with the rest of your body.  If something else is out of whack – it can and usually affects other areas. We will assess your core, back, legs, ankles and feet to make sure that everything is align correctly 

What can Physical Therapy do for Knee Pain

The Physical Therapists at Balance Within will look not only at your knee but your entire body to access the root of the problem.  PT should begin with a full body review and look for all areas that can be affected. They may do a gait evaluation where they watch you walk to see how your legs and feet align.  They may also do a range of motion test to see how well your knee moves and where the pain is coming from.  Your therapist may also test the strength of the knee and feel for any abnormalities that could be causing pain.    Your Balance Within PT will also consider the following:

  • Your core and lower body may be out of alignment –  Your core and pelvic area provide your body with stability and balance.  Even a slight out of alignment can cause your body to over compensate in other areas.  This is often the case with the knees taking the brunt of the shock and pressure.
  • Core not firing correctly –  If your core muscles are weak, this can create issues within your legs as they are working hard to assist your body with stability and balance.  Overtime, this can cause knee pain as your knee joint is working to assist the body.
  • What is going on above and below your knee –  Looking at your upper thigh muscles and your lower calf muscles is key to assess knee pain.  Often times, what is happening above or below your knee can make all the difference with the severity of your pain
  • Body mechanics are so important –  Your sitting, standing, and walking position should also be assessed as 
  • Your physical therapist will also provide you with at home exercises and tips so your pain does not return.

PT is an excellent resource to assist with knee pain.  Your therapist should look at the overall body picture to find clues to the source or reason behind the knee pain.  Temporary or fast pain works well in the short term but the goal with PT is to work toward removing the immediate pain and also to prevent the pain from returning.

How to Ease Knee Pain Over time

Looking long term to maintain your healthy knees and a healthy body, you should

  • Exercise –  Movement and a regular exercise schedule provides so many benefits.  Keeping your joints fluid and moving is key to prevent future problems as well. If exercise is hurting, PT can help so this feels great again. 
  • Maintain an ideal weight –  Your knees are joints that handle pressure and shock on a daily basis.  Maintaining an ideal weight will help ease the stress on those joints.  Being overweight adds to the stress on your joints and can lead to future problems. Please know however that you are not ‘doomed’ to have knee pain if you’re overweight. While weight loss helps, there’s much more to the picture! 
  • Wear supportive shoes – orthotics – Your shoes may be the cause of your knee pain – those with pain should usually avoid flip-flops, sandals or high heels.  Custom orthotics from Foot Levelers is a great option (which we offer in our clinic hooray!)  These custom made inserts as well as orthotic sandals to help support your feet, legs and knees.
  • PHYSICAL THERAPY – balancing out the body with making sure you have enough strength to support your joints, that the joints are moving OK and not too stuck and that the fascial system is not throwing things out of whack… addressing these issues and many others, this is how we truly get to the root cause and get you back to living your best life! 

Knee pain is not something you need to live with.  Just because you are getting older, have arthritis or osteoporosis does not mean you have to live with knee pain.  We can help.  Click the button below to request a free knee pain troubleshooting consultation.  Balance Within PT will meet with you to discover the root cause of your pain and develop a customized treatment plan to get you back to your fall activities and living your best life.  

Click here to request our free Ease your Knee Pain Guide –  it offers helpful tips to provide relief for your pain.
Knee Pain – Balance Within Integrative Physical Therapy In Delafield, Wisconsin (

We also offer a FREE KNEE PAIN TROUBLESHOOTING SESSION to look at your overall pain issues and look for the root problem.  Click here to request a FREE session today!


Doctors Jereme and Sarah Trunk

Balance Within Integrative Physical Therapy

We Help People Looking For Physical Therapy In Delafield & Beyond Find LASTING Solutions to Aches & Pains NATURALLY… So They Can Get Back to the Active Lifestyle They Want
(...without unnecessary medications or surgeries)

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