4 Months After TKR Surgery (My Pain, Progress, Setbacks)

(I may earn a small commission from the products mentioned in this post.)

It’s been four months since I had my total knee replacement. Once again time is flying by. Immediately after TKR, time seemed to drag and the healing progress was slow.

Now that the real hard work is over I feel much better and I’m able to do everything that I could do prior to TKR, only now it’s without pain. I still feel soreness and stiffness along with occasional swelling around my knee after activity.

However, I continue to work at my rehab and an exercise routine is still an important part of my day.

In this article, I’ll share my experience during the last month and I hope it encourages you to work extra hard in the months after knee surgery. Those first few weeks after TKR surgery with the physical therapists are so important.

My Pain Level 4 Months After Knee Replacement

My pain level continued to decrease from 3 months after knee replacement to month 4. If you work hard following your surgery I expect that you will feel a big difference in your knee, just as I have.

I feel no more bone on bone pain and overall, I feel great. I tell people to surgery was a “miracle”.

You might experience some soreness in the muscles, ligaments, and tendons around your knee as I have. It’s common to experience minor swelling after heavy workouts or play and also some feelings of heat in your knee.

I recommend that you continue to ice your knee after activity.

My joint feels much more stable and strong and I’ve received many positive comments about the difference in my walking from friends when I am hiking, playing pickleball, and golf.

Everyone comments on how fast I’ve recovered and they are amazed at my mobility. Recently, I had a few people tell me that they had no idea that I had TKR after a pickleball session.

Before and after 4 months after total knee replacement surgery
Prior to surgery and 4 months after (notice the bowing before surgery)

Range Of Motion 4 Months After TKR

As I’ve mentioned in other articles, your range of motion will increase the most in the first few weeks after knee replacement (check out my detailed article on my range of motion progress).

However, you can still achieve some improvements in the 3rd and 4th months.

I would encourage you to continue to do the range-of-motion exercises that were prescribed by your physical therapist. I use a fitness center to continue my workouts; Use your Silver Sneakers free pass for fitness centers if you are over 65.

I’ve developed a routine with the physical therapy exercises, the stationary bike, and regular bicycle rides 6 to 10 miles. I believe they continue to help me maintain flexibility and help me to increase my range of motion, slowly, by a few degrees.

I am not seeing the huge gains as I did early on, but I am increasing my range of motion little by little.

I continue to massage my knee with Free Up (check out Free Up and more items you need after TKR) before and sometimes after workouts. It helps to loosen the knee before activity and feels better when I begin my exercise.

Leg Strength and Endurance: Activities I Can Do

If all goes well, you will definitely feel that your leg is stronger and more stable after four months.

I’m playing a few games of pickleball 3 times a week. I’ve walked 9 holes of golf 3 times with a pull cart. I walk on the beach for 5 miles barefoot at least once a week and I’m swimming a half-mile in the pool 3 times a week (keep in mind I was also active prior to knee replacement but did-so with pain).

I’ve gone swimming in the ocean and my major accomplishment was hiking at Mammoth Lakes with a 1700-foot elevation gain. I was physically spent after the hike. Every part of my body was sore but I felt no pain in my knee whatsoever. It was amazing.

If you plan to hike, consider using hiking poles. The poles will give you both stability and confidence and take some of your body weight off the knees.

Don’t hike without poles (feel free to check out my article on hiking poles after knee replacement)!

Should Others Anticipate Knee Rehabilitation Setbacks

Thankfully, I have had few setbacks. I’ve read a number of stories about others who have struggled to regain their mobility. I even know a few people who had to go in a few months after surgery to have their joint manipulated by the doctor under anesthetic (limited range of motion).

Early on I didn’t feel like dealing with the painful exercises, but I’m glad I pushed through the pain and remained active. I feel a little better and stronger each day.

The hot tub has been soothing after swimming and other heavy workouts.

I still feel soreness and some aching around my knee after workouts and activity so I take time to elevate my knee with my wedge pillow and ice my knee after activity even if it does not feel swollen.

