TKR Therapy verses a MUA<

Thank-you, this info was very informative since today I am scheduled for another class. I have had one but had a set back with pain. The surgeon did tell me he was pleased with the motion and I walked without a limp. Rarely using the cane. Been a rough six weeks yet, I got this far without exercises and a great group of people here. Day to day is where I am at.
 
Recovery from TKR is definitely a day to day thing. Day to day to day to... well, it goes on for months. Day to day. That's why the tortoise and hare reference is so very on target. It really does feel like it's taking forever. Also, the people who try to rush things often end up being the hare. If they don't listen to their knees, they may end up at the side of the road watching as you plod toward the finish line ahead of them.

Your knee is the boss. If you're making progress, keep doing what you're doing! Progress is a sign you're doing things right. :)
 
Doesn't sound like you need PT or an MUA!! I am well qualified to comment on this.
First TKR I did PT which led to inflammation of underlying tissues and thence to adhesions. I had to have MUA at 12 weeks as ROM stuck at 50.
Second TKR I refused to do any PT just kept moving and walking about. Result-rapid improvement and discharged at 8 weeks with ROM of 100.
Incidentally the MUA was much better than I had feared. It was OK. It worked well but would have better if I didn't have to have it.
Dump the PT!
 
I also had very slow improvement in my ROM. I was probably only 70 at 4 weeks and 90 at 3 months. My ROM in Lefty has significantly improved only just recently when I was paying more attention to Righty! So you need neither a MUA or PT, just to rest and do your ADLs.

PS I also have a husband who has a hard time showing empathy or being helpful. He just doesn't know how and when he tries it's almost worst. Recently he stayed home from a trip over Labor day to "help" me, instead of going to see our daughter, but he actually ended up being home only a few hours. He spent all his time"running errands" or doing stuff in his office. I barely saw him! So I don't ask much of him and when he does do something I am sure to express gratitude to encourage him.
 
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@Indi55 I'd really like to offer you some structured advice but in order to do that, I also need to ask you some questions. Are you willing for me to do that?
 
Thanks, Spex 10, Your response helped me today since I did not go to PE this a.m. I really had started to get ready for it until I realized how weak I was feeling and knowing I also had to drive myself. I listened to my whole body this time") I also don't have the support of a husband either so, it makes it even more difficult recovering. I've written and thought so many times over how lucky I am to have found this group.
 
Here y'go then!

It would be very helpful if you would answer each one individually - numbered as I have done - in as much detail as you can then I'll come back as see where you are ....

1. what are your pain levels right now? (remember the 1-10 scale: 1 = no pain and 10 = the worst you can imagine. And don't forget to factor in other forms of pain such as soreness, burning, stabbing, throbbing, aching, swelling and stiffness).

2. what pain medications have you been prescribed, how much are you taking (in mg please) and how often?

3. how swollen is your leg compared to these?
ai63.tinypic.com_eta39s.jpg


4. what is your ROM - that's flexion (bend) and extension (straightness)

5. are you icing your knee at all? If so, how often and for how long?

6. are you elevating your leg. If so how often and for how long?

7. what is your activity level? What do you do in the way of housework, cooking, cleaning, shopping, etc., and

8. are you doing any exercises at home? If so what and how often?
This is the most crucial question so please help me by using the format I have left as an example
(which means please make a list and not an essay!)

Exercises done at home
- how many sessions you do each day
- enter exercise by name then number of repetitions of each
etc., etc.

Anything done at PT
- how many times a week
- enter exercise by name then number of repetitions of each
etc., etc.
 
1. A 4½ (worse late afternoon into night.)

2. Norco 5/325 during day 1 every four to six hours if needed in between Tylenol or Motrin). Night time 2 Norco before bed. If pain persists throughout night 1 every 4 hours.

3. Moderate

4. 90 degrees

5. 6 to as many times plus

6. 6 to as many times plus I lay on couch or bed.

7. Light house work, cooking small meals, drive short distances close to home. Walk up and down 13 to 14 steps to second floor apartment.

8. Straight leg raises 2 sets x10 twice a day.
Terminal knee extensions. 2 sets x10t wice a day.
Self Mobiration downward kneecap push 1 set x12
Upward kneecap push 1 set x12
Outward kneecap pull 1 set x12
Once a day.

