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Can Hamstrings Hurt after a Total Knee Replacement?

Hi everyone!I recently had someone ask me that, and the answer is a definite, resounding “YES!!” I originally wrote about this topic in 2008, and because I have received numerous requests for this article, it seemed logical to bring it to the front of my home page again. So, that is why you will notice comments dating back to that year. FYI..

The back of the knee is where the hamstring muscles are. In fact, four months after my surgery, I still needed to elevate my leg on a pillow while laying down. Without doing that, it can be very painful. Even seven years post-tkr, the back of my knee hurts sometimes.  It is getting better, however.

If someone does not have painful hamstrings after a total knee replacement, I say they are very lucky.  I’m envious….

BTW: I Just found out about a great exercise for strengthening hamstrings…sit in a chair with feet flat on the floor, pull your heels back toward the chair.  Or, sit in a chair that has wheels (like an office chair) and pull yourself around the room with your weak leg.

Find interesting? Kindly share…Thanks!

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40 comments to Can Hamstrings Hurt after a Total Knee Replacement?

  • DG

    I’m 3 weeks post op from an ACL reconstruction and was doing well with my range of movement, balance, and general use of the knee. However, just recently, i was stretching my hamstring out the way my doctor showed me and i felt a sharp pain in the back of the knee and heard a slight click. I’m afraid I might have torn my hamstring as a result of it being very weak after the graft was taken out to repair my ACL. I can nearly touch my toes but there is still a sharp pain when I bend down behind the knee and it feels tight like it will cramp really badly if I go any further (which I am not game enough to try). Anyone know what to do for hamstring tears and how long it will affect me for?

  • booktoots

    Thanks for commenting about your torn hamstring. Unfortunately, I have no idea about what to do for them, nor how long you will be affected by them.

    Anyone have any suggestions for DG?

    My hamstring wasn’t used for 30 years, so I needed to retrain it.
    Best of luck to you!

  • Oh yeah, my therapist just keeps looking at me like I am not doing my stretches.

  • donny

    Hi everyone, I am also 3 weeks post op of an acl with hamstring graft, and meniscus reattachment. – am experiencing the same thing in my hamstring and back of the knee! I’m very curious to what this is, does anyone know?

  • booktoots

    Hi Donny,
    Thanks for visiting my blog and posting your concern. Sounds tricky.
    I recommend contacting your medical care provider. We don’t diagnose here.
    Good luck!

  • Liz

    Hi I am 3 weeks out from total knee replacement. First 2 weeks I was amazed because of no little pain, I had my first knee replacement 7 monthes pryor. Then I developed cellutis, and with that inflamation it set off hamstring pain. Now a wekk later I feel like i just had my surgery. It has not prevented me from continuing my rehab, just more pain. But yes it can happen. DO what the therapist tells you and be patient it gets better

  • Thanx for informing about your problem..Getting proper rest worked great for me…

  • Jake

    I had a TKR Sept 2011 and since then have had nothing but problems. I’ve been sitting here for the last couple of hours reading horror stories about TKR, so much of it sounds so familiar. My TKR was covered by L & I, and that was a joke in itself. I was covered for 4 weeks (twice a week) of PT and by October 2011 my work began nagging me about coming back. I worked a desk for a about a month then went back to full duty. A friend of mine had a TKR about four months ago and his career is now over and I’m thinking I’m next. I’m hoping someone can guide me in the right direction, I’m only 56 and not really for retirement.
    The pain, swelling, numbness and buckling (backward) hasn’t stopped, but become more frequent. The pain is in the front and inside part of my left knee mainly, the numbness runs from the front of my knee, down my leg and into my foot. My knee has never stopped swelling, even in the morning when I wake up it is swollen. By the end of the day it looks like a balloon. My knee gets almost like a “popping or clicking” sound when I move and it seems that is a common element now. The last part is pain behind the knee. After the surgery I found I couldn’t extend my leg out (lay it flat) without the outside rear part of my leg feeling like it was being ripped out. I thought there was a bone back there and it turns it is the hamstring (shows how much I know). This (hamstring) started hurting bad! The pain was so intense I thought I would scream. I started PT about a week after surgery and asked why the bone behind my leg was hurting so bad. I was told there was no bone back there, it was the hamstring. She couldn’t believe how tight it was and referred me back to my surgeon. The surgeon said it was normal, but now over a year later I still can’t bend the knee flat without causing serve pain.
    The pain in the knee is bad enough I’m can’t help but limp, my knee is so swollen by the end of the day, I can’t do anything but get off it and the numbness is really worrying me. I have done everything my surgeon told me to do and everything the PT told me to. Nobody had been able to give me an answer about the pain, numbness or swelling and the hamstring appears to be a mystery.
    I’m hoping someone can help me with some answers.

