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MUA Festina lente -Hastening slowly

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Thanks. My knee isn't sore. Pain isn't the issue. It just wont bend! I mean 45degrees or 50 with me really pushing just isn't right. I can't drive -I can't even get into my car as my leg just wont bend!!
I'm beginning to think that the OS with experience of seeing the outcome of thousands of these ops is most likely right. I wish he wasn't. I wish the Bonesmart way worked for absolutely everyone but it doesn't seem to be the way ahead for me. I can't tell you how much I wish it did. The thought of MUA makes me sick. The thought of being like this permanently makes me sick. People will say give it time but I suspect that the underlying tissues so firmly anchoring my knee can only get stronger.
 
You might be in the minority who get adhesions, but then again, you might just be swollen and stiff. It won't hurt to give your knee more time to respond.
 
Don't despair.. this is a long process with stiff and unstiff days.. You are still quite early.. How and how often are you measuring ROM?
I know I have less good days and better days. I try to measure with the same method on the same surface..lying on a hard bed doing five heel slides( properly..holding for 10 seconds each time) then measuring at the last. My husband is an engineer and fabricated a goniometer. Its not totally accurate but tells you if today is better or worse than last week
We try not to measure every day.. That would just depress me.. And the odd thing is that when I think the ROM is worse, it isnt when we make an actual measurement.

Have you changed shoes? I find that my winter boots catch on car doorstops stll.. The summer shoes didn't . It does not indicated decreased ROM..

I think that you are hoping for overnight success but it doesn't seem to work that way.. And here the idea is to do a couple of exercises properly but rest and do a bit more of normal life as you are comfortable with.

I have a little knotty band on the outside of the kneecap about two inches long.. I massage it.. Hubby does a better job. It does loosen.. And then I do just 10 min on a bike once a day plus 5 heel slides 3x a day and some quad sets for extension ( though I don't feel a thing in the quad anymore, but in the morning I do have contracture).

Anyway.. Just dont give up Spex10. Yes I have felt the pull while doing slides.. It was new at one time for me..

Massage therapy might be good.. I don't know.. Have not done it.. don't have the money to do it from a pro.
 
Thanks. I have a proper goniometer. I seriously can't do heel slides. My OS said that I have arthrofibrosis. I don't think I can beat that by myself.
The follow up to surgery hasn't been great. I wish I'd had better support and advice. I wish I had access to a CPM but I didn't and now I'm in this mess.
 
Studies have shown that whether you use a CPM or not has no bearing on the long-term result, so don't waste any time regretting not having used one.

It would be very unusual for someone to develop arthrofibrosis as early in their recovery as you are.
I'm still firmly of the opinion that your problems have been caused by excessive exercises - and an MUA won't cure that.
 
You have to give resting, elevating, icing as much time as you've spent exercising your knee. A few days of elevating isn't going to fix a month and half of trying to exercise an injured knee. If your dr has prescribed anti inflammatory meds suffice it to say he believes your knee is swollen. Everything I've read about arthrobrosis says that early on the most important factor is decreasing swelling. So follow the BoneSmart mantras and don't worry about ROM. Worry about getting the swelling down.
 
Swelling is the enemy of ROM. I heard it said on here that a swollen knee is like a hose full of water with the nozzle cut off. Can you bend the hose when it's like that? Nope. Well the knee won't bend when it's full of fluid either. Please don't obsess over this. We all have been through that swelling and little ROM. It increases when the knee decreases in size and fluid. Read a bunch of threads of us old-timers. You will benefit from our experience.
 
Thanks but were you 'old timers' stuck at 45-50 ROM at 7 weeks?
Actually the swelling has reduced. I measure it with an inch tape each morning so its an exact measure.
 
Spex10 said:
It just wont bend! I mean 45degrees or 50 with me really pushing just isn't right.
Click to expand...
You see, it's the pushing that is part of your problem. Pushing on your knee and trying to force it only irritates those angry tissues still further. The result is more swelling and, therefore, less bend.

I'm really sorry you're in this fix. It isn't your fault. It's the result of misinformed advice. You were told you had to do lots of exercise - but that belief is outdated.

It will take at least a month for everything to settle down, so don't despair. Even if your swelling seems to be going down, it only takes a very little extra fluid inside your knee joint to gum up the works, so to speak. That's because it's a pretty small space inside your knee joint.

