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arthritic muscle inhibition

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Dear Celle,
Thanks so much for the quick reply. Am having a hard time getting info about arthritic muscle inhibition. Guess it is rather rare. I am a Physical Therapist, so that might explain the specificity of my questions and concerns.
Have you heard of/seen arthritic muscle inhibition? I know that my the arthritis in my knee will only get worse if I continue on without the surgery, as well as the other compensatory issues all over the rest of my body and I am finally at peace with my decision to proceed with surgery.
As part of my personal process in trying to "wrap my mind around" this massive endeavor, I want to be be sure that I do not get depressed and discouraged, so I am trying to get more of a handle on what are realistic expectations. What is causing me the most distress is the arthritic muscle inhibition, and I am trying to determine if that situation in particular will be solved after TKR. Have found almost no info online regarding this. If after TKR my pain is less, but due to arthritic muscle inhibition, my ability to navigate my world is no better, I need to be emotionally prepared for that. Could you be kind enough to comment if you can, or alert someone else who might know the answer.

Thanks again, and you are a real sweetheart. Sorry if I am driving you crazy with all of my worries!!
 
I 100 percent agree with the above post . I did pretty much exactly what skigirl did during her recovery during mine . Basically laying down ,leg wrap with ice and elevated toes above nose and never missed a dose . My pain level rarely got to a 4 but everyone is different. If you follow the mantras Josephine sent you ,you will do great ,best wishes, iceman
 
I really don't think anyone can predict this part of your recovery. We have had members who had quad weakness prior to surgery that did very well. We have had others that had to work at it quite a bit over years to regain strength. I think it depends somewhat on how long you have had the problem. If it's been a while, you're going to need to be patient in recovery. First your knee joint will have to heal and then at maybe the 6-9 month point, you may be ready to start on strengthening those quad muscles again.

Perhaps @alexthecat or @kneesrus can comment more on the therapy aspect of your recovery.
 
I think @Pumpkln might be able to chime in with some info—she's a PT, too.

I Googled "muscle inhibition after TKA" and got lots of results. A glance through them show somewhat discouraging results, but the studies I saw only go out about a month from surgery. As many folks on this forum have found, the recovery can take many months, and improvements of all kinds can be had at all stages! There's no way to know for sure what will happen, but I would keep hope in front of you, and take it one step at a time.
 
Sounds like a good question to ask your surgeon.
I don't see a TKR date on your signature; when are you having your TKR?
 
PrincessTia said:
There's no way to know for sure what will happen
Click to expand...
That's quite correct. There are no guarantees. However, many of the people on here have had some of your problems and, even if they don't get 100% recovery, they are better off than they were before.

The only thing you can count on is that, if you don't have the TKR, your knee will continue to get worse and worse. Having the TKR gives you a very good chance of improvement.

Can I suggest that you stop researching all the things that just might go wrong (but probably won't) and concentrate on finding a surgeon with plenty of experience at doing knee replacements? Once you find a surgeon you feel you can trust, I am sure he/she will be able to reassure you about many of your worries.
 
Hi @lovemydog - I'm probably one of those people who have/had arthritic muscle inhibition (but it was never diagnosed that way). I had surgery when I was 15 years old and told one day I'd have to have a TKR but to wait as long as possible - and so I did - way too long it turns out.

I had a pretty horrible valgus knee and over the years muscles had shut down and I learned other ways to function. This caused all kinds of other problems - looking back now I'm fairly convinced my spinal surgery was due to the way I carried myself since many of the leg muscles weren't working properly anymore. I'm nearly 5 months post-op and my physio and I are continually finding muscles that aren't firing properly if at all. My most recent discovery - pes anserine inflammation due to the gracilius having given up working a decade or more ago and between that and the lower quads also being on extended leave, I still can't straighten my leg. Let me clarify that. I have about -5 extension, but if I raise my leg out in front of me, I can't lift it up to be straight, best I can get is maybe 15 degrees. From what I can tell it will always keep me from goose-stepping :-)

I would tell the average person that you need to have a really good relationship with your physio and keep the lines of communication open. Since you ARE a p/t, maybe you just need to keep an open mind and when you find something you can't do, research it a bit more deeply than you might normally. I can tell you, many of the problems I'm running across now are not something people associate with knee replacement.