  • Sue

    Hi There,

    I am 44 and i had a total knee replacement 12 weeks ago. My progress has been good and i now have 140 degrees flexion.
    My pain however is very intense and like others whilst i was doing my stretches i heard a huge click followed by the most sickening pain. My pyhsio assured me it was my hamstring since it hadn’t been used properly in a long while. The hamstring saga still continues.. i really do hope it eases 🙁

  • Jeryl Presley

    I am 59 yr old female and had TKR surgery on Dec. 27, 2012 . I have also developed ham string tendinitis which is far worse pain than the actual TKR surgery. I expected the pain in the knee post op, but never what I am facing with the tendinitis BEHIND the knee. I went to an inpatient extended care/ rehabilitation center post op and began physical therapy three days after my surgery. I had therapy twice a day every day and in between the therapy I was on a CPM machine for an hour or longer 2-3 times a day to keep my knee moving. Three days into my therapy sessions, I could not stand the pain behind my knee. I also could not withstand the therapy exercises of bending my knee toward my chest. I could not make a full rotation on the recumbant bike and I think the therapists thought I was just a big baby. I ended up going back to my surgeon and he treated me for tendinitis with a pain patch, ice packs, deep massage therapy and exercises for the ham string. He had them to ease up on the aggressive knee therapy until the ham string could heal.(A ham string needs rest, but the post op knee needs to keep moving so I was doomed!) It got a little better, but my knee movement diminished;I was there for three weeks. I am now home with visiting therapist three days a week for my knee PT.It has been six weeks today since my surgery and my flexion is only at 93 due to my continued ham string pain, swelling and diminished knee movement. I am doing everything I can possibly do to get this thing moving. I DO NOT want to have to go back to OR for a manipulation, but that is the next step if this does not get any better. That will only start the healing process over AGAIN and I am afraid it will aggravate the tendnitis even more, so what do I do?

  • Hi Jeryl,
    Thanks for visiting my site and leaving your comment. That is some story you have. I feel for your tendonitis issue. Yikes…
    I wish I could provide an answer about your ‘decreased flexibility’, but I cannot. My flexibility is about 93 and will not improve for a variety of reasons. I’ve written about this throughout my site, so take a look around. I’m not complaining at all since I’m grateful to walk without pain. And…like you…there’s no way I’m having a manipulation done.
    Only you can decide what is best for you. I am not a medical professional who gives advice.
    Best of luck to you and keep in touch…

  • I had my op 10 weeks ago. After a two week set back because of blistering due to dressing I had 4weeks Hydro .once you reach 100/5 bend straight that’s it. I too have cramp in ham string .
    Have to go Back to work soon should be fun as a primary teacher!
    Think I will try a private physio and let you know if it helps.

  • Hi Lynnette,
    Thanks for visiting my site and letting us know how you’re doing. Keep in touch about how your private physio treatments go and good luck!

  • LHay

    I am 8 weeks post op and having difficulty bending past 100 degrees.due to stiffness and painful hamstrings. I use heat and ice several times a day, but still have to take pain medication before PT.
    Any suggestions?

