TKR MUA

[glidefloss]

@Jockette the post op blues, I am all of that right now. Thank You for the info. Its a mental game as well as physical. Some days I manage to keep it all in perspective, but other days I just want a big pity party

Hi @LadyN , as others have mentioned, we all go through the post-op blues. It can hit at regular times (for me getting out of bed was my least favorite time of day) and it can hit at unexpected times. Things I've found useful include - reading forum postings, watching replacement type YouTube clips, keeping a daily log. The daily log is very helpful (the more detailed the better, I'd think) as it allows you to look back a day, a week, a month ago to see how you were then compared to how you are now.

Another thing I found helpful was setting lots of "low bar" daily goals - no matter how small and trivial and inconsequential - which allowed me frequent "declarations of victory" throughout the day.

Hang in there ... things'll get better!

 

[glidefloss]

I wish I could see even an improvement when I use my bike ….but don’t think I’m any better than I was two weeks ago on it, and all I can do is go backwards and forwards with the pedals.

Hi @LadyN , it took me many weeks of forward-back rocking of the bike pedals before I was finally able to do 1 full revolution. It might seem like you're not making any progress ... but ... if you keep at it, before long, you'll manage that first full revolution. Keep on rocking!

Hang in there ... things'll get better!

 

[Carol Anna]

I was about 12 weeks before I managed a complete revolution. I am now into my 6th month and can do 15 minutes on the static bike at varying resistance levels but none too hard. I went for a walk this morning for about a mile and will go to gym this afternoon for an hour to do gentle excercises. Not totally recovered but I am getting there and have to keep reminding myself that slow and steady wins the race.

 

[benne68]

Hi @LadyN !

Just checking to see how you are, since it's been a couple of weeks since your last update. Let's us know how you are doing!

 

[Gorhop]

Hi and Welcome!

The thing about this recovery is, for many of us, the more we push early on, the more it sets us back. You cannot bend a swollen, painful knee, and overworking it to improve ROM, just causes more pain and swelling.

Since all your efforts thus far have not worked, consider trying a different tactic. Stop all the exercises, and just very gently bend your knee, no discomfort at all, just give it movement. Go about your daily activities and let those movements be your exercises, and forget about your ROM. Sounds crazy, right? But, for some of us it works just fine. Here’s an example:

This is what one of our members, TortiTabby, experienced:

(Just so you know, ADL means Activities of Daily Living.)

“At my six week appointment this is what my OS wrote in my visit summary: "She reads an online website called Bone Smart which states to not push through pain following knee replacement. If she were to follow this direction, she will have to learn to live with a knee that only reaches to 85 degrees of flexion. I believe this website is very misleading."
It has now been 20 weeks and all I do is ADL and this is what my ROM has done:
3.5 wks: 75
6 wks: 85
7 wks: 90
10.5 wks: 95
14 wks: 100
17 wks: 105
20 weeks (where I am today): 110
I am so thrilled it keeps improving and improving and I know now that I will get to my goal of 120 (or even better, dare I say!)
So, if a OS or PT bullies you into thinking your ROM will not improve over time they are wrong. By the way, I haven't been back to see the OS since that horrible appointment at 6 weeks, but I sure am going back when I reach 120 just to say, "Ha! You were wrong, BoneSmart was right!" “

And,

“Just an update for those who are apprehensive about gaining ROM:
It has now been 26 weeks and all I do is ADL and this is what my ROM has done:
3.5 wks: 75
6 wks: 85
7 wks: 90
10.5 wks: 95
14 wks: 100
17 wks: 105
20 weeks: 110
26 weeks (where I am today): 120!!!
I did it! My goal of 120! No "pushing through pain", no PT after the first 3 visits, and most importantly to me: No MUA! My surgeon who said I would never get beyond 85 ROM without pushing through pain was wrong, wrong, wrong. I'm excited to see if it gets even better. “

Regaining our ROM is more about Time than repetitions of a list of exercises.

Time to recover.
Time for pain and swelling to settle.
Time to heal.

Our range of motion is right there all
along just waiting for that to happen so it can show itself.

In the general run of things, it doesn't need to be fought for, worked hard for or worried about. It will happen. Normal activity is the key to success.

My new inspiration!

 

[LadyN]

I haven’t posted on here in awhile, I had a LTKR on Feb 10th 2022. At 6 weeks my ROM was 60, I am now at 13 weeks and still at 60 degree bend. I am still doing exercises. I have an MUA scheduled for May 24th. I am beyond frustrated. At no point after having my surgery did I foresee a situation where my mobility would actually be worse. I recovered well from the surgery, my knee feels fine, but I just cannot bend it. So life is difficult, so many things I can’t do. I need and want to return to work. I had a 16 month wait for surgery, and haven’t been able to just go for a walk in over 2 years. It’s pretty hard to keep a positive mindset that’s for sure. I‘m worried the MUA won’t work and I’ll be stuck like this. Obviously at this point I’ll take ANY again I can get. I’ve had 2 prior surgeries on the same knee and this surgeon says I have a lot of scar tissue. Wish me luck!