I think I'm starting to get more muscle mass in my calf and I think my lower quads are looking a bit more defined. I have to remind myself I'm no longer just healing from a TKR, but also learning to walk all over again. The relief from bone-on-bone is overwhelming. I'm not out kickin' it yet, I know I have a lot more work to do before I get there - but get there I will.

Not only will the bone-on-bone not get any better for waiting, it will get worse and so will the muscles that are being left to atrophy. Easy for me to say now that I'm on the other side, but really I'm trying to reach out to you - you in particular to let you know that the path you're on now without a replacement goes very ugly places. The sooner you start the journey the better off you'll be. You may not get it all back, but you just might. I'm still fighting to get all mine back.
 
The research I have read indicates better outcomes if you go in with better function and strength. Since you are a PT you are already trying to strengthen the muscles as best you can. Some of my research indicates it may take you longer to fully recover but without the pain I would think you would be able to get those muscles to fire again. The connections are still there, just need to wake them up. I know from my own experience once the pain and swelling from an arthroscope or injury subsides it is much easier to get muscles to fire again.
 
@lovemydog I have taken the unusual step of merging your 10 threads. We don't normally do this in Pre-op. The reason I have done this is that it appears you tend not to revisit your previous threads but just start new ones. That's okay up to a point but you are missing all the comments people have left you and therefore missing out on the advice and reassurance that's on offer. Also, people are repeating information you've been left before.

If you don't know how to locate your previous threads, please read this article which tells you how to do it How can I find my threads and posts?
 
Dear dovemck,
Thank you so much for sharing your story with me. I think I would be hard pressed to find someone else with a similar situation of arthrogenic muscle inhibition so I am glad that I found you. Just so happens I am about your age. I am 54. I can definitely relate to your remark about problems elsewhere in your body resulting from your knee dysfunction. My R knee is the dysfunctional one, and I had to have a ganglion cyst removed from my L ankle, and the valgus deformity in my R knee is causing problems in my right foot. I have difficulty feeling my R quads or gastroc contracting, even when they are, and I do not know if this is part of AMI and if it ever gets better.
I did google AMI and TKR and most of the info states that people with AMI that have TKR end up with permanent strength deficits. However, I have a valgus deformity and I find that to help my muscles to fire I have to contort my body. I do not know if the cases sited in those publications had abnormal joint axis orientation prior to TKR surgery. My R leg feels like it is lifeless and wooden.
I was wondering if your knee was malaligned due to your injury at age 15, did the surgeon correct this, and what was the injury. I was hoping that if our knee joint axes had been previously malaligned and then were corrected, our weight could then pass through the knee and other joints on that side correctly, we would have improved proprioceptive input, resulting in enhanced muscle firing, and improved function, but I do not know if that is the way things work in real life.
I have been working with a personal trainer in the gym since July and have made some slow gains in hams, quad, gleut definition and firing, but the gastroc seems to be a "tough customer". We work for 1 hr 2x/week leg press, knee extension and prone hams machine, single legged squats, bosu ball, theraband and manual resistance slow controlled contractions, especially the negative eccentrics. I work to muscle failure, but my trainer spots me, avoiding painful range of motion, and assisting in areas of instability. He has figured ways to work around my limitations, and I know I will be depending on his help post surgery. I would be so grateful to not lose what I have worked so hard to gain, and beyond that to get my life back.
I just thought some of these insights and ideas might be of some help to you. please keep me posted on your progress.
Take Care
 
Sorry for not responding sooner. I do not have it scheduled yet. I have appts with 2 MD's Jan 12 and 22, and am praying to have surgery ASAP so i can get through this and have it behind me ASAP.
 
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