  • Hi all!
    I just wanted to inject some of my problems related to a TKR. I had my first TKR done in 2011. I had a lot of pain but with proper Physical Therapy and working out at the gym on my own I was able to get my knee bent to 125 degrees and was able to go back to work in ten weeks. I was back on the golf course in three months. Now, lets talk about my latest TKR which was done June 3rd. I was in the hospital for four days and then in rehab for a week. During this time I was able to get my knee bent to 95 degrees. I also came down with a bad case of Prostatis and hemorrhoids. I can’t believe the pain I had not only with my knee but these other ailments. I am now in week 8 of my recovery and can walk short distances without a cane. I still have awful pain in my rear knee which I think is tight Hamstrings. I am now working out at the gym on the days I’m not in physical therapy. I hear all these horror stories and want to let everyone know there is pain and it does take a lot of time for it to go away. Please be patient and work your knee out as much as you can. Also, ice, ice, ice. I’ve still got my sights set on golfing by the middle of August 2013. Oh, I also take my pain medicine whenever I go to therapy so I can have the therapist work the heck out of my knee. I still can’t get my left leg straight. It is still bent to about 5 degrees.

  • Tamara

    Hello ~ I had TKR on March 25 2013. I did a lot of research and went to one of the best doctors in the country and a hospital with an excellent protocol for preventing infection. They were rated way below national average for number of infections after surgery. What I did not count on was the issues I would have due to the severe damage to my knee prior to surgery. That has led to a lot of issues. After surgery my doctor came in and said I had one of the worst knees he had ever seen. Over 30 bone spurs had to be removed, lots of internal swelling and bone on bone.
    After surgery I came home with at home PT. Me knee was very swollen. After my first PT session it was 3x the size of the other knee. The doctor had to back off PT for a couple weeks because of the swelling. This led to scar tissue forming and lots of pain. My hamstrings have scar tissue and are limited in motion due to previous injuries. Week 4 I started therapy outside the home. I was at a 65 degree ROM. I have been in therapy about 4 weeks and have a ROM of 100 degrees. The PT has been horrible. To the point that the pain is so bad I get physically sick and break out in chills. I force myself to push through. MY hamstring pain was keeping me up at night. As an herbalist I decided to start using herbals I knew helped with inflammation. I drink nettle infusions everyday and can tell that my inflammation is worse if I miss a day or two. Castor oil packs help with breaking scar tissue. After using the packs I do a deep massage on the area. I make ice cups and do an ice message on the hamstrings for 5 minutes 4 or 5 times a day and this helps tremendously. I have found the ice is more helpful than the pain meds. I am also using an anti inflammatory extract that has turmeric, ginger and other herbs that I find useful. I have talked to several people that have stated that message therapy and acupuncture were a tremendous help. We are moving in a couple of weeks and I plan on going to an acupuncturist as soon as I can do the research to find a good one in the area. Blessings to all

  • Hi Tamara,
    Thank you for stopping by and leaving your very interesting comment. I love your insight into herbs and natural treatments re: tkr. Would you be interested in writing a guest post for our readers? I’m certain it’ll be a hit.
    Keep in touch and good luck!

  • Cookie Pack

    I had a total knee replacement done on Feb.17 2014. I take therapy three times week. Hamstring is so tight, they cannot break it. I am in pain all the time. I now have a brace that I use two times a day by increasing the tightness every 5 min for 30 min. A day and sleep in it at night. My leg will still not go straight. Don’t know what to do about it. It hurts so bad from my groaning to my foot. Any suggestions would be appreciated.

  • Hi,
    Thanks for visiting my site and leaving your comment. This a common problem and I sure do sympathize with you.
    I’ve written about this in posts throughout this site. Search for “leg straightening” “hamstring exercises” and similar terms to have a list of articles brought up. The Search Box is located in the upper right-hand corner of my site. Good luck and keep in touch!

