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MUA 10 weeks after TKRS and not yet happy

These are the mantras. They summarise the BoneSmart approach to recovery:
- rest, elevate, ice and take your pain meds by the clock
- if it hurts, don't do it and don't allow anyone - especially a physiotherapist (PT) - to do it to you. Exercise only gently
- if your leg swells more or gets stiffer in the 24 hours after doing it, don't do it again
- if you won't die if it's not done, don't do it
- never stand when you can sit, never sit when you can lie down, never stay awake when you can go to sleep!
- be active as much as you need to be but not more than is necessary, meaning so much that you end up being in pain, exhausted or desperate to sit down or lie down!
 
The mantras are in post #2 that Celle left for you and a shorter version above. There a short articles also that many have found helpful. I suggested taking a break to give your knee some time to recuperate because you're 10 weeks post-op already, but take a look at the activity progression chart because it'll give you some boundaries as far as walking etc. and keep you from over doing things.
 
BARBRI said:
I am just sooo afraid that by stopping or cutting back on my exercise routine that I will end up with a permanently stiff knee without the full range of motion. I know of a couple of people who did not exercise after surgery and that is the way that they ended up.
Click to expand...
That's a total myth told by PTs and surgeons to make sure their patients don't do absolutely nothing!

But it's not the exercising that gets you your ROM, it's time. Time to recover, time for swelling and pain to settle and time to heal. One thing that seems to be missing from all the PT's protocols is that all your ROM is there right from the start, just waiting for all that to happen so it can show itself. In the general run of things, it doesn't need to be fought for, worked hard for or worried about. It will happen. Exercise as in strength training is counter-productive and does more harm than good. Normal activity is the key to success.

As said previously, there are many of us on here who have done absolutely NO exercising at all, not even so much as a single heel slide, and we got excellent outcomes. I recommend you read my recovery thread to see how little exercising I did for either knee! Knee recoveries UK style Parts I & II (Josephine)
 
I've got to agree with the others about not pushing. I've learned the hard way-thru pain and extra swelling-to stop doing too much.

It seems like this phase of the recovery will go on forever, doesn't it? I look back at where I was 5 weeks ago and realize that I had to lift my leg into the bed. Then I realize how far I've come.

Just starting to get some good sleep again.

I promise it will get better. Hang in there.


Laura
LTKR 21 November 2016
 
We are all knee replacement survivors! We all feel/felt the same way that you do about having a permanently-stiff knee. You've tried their way and you are REALLY struggling. THIS way is certainly worth a try!


Sent from my iPad using broken link removed: https://r.tapatalk.com/byo?rid=75543
 
BARBRI said:
I am just sooo afraid that by stopping or cutting back on my exercise routine that I will end up with a permanently stiff knee without the full range of motion. I know of a couple of people who did not exercise after surgery and that is the way that they ended up. I am in a quandry.
Click to expand...

Me too ...[emoji51][emoji51] worried about stiff joint if exercises aren't kept up!!


Sent from my iPhone using broken link removed: https://r.tapatalk.com/byo?rid=75543
 
@Penny Lane - There's no need to worry about that . It doesn't happen.
It's normal for your knee to be stiff at first. It's been wounded and it needs time to recover.

I have asked the Moderators to start a recovery thread for you, so that we can discuss your worries without interrupting other people's threads.
 
Thank you.


Sent from my iPhone
 
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I am currently taking Tylenol 3 as a pain killer. It seems to afford me little or no relief. Any suggestions?
Also,my blood pressure has become elevated to the hyperytension level since my surgery. I normally have moderately high blood pressure which is controlled with medication.
 
I had surgery about 13 days ahead of you. I did not do gym workouts for a good six weeks.. I did gentle PT twice a week.. and nothing the other days. Walking a bit. I still only go to the gym twice a week and ride my at home exercise bike twice a day for ten minutes each.. and those are NOT for ONLY the knee. I have forgotten I have a fake knee for the most part.. No pain at night no pain at day. Yes it was stiff after five hours in the car today but that was to be expected and it loosened right up after six steps. The only reminder of the surgery is when I kneel on the scar... ow. I am trying to desensitize that.

