MUA Festina lente -Hastening slowly

[sistersinhim]

After my first lateral release and scope I was in a immobolizer for 6 weeks. I had a hard time bending when I first came out of it. I busted my scare tissue myself by, over many days, I got into a tub of hot water, as hot as I could stand, and would get my knee really warm. Then I would rock back and forth with my knee bending a little more each time. When my knee cooled off, I heated it up again and repeated the process. This process worked and I did it on my own, on my own time frame. It might work for you.

 

[little red canoe]

I never took anti inflammatories.. I think most here did not.
Ice controls swelling and I have seen no mention that you have iced several (>4 ) times a day for >40 min Spex10

If you are worried about swelling.. post MUA.. ice could be your friend.. As I have no expertise in that field..I'll defer to the nurses.!

 

[Spex10]

Thanks. I think that makes sense. My knee is certainly more flexible when its warmer. We only have a shower these days but I play the warm water on my knee. I also massage it with as warm hands as poss just before I try my stretching. I don't know if I could be strong enough to break up my own scar tissue though

 

[Spex10]

Sorry little red canoe, I do ice my knee and simultaneously do the toes to nose thing. I set up the pillows as shown in the photos on this site.
I guess that's one of the reasons I'm so fed up -I've really tried to do everything right but am in this situation.

 

[KarriB]

The exercises you were doing post op such as squats are very bad for the soft tissues after a TKR. They're ok months later, but not directly after as they promote swelling of the soft tissue and diminish ROM. After an MUA many experince swelling and stay away from PT for the first week or so to let the soft tissues heal.

 

[little red canoe]

Sorry Spex10 I missed any mention of ice and assumed wrongly you might not have used it.
I am so sorry that , after you have done everything right, you are in this pickle.
there are some You tube videos that are encouraging about MUA's

 

[Spex10]

Still trying my hardest to do do everything right. 7 and a half weeks now and best I can manage is 64 degrees ROM.
I feel quite well though and knee feels more 'healed' somehow. Its just healed too tight!
I do appreciate everyone's helpful comments. I'd like to read other peoples' experiences of MUA if there are any on here. How do I find them?

 

[FlaGranny]

Go to the Recovery threads. The first one I see is on page 5. You will see [MUA] in grey in front of the thread title.

 

[Spex10]

Thank you. Will check it out

 

[newlybionic]

I hope that you can decide what path is correct for you. It is hard to figure out what your next step is at times.

 

[Celle]

7 and a half weeks now and best I can manage is 64 degrees ROM.
I feel quite well though and knee feels more 'healed' somehow. Its just healed too tight!

Can I suggest that you stop having your ROM measured? It's just giving you more cause for worry.
Anyway, it's almost impossible to get a measurement as precise as 64 degrees with any certainty of accuracy. It could well be 60, 65, or 68.

And you're only 7.5 weeks out from major surgery. Your knee isn't healed at all. Complete healing takes at least a year. Your knee is tight because it's still swollen, internally and externally. It takes time (as long as a month) for the after-effects of excessive exercises to wear off adn for all your inflamed tissues to calm down again.

Keep on resting, elevating and icing, and taking your pain medications, do minimal exercise (just walking around the house and garden) and don't measure that ROM for at least 2 weeks.

There are a few (very few) people who do benefit from an MUA. For the majority, having an MUA this early in recovery just causes further injury to an already injured and angry knee and sets back their recovery.
MUA: the ineffectiveness of early MUA (JBJS)
[URL='https://bonesmart.org/forum/threads/mua-manipulation-under-anaesthetic-and-adhesions.3656/']MUA (Manipulation under Anaesthetic) and Adhesions[/URL]

 

[Celle]

I don't know if I could be strong enough to break up my own scar tissue though

This early in your recovery, it is most unlikely that you have scar tissue. Is your PT telling you that you do?

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!!

You wrote the above just 9 days ago. And today you say you're about 64 degrees. That's progress, my friend.

 

[newlybionic]

You're moving along with gaining ROM. Slow and steady wins the race !

 

[little red canoe]

The preoccupation with ROM really fascinates me.. None of us probably measured it presurgery.. now back to ice

the most I do is compare it to the good knee ( yes there is one). Its almost the same..

When I was in PT they warmed up the knee with repeated massage and slides and some bike before measuring.. When it was stiff of course ROM was less

 

[nancyjo]

Best thing in the world to do is let it rest, ice it, and elevate it. Nothing is going to happen to it in the short time you give it a rest. Patience is the key ti healing a TKA I learned and am still learning. Ice, rest and mild activity is best for it iI have learned.


Sent from my iPad using broken link removed: https://r.tapatalk.com/byo?rid=75543

 

[Celle]

I never had my ROM measured at all. But then, I didn't do any PT for my last TKR. For the previous one, the only time my PT measured was at my final visit.

My surgeon doesn't measure. He just says "Show me what you can do." Function is more important than the numbers.

I think the reason why PTs measure so much is that it's one way they can prove to the insurance companies that their ministrations are effective. So, they obsess about the numbers. Consequently, they natter and nag, telling you that you need to increase ROM quickly - which is completely the wrong way to go about rehab.

It's not exercising that gets you your ROM, it's time. Time to recover, time for swelling and pain to settle and time to heal. Your ROM is there right from the start, just waiting for all that to happen so it can show itself.

ROM can continue to increase for at least a year after a TKR, so there's no need to rush.

 

[Spex10]

Thanks all. I suppose my rush is that I'm due to see the OS on 6th Jan. Last time I saw him he said I have arthrofibrosis and would benefit from a MUA. All the posts I read are of people who seem to have great flexion (well great compared to me). I can feel the stiff bands specifically and just wish they would snap. My fear is that they would grow stronger leading to greater difficulty down the line.

 

[Celle]

Remember that it's your knee and the decision is yours. Your surgeon can recommend an MUA, but you have the right to say "I'd like to wait a bit longer." There's no harm in waiting for a bit longer.

As long as your ROM is improving, no matter how slowly, you are making progress and it is unlikely that you have arthrofibrosis.

 

[mcmars]

Hello, new here and 6 1/2 weeks out from TKR left side. Extension has been my nemesis, but I know the stiff knee deal and do heel slides in bed before getting up in AM. I find the exercise bike is best way to get ROM, spin backwards and forwards at first gently, no load, and after a few minutes I was able to get full 360 degrees with seat up real high a week post op. This is my 5th surgery in this knee and I always use the bike to get the motion going. I just bought a "spin type" bike on amazon this week, they were on sale for under $200. So I use it 3-5 times a day now, just for 5 minutes or so as I do not want to over do it and go backwards in my rehab. I am at 115 degrees on a good day when swelling is down and 7 to 1 degree+ extension.

 

[little red canoe]

Tight band feeling is common among many. It's due to swelling. I loosen it up by walking or stationary bike ( the latter might be tough for you right now)