MUA Getting Back in the Saddle

[HorseyLady]

Thank you puffin and maryo52
Guess a reality check was needed.
Another confusing visit from the Rehab team today. I now have to cut down on the cpm machine! And get some ankle weights to work on strength. She has also just told me that "for me" 90 will be a good result if I can actively get it myself. Well I hate to say this but 90 will not be a good result for me as I was getting more than that before my TKR and was more mobile. I am in loads more pain now and if I am not going to get a decent bend then it has all been for nothing.

Oh dear, I am definitely having a pity party now

 

[new knee in June]

Dear Alison,
Please don't be upset. Possibly she meant " for now " 90 will be good for you to get to. Sweetie, you are
Only 2 weeks out from your procedure, there's plenty off time for rom. your mua was an assault on your
Knee & there must be swelling. If you need more pain meds,call your doctor.
I have great hopes for you....this will work for you & you will be happy with the results
Like everything worth having, time & patience will over come.
Thinking of you always,
Diana...June sunbeams ...time & patience......

 

[HorseyLady]

Ah thank you Diana new knee in June, you are so kind and comforting

No, she definitely meant long term as she said " we need to think realistically about where you are going to get to long term" before telling me that 90 was a good result. I think it was that that caused me to get upset. Plus adding ankle weights on a knee that is always hot and sore? The cpm will be going in a few weeks and that worries me too

You're right though, time and patience are needed. My knee is more painful now for some reason but I do have some more Tramadol from my GP so probably just need to return to my proper meds schedule. Now is not the time to cut down - but I just don't want to take them if I need to drive - and I'm trying to get back to the land of the living

 

[puffin]

Hi Alison

I would not be too discouraged just yet as if you flick through many of the MUA threads you will see that many people were discharged by physios at around 90-95 yet continued to add 20-30 degrees up to 1+ year after surgery and have ended up in the 115-130 range a year on. So it is probably that you "discharge ROM" in their records will not be the final ROM.

Personally I would be wary of any weights/pushing while your knee is still hot and inflamed. The idiot hospital physio set my recovery back by recommending that I do this. My own physio recommended that I focus on bending/stretchning exercises improve ROM. These were the ones I did
- heel slides
- standing (holding a chair/walker) rise up to tiptoes
- bending knee under while sitting on a chair (some people get a better sitting ROM than lying ROM)
- sitting and stretching knee as straight as possible until it raised off ground (easier than lying)
- lying on front on bed gently bend knee so that heel goes towards bum

Hope some of this works for you

 

[My way]

Hi HorseyLady :iagree: My PT told me the ROM a person has at 8 weeks was as good as it will get! Utter rubbish! My ROM has increased this past week.
Wanda

 

[HorseyLady]

Hi My way and puffin
Thank you for reminding me about the stupidity of some PTs - I must remember that when I take what mine says to heart. Lately I have been much better at listening to my knee but for some reason today I let my PT get to me and stopped listening to myself. I am sure my knee is still only ready for gentle cpm and stretches and exercises that Puffin outlined - not strength training with ankle weights. Oh and she started talking about doing one legged bends and squats too, does she really think 2 weeks after MUA and Arthroscopy, with a hot and swollen knee that still isn't bending to 90 - that this is appropriate?

maryo52 Help I have some questions for you! How long did you go on the cpm for after your MUA? My PT has started to talk about "weaning" me off it. As if I'm getting addicted to it Also, as I have gained a few degrees ROM I have noticed I have lost some extension and straightening my leg is now painful. Have you any experience of this happening?

 

[maryo52]

Well, yes, I lost some extension but then slowly worked on it. It hurt SO much that people just could barely touch me and I rose off the floor. Eventually I had my husband push down on my knee with me telling him how hard and how slow. It was very very gentle.

