MUA for me...I'm discouraged...and a strange pain

[beth1954]

I guess this physical therapist is the same one that told you that the pain you were feeling (pre-MUA) must be in your head because metal and plastic cannot feel any pain? For me there is a fine line between doing too much PT and not doing enough and honestly I have not found the magic place on that fine line! It's so frustrating too, isn't it? I have tried to let it rest and just do gentle stretches, but then it stiffens up. Then I go to PT determined that I am going to really do something........which also makes it swollen and stiff. Icing and elevating doesn't usually do that much for me. I do it because I know it's the right thing to do. With my first knee I would see and feel results when I iced.
I'm sorry that you feel like you have had a setback. That's never a good feeling. I hope great improvement s come for you real soon!!

 

[jerseygirl-in-ca]

I am finding maybe because of my long legs that the pad in the middle of machine when setting flexon at setting above 75 pushes into the back of my leg and causes bruising and swelling. When the pt was here I showed him and he agreed it was doing that Has anyone else had that issue. It ends up seeming like the back of your knee hurts.

 

[maryo52]

I have long legs but didn't have that problem. I guess it depends on the make. Can it be padded further? Or other adjustments made? Mine didn't have a pad that came up behind the knee. Because of my long legs, I had to adjust the foot piece out further.

 

[skigirl]

I hated the CPM---it hurt my back and the thing would "walk off" the end of the bed--with me attached!!! It hurt everything, my back, my leg, my calf. It was a relief to call and have it picked up!! Then I just moved my leg on its own.

 

[maryo52]

Research has shown that CPM does not impact ultimate ROM in primary TKR. However, I personally believe that it has a role in other situations, and post MUA is one of them. I believed this so strongly that I actually bought (off craigslist) a CPM because I could not get hold of one otherwise.

This is my untrained but logical thinking about this topic: When you already have a process going on in your knee involving abnormal (fibrotic) tissue generation, which is a fact established by research (fibrotic tissue by its nature attaches to adjacent structures, in effect tethering muscles, ligaments and bones together), the movement of CPM can help defeat that process. Had I spent those hours I used the CPM moving my leg on my own, the inflammation would've shot right over the moon, and that inflammation is like fertilizer to arthrofibrosis.

Whatever you do, you should aggressively quell the inflammation and focus only on ROM. Another alternative to CPM is to do 2-3 very slow bends held 60 seconds or more, each hour over the day, followed by icing.

 

[jerseygirl-in-ca]

Great thoughts on MUA and fibrotic tissue for cpm . As I has the right leg done in July and a MUA I am trying to make sure it didn't happen again. Add to that YET again I had no Home pt on my MUA till day 8 in the afternoon is bad. In my case since on the new knee I can so clearly see cause and effect if I am even half way compliant on the CPM I am determined to find the reason. I am also fat but not my legs so much as I am pan pituitary and have adrenal insufficiency and growth and otter hormone deficiency so mostly central trunk fat. Research showed it was after 70 degrees the pad piece on the bottom of the second peace on the machine pulls and curls under. When I pulled the whole pad apart it is a series of pads. 5 to be exact without the foot. The back of my leg is hit with that curved edge in two places after 70 Degrees comes. Funny, as in me and I am guessing in others the pain doesn't actually seem the back at the knee joint, but all over the back of knee and shin. I guess it radiates. The pads are the cheapest standard pads to fit any machine. I am guessing that is typical in any company that rents cpm machines and I am sure they have several makes or at least models. I am going to make a modified pad for me. I am going to use 1/2 hour at a time until swelling and blood that pools at the bottom of leg ends.
Why do and how did you use after MUA?

 

[maryo52]

I didn't use CPM after MUA. I went back to PT, got pushed, and had what little ROM gains go backward. So I needed another intervention, arthroscopic removal of the scar tissue. After the MUA fiasco (the procedure was fine, it's the aftermath that was a fiasco), I took matters into my own hands. My opinion? No PT can make our knees bend. We undergo these MUAs and everyone's approach after that seems to be all about pushing the knee to get ahead of the scar tissue . . . but that's exactly how scar tissue gets stimulated in certain knees.

I had to figure out for myself what worked and what didn't. Pushing an unbending knee does NOT work. It only makes the scar tissue take hold. The CPM slowly bent my leg in a non-pushing way. I could relax and watch TV and have ice on it, all at once. I felt as if I was literally out-running and out-smarting scar tissue. It's hard to have faith that the ROM will come when it's so slow, but pushing never ever helps such a knee bend better.

There are loads of people with some kind of physical disability who have to improvise padding on their assistive equipment. Good for you for taking that matter into your own hands. Remember that you are the expert when it comes to your knee and your recovery.

 

[jerseygirl-in-ca]

@skigirl I know the machine traveling is not having the mesh under the machine and the foot part too short. The pain up the leg and back seems to be the pressure at the back of the knee. That is the pain I am talking about. Some people do not not seem to know anymore than they do not like it

 

[jerseygirl-in-ca]

@maryo52 so you didn't use the machine at all on the MUA knee? How soon did you start pt after MUA? One my way to DR will check when I get back

 

[skigirl]

I used the machine twice and then decided that I would rather walk around!!