MUA 10 weeks after TKRS and not yet happy

[KarriB]

Typically I've noticed that when someone overdoes things the knee/leg lets you know it at night. Using an elliptical so soon after an MUA is probably why you're in pain. Soft tissue is sore and swollen after an MUA, so all you need are gentle stretches and walking, not a work out.

 

[BARBRI]

I think that you might be right KarriB. The pain does not subside so I do not think it is a deadleg. Right now my whole leg,knee and below is aching with significant pain on the upper inside and lower outside of the knee. I am going to take the day off today and see what happens. If things do not improve in the next day or two I am going to see my OS. I think that possibly something wrong is going on inside my knee.

 

[Spex10]

That does sound worrying. Good idea to get it checked out. I'm sure it'll be OK but good to set your mind at rest.

 

[OUCH!]

I'm guessing you have overdone it. How would it be to not exercise at all for 2 or 3 days? Ice, elevate and move around as you need to in order to take care of your needs, but don't exercise at all? Maybe just gentle stretching and bending once in a while, but not any formal reps.

I know how hard this is. I have had many, many surgeries, and I have always followed all the professionals' directions and worked very hard at getting better. I have found with the knee that doesn't work as well. Its very frustrating, I know.

But, the feeling you are describing is how I feel after a good, hard work out in PT. It feels really good to move and exercise and even sweat when I am there, but then that night I am often miserable. That feeling lasted in to the day yesterday. It was awful. My leg will ache from above my knee to the tips of my toes. I have restless legs and hard workout will increase that feeling as well. I can't keep my leg still and yet it hurts to move. I can't get in a comfortable position and just toss and turn and whimper.

If I were you, I would honestly just completely rest the knee for two or three days and if it hasn't improved by Tues or Weds, call the doc.

I know how hard it is to go against the grain of not working hard, but maybe its worth a try? Even if it ends up not being the answer, I don't think a couple of days of nothing is going to hurt you.

Good luck and feel better.

 

[Spex10]

I would never ever do a hard workout!!

 

[BARBRI]

I am going to back off the exercising other than stretching for a couple of days and see what happens. That is difficult for me as I feel guilty when I do not do so on a daily basis. Thanks for all your helpful input folks. Please keep it up.

 

[OUCH!]

@BARBRI I agree its hard to lay off which is why I did a "hard work out" in PT yesterday.
@Spex10 an athlete would not have found it a hard work out, but this middle aged lady who has been fairly inactive for the last month it was hard. And I learned my lesson. I will need to tone it done next time I go to pt.

 

[Spex10]

Even when I was an athlete I avoided hard work outs as they always just led to build up of lactic, stiffness and sore muscles!!

 

[KarriB]

@BARBRI i think it is taking physicians a while to get on hoard with the new protocol. The Mayo Clinic is no longer prescribing PT or exercises for TKRs, just stretches. I think @Spex10 has had such great results from her MUA because she has done very little in the way of exercise. There'll be plenty of time for all the exercise you want in a few months, but working out an injured leg is counter productive. It may take longer than a day or so for the pain to subside.

 

[BARBRI]

The outside of my knee is very painful,numb and stiff. Lateral knee pain I believe it is called. Prevents me from walking downstairs normally,from riding a standard stationary bike,restricts my ROM and keeps me awake at night.
I would have thought that after almost 15 weeks post TKR and 11 days post MUA that things would be a lot better. Thoughts please. Thank you

 

[Jaycey]

Just curious why you think there would be no impact on your ROM after riding a stationary bike at only 11 days out. You really do need to give that poor knee a break. Rest, ice and elevate and let all the soft tissues settle.

 

[BARBRI]

I was advised by my OS and PT to keep the knee active and moving and riding the bike was one thing suggested.

 

[Spex10]

After my MUA I was advised to do gentle heel slides and short sessions on my pedaler. This has worked well.

 

[Pumpkin]

Barbri,

15 weeks post TKR and 11 days post MUA that things would be a lot better.

Your recovery was re started 11 days ago, you are over using the exercise bike and irritating your knee. No more than 5 minutes on the exercise bike, if you knee is still sore even less time until you are further along. Be sure to ice and elevate your knee immediately after using the exercise bike
Here is how to do heel slides. Heel slides and how to do them .
Active and moving means your normal activities around the house, not additional activity that irritates your knee. There is nothing you can do to speed up your recovery, but you can set yourself back by over doing, increasing pain and inflammation.

