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MUA Festina lente -Hastening slowly

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Spex10 said:
......its a bit discouraging to have zero progress in knee bending since the op six weeks ago today.
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I know the feeling, as my progress bending has been slower than I would like. I'm almost at 8 weeks and the left is barely 90 and the right was stuck around 70ish most days. As soon as I think I'm making progress I have a bad day and I go back to where I was. BUT that progress is sneaky.

I have a tiled bathroom floor. When I first came home from the hospital, the back of my heels barely touched a particular grout line (while I was on the toilet). My left leg has been able to comfortably move to where the tips of my toes were just behind the grout line, but about 80% of my right foot was still crossing the line. I was stuck there for the last 2 weeks. In the last couple of days, suddenly my left foot is 1.5 inches behind the line and just the tips of my three longest toes on my right foot are on the line (the other two are behind the line). Progress!

It will come for you, just as it is slowly coming for me.
 
Interesting measurement technique!! I also seem to be able to get my heel down slightly nearer than I could last week. That is sitting at my desk. Must just rush to the loo and draw some lines on the floor!!
 
This recovery takes patience and time. There's nothing that'll hurry it along, but quite a lot that can slow it down. @Want2hike , way to look for and celebrate the little but important things.
 
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As has been said before, once the swelling comes down, the ROM will increase. You can't bend it if it's way swollen. There's just no way. It will bend. It did in the operating room when the OS tested it. You weren't swollen then. You are now. Time is what it takes. If you push it when it's swollen and try to force the bend your tissues will just inflame more, causing more swelling. It's a losing battle and causing your knee and you excess and needless pain!
 
Want2hike said:
I have a tiled bathroom floor. When I first came home from the hospital, the back of my heels barely touched a particular grout line (while I was on the toilet). My left leg has been able to comfortably move to where the tips of my toes were just behind the grout line, but about 80% of my right foot was still crossing the line. I was stuck there for the last 2 weeks. In the last couple of days, suddenly my left foot is 1.5 inches behind the line and just the tips of my three longest toes on my right foot are on the line (the other two are behind the line). Progress!
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Aha! Someone else who uses "my " technique.
Our bathroom floor has tiles marked too.
I used to sit on the "throne" and use the tiles to measure how far back my foot could go. As my bend increased, I could see that I could pull my foot further back. That's the only way my ROM was measured, as I didn't go to PT.
 
Drat. We have a wooden floor and the planks run outwards from the throne so no lines!
 
Or if you don't want to use tape, get rug anchors to anchor bath mat or bathroom rug in place.:wink:
 
It's hard to give up on something that you've been told should be helpful (p/t) but if you give it a chance you will see a improvement. I had a hard time taking all this info in from this site and weighting it against people who were actually seeing me and my knee. My thinking was they should know what there doing, there professional in there line of work. But come to find out, like many things in life you have some that know their business better than others, the ones that push us only cause us more discomfort and at this it was hard for me to wrap my mind around the fact that hey I am doing what there asking of me, but I am not improving. Once I cut back emotional I felt better and physically I began feeling better all the way around also, but again it's hard to let go.
 
That's exactly how I'm feeling Zzevy. I'm really hoping that my appt with the surgeon goes well today and I'm not left feeling a failure or that its my fault that my knee doesn't bend much. Fingers crossed!
 
Worst fears realised. Dr says I have Arthrofibrosis. Said its my own body overcompensating trying to recover. Has given me a month to increase flexibility. After that the dreaded MUA.
He is a national expect and I discussed what I've found here and in the NICE guidelines but he said that people's reactions to this surgery vary enormously. Mine is an overreaction and that in his experience MUA would be best in my particular case.
He's also prescribed Naproxen (anti inflammatory) as I've now stopped the Aspirin. Feeling downcast
 
Ice and elevate around the clock. You have a month and a lot can change in a month. Then you can decide if a MUA is right for you or not.
 
Thanks Ronsgirl. I'll do my best.
 
Spex10 I am really really sorry about your news from your appointment but don't give up - I'm praying you gain miraculous increase in ROM in the next month and surprise the surgeon. I am also 6 weeks post op and have my first post op OS appointment next Wednesday. I'm praying for myself that the Dr is happy with my 90 - 95 degrees as I was 90 the first week after my op with little improvement since. I can't take more time off work for a MUA so here's hoping.

Sent from my SM-G930F using Tapatalk
 
Fingers crossed for you Cait81!
 
Spex10 said:
Worst fears realised. Dr says I have Arthrofibrosis. Said its my own body overcompensating trying to recover. Has given me a month to increase flexibility. After that the dreaded MUA.
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Arthrofibrosis is not a ghastly end of the line condition. It's just a term used to describe an excess of inflammation around the joint - or in simpler terms, swelling! I'm also not convinced that an MUA is best treatment for a stiff knee, especially one that is barely 6 weeks out. You need to give it more time - lots more time. And in the meantime, tell him you decline his generous offer of an MUA!

Read this BoneSmart philosophy for sensible post op therapy especially the second post.

Another truism to bear in mind is that 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.
Spex10 said:
He is a national expect
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You said he's a "national expect" - wonder what that means!

But assuming you meant expert, if I had a pound for every time I've read that, I'd be such a wealthy woman now!
According to everyone, their surgeons are always the best, the top man, and now 'the expert'! Most of them might be good but those appellations are generally reserved for the best of the best!

However, you never answered my questions so I am supposing you're not actually interested in my input. So be it.
 
Josephine- I did answer your questions! I wondered why you didn't respond! Maybe I didn't set the answers out with numbers attached to correspond to your questions. If so I'm sorry.
BTW my surgeon really is a national expert!!
 
Who's knee is it? How can your surgeon say that you have to have a MUA? That's a ridiculous thing to say at only 6 weeks out from your surgery. You would not believe how many national experts we have heard about on here. I've been part of Bonesmart for a year now and I have read many, many recovery threads and the thing that everyone has in common is swelling, and lack of ROM for quite a while. PT tries to work the knee so that the ROM might increase. So what happens? The knee becomes more inflamed and swells more and ROM stops or even goes down. When people stop all the unnecessary exercises and PT and uses the BS way, then the swelling goes down and automatically the ROM increases right on it's own without any help from anybody. I can't believe anyone can tell you what you have to do to your knee! Trust your body to do what it will naturally do.
 
I agree with Josephine. I think your surgeon's diagnosis of arthrofibrosis is premature. It just doesn't appear so early.

Try doing no PT or exercise at all for a month, apart from gentle walking. Spend lots and lots of time resting, icing and elevating your leg, so that you help the swelling to go down and the inflammation caused by excessive exercises to die down.

There is no time limit on when an MUA can be done, so there's no harm in waiting.

And, your surgeon can't force you to have an MUA. It's your knee and your choice.
 
This is so hard for me to get my head round. I've checked the latest research on MUA and its pretty positive. Outcome after a year the same as for those who didn't need it. Only a small percentage of people have the sort of tissue overreaction that I seem to have.
I'll do my best to have improved my ROM by January but can't say I'm optimistic.
I should say that the surgeon was in complete agreement with the Bonesmart mantras but that some people like me are likely to need a different approach. He's a nice man. There's nothing in it for him. I think he feels bad that, basically, my ROM hasn't improved since I left hospital.
 
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