MUA Bunion forming

[medan2012]

Gamera, I get weird feelings in my knee area. It feels like a moving sensation but is not painful. Feels like my skin is being released from a tendon is the only way that I can describe it....... I still get tinges of pain around my knee (tissues, tendons & muscles) but it is bearable.

I to am bothered with my ITB. I experinced minor ITB problems before my surgery & it seemed to go away after surgery but my PT was trying a different bend procedure and really stretched my thigh area. Since then, I have been having IT pain every now & then.

I also use moist heat on the ITB area and sometimes sleep with a time-control heating pad.
I asked my PT what type of exercises I could do...... I use a large foam roller while I am at PT & I have a heated massage roller at home. I use it as needed because I don't want to make the area any more sore.

I do notice when I go down the stairs (not going down one stair at a time) the normal way; I feel a tug on my IT band..............

Soon, soon I pray that most of these issues will be over. I am not persuaded to have my RK done until I feel comfortable with my left knee........

Hang in there Gamera.....

 

[Gamera]

Hi Josephine,

For medication I am taking the ibuprophen/tylenol cocktail during the day that you had mentioned in one of the threads. At night I take 3 Norco tablets...... One around 9pm, one about midnight, (i am usually still awake from discomfort at this time) and one about 4am. My OS had suggested 2 Alieve during the day but I found it just wiped me out. Oh... I also take a Norco pill when I go to PT and adjust the tylenol in the cocktail.

I am icing at least 6 times a day and then once in the middle of the night when I wake up.

I am only elevating twice a day because it is so uncomfortable. It feels like my foot goes to sleep and My leg gets tingly. I have a big pillow pile that I copied from one of the pictures. I have it at a slope so my whole leg touches. It looks like it should be comfortable, but when the swelling starts to disappear down my leg It aches. My foot is about 2 feet high. The swelling seems to disappear from my foot through the top of my knee and settle in my lower thigh. As soon as I stop elevating all the swelling comes back down the leg and that hurts to.

I have PT twice a week now. I just started outpatient (4 sessions). They have now decided after trial and error that what works best for me is a non aggressive exercise program that includes massage and some sort of electrical current machine that is quite pleasant. Yesterday was the first time they settled on this and what a difference it made. I had a lot less pain through the day and evening. However, my ROM has not moved from 80 for 2 weeks now. My PT has commented that I have a lot of swelling and until that goes down I may not see any change.

I am up doing things around the house (feeding animals, making meals, doing dishes, laundry, vacuuming) about 3- 4 hours during the day. The cats take about 2 hours of that time. I try to limit my time on my feet to 30 mnutes and then ice or rest. I don't do the dishes everyday or vacuum everyday. Etc.. I try to put things off as long as I can. The cats will not be put off.

The only time my knee bends is when I do my exercises. It stiffens up immediately when I stop.

Is it me doing something wrong??

I am happy other people feel that movement in the knee and tendons and appreciate your thoughts!

 

[Josephine]

My OS had suggested 2 Alieve during the day but I found it just wiped me out

Aleve (naproxen) is an NSAID so you should be taking them and ibuprofen. In which case you are right not to take them. They are als unlikely to make you feel tired.

It looks like it should be comfortable, but when the swelling starts to disappear down my leg It aches. As soon as I stop elevating all the swelling comes back down the leg and that hurts to.

Well, it will do! Gravity, don't you know!

However, my ROM has not moved from 80 for 2 weeks now. My PT has commented that I have a lot of swelling and until that goes down I may not see any change.

I agree with her.

I am up doing things around the house (feeding animals, making meals, doing dishes, laundry, vacuuming) about 3- 4 hours during the day. The cats take about 2 hours of that time. I try to limit my time on my feet to 30 mnutes and then ice or rest. I don't do the dishes everyday or vacuum everyday. Etc.. I try to put things off as long as I can. The cats will not be put off. It stiffens up immediately when I stop. Is it me doing something wrong??

Yes, you are only 8 weeks out and doing far too much! Somehow you have to trim your activities and rest more. This is why your swelling is out of control. The only answer is rest. Don't care how you do it but it's got to be done but probably only for 2-3 weeks. Which is better - letting the house go to pot for 3 weeks or ending up with a permanently stiff leg? I don't mean to scare you unduly but you have to make a trade off with these things. I appreciate the cats won't be put off but then, neither will your knee!

 

[Gamera]

I'd rather go with the messy house than a permanently stiff leg. Oh you all should see this place! Thank you Josephine. How do you hear our cries for help? You can't possibly have time to read every post!

