MUA Oct 2017 TKR - Hematoma - MUA - Finally past 90!<
- Thread starter funkymuse
- Start date
KarriB
Former BoneSmart staff member
- Joined
- Apr 20, 2015
- Messages
- 11,941
- Age
- 70
- Location
- Pittsburgh, PA
- Gender
- Female
- Country
United States
If my knee didn’t get “stuck” after not bending for a month I can’t imagine it happening to many other TKRs. There really isn’t anything you can do to hurry the healing process, it takes time for the soft tissue to settle and get the swelling down. Aggressive PT just makes the swelling worse, so easy stretches, walking a bit around the house with lots of ice/elevation/rest gets the best results.
OP
OP
funkymuse
senior
- Joined
- Oct 22, 2017
- Messages
- 464
- Age
- 67
- Gender
- Female
- Country
- United States
To everyone who replied to my frustrating 6 week post op appointment post with my surgeon 'THANK YOU.' It really upset me and last night I was waking up in fear in thinking of having to face him again! But the scheduling person that booked the '3- week' re-visit with him actually booked it for Jan 3rd so I figured that was God working in my life! It was supposed to be 3 weeks from Nov 29th but instead I get an extra week and a half before I have to see him again! So in reading several threads on here today, I decided to NOT do the exercise where my husband pushes back my knee and to just do was I was doing but to up my recumberant cycle riding. So 2 times a day for 2 min each time and tonight I did 3-1/2 min. I don't know how much to increase daily so I guess I'll figure that out. I did some heel slides also and some stretching and some bends on a stair and that was about it. I cooked breakfast, took a shower and for the first time a bath (what I do is wash off in the shower, and then run a tub so that I'm clean when I soak), and it was wonderful. My knee felt lovely in the water and I think I got some more bend out of it when it was warm. I also iced alot and elevated. I walked around the house and I also put some split pea soup in the crock pot and cooked some chicken. So I did alot of ADL stuff. I'm going to try to fully embrace the Bone Smart way of recovery. I mean what have I got to loose but frustration, pain, stiffness and fear of ROM! If in another 6 weeks, my knee is still not making progress I can always consider an MUA then or maybe NOT. We will see! I am tired of living in fear and making myself nuts. BUT having a young surgeon who is obviously NOT into gentle recovery makes life 'interesting.' A challenge I certainly DID NOT want. I do have a PT appt next wed and we will see how that goes. If it goes bad, I'll have to have a talk with them and if they don't want to play ball, I will have to refrain from going which won't make my doctor happy.. so we will see. One step at a time here. Thanks again everyone.
SusieShoes
Former BoneSmart staff member
Relax and enjoy the holiday! :reindeerlights: You’re going to enjoy having a relaxed, sane recovery just going about your daily activities and very few exercises. It takes a load off your mind and gives your body a break. Really, it does! People who are stressed don’t just stress their minds and emotions, their bodies also get stressed and stress impedes healing. So kick back, relax, and heal better.
I totally embraced the BoneSmart way because like many others, I never did enjoy going to gyms or “working out.” A good walk or swim works best for me, but that wasn’t going to happen right away. There’s a temptation with set exercises —like so many squats, then so many lunges, then so many leg presses— to think “hey, because I can do these now, I can do lots of them!” Just because a body can do something doesn’t mean it should be doing them.
Anyway, I blew off the set exercises (just bent my knees when they wanted to bend and stretched when they wanted to stretch) and only started pushing myself when I could actually walk well enough to take walks. Everything else was just living: bathroom breaks, fixing meals, a bit of very light housework.
I’m sorry your surgeon is being unrealistic. Yes, some people get great ROM (120 is great flexion at two months, and I do mean great) early, but most people take longer to get there. My OS was another one who just eyeballed my knees, was happy with the result, and told me to go on, walk a lot, and have a good life. The whole point of having knee implants was to restore function. Think of it this way: What good would there be to knees that can achieve 120 flexion, but are always in pain because they’re inflamed from aggressive exercise? Most people would rather have knees that don’t hurt. And good flexion. That good flexion will come as the knees hurt less and you move more.