  • Jason

    Hey. I’m 40 year old and just had tkr last wee 9/4/14. The pain has been almost unbearable. My quads and hamstring have been so knotted up and painful. I know the docs say to stay away from heat, but I put a heat pad around my leg towards the top away from the surgical site. It feels incredibly good! A good friend of mine from the Navy is now a DPT. He told me that applying heat is ok away from the surgical site, but only for a limited amount of time. Just thought I’d share my experience. Thank you all for sharing yours. Best of luck to everyone.

  • Jason

    Sorry….the heat pad wrapped around the hamstring or just sitting one it is amazing as well.

  • Deb

    Hi, I had a TKR August of 2013. Everything was going real well. In February 2014 I slipped and ended up with a large tear in my rotator cuff. I had surgery to repair that and had to be in a sling for 6 weeks. No knee therapy for that time. So today, I am in therapy twice a week for both my knee and shoulder and experience pain 24/7 in my knee. Down along the sides in the front and behind the knee. I thought by having knee replacement I would have been feeling better than this by now. I am 52 and will no longer be able to go back to my profession as a kitchen manager. The therapist just started working on my hamstring and thats more pain than the actual TKR. I am just lost and stressed because of the pain and not being able to find a job and just not knowing what to do. God Bless You All!!!

  • Hi Deb,
    Thanks for stopping by my site and leaving your tkr comment. That is some story you have. I, and I am certain my readers will agree, completely feel for you and your situation. I remember how painful my hamstring was during recuperation. Combining your tkr with rotator cuff surgery is just daunting.
    Believe me when I say that everyone feels lost at some time during the process. You are not alone. If someone says it doesn’t happen…they are masking the truth.
    Keep in touch and good luck!

  • Kim Andrus

    Thank You for the tip on how to stretch my hamstring. I just had a revision of my right TKR last month and my hamstring is really hurting me and I have to sit on my bed with my leg on the side of the bed for me to feel relieve. I am also going to therapy and doing some stretches as well and seem to be helping. I am going to try the office chair and pull myself around the room.

  • jamy Rodgers

    I just had my 2nd tkr 9/2/2014 just 8 wks after my 1rst leg tkr. This last surgery has been a nightmare. Pain in the knee, behind the knee and rear end since day one. Day 8 I took a back step and it stepped up all the pain and swelling everywhere on front and back of knee. The more pt made me work the worse it got. I could never get past his asst who ordered 3 800 mg ibuprofen per day. I could not get to the dr till Nov and he rushed in and out and blew me off with NEVER examining me just saying work harder. Dec 4th went back again after a bleeding ulcer from the meds. He tried to blew me off again. I stood my ground. He admitted after 1rst exam since surgery that there was severe tendonitis in hamstring and gave me steroid shot. I had several days of relief maybe more like two 1/2 weeks. Due back in Jan 5 2014. I spent all of Sept, Oct, Nov going to PT 3x a week pulling twisting and having my PT and DR say work harder. The worst thing to do is push an injured tendon. I am sure his help will be limited. Has anyone gone to another DR when their DR is useless?

  • Trish Dial

    Hi, I am 50 yrs old and found i had avascular neucrosis (dieing of the bone) caused from the prednisone in my chemo from 1993. It took a long time to attack my knees. I had a bilateral knee replacement on Dec 30th 2014. I am one month out and doing great as far as my knees go. Very little swelling due to using ice machines for the first 3 weeks continually. My hamstrings are very sore. I do pt 3 times a week with aquatherapy and it is wonderful. I have a 105 bend at this time and am driving. My major problem is what happened at the hospital right after surgery. They started me in therapy the day after surgery. I was put on the CPM machines twice a day for an hour. On my 2nd day a couple nurses clearly did not know what they were doing and set the bend # too high and the flat number at a negative 5 or 6 which bent my knee down so far i screamed. They had left the room and i did not know how to operate it. It pushed my hip up so far that it messed with my back mimicking a pinched nerve. I immediately started having pain in the lower back on my left side down the back of my thigh then the pins and needles in the calf with neuropathy from mid calf to my toes. This continued throughout my entire 1st month. I went to my back dr and got an epidural that did not take which led me to a CT scan and Myelogram with severe migraines!!!! Had i not had the back issue I would only have good things to say about my experience. I apply vitamin E oil to my scars once a day in the side to side direction, not lengthwise. My scars look great!