Today I took it very easy. My housework for the day was to sit and sew missing buttons on two coats. I did lots of icing and elevating. I lay down to take a nap and woke up about 20 minutes later with a fierce aching on the inside lower knee. I don't move when I sleep (it hurts to lay on either side) so what was that all about??? I certainly didn't strain it. I had to give up on the nap and massage and ice my leg.

Now tonight my knee is stiff as a board, snapping and sore. I took a Norco instead of tylenol. I have done just a few very gentle bending exercises, but it is fighting me even with that. I iced and elevated right before I started the exercises. When this happens do you give up on exercise or try to continue gently stretching?

This knee runs the show.

Medan2012, If I were you, I would wait too. I know I will need a hip replacement. But, There is no way I would consider this until my knee has recovered.

Laurie

 

[Josephine]

You can't possibly have time to read every post!

I open several tabs and read about 4 messages all at the same time!

woke up about 20 minutes later with a fierce aching on the inside lower knee. I don't move when I sleep (it hurts to lay on either side) so what was that all about???

Things are inevitably going to get a bit worse before they get better. It's also about finding the delicate balance between doing enough and not doing too much.

What pain meds did you take before you slept and after?

 

[medan2012]

Gamera, I find putting a pillow between both knees if you sleep on your side will take the pressure of the other leg off the surgery leg. Sometimes we do move around in our sleep & don't realize it. Even sometimes with the pillow; I wake up to my knee hurting a little but not as much.

Hopefully, things will settle down for you....... We all heal in our own time and YES, the knee has a mind of its own. I often tell myself that I am ready but the knee says"Nope, I'm in charge."

 

[Gamera]

I have decided that I am going to be a 6 month recovery person not a 3. And.... In that there is a sense of peace.

Josephine, yesterday I was taking the "cocktail" during the day when my knee started screaming. Then instead of taking tylenol at 7pm when it was due, I took the Norco. I did that mainly because my knee was so stiff even after icing and elevating that I could not do my exercises without pain. it didn't help much.

I made the decision to skip the exercises rather than cause more pain. I did some gentle heel slides later in bed when things loosened up.

Today is much better and I am taking the cocktail once again. I guess it is just one of those things......

Medan2012, I tried the pillow between the knees. Even with the pillow, my surgery knee still feels twisted or out of joint when I lay on my side though. I have to help it back to a straight position to make it feel right. Hopefully this will change in time. I miss a change in position!

Laurie

 

[referee54]

I to am bothered with my ITB.

Did your PT give you these stretches to do?

My PT also taught me to use an ice massage---I filled Dixie cups up with water and froze them---then applied the ice directly to the affected area of the IT Band. As the ice melted, I tore away the paper. This helped a great deal.

 

[medan2012]

Tim, no my PT did not give me the above mentioned exercises for my ITB. Actually, my ITB is much better after massaging by my PT, foam roller massage at PT & using my home infrared massager. When I attended PT on Friday, I did not have issues with my ITB so my therapist did not massage or have me do the foam roller exercise.

 

[medan2012]

Laurie, I'm sorry the pillow between both knees did not give you comfort. Hopefully in time, you will be able to find a comfortable position.

 

[Gamera]

Hi medan2012,

I think I am just one of the slow healers. All good things in all good time!

My favorite part of the physical therapy is the massage. i know it doesn't increase my ROM, but my knee feels so much better after my PT is done. The stiffnes and swelling seems to diminish a little for the rest of that day and I sleep better that night. It definitely brings relief to my IBT.

How is your knee coming along?

Laurie

 

[Gamera]

Hey everyone,

This is so exciting. I sent a post today and discovered that I am now a "Junior Member"! I have graduated.

Of course, this does not mean that my brain is any bigger. But it is pretty cool.

Laurie

 

[Gamera]

The fear is setting in. 9 weeks out. Tomorrow I go back to work - 6 hours a day, 5 days a week for 3 weeks until I meet with my OS for my 12 week check up to see what he thinks. I know it is going to be gruesome. From what I have read about others who went back to work in the shape I am in: I will experience a set back and my recovery will last a lot longer.

I am planning on bringing something to ice with... Hoping to ice at least twice. For the most part I will be sitting, but I will be able to stand occasionally and take two short walks. I plan to do some gentle stretching and massage as part of one of the walks. I am wearing my trusty sweatpants because my knee is still quite swollen. Should look very stylish with my uniform.

I am bringing my crutches because this is Minnesota and the walk from the parking lot to the door may be treacherous. We have lots of snow and ice on the ground. The crutches make me feel sturdy .

My drive there takes a half hour. I know that will hurt when I can't move my leg much.

I am thinking of continuing the advil/tylenol cocktail while I work. Then taking the Norco aand icing/elevating as soon as I get home.