Hope you have a restful, joyful holiday! :treestar:
I totally embraced the BoneSmart way because like many others, I never did enjoy going to gyms or “working out.” A good walk or swim works best for me, but that wasn’t going to happen right away. There’s a temptation with set exercises —like so many squats, then so many lunges, then so many leg presses— to think “hey, because I can do these now, I can do lots of them!” Just because a body can do something doesn’t mean it should be doing them.
Anyway, I blew off the set exercises (just bent my knees when they wanted to bend and stretched when they wanted to stretch) and only started pushing myself when I could actually walk well enough to take walks. Everything else was just living: bathroom breaks, fixing meals, a bit of very light housework.
I’m sorry your surgeon is being unrealistic. Yes, some people get great ROM (120 is great flexion at two months, and I do mean great) early, but most people take longer to get there. My OS was another one who just eyeballed my knees, was happy with the result, and told me to go on, walk a lot, and have a good life. The whole point of having knee implants was to restore function. Think of it this way: What good would there be to knees that can achieve 120 flexion, but are always in pain because they’re inflamed from aggressive exercise? Most people would rather have knees that don’t hurt. And good flexion. That good flexion will come as the knees hurt less and you move more.
Hope you have a restful, joyful holiday! :treestar:
I was barely at 90 at six weeks (the PT's magic number) because I still had quite a bit of swelling. I kept working on icing, elevating and limited activity/exercises and over the next few weeks I increased about 15 degrees. No cranking on the leg or intense exercises. What had changed? The swelling decreased.
Polkadot
graduate
So glad you have shaken off that nasty 6-week appointment. Waiting to decide on things like an MUA is a good decision, too, I think, because you want to give the BoneSmart way a chance. The best news is that you are taking charge.
OP
OP
funkymuse
senior
- Joined
- Oct 22, 2017
- Messages
- 464
- Age
- 67
- Gender
- Female
- Country
- United States
Tomorrow I will check in for my 7 week update after my PT appointment but wanted to drop in and ask a question.
As far as flexion numbers go, does it go from higher to lower to higher to lower depending on whether I have just iced or been on my feet too much, etc.? It seems as after I ice or have been on my feet for awhile or when I just wake up, or when I have rested for awhile with my leg up, there's not much flexion.
And for those of you with great flexion, when you talk of swelling and stiffness continuing in your knee for up to a year, is your flexion affected by this? I get confused because so many come out of the surgery shoot with such good flexion but they still say they are dealing with swelling and stiffness. But we are told here that the swelling and stiffness have to go down before we an achieve decent flexion. So I'm wondering how folks got that flexion with all the stiffness and swelling in the early days.
Thanks for input on this!
As far as flexion numbers go, does it go from higher to lower to higher to lower depending on whether I have just iced or been on my feet too much, etc.? It seems as after I ice or have been on my feet for awhile or when I just wake up, or when I have rested for awhile with my leg up, there's not much flexion.
And for those of you with great flexion, when you talk of swelling and stiffness continuing in your knee for up to a year, is your flexion affected by this? I get confused because so many come out of the surgery shoot with such good flexion but they still say they are dealing with swelling and stiffness. But we are told here that the swelling and stiffness have to go down before we an achieve decent flexion. So I'm wondering how folks got that flexion with all the stiffness and swelling in the early days.
Thanks for input on this!
I don’t know how to explain how some people have good flex early while still having swelling. I guess the more swelling you have, the less flex. And there really isn’t any standard measure, so one person’s “a lot” could be less for someone else.
I do know in my case, I had a major flex set back at 4 months. We visited friends for a weekend and I struggled the whole time with their low toilet and very little to help me get up off it. By the time I got home my flex was shot. I didn’t see much outer swelling but I could hardly bend my knee. I’m sure I strained my quads also with the effort of getting up.
It took a whole month before I started to bend better and then my son got married when I was 5 months post op. The wedding and all its extra activities over the course of 3 days was 90 minutes away. So in the car a lot back and forth. There was a lot of standing involved and little time to elevate my leg, even as high as just an ottoman. This set me way back also, since I had barely recovered from my weekend visit the month before.
