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

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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
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.

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