Does anyone have any words of wisdom or ideas I have not thought of? I am so worried. My recovery is very slow. I still have an ROM of 80 and that is only when I exercise. My leg stiffens up pretty fast once it has a choice. It does not bend when I walk and I practice everyday.

 

[referee54]

I will experience a set back and my recovery will last a lot longer.

I do not know if you will call it a setback, per se, but it may slow you down a little bit. I went back at eight weeks, and, in looking back, I see that was too early.

I believe that you are wise to ice at least twice while you are at work. Do you have any type of handicapped parking placard---can you use that in anyway?

I would also urge you to take it easy on weekends and , at least one day on the weekend, to do absolutely nothing but ice, elevate, and rest.

My knees both stiffened up after about four hours in the classroom---just ice and take it easy when you get home. If you are doing PT, I would cut back a little, too.

Best of luck to you, and let us know how things are going!

 

[medan2012]

Hi Laurie,
My knee is coming along. Today, I went to the recreation center and did some exercises that I normally do at PT in the pool (squats & knee kick backs). Afterwards enjoyed the hot tub (ten minutes of bicycling in the hot tub), bicycled for 15 minutes on the stationary bicycle and 3-15 repetitions on the leg press. I prefer the leg press at the rec ctr better than at PT. I guess because it is more modern!!!

My day was topped off by going to the commissary to shop for a few groceries. So far I feel pretty good. Focusing on my heel-to-toe gait so eventually, I hope to get rid of my cane but no rush........

One day at a time is my quote when someone ask me how I am doing........

I love my massages also. My PT doesn't massage my knee. He massages my quads/ham strings before he performs my knee bends but massaging my quads/hamstrings doesn't help with my bend. I feel my flexion will come in time. I feel as long as I can do the things that I need to do; then I will not worry about my flexion!!!

Hang in there. Each day is a venture and one day closer to your recovery.

Take care. Have a good night.

Mary Ellen

 

[maryo52]

Gamera, I was a long-time member of the unofficial Limited ROM Club. There are a number of causes and this will shake out in time. The only approach in the interim is the "slow gentle" one so that swelling is limited. So you are on the right path and at 12 weeks you will re-assess with your ortho and see where to go from there.

Your pain is no doubt increased by your efforts to bend which does pull on and therefore hurt the soft tissue structures around the knee. If you were to do no PT for a few days, you'd probably find that your aches and pains subside.

What's aggravating is when the "foreseeable" future is not foreseeable at all. Normally we can look ahead three months and have some idea how things are going to play out, short of any big glitches. With a post-TKR leg that's having trouble bending, it's even more unpredictable. I was lucky in that I didn't have a work commitment. In fact, my poor recovery turned out to be a great excuse to not return to my per diem nursing position that I didn't like.

One thing I wish I had done better when my ROM was stuck was to love my poor knee more. Instead, I felt betrayed by it. I grieved the loss of my old knee, which was at least was somewhat cooperative.

Your 80 degree limit was similar to mine, and if you look at my signature, you'll see the steps that were needed to correct my situation.

Best of luck.

 

[Gamera]

Maryo52,

So odd. You must have read my thoughts this morning. I was looking for information regarding the manipulation procedure and found your post about your experience. I was wishing I knew how to contact you about the same time you were writing me.

When I saw my PT Tuesday morning once again my ROM was 80. We talked about the procedure which I am certain my OS will recommend when I go back in 3 weeks unless the new knee has a sudden change of heart. I was concerned about wasting PT appointments now when they may do me more good later. I was questioning whether I should move my appt. with my OS up a week... If it was crazy to wait being I was not progressing. My PT thought I may want to consider moving the appt. ahead. She did not think I was hopeless but did think manipulation was a distinct possibility. I saw that you had yours before the 12 week point. I always like your posts and value your opinion. Knowing what you know now would you have gone ahead with the MUA when you did or waited until the 12 week point to decide?

When you mentioned holding off on PT for a few days, did you mean just the appt's or also the exercises I do on my own. I did go about 5 days without seeing the therapist a couple weeks ago and had no change in pain and stiffness. I was continuing my home routine.

However, last night after my first day back at work I was too exhausted to do my exercises and only iced and elevated before going to bed. My leg actually felt a little better than usual in the morning. When I sat on the side of the bed my leg hung straight down instead of sticking out like it always does. As soon as I started exercising it began to stiffen up and my bend seemed to shorten. Do you think it would be worth a try to stop exercising for a couple days too?

I am trying to be kinder to my new knee. My first PT (in home) told me that people should never speak poorly about their body. So I try to think of it tenderly. I talk sweetly to it when I rub the vitamin E oil on. But I often wish the old knee with the full bend was still with me.