My flex took a long time to come back, and even now at almost 9 months post op, I can hardly bring my foot up behind me, whereas before that weekend visit I was doing a gentle stretch that way just fine.
Well I’ve written a novel here and I’m not sure I’ve addressed your question.
I guess my point is, you don’t have to have visible swelling for your knee to be affected by it.
I would never have thought I’d have such a long set back when I left home that day to go visit my friends.
I now have a portable raised toilet seat to take with me as I don’t ever want to go through that again!
I do know in my case, I had a major flex set back at 4 months. We visited friends for a weekend and I struggled the whole time with their low toilet and very little to help me get up off it. By the time I got home my flex was shot. I didn’t see much outer swelling but I could hardly bend my knee. I’m sure I strained my quads also with the effort of getting up.
It took a whole month before I started to bend better and then my son got married when I was 5 months post op. The wedding and all its extra activities over the course of 3 days was 90 minutes away. So in the car a lot back and forth. There was a lot of standing involved and little time to elevate my leg, even as high as just an ottoman. This set me way back also, since I had barely recovered from my weekend visit the month before.
My flex took a long time to come back, and even now at almost 9 months post op, I can hardly bring my foot up behind me, whereas before that weekend visit I was doing a gentle stretch that way just fine.
Well I’ve written a novel here and I’m not sure I’ve addressed your question.
I guess my point is, you don’t have to have visible swelling for your knee to be affected by it.
I would never have thought I’d have such a long set back when I left home that day to go visit my friends.
I now have a portable raised toilet seat to take with me as I don’t ever want to go through that again!
I should add that even though I still can’t bring my foot up behind me, I am bending the knee much better. At my 7 month check, while sitting in a chair, bending my knee on my own comfortably, was 114. I was thrilled it was that high at that point after my lengthy set back.
SusieShoes
Former BoneSmart staff member
Your flexion (and the number) will vary according to all kinds of things: who is measuring, how they are measuring (placement matters), the time of day, whether your knee is hot or cold (warmed up soft tissues are a little more bendy than cold tissues), the weather (my knees tended to swell a little more when things got rainy, don’t know why), and whether the knee is more swollen for any other reason. If I had exercised a lot the day before, and my knee was angry and inflamed, it bent less.
My flexion immediate after surgery (I tested in the recovery room) was much better than it was a day later when I could hardly bend it at all. My knees continued to swell in the interim. But I had good flexion early on. Still, I noticed some pretty wide fluctuations in my flexion numbers.
Just in rehab, the first week after surgery, my flexion might be 95 one day, and 110 the next, then back to 98. It was all over the place. It was best with the gentle therapists. One therapist, who pushed me to use lots of straps and pull on my knee for more flexion led to lots of swelling that night... and lower flexion numbers the next day. No surprise there. I learned not to worry about my flexion numbers. It was all about the swelling.
Swelling gets in the way of bend. That’s just physics. If something, inflamed tissue and the fluid it produces in this case, is in the way, the joint can’t bend. Stiffness is a feeling. It can be caused by swelling. It can also be caused by fluid collecting around the joint because of how the joint is positioned. Like when sitting with the knee bent, and the fluid can’t move as freely. So when I stand, that fluid pushes on my tissues and everything feels stiff until I move around and the fluid gets a chance to leave the joint. That’s why sitting for long periods in early recovery is so painful.
For the first five months of my recovery, I was always stiff in the morning upon getting up. I no longer have morning stiffness, though. Similarly, for those first months my knees were stiff whenever they didn’t move for a while. That’s why I would sometimes just bend them while in the recliner or up on my Lounge Doctor, just to work out the stiffness. Being immobile meant fluid collected in the joint.
I don’t have much swelling anymore. But I can still get a bit of stiffness when fluid collects in the joint for any number of reasons. The weather still can contribute. Sitting for long periods, like during my recent six hour drive to Cleveland, means stiff knees on exiting the car or getting up from a table. The stiffness resolves quickly, within a few steps, but it does occur.