 

[Jcx]

The very best of luck with your MUA.
Take care jcx

 

[Jockette]

I’ve had 2 prior surgeries on the same knee and this surgeon says I have a lot of scar tissue.

I hope the MUA gives you a good improvement.

Can you tell us what those surgeries were, and their dates? We’ll add them to your signature, as that will be helpful knowledge.

By the way, I merged your newest thread with your original recovery thread, as we prefer that members in recovery have only one thread.

This benefits you because all your information is in one place, easy to find, and maintains a nice journal for you.

This also benefits our staff, as your information is all in one place, and we often go back through your thread for previous details, so we know what you‘ve been through which helps us advise you better.

So, please keep all your posts in this thread. If you’d like a new title, let us know what you want, and we’ll change it for you.

Many members bookmark their thread in their computer browser, so they can find it when they log on.
How can I find my threads and posts?

Best wishes on your continuing recovery!

 

[LadyN]

Thank You! I had surgery 2008 and 2012 on the same knee for meniscus tears. I also fell two months before my TLKR and my Leg went sideways underneath me and my knee was very swollen.

 

[Jockette]

I also fell two months before my TLKR and my Leg went sideways underneath me and my knee was very swollen.

Well your poor knee has been through the mill! Recovery might take you a bit longer.

It seems that often after an MUA, a rather aggressive PT program is recommended. Please remember that the MUA is going to disrupt your healing a bit, and will require recovery from the actual MUA. I suggest you not let them be too aggressive with you. We have found that more exercises and forcing your knee to bend, right after an MUA will not help your knee recover, time and gentle treatment will be more beneficial. Be careful with your PT going forward. Remember what is said in the Recovery Guidelines:

3. Do what you want to do BUT
a. If it hurts, don't do it and don't allow anyone - especially a physical therapist - to do it to you
b. If your leg swells more or gets stiffer in the 24 hours after doing it, don't do it again.

 

[Jamie]

Try not to worry about your knee. It's good that your recovery in general was uneventful. Your knee has been through a lot and sometimes this can contribute to the development of scar tissue. MUA's can be very helpful in these cases. It will be important to keep inflammation and swelling down after the MUA, which is why Jockette mentioned the potential for problems if your post-MUA therapy is aggressive. Inflammation can heat up soft tissue and cause it to be drier than normal. Tissue surfaces that should be slick and glide across each other easily can tend to stick together and this is what causes the adhesions that are most likely holding your knee back. Gentle movement to the point of mild discomfort (and no more) is all that's needed in the first weeks after your procedure while the tissue heals. All the best to you! Let us know how you're doing.

 

[LadyN]

I just saw my family Dr and we discussed my upcoming MUA, he told me he would dry needle my knee today…..so he takes a needle and jabs it up and down the full length of the scar and it Instantly felt looser!!!! I still need the MUA but I can feel a difference! anyone else had that?

 

[benne68]

Hi @LadyN

Checking in: Did you have the MUA on the 24th? Let us know how you are doing!

 

[loyal1967]

I didn’t want to dissuade you from an MUA. Probably in some instances it is needed. I really think surgeons go ballistic when patients don’t make the kind of progress they want. I did exercise constantly for a month, but a lot were stretches to loosen my hamstrings which were really tight. I also was put on steroids to take down the swelling. I’m not a big fan of steroids,but I guess it helped, Swelling inhibited me. This time I had a different surgeon. He has me on Celebrex for 3 months. Just hang in there. It will get better.

 

[LadyN]

I had my MUA on the 24th, there’s a big difference in my ROM. I was in physio the following 3 days and back Monday. My ROM going in to the MUA was very, very poor at 15 weeks I was measuring 60-65 degrees. I don’t know what the surgeon got me too because by the time I woke up from anaesthetic he was gone. I see the surgeon in 2 weeks so will ask him then. My knee now obviously is swollen and tender from the MUA, but 3 days after MUA my ROM was 97….and I’m sure will keep on improving, especially once the swelling has settled down. So I know a lot of people will still consider my ROM poor….but for me going from 60-65 to 97 I’ll take it and keep working with what I’ve got, it’s quite the journey one way or another.

 

[benne68]

I’m sure will keep on improving, especially once the swelling has settled down.

Yes it will! Treat your MUA as though you are starting over from the TKR by icing and elevating and babying that knee until the inflammation comes down.

a lot of people will still consider my ROM poor…

Please don't worry about what other people think. The only thing that matters is that YOU feel real improvement. And, you are right going from 60 to 97 is a huge improvement. It will get better with time.

 

[maryo52]

I had honest to goodness arthrofibrosis with my first surgery, and the harder I tried to get ROM it seemed the worse they became. I did MUA -- it's a cinch. But for me the scar tissue reestablished itself rapidly. Oddly, my 2nd surgery and 3rd had no issues with scar tissue. Different surgeon for those.