What is the procedure you had after the MUA?

I appreciate your note!!!! I love that cat in your avatar. I have one that is almost identical in bed with me now.

Laurie

 

[maryo52]

Good morning, Gamera.

Well my PT said "you don't need the MUA." They were sure PT would improve my ROM. So I called and cancelled my MUA. But it didn't take much more useless PT to convince me to go ahead with MUA. THere's a difference between ROM that is slow to improve -- at least you gain a degree or two a week -- and NO gain. That's called a "hard stop" and no amount of PT would've helped me, I believe.

My arthrofibrosis (internal scar tissue formation) was so aggressive, however, that despite my earnest efforts, the gains of my MUA were quickly lost and then my ROM steadily decreased until it was about 70 the day of my arthroscopic removal of the internal scar tissue. During that procedure my ortho found a 1/4" band of scar tissue tethering my quad to bone. Trying to gain ROM with that kind of situation is like trying to open a locked door.

Although many on this forum recommend putting off MUA until later, and they're right 99% of the time, for someone like me with a "hard stop," it was the only way of moving forward. Basically they put you under, and with the ortho grabbing your lower leg just below the knee, they gently but firmly bend your leg and break the scar tissue that tethers things together. They can actually feel the scar tissue being broken. My MUA produced three small tissue breaks and one big one, which no doubt was that 1/4" band which quickly grew back -- the nature of arthrofibrosis.

What I liked about my ortho was that he mentioned the next remedial step if the current remedy didn't work.

I have to agree with your thinking that going to PT while awaiting MUA is fairly nonproductive. What I did was continue gentle (very gentle) stretches at home just to keep things moving as well as possible and foregoing PT until my MUA. It was very demoralizing going to PT and getting nowhere, especially while the 82 year old man with his 2-week post TKR next to me bent and straightened perfectly fine, not to mention was already off narcotics.

I'll try to keep track of your thread in the coming weeks so I can support you. Just try to keep in mind that there is a day in a month or two or three when your ROM goes past your hopes and you begin to feel that you are finally reaping the rewards of this major undertaking.

 

[Gamera]

Going back to work has been quite an adjustment. I wish I had been able to wait to start back until 12 weeks as everyone advised. Even though I am only working 6 hour days and have been able to ice and get up and walk around a bit, I find those last two hours are almost unbearable. I soon as I get home I take a pain pill and hop in bed to ice amd elevate my leg. At work I take the Advil/tylenol cocktail but it just can't keep up with the pain.

I am still going to PT twice a week and exercising at home. My ROM remains at 80... No change. Some of the swelling in my knee has gone down... YAY. It is still very stiff and feels like that tight band is around it. The upper part of the icision hurts but the area on the inside lower part of the knee is the killer. I have always had pain there. Sharp shooting pain. When I exercise or have PT that is the area that holds me back. It hurts to touch it.

I have an appointment with my OS next Tuesday. My PT says there is nothing more she can do other than help me maintain the bend I have now. She thinks I need a manipulation. It has been 10 weeks since my surgery. I am anxious to see what my OS has to say.

I wish I had access to a hot tub. It sounds so relaxing when you mention it, Medan.

This part of my recovery is in some ways more difficult than my first few weeks. Offers to help have dropped off and I know people want me to answer, "I am doing just fine" when they inquire. Sometimes I don't think I will never get well. I am the one that has always helped other people and never gets sick. Part of who I am is gone. I feel sort of half here. Like a ghost of myself. Does that make sense?

Thank you for your help Maryo. I can relate to what you have been through and it does give me hope! I had to laugh about the 82 year old man showing you up. I had a similar experience. I am afraid to look ahead because my expectations so far have been dead wrong. I am so thankful that there are people like you and so many others here at BoneSmart who have recovered but stay around to guide and cheer on people like me!

Laurie

 

[maryo52]

Gamera, your post today really took me back, the part about people asking "how is your knee" expecting to hear good news. Then of course came "Are you doing your PT?" And yes, I did feel like my old self was gone. My life as I knew it was gone. I experienced a lot of hopelessness.

You are doing everything right, in my opinion, and also keeping as positive as possible considering your circumstances. It's really now a matter of time, of getting to that appointment, of sketching out a plan with your doctor, of pursuing that plan. And don't forget, all the while your body is healing at the cellular level and that's moving you forward. Just be ready with your list of questions at your appt. Be sure to ask what remediation he proposes, and if that step is not ultimately successful, what would be the next thing to try. It was so helpful to me that when I went in for my MUA, my ortho mentioned he had had patients in the past for whom MUA did not work and he had to "go in" and take out the scar tissue -- good to know if the current plan doesn't work, that there is recourse.