TKR Knee extension problem

[Dhare63]

Maybe a new nickname is in order, how about CB! In any case, the MUA may or may not need to be repeated. It all depends on your physiology. I had MUA 12 days ago and at first, my extension was great. Then I went to PT where they started to really push which set off a swelling that is just now going down. I believe that if I had stopped that hard pushing, stayed home where I could work on exercising and being in the CPM machine several times a day, I would be in much better shape. My beginning measurement today was 14, but after some massage and stretching, we got to 5. That was without the PT pushing down hard. That made me happy. Just know that your knee will recover on its own schedule, and the MUA might be a little speed bump but ultimately you will get better. Keep posting here, like minded friends will support you on the journey!

Take care, Dawn

 

[Jamie]

I am scared of MUA because my OS said the scar tissue often comes back and it has to be repeated -- ad infinitum, it sounded like. I got the image of being permanently in pain, in the spiral of invalidism without cure.

.

Well, if that's what he told you, it is wrong. It is possible that scar tissue may return, but quite frankly I cannot recall any cases for our BoneSmarties where that has happened. Instead, folks report improvements...sometimes almost immediate in their range of motion. The only time I've seen an MUA not be as effective as it should be is when they are done too soon and tissues are still inflamed and swollen. In that case, the forced bending of the MUA only serves to further inflame the knee. That's why we tell folks to wait! There is no hurry to rush to an MUA if you don't have ROM in the early months of recovery.

At three months out (which is about what I think you'd be by Christmas), you might consider an MUA.....if you are not improving at all and if your swelling is down. Please try not to worry about it until then. Keep working on the extension exercises detailed in the Library and let's see where you are.

 

[Josephine]

In all my 50 years in this business, I think I've known of maybe a dozen patients who had to have a redo and most of them were victims of road accidents whose knee had been well mashed up! He was just covering his back with a little (to him little) exaggeration which was very uncharitable of him.

 

[Crybaby]

I'm reassured by your comments--I'm working to improve the extension and will at least be better prepared for my next meeting with the OS. Amazing how adversarial my relationship with him has been. Tomorrow I meet with the aqua therapist and hope that will be helpful.

 

[Dhare63]

Good luck CB, hope the aqua therapy helps. So far has not been offered to me although the PT group offers it. Wondering why some people get it and some don't?

 

[Mountain Kat]

Good luck CB!! I had my first pool therapy yesterday and it felt great!! I hope it helps you too.

Dhare63, you might have to ask for it? I think the OS has to either approve or give orders for it. Not sure, but worth checking into!

 

[RestAssured]

Well, it's time for you to come up with a new name for yourself! You will be fine, no matter if you end up needing an mua or not! We are here to support you and we haved all cried along the way. We have all had our share of joy too! So ask Jo or Jamie if they can help you change your name to something that will make you feel great about yourself; not what the doctor (a curmudgeon) "might" but probably doesn't think of you!

 

[Crybaby]

Great suggestions and I will call myself CB for short. Today I had an evaluation and tour of the pool facilities and tomorrow I will have my first session
Best, CB

 

[Dhare63]

Good luck in the pool, looking forward to hearing how it goes!

Dawn

 

[zjrog]

I worked out in the pool on my own. And all was good. It felt weird at first, but it helped.

 

[Crybaby]

I had my first aqua therapy session today-- very pleasant to be in the warm water and the exercises felt good. Now I have to wait and see how it works for my extension problem.

 

[rubysue]

I can't wait to try the pool! It seems like I'm getting busier now that my return to work date is looming (December 14). I hope hubby and I can go tomorrow to our rec center that has a physical therapy pool, although we are also meeting a bunch of people at the new IKEA store for lunch (mmmmm, Swedish meatballs).

 

[Crybaby]

I have had three pool sessions so far-- very intense with squats, lunges, etc. Afterwards I am exhausted, can barely walk to the car with my rollator, collapse when I get home; and the extension angle gets worse. It's now the morning after and still stiff, painful, and crooked. Is this because I am working hard at exercise and will slowly get stronger?

Next week I see my OS at 9 o'clock in the morning. I'm always stiff and have worse extension that early. any advice for getting unstiff faster n the morning? Doctor does not want me to use heat.