There's no time limit on when an MUA can be done (even though some surgeons like to do them early), so why not try what we've suggested for a month? If you still see no improvement, you can then try an MUA. At the moment, though, an MUA is just going to cause more injury to your poor knee.
 
We've tried hard to help you with our experiences. What have to got to lose to not do exercises or pt for a month? But, you have to do what you think is right.
 
I really do appreciate everyone's support and suggestions. I am still confused and upset about it all. Can't say any more than thank you.
 
I was definitely stuck at some point because as I said earlier on your thread, I was not allowed to bend my knee at all. I was in an imbolizer that kept my knee straight at 4 weeks out for a month. But my OS said it would bend when we told it to bend and he knew this because my leg was not swollen. It wasn't swollen because I was doing no PT whatsoever. None, my OS, who did his training at The Mayo Clinic ordered NO PT. When I was allowed to bend he ordered non-aggressive PT which was just stretching and heel slides. No squats, or stepping ups because they aggravate an already injured knee. So spend the next few weeks not pushing to bend your knee because it's not working. Spend the next few weeks icing, elevating and resting your knee so the swelling will go down, then and only then will you know whether your knee can bend or not.
 
The first post was 8 days ago... I think the missing element is time.. And another element of tenseness has been introduced.. worry won't help flexibility.. When I had PT the therapist reminded me to relax..relax...she could tell the difference in the feel of the tissues.
 
Well I saw a brilliant physio today. My usual one was full up. This lady really knew what she was doing. I only wish I'd had her since the op. She massaged and manipulated my knee and was encouraging and supportive throughout. I found her really helpful.
The downside is that she could demonstrate that there really is scar tissue. Unfortunately, my ROM has reduced since my last appt. I'd cancelled the last one and spent the subsequent weeks resting etc in the prescribed Bonesmart way. She obviously has a lot of experience with knee replacements. She said that she's seen good results with MUAs but that there are risks. I felt she'd been very honest. I think I'm just one of the unlucky ones.
 
Reviewing my current state : I'm lucky in that I don't seem to have the problems with pain that others sometimes do. I sleep well albeit in my back. I get about OK in my current limited state. Knee has healed well. BUT I'm still stuck at 45/50 degrees. I rest, ice and elevate as well as the gentle exercises recommended by the good PT. I massage my knee with Bio oil etc etc etc.
I take my Anti inflammatories. The swelling has reduced and doesn't increase after exercise. I'm really doing as well as could be expected but still feel under the shadow of MUA. I fear it could take me back to square one. But can I really go on limping as I do? No answers really. It just helps to write this down. Sorry.
 
Spex, I'm sorry to hear that you are having complications. I have no experience with MUA on my knees, but several years ago I had one on my lower back. It was the best thing I could have done in terms of relieving pain and gaining flexibility. I was sore for two days and then felt better than I had in years. I hope you have a quick recovery from the MUA and your knee gets to its full capabilities.
 
Goodness me! I didn't think you could have a back MUA. That must have been a scary and potentially risky procedure. I'm glad it worked for you.
I've been reading all the latest scientific literature on it and it seems quite positive. I just think if my knee swelled so much last time why wouldn't it if subjected to such a nasty procedure again.
I can really feel the specific tight band now. Don't know how they'd snap it. Oh. Wish I hadn't thought about that!
I've just been doing another bout of stretching. Could just about make it to 60 but that was a real strain.
 
Oh, your knee we swell quite a bit after an MUA. Chances are they'll tell you to delve back into aggressive PT, but that'll just start the cycle of swelling all over again. After an MUA you should ice, elevate until the swelling goes down. I suggest you read threads here of those who've had MUAs.
 
The post TKR PT wasn't brutal. I just couldn't even do heel slides.
What I think happened is my system overreacted to the surgery hence swelling. If I get even a small bruise it comes up into a lump. I have dermagraphia (extremely sensitive skin that can be written on with a blunt implement). As I had to take anticoagulants for 6 weeks after op I couldn't take antiinflammatories too. In that time the swelling covered up for the development of rapid scarring. Now I'm on ant inflammatories the swelling has reduced and the very clear section of scarring is observable.
So post MUA how to find a way to prevent DVT and inflammation that are not mutually exclusive!
Meanwhile I'll continue with the usual regime and keep trying to stretch my knee.
 
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