MUA 1 Week post op

[analysta]

Hey KS (Kameron Steele is an excellent name!) Can you talk more about what using the APS device feels like?

 

[KarriB]

My OS said it's quite normal for a TKR yo be hot for many months and some even a year. I wouldn't worry about it being hot.

 

[Wanttobebiking]

Hi Kameron! Sounds like things are progressing. My knee was hot 24/7 until yesterday and now I have periods during rest when it is only slightly warmer than the other knee.

I am now on my bike trainer indoors.

Glad things are looking up.

 

[Josephine]

I of course am apprehensive , fearing if I do my daily exercises and push too much I'll lose my passive ROM. As I write I'm still at a very easy 90.

Passive or active, they're both pretty much the same. But that's fine at 7 weeks, especially as you stalled in your progress some in the early days. 90 is terrific now and you will find that progress begins to slowly pick up over the next few weeks. You could even afford to cut down on exercising and PT now. You might even progress the faster then.

I think my APS machine is a great help in reducing that internal swelling and stiffness.

I wondered what it was too but Mr Google tells me it's a version of a TENS machine.

 

[KameronSteele]

Hey KS (Kameron Steele is an excellent name!) Can you talk more about what using the APS device feels like?

lol, thanks i think its kinda neat too..The "feeling" of the APS is similar to that of a TENS or ESTIM ( I've used them all. And use ESTIM at PT) ..it's kinda of prickly. BUT..here's the cool part about the APS..as your dialing in your setting you'll feel a prickly sensation (but it doesnt hurt at all), you back off that a bit to when you feel nothing and thats your treatment setting for 8 minutes.. At least thats what the instructions say. The research paper I posted on here last week talked of the best results for knee swelling at "high" current which I think was 0.75. Depending on how swollen or damaged your tissue is,you may feel nothing at 0.75 or you may feel it immediately when you turn it on-just depends. The other cool thing about the APS and why I think it's the most effective of these type devices is the current mimics that of the human body's own current and allows for release of all the healing hormones, ATP etc. So kind of like a TENS but not. A TENS or ESTIM current isnt the same as the bodies own current. Here's an explanation of the APS from the research paper I was referring to: The (APS) therapy produces a current that is claimed to simulate an action potential in the neurone. This current is supposed to mimic the body’s natural electrical impulse, which then causes synchronous depolarisation. Thus, it is claimed that electrolysis may occur within the cell. This current is supposedly four times stronger than the naturally occuring action potential (Lubbe GA, 1992). In the area of pain or inflammation, there be a blockage somewhere along the path of the nerve impulse. A weakened current or even no current at all may then be produced depressing the response in muscles, glands or any other organ. Stimulation by the APS current, is said to create a normal action potential which is then said to restore the inherent biochemical processes in the region. This current stimulates the production of neurotransmitters in the brain and spinal cord, such as melatonin and leuenkephalin."
I recommend reading the entire paper-even parts that are not referring to knees. Its fascinating.
https://www.apstherapy.com/wp-content/uploads/2014/01/APS-Therapy-Research-2014-05.pdf

My OS said it's quite normal for a TKR yo be hot for many months and some even a year. I wouldn't worry about it being hot.

i think its cooled slightly but still warm. i guess getting in and out of the attic prolly doesnt help. hehehe

Hi Kameron! Sounds like things are progressing. My knee was hot 24/7 until yesterday and now I have periods during rest when it is only slightly warmer than the other knee.
I am now on my bike trainer indoors.Glad things are looking up.

so it just stopped being hot..overnite. just like that?i hopped on my trainer the other day but cant get a full revolution..yet!! congrats on that! doesnt it feel goood!?

Passive or active, they're both pretty much the same. But that's fine at 7 weeks, especially as you stalled in your progress some in the early days. 90 is terrific now and you will find that progress begins to slowly pick up over the next few weeks. You could even afford to cut down on exercising and PT now. You might even progress the faster then.
I wondered what it was too but Mr Google tells me it's a version of a TENS machine.

i totally stalled. i think i just over did it..yanking and tugging with that rope around my foot!! im now at a very easy 90 no tugging at all. first thing in the morning im at about 75 ish until i get the ol' knee warmed up..then we're at 90!! and see above about the APS ) and you think pt 2 week is good and i can stop home exercising?