Sleeping was difficult in the days after knee replacement, but now I have no trouble sleeping. I sleep on either side, on my back, or on my stomach. I’ve made it a habit to do ankle pumps and ankle circles before standing up in the morning.

One thing I’m not pleased with is that it is still uncomfortable to stand in one place for long periods of time. Driving also requires stops every 45 minutes to an hour for a break where you can walk around for 5 or 10 minutes (read more about driving after knee replacement).


The last two months have gone by much quicker than the first two months post-knee replacement. The healing process is amazing.

You should expect to be back participating in the activities that you enjoyed prior to TKR and you will enjoy them even more without pain. It is important that you continue to use your physical therapy workouts on a regular basis.

>> Update article: 5 months after knee replacement

Add swimming or bicycle riding to your routine if possible and take walks. Use stairs if your body feels capable.

Expect some swelling! My doctor said my knee would remain swollen for six months. Don’t get lazy and stop elevating and icing your knee.

I also recommend massaging your knee regularly or get a professional massage if you can afford the expense.

Even though you will feel much better after 4 months don’t think the work is over. If you want a great recovery, you need to continue your physical therapy workouts.

Establish a good combination of workouts and exercise that you enjoy (golf swimming, dancing, yoga, etc.). Find a routine that you like and stick to it.

The more you build up the muscles, tendons, and ligaments around your knee, there will be less pressure on the knee joint.

I will keep you posted on my recovery. Check back in a month and see how I am doing. Thanks for reading this article.

49 thoughts on “4 Months After TKR Surgery (My Pain, Progress, Setbacks)”

  1. 2 months after tkr no paint at all 4 months pain down my shin need Motrin little pain around knee but down shin is a 5
    I’m starting to feel disappointed

    • I encourage you to be optimistic. At 2 months your body is still adjusting to its new knee. My surgeon told me it would take up to 1 year to feel my best. Good to hear your knee is feeling decent. I didn’t experience shin pain, though it could be shin splints (common overuse injury that eventually goes away with rest). Check with your doctor about it, I haven’t heard if that’s a common problem during recovery but I’d be interested to know more. I hope you’re continuing to ice as well. Thanks for the comment!

    • Thanks for the information I am at 4 months and it’s getting better everyday the continued exciting definitely helps I do the step ups also side steps and getting up from the chair for strengthening my knee and the other stuff too

  2. I’m just one week shy of 4 months. I’m still in a ton of pain. I do my exercises faithfully and have all a long. I went back to work a few months ago. I’m so swollen from work every day that it’s hard to come home and do much activity other than my stretching exercises. I still can’t get up from sitting or sit down without my hands helping me. I can’t do stairs. Anythink I do at home, chores wise, I get swollen. I feel so lost. You mentioned the last two months have gone quicker than the first two. I’m still in agony every day and am getting so depressed due to inactivity. When I push myself, I am in too much pain to sleep at night. And I pay for it for a few days. I hope to get some relief soon like you have. Thanks for sharing your story

    • I’m sorry to hear you’re still experiencing pain. We all heal at different rates and due to work it may take a bit longer. Icing and elevation helped me after long days. Hopefully, your doctor can provide insight that will help your specific situation. Thanks for visiting, wish you the best!

    • Hi I know this is a while ago but I am struggling so much with lot of what you have said
      The pain is still
      Bad when I walk and so stiff
      Is yours much better now
      Thanking you
      Lynn hanney

      • I’m at four months, but really concerned about rom, tried to ride exercise bike, but cannot get anywhere near full circle! We went into lockdown a couple of weeks after my surgery, I only had two half hour physio sessions before everything was cancelled! Read lots of info on internet for guidance, but not the same as having face to face confirmation that what I’m doing is correct……really quite concerned…..still getting quite a lot of discomfort, numbness etc….. any advice from anyone would be very much appreciated!

    • Hi, I read your note about up your knee and I’m wondering how you are doing? I’m 3.5 mos out from tar right side and the hardest part for me is my other knee is as bad or worse so I’m not sure how I am as I now worry about my new Bad side lol. Replacement side I am really pain free except for top of the knee spasms..pain spasms. They can be doozies.