I can hike over a mile now on uneven ground.. The knee starts to speak then so I don't push it further.
The mantra is not do nothing.. Do activities of daily living according to how your knee feels and swells.
Nobody is advising sitting around. I am advising that at this point your knee should not be the focal point of your life and it still is.. So something that has been done is awry.. You probably should give it a vacation and rest ice and elevate, then see how a gradual resumption of your activity goes. Healing is like letting a scab resolve.. keep picking at it and the injured soft tissues never have a chance.

Yes its true that in some things less is more.. I wish you a speedier recovery in the future. Some folks have a slower recovery than others so don't fret. Eventually you will forget about your knee too.

Your HTN ought to be addressed with your surgeon.. I wonder ( have no answer) if your pain level contributes to that..

I will tag @Josephine our nurse professional.

I noticed you are a guy.. Its hard to keep guys from gymming it.. go but work on the upper body!
 
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BARBRI said:
I am just sooo afraid that by stopping or cutting back on my exercise routine that I will end up with a permanently stiff knee without the full range of motion.
Click to expand...
A stationary bike is a great help even if you can't make a single rotation!

  • Set the bike to zero resistance
  • If you can't make a rotation, set the saddle as high as possible and rock the pedals back and forth as far as you can with discomfort but no pain
  • If you can make full rotation:
  1. Set the saddle at a point where a single rotation is a challenge; difficult but not painful. When a rotation becomes easy right from the start, lower the saddle a max of 1cm.
  2. Gently turn the pedals.
  3. Continue until the knee is 'warmed up' and the rotation is now easy, or for 2 minutes, whichever is the shorter time.
  • Repeat whichever exercise you can do several/many times a day
  • Do not pedal fast or for more than 2 minutes, this is a stretching exercise, not training.
Here is a bit more chat and some pix https://bonesmart.org/forum/threads/rom-and-extension-stretches.13159/page-3#post-423701

BARBRI said:
I know of a couple of people who did not exercise after surgery and that is the way that they ended up. I am in a quandry.
Click to expand...
Do you know these people personally?
 
BARBRI said:
I am currently taking Tylenol 3 as a pain killer. It seems to afford me little or no relief. Any suggestions?
Also,my blood pressure has become elevated to the hyperytension level since my surgery. I normally have moderately high blood pressure which is controlled with medication.
Click to expand...

Tylenol 3 is made up of acetaminophen and codeine. If it's not working there are many other options for pain that your surgeon or GP can prescribe.

Cutting back your exercise and increasing the amount of time you spend resting, icing adn elevating your knee will also reduce your pain.

Please talk to your own doctor about your blood pressure, if you haven't already done so.
 
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I fell for that make sure and exercise a lot or your knee will never bend thoughts with my first surgery. All I got was pain, swelling and poor range of motion. The second time around I follow the ideas put forth in this forum. It was actually contra to what I was taught in nursing school many years ago. Mu current OS gave me 1 rule to follow. "If it hurts, don't do that". I follow that and I recovered even better than he projected I would. You've got nothing to lose. I would also suggest following up with the doctor who monitors your blood pressure and medications. While it is possible that when you are in pain your BP can rise it is not something that you want to not be on top of.
 
Hello again. It has now been almost 12 weeks since my knee surgery. Still have that stiff sore feeling like being in a vice especially at night. Can get a full bike rotation with much difficulty and cannot walk for long distances without considerable pain. Can go up and down stairs normally,but with some discomfort. Knee bend is at 110 degrees and 10 degrees short of being able to fully straighten my leg. Do I have cause for concern at this point in time? At what point should one consider MUA? Thank you for your input and feedback.
 
I'm having a MUA this week. My ROM is about 50. Its never been much more than 60 with pressure. Apparently my development of scar tissue is genetic. I suppose I'm an example of someone for whom neither the Bonesmart mantras nor the full on PT approach actually work. There's always one!!
 
Barbri have you tried putting your foot on an ottoman while you sit on a chair.. let your knee be in midair..relax it.. Stay that way till it hurts.... Repeat a few times a day.

This tip from my OS.. Seems to have helped me.
 
There are more up to date studies on outcomes from MUA. The most recent was published in 2015 and was very positive. Phew!
 
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