  • Karen LaGier

    Hi..I”m 61 yrs old and had a TKR on Feb. 3rd.2015..I had a partial knee replacement in 2007 and did not go to PT and my knee did great none the less..I found as the swelling went away so did my knee pain and my flexion + mobility all went back to normal…I hadn”t intended to go to PT this time but went today because the Doctor”s PA begged me to so the Dr. wouldn”t get mad..Results—^swelling..+^ hamstring pain…The doctors and PT profession are in cahoots….and you”re lucky to find a PT person who doesn”t have a God complex…I went in there today with 105 flexion WITHOUT having gone to PT…I could ride their recumbant bike just fine…but when they wanted me to do the exercises they pushed me like I was in their army and they were the drill sergeant….I think if you know your own body and do your own , rest. + elevate –continue walking everyday..I happen to think one can do without PT.I wouldn’t go back to Pt unless I was trying to regain mobility lost d/t a stroke…I would love to do aquatics but my Pt person told me that MAYBE I could go in the water once my Pt was finished and got my doctor”s ok..Not very encouraging….

  • Hi Karen,
    Thanks for visiting my site and leaving your tkr comment. I also was told that aquatics were not for me during my PT period. I swear by them now, but it’s been seven years since my tkr. Thanks again for your insight. Keep in touch and good luck!

  • Rob

    I first injured my knee in July 1975. After decades of bone on bone I could no loner stand the pain and agreed to a Total Knee Replacement done at the local VA.I had the TKR on December 9, 2014 and immediately had blisters. I was also in extreme pain that only injections of Duluth into the IV helped relieve. Turns out I had an infection and a blood clot couple with Narcosis. January 5, 2015 they operated to cut out the blood clot, infection and the narcosis. I was then required to wear a Wound Vac pump until April 2015. On April 21, 1015 another surgery to remove slough (low grade infection) This infection went all the way done to the tibia. This required a procedure called a “FLAP” . This where the cut off part of my calf muscle and relocated up into the knee to fill the hole left from cutting out the infection. So now I have about a 12″ scar on the cabck of my calk that circles to the front of the knee. I have started PT two weeks ago and have 100 degrees of flexion and only 35 degrees of extension. I also have serious pain in the back of the kneeplius pain that goes uo the leg to buttocks into the lower back. The PT therapist says its due to 6 months on noon movement of the leg and will require a manipulation and some serious time i PT. However, in my second PT session the extension degrade from 35 degrees to 45 degrees. I am so tired of hurting all the time and the pain pills do nothing any longer! I am ready to have them take the leg off. I have now been out of wrok for 6 months with no end in sight!

  • Hi Rob,
    Thanks for stopping by and leaving your tkr situation update. It is disheartening to hear about the horrendous ordeal you’re doing through. Hopefully, things will improve. Stay in touch and good luck!
    P.S. Thank you for your service to our country.