      I hope you are much better.

  3. Hi There,
    I’m just 4 months after surgery. The pain went after 3. Months but my leg is still very stiff around the knee. When I Walk I feel as if I’ve got a wooden leg. Although I went for physio at our hospital working using the bike I got a groin hernia which stopped any more physio. At present I’m waiting to have the hernia done. I still do the things the hospital told me to do twice a day. I’ve got a 90 degree bend in my leg which is what the hospital wanted. However I’m not too pleased about walking, I’m using a stick.

  4. Sorry to hear your leg is still stiff. I’m 5 months post op and I’m stiff and a combination of sore, aches and the pain shoots down my calf to my ankle. I invested in cannabis cream that I massage in 2-3 times per day. I’m still taking 3 Ibuprofen 2xdaily. Hope you’re all feeling better!

  5. I’m glad I found your website! I am just past month 2 and it seems that every time I extend myself a bit I suffer. I went to the gym for the first time on Friday and dismay PT routine plus very light overall exercise, and the next day I was in agony. The following day I walked half a mile and my knee hurt so badly I haven’t been able to do my PT. Today is Sunday and I will try again. I jumped back on a whole Tramadol, something I have been having and trying to get away from by cutting g the 50mg in half, combined with two extended release Tylenol. I am increasing my mobility, but the darned pain comes back so easily. Your website has encouraged me, as have the comments from others who also have not had an easy go of it. This is my second tkr, my first one having been done 15 years ago at age 60. Thanks for your help, Anne

  6. March 25 2019 my first TKR I’m so regretting it! I can’t sit for long never comfortable make myself push thru most days my new knee is always numb stiff feels like a heartbeat at times on the side my legs numb n get so stiff other knee is not good either but I was doing better than this! So disappointed I did 5 weeks home Pt 6 weeks in clinic pt . Along with a lateral yearn my spine and 4 bulging disc and the other bad knee I’m at wits end! Will I ever be able to sit thru a movie or go on a trip again? I have my doubts🤣 worse mistake I have ever made! I’m 62 yrs old!

    • Hey Vera, I just left a message for you and realized after I posted it that I could directly respond to yours. So you can see my message I posted below. Worse mistake of my life, too! Hang in there!

  7. Vera – I commented on this on June 9th. Now it’s August and I’m still doing poorly. So I can totally relate to what you’re going through. I had my surgery in Feb. I’m 57. This has been the worst thing ever. I saw the Dr last week and he said I have Bursitis and that’s why I’m still in a lot of pain. It’s now been six months for me. I’m like you. I wonder if I’ll ever be able to sit through a movie again or go on a trip. This has consumed my life and I feel I have no life. I’m unable to take ibuprofen or any anti-inflammatory drugs, so I think that’s why I’m worse. Hang in there. It helps knowing there is someone else out there like me. Hope things improve for you!

  8. I just past my 3rd month TkR and it feels a little stiff our the knee.An to when I have to get out the van I have a hard time getting out of it an even the regular car,an to I can’t even get out of our big tub or I can’t go up my steps at at home ,an I have to go through more therapy .My Dr thought it be best.

  9. I am just past 4 months tkr (right knee) My pain issue is behind my knee..I can walk my dog 45 mins and just recently can ride the stationary bike.I dont know what the pain is from. Very little swelling so dont think it is bakers cyst. Massage therapist thinks it is tight tendons or ligaments so I stretch calfs and hamstrings twice daily. Rom has just recently improved but after 3 months. Surgeon says it doesnt matter what issue is just keep bending. I also do hydro therapy nut this pain wont go. I cant stand and bend leg up to bum without pain behind knee and hamstring cramp. I keep plugging along but wonder if it will ever subside. Any advice. Help