 

[Celle]

The MUA may help with ROM, but it does damage your soft tissues again. This sets back the timetable for your complete recovery. Just as in the early days after your knee replacement, your knee now needs lots of gentle treatment, with plenty f rest, elevation and ice.

Keep it moving gently by all means, but it doesn't need a lot of exercise. In fact, doing too much at this point could undo the gain that the MUA has given you.

 

[BARBRI]

Thank you for all your valuable input folks. I appreciate it.
I talked to my PT today and he thinks that I over did it on the elliptical machine the other day. I am going to quit that for the time being. He has suggested that for the time being to concentrate on some daily bike work and the pool exercises which I find to be unstressful and helpful. Of course along with stretching,icing and elevation.

 

[skigirl]

Here is my approach to exercise post tkr. Ride the bike for 5 min. swelling? take some time to rest and elevate. No swelling---ride the bike for 10 min. swelling? back to 5 min. no swelling? try 15 mins. You get the idea . It does not take a rocket scientist to see that you will have to juggle activity vs. rest and elevation for your knee for a while. Using the elliptical? for how long---and the bike too? try one thing at a time until you can use it for 15 min with no swelling. Then add 5 min of elliptical, etc.

 

[Jamie]

@BARBRI ... I'm just now reading your thread and one thing that is very plain to me is that you are not taking on board the idea of allowing your knee time to heal. Now that you've had an MUA, that restarted your recovery time clock, so please don't even think about the initial surgery when you are counting "so many" weeks "out." Recovery started again with your MUA.

You need to stay off the elliptical machine completely for at least 3 months. Using the exercise bike twice a day is fine, but no more than 5 minutes at zero resistance and a speed of 5-8 mph. Water exercises are okay too, but you shouldn't do them longer than 15 minutes the first week (this week). It is very easy to overdo things with water because it feels fine during and immediately afterwards. Many times the pain comes a day later. If you're still feeling pain at the end of that first week, stop everything and don't go to the gym. Just do gentle bends and stretches throughout the day at home until the pain lessens.

Don't do these exercises (with the exception of the 5 minutes on the exercise bike - that's okay daily) every day. Every other day is fine or even every two days. Your body needs at least one day in between to recover and for you to assess the impact of the exercise on your knee. Stay on this limited exercise program for at least 4 weeks. When you're not exercising, do no extra activity like errands, going out to dinner or for visits. You should be elevating and icing your knee as much as possible and just doing normal activity (walking about every hour or so) around the house.

If you continue to irritate your knee by overdoing exercises, you risk developing a chronic pain condition that is very difficult or impossible to overcome. Please don't do that to yourself. Your knee is now in the early stages of recovery from that MUA and it needs to heal. Stop feeling guilty for putting your health and well-being ahead of a gym routine. There is plenty of time for all that once you are at least 6 months out from your initial TKR.

I suggest you go back through your thread here and read all that has transpired. When you read the chronology of your recovery so far, it's pretty easy to see the problem is that you have been impatient and not willing to listen when your knee is telling you to slow down. Your knee heals on its schedule and not on yours, your surgeon's or your therapist's. Your ROM is actually fine for this point.

I apologize if my post seems a bit blunt. But I am concerned about you risking a chronic pain condition if you continue to overwork your knee.

 

[BARBRI]

Thank you for your thorough analysis and assessment Jamie. And no you were not being blunt,but just emphatic.
You are no doubt correct. I have been following my PT 's advise and direction and yes along with my own propensity to work out in the gym.
For this week at least my plan is to use the bike daily along the lines you have suggested and to do the water exercises daily being careful not to overdo it. Also,ice,stretching and elevation. No elliptical or weight baring exercises.

 

[Cratchit]

Some good advice there. I am just four days ahead of you and have experienced the same frustrations and obstacles that seems to beset most tkr recoveries. Without doubt, though, patience is a virtue which exceeds any and all advice regarding recovery, alongside the usual ice, elevation, rest etc. It pays off long term.

There is such a very fine line between doing too much and doing too little and the line seems to change all the time. But uncertainty is mitigated by tuning in to your knee and learning to listen to it and responding to it accordingly. Progress seems to happen almost by chance and not by force; you suddenly realise you are doing more than you had previously and that happens spontaneously. - if you let it.

I hope you follow the suggestions given and that you start seeing real progress, however long it takes.