I’m 10 weeks post-op and my knee feels very tight and stiff. Physical therapist got the bend to 110-but that was very painful. The OS said he may do a MUA. Has anyone had experience with MUA? I wonder if it’s painful afterwards? About 3 days ago I started experiencing sharp, stabbing pains in my thigh and from my knee down my calf. This is a new pain in my recovery the OS said it’s scar tissue causing this new pain. I’m still walking with a cane as I don’t feel steady and sometimes it feels like my knee will buckle. I did NOT expect this recovery to be so difficult. I’m starting to feel depressed. Any advice would be greatly appreciated.
PKR 10 weeks post op/lots of pain
- Thread starter Lsilva
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to BoneSmart. So glad you have found us, can you provide your surgery date and which knee was operated on so that we can create a signature for you xI think it is very early in your recovery to be considering a MUA , most likely the stabbing pains are "zingers" these are the nerves healing.
Please read the guidelines, then we're ready for specific questions
Knee Recovery: The Guidelines
1. Don’t worry: Your body will heal all by itself. Relax, let it, don't try and hurry it, don’t worry about any symptoms now, they are almost certainly temporary
2. Control discomfort:
rest
elevate
ice
take your pain meds by prescription schedule (not when pain starts!)
don't overwork.
3. Do what you want to do BUT
a. If it hurts, don't do it and don't allow anyone - especially a physical therapist - to do it to you
b. If your leg swells more or gets stiffer in the 24 hours after doing it, don't do it again.
4. PT or exercise can be useful BUT take note of these
the BoneSmart view on exercise
BoneSmart philosophy for sensible post op therapy
5. At week 4 and after you should follow this
Activity progression for TKRs
6. Access these pages on the website
Oral And Intravenous Pain Medications
Wound Care In Hospital
The Recovery articles:
The importance of managing pain after a TKR and the pain chart
Swollen and stiff knee: what causes it?
Energy drain for TKRs
Elevation is the key
Ice to control pain and swelling
Heel slides and how to do them properly
Chart representation of TKR recovery
Healing: how long does it take?
Post op blues is a reality - be prepared for it
Sleep deprivation is pretty much inevitable - but what causes it?
There are also some cautionary articles here
Myth busting: no pain, no gain
Myth busting: the "window of opportunity" in TKR
Myth busting: on getting addicted to pain meds
We try to keep the forum a positive and safe place for our members to talk about their questions or concerns and to report successes with their joint replacement surgery.
While members may create as many threads as they like in a majority of BoneSmart's forums, we ask that each member have only one recovery thread. This policy makes it easier to go back and review history before providing advice.
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@Lsilva
Welcome to BoneSmart, glad you joined us!
Swollen and stiff knee: what causes it?
It is your knee and you can say NO to a MUA.
Please focus on letting your knee heal with Rest, Ice, and Elevation.
Ask your PT to focus on reducing the swelling and inflammation in your knee, with retrograde massage, lymphatic damage, electrical stimulation, an a few gentle excises you can do on your own at home.
Tell them NO pushing and shoving on your knee as it is causing swelling and pain.
Saying no to therapy - am I allowed to?
For ROM we recommend these two gentle activities.
Heel slides and how to do them and Extension: how to estimate it and ways to improve it .
Welcome to BoneSmart, glad you joined us!
"Tight band" feeling across the front of my knee
Swollen and stiff knee: what causes it?
I suspect this is what is behind your swelling and stiffness, pushing and shoving can cause increased swelling and pain and may set back your recovery.
Generally speaking once someone has reached 90 degrees, a MUA is not performed.
It is your knee and you can say NO to a MUA.
Everyone recovers differently some are using assistive devices at 3-4 months. If you knee feels unstable you need an assistive device.
Please focus on letting your knee heal with Rest, Ice, and Elevation.
Ask your PT to focus on reducing the swelling and inflammation in your knee, with retrograde massage, lymphatic damage, electrical stimulation, an a few gentle excises you can do on your own at home.
Tell them NO pushing and shoving on your knee as it is causing swelling and pain.
Saying no to therapy - am I allowed to?
For ROM we recommend these two gentle activities.
Heel slides and how to do them and Extension: how to estimate it and ways to improve it .
Rockgirl4
Former BoneSmart staff member
If your knee is already bending to 110 at 10 weeks, you do NOT need an MUA. The information you're getting is very troublesome. Many people need 3-4 months to get back to 110-120, and time will make things improve. I've been down this road with 11 knee surgeries and years of PT following articular cartilage repairs, TKR, and numerous other knee procedures. Adhesions (scar tissue) don't typically cause pain into your upper and lower leg----overworked muscles forced by aggressive PTs pushing on you DOES cause pain. It makes me very angry that you are having increased pain from the PTs pushing/forcing your bend, when the knee needs TIME to heal. 
This is a brutal surgery that causes lots of trauma to the soft tissues surrounding the knee. It is NOT like an athletic injury recovery. Those soft tissues need more time to heal than the knee itself sometimes, and they WILL complain, simply because they were pulled/pushed into all sorts of directions while the surgeon was doing your TKR.