 

[Wanttobebiking]

so it just stopped being hot..overnite. just like that?i hopped on my trainer the other day but cant get a full revolution..yet!! congrats on that! doesnt it feel goood!?
it

Hey Kameron, yup, that's pretty much what happened. My swelling was getting to be less and less and my knee was probably not as hot as it was early on but still very warm. Then one day I wrapped my hand around it to see how hot it was and there was no heat. None. Since then the heat comes and goes and it doesn't seem to matter if I am taking an easy day or If I have been working it. On my bike outside now but I have no stamina, I did 1.5 miles today and I was winded. My knee seems to be a bit tighter tonight. But now I know I can do it. I remember my first rotation on a stationary bike. I was so happy I cried. Congrats on the easy 90, and pedaling is in the near future I am sure.

 

[KameronSteele]

Hey Kameron, yup, that's pretty much what happened. My swelling was getting to be less and less and my knee was probably not as hot as it was early on but still very warm. Then one day I wrapped my hand around it to see how hot it was and there was no heat. None. Since then the heat comes and goes and it doesn't seem to matter if I am taking an easy day or If I have been working it. On my bike outside now but I have no stamina, I did 1.5 miles today and I was winded. My knee seems to be a bit tighter tonight. But now I know I can do it. I remember my first rotation on a stationary bike. I was so happy I cried. Congrats on the easy 90, and pedaling is in the near future I am sure.

thanks wtbb, im sure ill be at it soon too. i just do rockbacks now, but heck..ill take it!! atleast im not confined to this house or worse yet..the bed. ugh.. so are you still icing? anti-inflammatory meds? still in pt? my surgery was day after yours. i think mine is internal swelling b/c i can push my finger into my skin on my TKR and its as if i have pitting edema..well i guess i actually do but not for cardiac reasons. everyday i compare hardness between my knees. TKR is still hard to touch and has that swelling thing but im making forward progress and thats what matters. talk soon!

 

[Wanttobebiking]

Yes, icing right now. I still ice before bed and after exercize. Lived in cryocuff for 4 weeks. Now i use actual bags of ice or ice packs because they stay cold longer. I am still in PT too. I see my OS tomorrow for my 6-week (2 weeks late), He is busy. I am going to ask if I can go to once a week. Most of my at home PT is now more like occupational therapy, walking up and down stairs normally. Still hard going down. Was doing it weird before surgery and have to relearn it. I am also walking with my right shoulder lower than my left (TKR) which she says is because my right hip is weak. So we are working on these types of things. I have been going twice a week for 30 minute sessions. I am lucky my swelling has been minimal, but if I remember correctly, I think your surgery was more complex than mine. I am so glad to hear you are making good progress.

 

[Wanttobebiking]

P.S. Still on Tylenol extra strength three times a day and Aleve twice a day but I am starting to forget to take them as pain is minimal too. The swelling I have is soft and in two places, upper medial and lateral corners and very tender to the touch. Am going to ask my OS about it tomorrow.

 

[Josephine]

i think its cooled slightly but still warm. i guess getting in and out of the attic prolly doesnt help. hehehe

i totally stalled. i think i just over did it

im now at a very easy 90 no tugging at all.

 

[KameronSteele]

Hey guys..I just wanted to give you a quick update. I think the last thing I mentioned was my second visit to PT which was 6 weeks post op. On that second visit I got to 90 and have maintained that with no problem. I haven't gotten any thing since then. Next week I'll be 12 weeks post op and at 90/4-ish. I suspect that next week during my 12 week f/u an MUA will certainly be the topic of conversation.