  10. I’m 43 yr old female and a little over 4 months post my 3rd TKR. I dislocated my first one and had to have it redone. I have an extensive orthopaedic surgical history. Currently I have full extension at 0 degrees and I can bend at 120/125. This third one has been a challenge but I’ve no regrets. I’ve been suffering a long time and had to wait to have these because of my age. I feel like I’m finally getting my life back. I’m finally back to where I was pre-OP in terms of mobility. I have very little pain!!! Its a huge, noticeable difference. My biggest struggle has been the mental recovery. Staying focused, and learning to live with these new legs. Im Learning how to be happy again because I was weighed down by chronic pain for 27yrs. Every day is a struggle but a blessing. My advice for others….patience. dont compare your recovery to others. Everyone is different and no 2 bodies are alike. We all heal differently mentally and physically. Mental recovery is just as important. Once depression takes a hold it can definitely negatively affect your recovery. Meditate to help with pain and sleeping. Plenty of self guided meditations on youtube. Good luck everyone. Stay positive. Your hard work will pay off.

  11. Hi, delighted to find this site . I had my left TKR in May and am having the second one done in 9 days time . I’m still using a stick to get around outside NOT due to the new knee but due to the second one needing support! My mobility is poor due to that , did anyone find that they had lower back pain and top of the neck pain that caused overall body stiffness ?
    I’m hoping that the next op balances me up and I can get back to work !

  12. I have left a few comments here over the months . I’m almost 9 months out and still struggle a lot with swelling. I’m constantly swollen and get worse by doing the smallest tasks. This has been the most difficult of my life. Still can’t bathe. Still can’t lay in bed on my side. I’ve had to on my back this entire time. My pain has reduced, thankfully. But the swelling causes it to be worse. Everyone keeps telling me to be patient for the year mark. I honestly hope that after a year I will feel whole again. I struggle wearing jeans and normal pants as I have to peel it off my knee at end of day due to swelling. I also had to go back to physical therapy a couple months ago. I feel it’s really helping. Hang in there, everyone. Hope we all get there 🙂

    • Glad you’re staying positive. And don’t forget to do the physical therapy at home too. After my paid sessions were finished, I asked the physical therapist to make a home exercise routine for me. Swimming has helped with range of motion and as a low-impact exercise. If you’re spending a lot of time on your feet during the day, make sure you elevate and ice in the evening. Hope you feel better, slowly but surely.

    • I had an experience similar to yours. I was allergic to the nickel and cobalt in the implant. Had a revision, recovering SLOWLY.

  13. I am 63 years old and was very active prior to my TKR. Dancing, AquaFit, working 12 hour shifts. My surgery was in July. ROM 120-125. Pain is tolerable. But my knee is still so stiff upon waking up and after sitting too long. I get to the gym 3-5 days a week and do 20 minutes on the bike then all of the stretching that I learned in PT. I take my ankle weight and the strap for stretching.

    I was just doing more research and considering a second opinion when I came across this site. Thank you for sharing your experience. I feel like I just need to give it more time.

    Best of luck to all!

  14. I’m 7 weeks in, I can bend my knee 90 degrees, I’m on my exercise bike ever day, I can walk ok but in pain after a mile or so. I just get frustrated how slow things are going. After I’ve exercised i always Ice but you knee always goes sore and my knee is still swollen, any advice would be great. I’m a 54 years old and just hope I can still do my job in about 6 weeks when I really need to return. Thanks

    • I’m impressed that you are able to walk for a whole mile after only 7 weeks. I am 6 1/2 wks post-op and have 125 degrees flexibility, but unable to walk or stand for more than 10 minutes at a time without pain and knee fatigue.

    • This made me feel better ! Tuesday will be the 6week post TKR for me. My ROM is 102. I am trying to warm and massage the incision several times a day. My biggest fear has been having to have scar tissue broken up!! I’m 19 months post partial left knee replacement and need to quit comparing the two. I returned to work 4 weeks after that one. Hoping to RTW at 8 weeks this time

  15. Sorry one thing I forgot to ask is , as I can only bend my leg 90 degrees and can’t fully straighten it yet after 7 weeks, did you find that gets better when the swelling goes down? Thanks

    • My flexion improved the most in the first 2-3 months. 90 degrees isn’t bad and allows you to sit properly. Also, I think knee flexion after surgery depends on the condition your knee was in prior to surgery. Swelling definitely made my joint harder to bend and more stiff so that’s why I did more elevation and icing after activity. Thanks for visiting!