I hope you realize I'm just going off of LOADS of experience here with YEARS of PT, plus the 1000's of recovery stories here. Some of my PT was easy, some brutal and forceful, and some in-between. The main point here is that a knee bending to 110 needs no MUA, and recovery takes TIME. I think you're dealing with a surgeon trying to get more of your $$$$. Most surgeons (mine included) won't do an MUA on a knee that bends >95-100-ish. Many here have surgeons who refuse to do MUAs if a need bends to 90, knowing most people get MORE bend in the year or so following the TKR surgery naturally, with no help from a surgeon, PT, or extra exercise. It comes with TIME!!!
I also wanted to add something called "rebound swelling." When PTs pushed/forced my knee to bend more, I usually end up with more swelling/inflammation in the 2-4 days afterwards, often decreasing my bend further. This has happened to me more times than I can count, and I always discuss it with my PTs before we start rehab, as I know my body better than they do after 11 knee surgeries. I have always been very athletic and know my body and how it behave---what it likes and doesn't like, and how I swell. That makes me just as much an expert as the ones with all the initials after their name.
Actually, I bet you a week off from the PT (and any forcing) just might GAIN you a few more degrees of bend. We see it here ALLLLLLL of the time.
This is a brutal surgery that causes lots of trauma to the soft tissues surrounding the knee. It is NOT like an athletic injury recovery. Those soft tissues need more time to heal than the knee itself sometimes, and they WILL complain, simply because they were pulled/pushed into all sorts of directions while the surgeon was doing your TKR. I hope you realize I'm just going off of LOADS of experience here with YEARS of PT, plus the 1000's of recovery stories here. Some of my PT was easy, some brutal and forceful, and some in-between. The main point here is that a knee bending to 110 needs no MUA, and recovery takes TIME. I think you're dealing with a surgeon trying to get more of your $$$$. Most surgeons (mine included) won't do an MUA on a knee that bends >95-100-ish. Many here have surgeons who refuse to do MUAs if a need bends to 90, knowing most people get MORE bend in the year or so following the TKR surgery naturally, with no help from a surgeon, PT, or extra exercise. It comes with TIME!!!
I also wanted to add something called "rebound swelling." When PTs pushed/forced my knee to bend more, I usually end up with more swelling/inflammation in the 2-4 days afterwards, often decreasing my bend further. This has happened to me more times than I can count, and I always discuss it with my PTs before we start rehab, as I know my body better than they do after 11 knee surgeries. I have always been very athletic and know my body and how it behave---what it likes and doesn't like, and how I swell. That makes me just as much an expert as the ones with all the initials after their name.
Actually, I bet you a week off from the PT (and any forcing) just might GAIN you a few more degrees of bend. We see it here ALLLLLLL of the time.
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Please post your surgery date, a moderator will add it to your signature for you. Having the exact date will help us properly advise you. Thanks!
With a ROM of 110 I sincerely hope your surgeon won’t even consider an MUA. If you truly needed one your number would be way lower than that. Even though it took your PT to get you to that number it indicates that you don’t have adhesions.
Scar tissue is inaccurately blamed for a whole host of issues. Often, the reason we can’t bend our knee to certain numbers is swelling, and not enough healing yet. When the swelling goes down, and our healing progresses, the ROM numbers get better. But it takes a lot of patience, on our part, and on the part of all our medical team.
Saying no to therapy - am I allowed to?
I also learned through Bonesmart that there are many different approaches to this recovery, and a painful approach is only one way. You can choose how you want to recover.
Don’t worry about still using a cane, I used mine for months.
Scar tissue is inaccurately blamed for a whole host of issues. Often, the reason we can’t bend our knee to certain numbers is swelling, and not enough healing yet. When the swelling goes down, and our healing progresses, the ROM numbers get better. But it takes a lot of patience, on our part, and on the part of all our medical team.
My PTs caused me a lot of pain, also, and as much as I didn’t like it, I believed it was how it had t to be. Then I found Bonesmart and learned that pain in rehab is not necessary, and isn’t even good for us. Treating the knee gently is more helpful to healing, rather than forcing a knee that has been surgically wounded, to bend further than it is ready for. You have the absolute right to tell your PT not to cause you pain.
Saying no to therapy - am I allowed to?
I also learned through Bonesmart that there are many different approaches to this recovery, and a painful approach is only one way. You can choose how you want to recover.
Don’t worry about still using a cane, I used mine for months.
@Lsilva ,
Just to reinforce what others have been telling you, there's no need to rush to get ROM (Range of Motion) because it can continue to improve for a year, or even much longer, after a knee replacement. There isn't any deadline you have to meet:
Myth busting: the "window of opportunity" in TKR
Painful PT should be avoided, as it tends to upset an inflame your wounded knee, slowing down both healing and flexion development.