I can see that the TKR is slightly larger than the other knee (not much but a little). it also is hard to the touch and indents when i push my finger into the knee. so this tells me that if the tissue is swollen (which is obviously is)-THAT- could be the problem and not adhesions..and that it may EVENTUALLY go down and i can bend it. but how long do i give it to go down? is the swelling preventing the bend or adhesions? how does one know? My dilemma is this-if it IS just swelling and not adhesions and OS cranks down on it during an MUA, wont that do more harm than good? it seems as if that would be smooshing that swollen tissue into submission. i used to be terrified of an MUA but im so frustrated at this point im ready to do it. Thots?

 

[tigz]

Well you know my pro MUA stance. :D It made a major difference for me. Don't be terrified of it, I saw it as the only way to move forward, and literally get rid of the concrete wall that seemed to stop my bend.

 

[Wanttobebiking]

Sounds like you are ready if you need it, Kameron. I have no advice but want you to know I am pulling for you!

 

[KameronSteele]

Well you know my pro MUA stance. :D It made a major difference for me. Don't be terrified of it, I saw it as the only way to move forward, and literally get rid of the concrete wall that seemed to stop my bend.

@tigz,yes, I do know your stance and so glad your MUA story is a positive one. Did you have reservations about doing it at 9 instead of waiting to see if you'd get more bend? How'd you know, that your 70 was it, and that it would not improve with time?

 

[KameronSteele]

Sounds like you are ready if you need it, Kameron. I have no advice but want you to know I am pulling for you!

Aww thanks so much @Wanttobebiking ..it really does help to have the support here. I just try to remember even tho I'm not where I wanna be and certainly not where I thot I'd be post op...at least I can walk, unaided, almost limp free esp if I focus... I of course can't navigate steps (well like a toddler I can, which is actually quite funny to see an adult tackle steps like that! I bet ppl think I've had cocktails...lol. I can't sit or stand w/o my arms, and a whole list of other stuff..but there are some on here that have no leg so I am thankful for what I CAN do..perspective is a very useful tool.

KS

 

[tigz]

I would have done it the day after the OS suggested it if I could! I wanted as much healing as possible before going back to work at 12 weeks.

My knee just wouldn't go any further no matter what I did. It was like there was a concrete wall in there that said no further. Two and a half weeks of rest, icing, elevation and gentle heal slides did not a thing for me. The PT contacted the doctor before my eight week appointment when I said more PT was just frustrating me and her and he told her that I needed a break from the PT.

 

[KameronSteele]

"concrete wall"...yup exactly what mine feels like....this exercise **** sure aint working for me either,lol.

 

[KarriB]

I hope if that's what your OS recommends it works for you. I know how frustrating complications can be.

 

[KameronSteele]

Hi all. Had my MUA today at 10am and doc said it was difficult to get my foot to my butt but he got it. I'm on my way to pt now.

Here's a question for anyone who's had an MUA.. I can't bend it anymore right now than before surgery and have significant pin behind my knee when I try. Anesthesiologist said the back of my knee will not numb from the nerve block but everything else will.

Is it typical to not be able to bend on your own right after the MUA? What this behind the knee pain? If anuthigj it should hurt back there bc I'm flexing, not extending.

Does anyone have any suggestions to help with ROM?

Thanks in advance.

 

[Celle]

Here's a question for anyone who's had an MUA.. I can't bend it anymore right now than before surgery and have significant pin behind my knee when I try. Anesthesiologist said the back of my knee will not numb from the nerve block but everything else will.

Is it typical to not be able to bend on your own right after the MUA? What this behind the knee pain?

An MUA bends your knee forcibly, against the resistance of everything that was stopping it bending before.
That doesn't just break up adhesions. It forces muscles and tendons to stretch beyond what they are accustomed to and that is going to cause some soft tissue damage.

In other words, you knee is wounded again and it will need time to recover from that.
You probably also have some swelling that is inhibiting ROM right now.

So, the treatment is similar to what you did after your TKR - lots of rest, ice, elevation and taking your pain relieving medication on a regular schedule. Exercise only gently, so as not to irritate those wounded soft tissues.

Things will settle down, but you do need to allow some time for this.