  16. I am now 4 months post-op from total knee replacement. My ROM has improved and I have less pain, however, I’ve noticed the back of my knee hurts a lot now from bending, I assume from getting in and out of the car. I drive more and when I stop to anywhere like the grocery store, getting out of the car is painful. Once I get out I have to stand for a moment, stretch my leg, and then proceed to walk. I’m still having nights where it’s hard to sleep from knee pain. What’s weird is maybe around the 10 week mark I started sleeping better but right here at 4 months, it’s like the restlessness is starting all over again. I’m thinking it’s coming from walking more riding my exercise bike more therefore by the time I go to bed, I’m worn slam out and toss and turn all night. I am making progress though taking one day at a time. I forgot to mention in October right at 2 months post op, I had lots of swelling and knee wouldn’t bend past 90 degrees. Ended up having scar tissue and had to get a left-knee manipulation under anesthesia. That set me back for a little while but knee is bending a lot better now.

    • Your 4 month post-op condition describes mine perfectly! I still have trouble sleeping most nights and some swelling mostly in the back and side of my knee as well as my ankle. Like you, I think it may be because I am more active now. How are you doing now that it has been a year since your surgery?

  17. I am so disappointed,, had TKR October 2019 by 2 months after TKR the swelling was down considerably and was walking half a mile everyday. I was going to PT twice a week and doing all the exercises they had me do 2 times everyday. at my 6 week appointment the dr was very pleased that I was at 0 and 120 said I could stop PT. At 7 weeks I couldn’t walk without a cane my knee swelled up again and I was having to take percoset so I could sleep at night. The dr started me back on PT with just range of motion since I had lost it all. not sure what has happened but now I have a mushy large lump on the outside of my knee. The therapist puts Kinesiology on my knee not sure it helps but I am just starting to get back to walking only a block or 2 but still so swollen, and am at 3 months in a few days. Thank you all for the hope you have given me

  18. So glad to have found this site! I am 58 and 4 months post TKR. Has been a really tough recovery road with issues with pain, anti inflammatory drug and renal reactions, intense swelling and therefore slow ROM. However I got the 120 degrees of ROM at week 10 so Physio and myself thrilled. Still experiencing pain and swelling after extra walking/ exercise etc. So need to take the next day easier. Doing stationary bike riding, water walking and other hydro exercises daily. My whole life is centred around exercises and getting the best result from this new knee so I can return to work and enjoy life better then I could before. Only major issue I am having is sleeping on my side, and pain at night. So I still elevate and ice my knee before bed. GP today actually referring me back to surgeon to see what is causing the pain. Hopefully nothing serious! But so good to read of others experiences and makes me feel not so alone. Wishing everyone the very best in your recoveries!!

  19. Hi I am four months one week after double knee replacement surgery able to go upstairs come downstairs ride the bike exercise walking 3.7 to 4.5 miles a day no issues except for long periods of standing I get sore in knees if I stand for long periods of time so that’s my only problem other than that everything else is going great that’s the luck to you all

  20. I am almost 5 months post op and am 52 years old. Over all, my TKR knee feels better. It seems to feel better with every month that passes. I am about 115 ROM and 0. It is very stiff in the morning or after riding in the car. It still feels better than it did 6 months ago!! Sadly, the other knee needs to be done but I am really building up muscle in both legs and exercising at the gym 4 times a week to put it off for just a bit longer. Like most have mentioned above, standing for a period of time is the toughest. I am very sorry for the people who are having a tough go of it. It’s a scary surgery to jump into voluntarily–it really is. For me, the pain was debilitating. Now, at least I can do things again, and people notice how much better I am getting around–which is nice to hear.