If you're honoring your knee's needs to cool down and rest, spending that down time in the cpm made a lot of sense to me. It was mostly elevated, often iced, and I always started well within the comfort zone (some depressingly low number like 60). I turned it up two degrees every 5 minutes until I got within 10 degrees of my max bend, then I rose a degree every 5 minutes. I would stop the machine at the fullest bend and just let my leg settle into the bend. There was plenty of stretch, not painful but uncomfortable. The whole thing would be 3 hours because as a nursing student we'd set TKR patients up in CPM for 3 hours. I did this twice a day. I stopped when I was able to do the max that the CPM did (110). My other routine was to sit on an exercise ball watching the TV and roll slowly forward, which bent my knee. I tried to do it in such a way that I was mainly focused on the TV and the stretching was secondary. I'd do 10 of those, slowly, twice a day. That's all. No strengthening for the first month. You must insist on not strengthening to minimize inflammation. Scar tissue is not well understood. They take a direct aproach. A rare few understand that this doesn't work.

Remember that I gave up PT so I didn't have any "experts" telling me what to do. The best way to progress, in my opinion, is solo. Also I went for massages. It was a long slow climb.

 

[Lmarshall]

Horseylady, I just caught up with your thread. Im sorry you have gone thru so much, but it does sound like things are looking up now! 90 degrees is great and I am sure you will notice improvement in time. Dont lusten to the pt that says it may be the best youll get...there are countless bobesmarties that can prove her wrong!

 

[new knee in June]

Good morning Alison,
Listen to the good people of " bonesmart" we have your best interest at heart. If you don't want weights on your
Leg tell her. Tell her you are doing only gentle stretching, icing & elevating, until the swelling goes down.
She works for you, don't do anything you are not up for. Tell her to work with you, not against you.
Don't listen to you will only get to 90, she can't predict the future. Let's prove her wrong
Listen to Mary, she has been through this & will offer good advise.
( off my soap box for now )
Have a great weekend....enjoy some horsey time,
Diana...June sunbeams .....listening to our knees......

 

[HorseyLady]

A nice horsey weekend as I have been able to see my boys on both days and spend some quality time with them now I am more mobile. Persevering with taking my old boy for short walks to graze as he loves the tall luscious grass at the edge of the lane. All is fine if he moves slowly and carefully as I am a bit unstable with no walking aid He is such a good boy and seems to know I am injured.

Tomorrow I am going swimming I am going to see if some gentle water exercises will help ease this stiffness. I am hoping the pool will be fairly empty so I can hobble down the wide steps and stay in the kiddies bit

Still using the cpm for several hours a day. I fell asleep on it at lunchtime. As you can see, I don't have it turned up so high it is hurting - it was on 85 and very comfortable.

Just wondered when this "energy drain" goes away? I am always tired and happy to nap at any time of day. I feel physically tired after I've seen the horses and just have to lie down. I guess a TKR then a MUA/Arthroscopy is quite a lot for my body to undergo? I am shattered

 

[puffin]

Hi Alison

So happy that you have been able to have a horsey weekend

Glad that you are able to go swimming. I found it totally exhausting the first few times and came home and slept for a couple of hours Take it gently - if you are going to "swim" properly you may find that the stroke kick aggravates your knee. I find I do a strange doggy paddle or cycling motion with my legs to avoid kicking outwards

I don't know what the anser is for energy drain - I still have it in a big way myself

 

[muddy paws]

Oh Dear Allison,
I so glad you had a wonderful horsey weekend. That makes it seem much better, doesn't it? Of course your wonderful old gentleman knows he needs to be careful of you. I would often hang onto my older guys manes when I walked them anywhere because it helps me to keep my balance and they just seem to know to slow down,even if they are heading in to eat. They understand.

My OS wrote on my script for the PT people , NO resistance , NO weights for 10-12 weeks and NO manual manipulation EVER!!!
So what makes your PT people think it's going to help your hot still inflamed knee ,that just had a MUA two weeks ago, by adding weight to your ankles? Wouldn't that make it all the more sore, hot and inflamed therefore slowing your progress down?