  • painter33

    I had bi-lateral TKR in 1999 and have not had any problems whatsoever since. I did go to a very experienced surgeon and a highly competent physical therapist who took a no-nonsense approach, thankfully, and I was playing golf and walking the course 12 weeks post-surgically. I was 52 at the time of surgery and had previously had nine arthroscopic procedures. I was and still am a “tight” person: I have never been “flexible”, and my hamstrings and quadriceps are particularly tight. Lately I have been suffering from hamstrings injuries, some more extensive than others; the latest was six weeks ago, and my ortho doc today told me to start the rehab of this very painful tear. I have complete faith in him and in all of my PT experience (24 orthopedic surgeries). The surgeons and the therapist are not “colluding for cash”, an absurd idea because doctors cannot dictate what therapist one sees. They are a team, so to speak, of professionals who are dedicated to helping patients. The only time physical therapy fails is when the patients “cheat”, and I’ve seen that over and over, as if the therapist doesn’t know that the patient is lying about the number of reps and/or sets. Additionally, I know people who have just expected the surgeon to fix everything and have not followed through with PT only to have disastrous outcomes – no mobility because the patient just sat down and wouldn’t budge because, “It hurts”. That causes adhesions to develop and then problems continue. The initial pain is from the incision, not the interior of the prothesis and it dissipates. In the end, the patient must do the work and it’s hard work, indeed, but the results can create and maintain a high quality of life versus thinking and acting like a disabled person (that’s “like” and not “as”). “Rob”, good luck, man. You’ve been through the mill and have suffered far beyond what a TKR involves.

  • Hello Painter, 🙂
    Thanks so much for providing wonderful insight and support into tkr recuperation. It is amazing how some patients blame anyone else for a poor recuperation, without doing the hard work necessary.
    Keep in touch and good luck.

  • lee m r

    thank you so much

  • Boater Jake

    I am 59 and had torn my ACL 19 years ago and had it replaced. At that time I was told that my knee was in pretty bad shape and that at some point I would need a TKR. At many years and one more surgery for a pale handle tear in another ligament I scheduled the TKR. The operation went well and I only spent one night in the hospital. Three days later the in home therapist showed up and we started. It was painful to say the least but when she had me sitting up in bed she place a pillow under my ankle and pushed down on my knee with a lot of force I felt server pain and saw blood through the bandage for the first time. After two weeks of in home treatment I started at the local rehab center. The too pushed me pretty hard and on one occasion had me face down on a table and the therapist put her shoulder on my ankle and tried to push my heel into my butt and I just about passed out. I could seem to get the point across that my initial injury was 19 years earlier and my leg had not been in those positions for a long time. Needless to say I am 5 months post op and my hamstring muscle is the only pain I have. I have to put a pillow under my leg when I sleep and I use a rolling pin on the back of my leg while sitting back in my recliner with my leg pointing at the ceiling. The doctor did a pretty good job explaining about what I could expect after the surgery but never mentioned the possibility of so much pain in my hamstring.

  • Hi Boater Jake,
    Thanks for stopping by and leaving your interesting tkr comment. That’s a great idea about the rolling pin. Wish I would have known about that earlier!
    Keep in touch and best of luck…

  • Dave

    Very interesting,I had TKR 5 weeks ago making great progress but painfull hamstrings are holding me back.I am going to try rolling the back of my knee and thigh with foam roller.

  • I had knee surgery on my right leg for meniscus tears and acl, my hamstring was utilize and now I have weakness in my leg. This surgery was approx. 5years ago. My question is can the hamstring be replaced.

  • Hi Walter,
    Thanks for stopping by. I do not know whether your hamstring can be replaced. I recommend contacting your medical care provider. That’s my advice.
    Good luck and keep in touch…

  • I had TKR on April 3, 2017. I am having hamstring problems, painful when walking and it will catch sending sharp pain up to my buttocks and down to my ankle. I had PT for 3 weeks and therapist was at a loss. I made an appt. with my doctor and he got offended saying there was nothing wrong with my knee, like I was telling him his surgery didnt work. He told me there was nothing wrong with my hamstring. I have to go back in 1 month and have to walk in pain. Any suggestions will be appreciated.

  • Hi Carole,
    Thanks for stopping by and leaving your tkr/hamstring comment. I had the same difficulties when at your stage of recuperation. I have written about it on posts throughout this site. Take a look around. 🙂
    And… If you are uncomfortable with your doctor’s treatment, I would recommend getting a second opinion. Find someone who respects your concern.
    Best of luck and keep in touch.

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