Myth busting: no pain, no gain
My surgeon doesn't allow any formal PT at all for the first month after a knee replacement. He says your knee needs that time, to start on its journey of healing. For that month, we rest, ice and elevate our leg, and walk around the house. The walking is our exercise and we increase it a little each week.
After that month, we just go to PT once every 2 weeks, where we are shown a few new exercises to do at home each day. No painful exercises, no pressure to achieve certain numbers within a set time.
His patients all do well and achieve good ROM, as I did, and he hasn't had to do a manipulation to help with ROM for the past 4 years. I think that speaks for itself.
Just to reinforce what others have been telling you, there's no need to rush to get ROM (Range of Motion) because it can continue to improve for a year, or even much longer, after a knee replacement. There isn't any deadline you have to meet:
Myth busting: the "window of opportunity" in TKR
Painful PT should be avoided, as it tends to upset an inflame your wounded knee, slowing down both healing and flexion development.
Myth busting: no pain, no gain
My surgeon doesn't allow any formal PT at all for the first month after a knee replacement. He says your knee needs that time, to start on its journey of healing. For that month, we rest, ice and elevate our leg, and walk around the house. The walking is our exercise and we increase it a little each week.
After that month, we just go to PT once every 2 weeks, where we are shown a few new exercises to do at home each day. No painful exercises, no pressure to achieve certain numbers within a set time.
His patients all do well and achieve good ROM, as I did, and he hasn't had to do a manipulation to help with ROM for the past 4 years. I think that speaks for itself.
Peaches0000
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Lsilva, I am so sorry you are having so much discomfort, honestly , I would take a long break from PT, just do those at home gentle exercises that you did in the beginning and ice and elevate as much as possible. Anytime a therapist pushes your leg back , it takes a week or two to recover from it- I had my 13 week checkup last week and both of my knees took a week to calm down after the Dr & his assistant took turns Pushing them back- I am just now at 110 without assistance and I am happy I can do normal everyday things- if it doesn’t get better in a few weeks, then you can always get the MUA if it really is scar tissue. I think that stabbing pain is just because you have set your tissues on fire. I hope you feel better soon. It’s a tough recovery, but hang in and take it easy!
@Lsilva please don't put yourself through unnecessary PT. I had PKN 21 Jan and had it not been for this fabulous site giving me the guidance I would have been a wreck. What a shock this surgery is, never experienced pain like it, never believed recovery could take so long, but I am a couple of weeks off 8 months and I am getting there. The stiffness, tightness, swelling, zingers etc., just didn't want to go away. Never thought I would walk properly, had my crutch for months, didn't drive till past 4 months, and PT......had 2 sessions and very politely told him not to touch me and again followed advice from here and so pleased I did. I really worked myself up constantly worrying about all the niggles, was I doing this right, how should I do this, am I bending enough. It all comes when it is ready, my saviour, ice, when I have overdone it or just a niggle, out comes the ice. I can't take painkillers, had low dose morphine for first few weeks but can honestly say ice is the answer. I still have a way to go, cant go down the stairs properly but so what it will come. Some days when I am doing my exercises, my knee won't bend as much , may feel a little tight, oh well manage as best. Please don't beat yourself up, this is a long journey and the key is to get that in your head. Ask as many questions on here and you really will get there. As one of our friends said, time is our friend. Stay strong we can do this xxx
My surgery date was July 10, 2020.
Many of our members have had MUA. For some it works. For others it just makes a bad situation even worse. Yes, it is painful post procedure. Basically you start the recovery process all over again. And unfortunately it sounds like your surgeon will expect you to endure aggressive PT.
As others have said - your ROM is fine and no MUA is needed. Rest, ice and elevate to get that swelling under control. Your ROM will naturally increase as the swelling decreases.
Thank you and thank everyone for the advice. I already feel better (mentally) knowing that so many others have been through the same as me and that I’m not alone in my recovery. I will not have the MUA at this point! I will try to take it easy and not expect too much of myself. As the others have said, this is a long road not a quick trip.
Hi! I took your advice and took a two week break from PT! What a difference that made! The physical therapist was shocked at how much better I was doing when I returned. I’m so glad I took that break . I’m going in on November 30th for PKR on the other knee. Hoping this recovery goes better. I think knowing what to expect will help. Thanks again!
Which PKR are you getting in November? (Lateral, Patellofemoral or Medial)
Which PKR was done on your first knee, and please confirm whether it was a PKR or a TKR.
Please also tell us which date goes with which knee and we’ll adjust your signature. Thanks!
Which PKR was done on your first knee, and please confirm whether it was a PKR or a TKR.
Please also tell us which date goes with which knee and we’ll adjust your signature. Thanks!
Qdogpa
member
You are not experiencing anything most of us haven’t experienced... PT is fine, but time will be your best friend thru your recovery process..I am coming up to 10 months post op, and knee continues to ache , but it is not painful, particularly when exercising. I do see a small improvement over last few weeks, but still not 100%..likely 80-85%... best wishes for a continued slow and steady recovery