I would think swimming would be a fantastic idea. It takes a great deal of weight off of your joints, let's you move your knee with a little resistance , keeps your knee cool and it's fun to do! I love to walk/ run in the my local pool because it's only 5' deep so I can walk end to end , working on my gait and if I fall,well, that's actually part of the fun

I would think after undergoing two surgeries in as many months would leave your body fighting to catch up. It's trying to heal and needs sleep to do so. I can't believe how much I have been sleeping since my RTKR! I sleep all night, I nap in the morning, I nap in the afternoon, all this from a person who before having my knee replaced, would sleep a whopping 4-5 hours a night. So maybe I'm totally wrong but I think if you have energy drain, it's for a good reason.

Ok, off my soapbox now. I just hope you can go swimming, have a bit of fun while you exercise and by doing so ,get a better range of motion.

Take care. Jennifer

 

[HorseyLady]

Just got back from swimming Well what an eye opener that was. I have always been a strong swimmer but not any more. This leg really is pretty useless at any normal stroke such as breaststroke. It cannot bend sideways or outwards and there is a hard block. Like Puffin, I found that a kind of doggy paddle leg style propelled me along but it was not pretty and the bad leg flapped feebly trying to keep up
I did plenty of bending exercises and muscle exercises, all gentle, so it had a good workout and also did some walking in the water which was great as I was straight. All in all, I really enjoyed myself.
I am now elevating as my knee is warm and achy so I hope I am not joining the ODIT club!

 

[puffin]

Hi Alison
Glad that you had a good workout in the pool - it will take time before you can do breaststroke kick again as it asks the muscles to do very strange movements
Try and rest up and hopefully you are not joining the ODIC

 

[new knee in June]

Good morning Alison,
My, you have been busy I think it's great you are at 85 & comfortable after only 2 weeks. It can
Only get better with time. I can picture your leg flopping about....but you just have to get your strength
Back. Point is you "did it"
Emery drain is a fact after this surgery & you have been through 2 surgeries. It will get better.
Do what you can & be happy, you are out & about
Horsey therapy will keep your heart happy...& gently exercises will keep your body happy.
I am so proud of you, my little sunbeam
Now, remember, don't let p.t hurt you , they work for you. I think my way has a frying pan she
Uses on unruly p.t people I'm sure she will let you borrow it
Carry on my little sunbeam
Diana

 

[puffin]

Hi Alison
I forgot to add that if you feel uncomfortable swimming - why no try deep water running? This is what I am doing mostly at the moment
Basically you go to the deep end or anywhere out of your depth and run without touching the bottom. Some people wear flotation belts/vests but I find that if I run hard enough that I don't need them
Worth a try while kicking is uncomfortable

 

[muddy paws]

Congratulations Allison!!
So happy you got to go to the pool and did all your gentle exercises and some walking. It really is a very good work out. Hopefully you didn't do to much but I bet you'll be a bit sore tomorrow because pushing against the water can be hard work! Thankfully you are resting, icing , elevating and maybe can take time off tomorrow . I imagine you will be even more tired and maybe will need a nap. Great job today!

 

[puffin]

How are you doing today Alison? Hope that you are not in the ODIC as a result of yesterday's exercions

 

[HorseyLady]

Thank you everyone for your best wishes. Guess what? I am not in the ODIC today! So I am really pleased with my swimming activity and maybe I should try a bit longer next time. I like the idea of Puffin's deep water running - I shall try this! Puffin I am holding you responsible if I drown You're right, I was very tired afterwards and had a nice lunchtime nap yesterday.
Diana - the Rehab team are not coming for another week but I will ask My Way for tips on using the frying pan to stop them hurting me. They are obsessed with breaking down my lumpy scar so I would be happy to use it on them!
I've had a quiet day today - a horsey visit for some grooming and cpm - so feeling ok at the moment. Tomorrow I will be trying another short horse ride

 

[new knee in June]

Allison,
You sound so happy I don't know if puffins suggestion is a vendetta against you, or not, have you been nice to her ?
Your are doing aqua therapy the right way ( a little more time every time) how's the cpm treating you ?
Are you going on a horse again ? please don't tell me "before" I would rather hear about the deed after it has
Been accomplished
Thinking of you always,
Diana....June sunbeams ....going off the deep end..