  21. 4 months 2 weeks out had both knees done on nov. 18 th and nov .25 th 2019! plenty flexibility 130 degrees on both !! Riding stationary bike few days a week for 45 minutes and doing pt exercises almost daily , no pain when sitting but more shin lower knee pain now then in December and january or febuary …. 1 st 20 steps after sitting very painful and walking in general… almost need a cane To get around .. what can I do for shin pain ????

  22. My husband had TKR on 1/8/20, had home health care for 2 weeks and had 20 PT visits. He is still having ALOT of pain in the knee, shin and his lower back. Hurts to get out of bed and from sitting in a chair. He has always been so active and this is really getting him down. Could the joint pain and back pain be coming from the way he walks because of his knee. Right now he just doesn’t feel like he’s ever going to be as active as he once was. Wishes he had NEVER had this done.

    • It’s still fairly early in recovery. There are so many factors and I can only speak for myself. The biggest keys for me were weight management, stretching, strengthening, and activity. I find that inactivity makes me start to get stiff. Best wishes to your family and thanks for the comment.

  23. Thank you for this site! I’m three months Right TKR. I, too, regretted it for the first two months. I will say, there is something to be said for over challenging yourself early on. I think I was trying to do too much: stationary bike 45 minutes twice a day, walking over a mile every day, swimming laps, and my PT sessions. It made my knee feel terrible! Stiff, swollen and painful! I back off the exercise a bit and and feel much better! Full extension, Flexion 116

  24. I am 3 months and 2 weeks from surgery. Having shin pain, swelling and something no one has mentioned, severe popping when I bend my knee- walking, stairs, swimming… I also have quad atrophy- I have been diligent with PT , currently in round 3. I have done everything the PT has advised- maybe to a fault. My ROM has been great since the beginning (140). Has anyone else had quad atrophy and SEVERE popping ? I know many people experience a clicking, this is like it adjusts every time I bend. I am 62 and in good health otherwise.

  25. I have left several comments here. My surgery now has been over a year ago. I’m still struggling quite a bit. I never got my complete range in motion, although I did my exercies religiously. I get a lot of clicking and still get pain. Can’t do much and then I’m hurting. However, I’m miles better than what I was and at least I can have a semi-normal life now. To any of you that are going through difficult times like I did, hang in there. It will get better. Just takes oodles of time. My Dr said if I were to do my other knee, I would probably breeze through that usually one is bad and one is good. But I will never do it. Best wishes to you all! -Shauna

    • Thanks for the comment. I agree, everyone reacts differently, and it sometimes takes over a year to get recovered. I am also better than prior to surgery and I’m glad I did it. Take care.

  26. I am 71 and had a TKR (right )on 20th Feb 20. I had to go into lockdown quite so afterwards and so didn’t do much walking in the early days. I have quite a lot of lower back pain, sciatica which goes down the outside of my leg and into my foot. Have really increased my walking and it has made quite a difference. difference. I can’t do stairs very easily. I do stretching exercises to try and get my knee to go completely flat, nearly there but can’t seem to get that last tiny bit. My knee is also quite warm all the time. Just hope there isn’t a reaction to glue/cement as I have an allergy to sticking plaster and sticky pads from my tens machine. Need TKR on my left but not too keen after this experience.

    • It is definitely a challenging time to rehab a knee during the lockdown. I’m sorry to hear about your struggles, but remember, I felt improvements all the way up to 1 year after surgery. Keep at it!

  27. Hi Ken,
    I’m a 74 yr old female and walked without assistance or a limp one day home from the hospital. By the second week my home health PT measured ROM at 130 degrees. I guess I was doing too well because today, exactly four weeks after surgery, I have serious pain even during a tiny walk. I haven’t overdone my exercise or lifestyle routine. The muscles on either side above my knee are painful and sleeping is difficult. Just on Tylenol. Is this karma?

    • Hi, it could be a variety of factors. You will have swelling for up to 12 months after surgery and it could be painful. I don’t know your specific situation but be patient and if you’re experiencing pain ice and elevation is always wise. If you think it’s a problem speak with your doc.

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