I have only been to one class outside of home as yet so unsure the exercises.
 
Something else I found out while at the Surgeons was he explained that my RA was so bad he had to cut away a piece of my bone in back of the knee while the kneecap looked like two shiny marbles with bone fragments all around. Prior to this, I was wearing a brace for a year every time I left my door since my leg would just give out on me for no reason.

Anyway, I take all that in account for a slower heal process as well.
 
I had a very unstable knee too before the surgery--I think due to a meniscus tear. I was so impressed on day 1 out of the surgery with how stable the new knee was.
Your #rheumatoidarthritis could be a factor in your recovery, but it is a long recovery for everyone.
I felt like my recovery with knee #2 wasn't so much shorter as a bit easier than my first knee, which had more issues, though both were damaged from the RA.
 
I had a meniscus tear I was told also. Very painful. And I can see the journey is a long one for us by everyone's personal story here.
 
Indi, I don't understand these
1. A 4½ (worse late afternoon into night.)
If it's worse afternoon and then at night, I need two numbers
4. 90 degrees
I asked for your ROM. Are you under the impression that ROM is just the bed in your knee? Because it's not. ROM is Range Of Movement and includes BOTH flexion (bend) and extension (straightness)
5. 6 to as many times plus
6. 6 to as many times plus I lay on couch or bed.
What do you mean by "6 to as many times plus" - it doesn't make sense to me.
Self Mobiration
What is "Mobiration" - I've never heard of it
 
Well, FWIW, a lot of husbands don't know what to do when they can't "fix" something and most people don't seem to understand knee replacement surgery at all. Perhaps you should suggest he read some articles here; that might be enlightening and helpful.

It sounds like you're doing very well. I'm a week ahead of you and would love to be walking without a limp. You might consider laying off the exercises for a while until you feel a little better; you can always go back to them. If your surgeon mentions the MUA again, ask him why he wants to do it so early in the recovery process.
 
Indi, I don't understand these
If it's worse afternoon and then at night, I need two numbers
1. 4 to 8
I asked for your ROM. Are you under the impression that ROM is just the bed in your knee? Because it's not. ROM is Range Of Movement and includes BOTH flexion (bend) and extension (straightness)
4. Range of motion is approximately 10-15* flexion contracture with 90* of flexion.
What do you mean by "6 to as many times plus" - it doesn't make sense to me.
5. 6 to 9 times daily.
What is "Mobiration" - I've never heard of it
8. My doctor gave me illustrations showing how to place my fingers around the kneecap to do different movements of gently moving small pushes to help with pain. It really does help.
 
That is a good question for my surgeon , Laurenkate.
Since you are a week ahead of me, how are you doing?
 
Indi, as you can see I have edited your posts to make better sense of your replies. What you need to do is to use the Quote tool to reply so it ends up as I have edited it How to use the quote feature
 
1. 4 to 8
Quite high but you are only 7 weeks out.
2. Norco 5/325 during day 1 every four to six hours if needed in between Tylenol or Motrin). Night time 2 Norco before bed. If pain persists throughout night 1 every 4 hours.
Sounds about right.
3. Moderate
Okay
4. 90/10-15
That's not good
5&6 icing. elevating 6 -9 times daily
You need to do this are least 40-60mins at a time
7. Light house work, cooking small meals, drive short distances close to home. Walk up and down 13 to 14 steps to second floor apartment.
Not bad

Straight leg raises 2 sets x10 twice a day - once you can do these, you don't need to do them any more
Terminal knee extensions. 2 sets x10 twice a day - and the same with this

Self mobilization downward kneecap push, upward kneecap push ,outward kneecap pull 1 set x12 each once a day- I take it these are in connection with the extra bone that was cut off?
I'm not sure any of these are good for you and I suggest you think about stopping them.

8. My doctor gave me illustrations showing how to place my fingers around the kneecap to do different movements of gently moving small pushes to help with pain. It really does help.
Okay, I get it
explained that my RA was so bad he had to cut away a piece of bone in back of the knee
But I don't see how this is significant. There is always bone taken from all around that area. It's normal.
 

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