I am still very depressed, cry almost every day, feel that these three months since the surgery have been among the worst in my life--and despair of getting better. I'll have a day of walking better and feeling more hopeful, then the next day am back to hobbling., pain despite using medication, deep depression.
Next week I will know if OS wants to do a manipulation-- assume since it is so close to Xmas that will take time to schedule. Should I try to get a second opinion?

I wish there was a group of TKA survivors I could
meet with but thiis forum has been a very welcome community.


CB

 

[Roy Gardiner]

The mavens will be along soon, but allow a one-week post-op his 2 cents.

I think you are being pushed/are pushing too hard. You are injured by the surgery, it will recover, but you can't train an injury to recover faster.

Pain = no gain.
No pain = gain.

Gentle stretching, maybe massage too, is what you need. Anything that hurts is no good.

PS. Would you put your surgery and date in your sig, please? It helps those of us who want to comment

 

[kneeper]

I tend to agree with Roy. Maybe a little sore is ok--barely able to function sounds like too much. :console:

 

[Mountain Kat]

I have to agree with the others, it sounds like they are pushing you too hard. I have been doing aquatic therapy for a couple of weeks and my therapist checks in before every session to see how I am doing and how I did after the last appointment. I have seen her take things easier when someone says they are sore or that the last appointment was too much for them. I know one day I wasn't feeling as good and she backed off a little. It is her goal to push us and help us improve with whatever our issues are, but not to cause more pain. Tired and a little sore is fine, but not pushing us into pain. I know this is working for me and I generally feel better after a pool session - tired sure, sore maybe, but never in pain or unable to walk to the car.

Perhaps they are pushing you harder because of your lack of extension and they are trying to help avoid the MUA. But this obviously isn't working for you and you should tell both them and your OS. It would be nice to see if gentler therapy would allow you to progress, but I have learned here not to fear an MUA. If you need it you need it and it is not because of anything you did or didn't do, it just is. Good luck with you appointment!

 

[Dhare63]

Hang in there CB. Don't do anything that causes you lots of pain and swelling, as that will inhibit your recovery. I was hesitant to stop the PT from pushing so hard and causing the swelling, but when I did, it helped a lot. They feel the need to produce results, which is fine, but no matter what you do in PT, it may not help. Its quite possible you may really NEED the MUA to gain extension. The OS will tell you for sure and truly, don't worry about it. It's not that bad and I believe can help a lot if scar tissue is your problem.

I know how bad the depression can be, it's hard to recover and you may feel isolated. You may want to discuss with your primary care Doc, perhaps an anti depressant is in order. Again, it best left to the pro's to advise you but you won't know unless you ask.

I hope you find some comfort in this community. You should post more often, it would probably help you, it has me.


Take care,

Dawn

 

[Crybaby]

Thank you all for your replies and support. I will tell the therapist for sure that I am very tired and sore after a session. My husband and daughter are coming with me to see the OS, which is helpful, because I have a hard time talking to him. I will also ask him if he thinks I am trying to do too much. It is hard to know how much to do-- some advise using weights which is even more than I have tried, others recommend rest.

I appreciate the positive feedback on the MUA-- both my OS and land therapist have presented it as a threat more than a help.

CB
LTKA 9/19/2011

 

[Pumpkin]

Some gentle ROM will help. Glad you are going to let the therapist know to slow down. I find better ROM with gentle and less intense activity spread out over the day.
Family support at OS will be very helpful, glad they are going with you.

 

[Dhare63]

CB, I remember all too well when the OS said "if you haven't improved by our next visit, then I will do the MUA". I became a woman possessed, and got PT in the same mindset as me. I endured painful PT for 4 weeks with nothing to show for it except an empty bank account!! I took it as a threat, but it really wasn't, it was a solution, and truth be told, it was my fault for taking it the wrong way. It set the tone at PT and wasted time. So, take your team to the appointment and make sure you don't leave before all questions are answered. This is your knee and life, make sure everyone who is participating in your recovery knows that. And don't freak out if the OS wants to do anMUA right away. When mine said he wanted to do it the following week I was shocked, but it's best to do things right away if the current course hadn't produced results. Keep your chin up and take charge, we will be that voice in the back of your head cheering you on!

Best, Dawn