All of which is to say one can have really good flexion, and fairly well-healed knees, and still have stiffness on occasion. Swelling from angry tissues is what hampers flexion.
My flexion immediate after surgery (I tested in the recovery room) was much better than it was a day later when I could hardly bend it at all. My knees continued to swell in the interim. But I had good flexion early on. Still, I noticed some pretty wide fluctuations in my flexion numbers.
Just in rehab, the first week after surgery, my flexion might be 95 one day, and 110 the next, then back to 98. It was all over the place. It was best with the gentle therapists. One therapist, who pushed me to use lots of straps and pull on my knee for more flexion led to lots of swelling that night... and lower flexion numbers the next day. No surprise there. I learned not to worry about my flexion numbers. It was all about the swelling.
Swelling gets in the way of bend. That’s just physics. If something, inflamed tissue and the fluid it produces in this case, is in the way, the joint can’t bend. Stiffness is a feeling. It can be caused by swelling. It can also be caused by fluid collecting around the joint because of how the joint is positioned. Like when sitting with the knee bent, and the fluid can’t move as freely. So when I stand, that fluid pushes on my tissues and everything feels stiff until I move around and the fluid gets a chance to leave the joint. That’s why sitting for long periods in early recovery is so painful.
For the first five months of my recovery, I was always stiff in the morning upon getting up. I no longer have morning stiffness, though. Similarly, for those first months my knees were stiff whenever they didn’t move for a while. That’s why I would sometimes just bend them while in the recliner or up on my Lounge Doctor, just to work out the stiffness. Being immobile meant fluid collected in the joint.
I don’t have much swelling anymore. But I can still get a bit of stiffness when fluid collects in the joint for any number of reasons. The weather still can contribute. Sitting for long periods, like during my recent six hour drive to Cleveland, means stiff knees on exiting the car or getting up from a table. The stiffness resolves quickly, within a few steps, but it does occur.
All of which is to say one can have really good flexion, and fairly well-healed knees, and still have stiffness on occasion. Swelling from angry tissues is what hampers flexion.
jakeleg
member
Oh, thank you all. I can't tell you what a gift the replies are. Jus t goes to show how the mind messes with me. As one of my friends said, " I say my prayers and go to sleep. when I wake up those other people that live in my head are waiting for me". That's why I have to get to Bonesmart with my morning coffee.
Hi funkymuse. How are you doing? Hope you got through your first couple of days at work OK. I didn't find it too bad although I did have to elevate for a while. I borrowed a dining chair from the communal lounge which worked quite well. I pulled it up to my computer chair and put the keyboard on my lap. It's amazing how we can adapt.
OP
OP
funkymuse
senior
- Joined
- Oct 22, 2017
- Messages
- 464
- Age
- 67
- Gender
- Female
- Country
- United States
Hello everyone.. thank you all for the great replies... basically I feel it comes down to the healing that continues to take place and how gentle or aggressive we get and the overall mystery of no matter what we do, the knee is going to do what it does based on it's healing progress and for everyone that is a different road with similar struggles. So as I've read many times here on the forum, we can't compare ourselves to one another but at the same time we can fully relate, support and commiserate with one another which is so helpful.
Today I woke up and besides the stiffness my knee is hurting a bit which is unusual. BUT for the first time I was able to sleep on my sides for longer and it didn't bother me.. so maybe there was some deep internal swelling from not being elevated most of the night. Yet again, another 'knee mystery!' I'm finding they are all impossible to figure out!
I have my 3rd PT today (I've managed to cancel several!), and I'm going to just check it out, see if I can talk the guy into a gentle session, and to see what I stand as far as my ROM numbers. I'm going to start a progression list as follows for flexion only since my extension is fine:
10/17 - LTKR
10/19 - 2 days surgery post op - Unknown
10/31 - Hematoma Removal Surgery & MUA - Unknown
11/8 - 1st PT evaluation - 45
11/14 - 1st actual PT session - 60
11/29 - OS 6 week post op - 60
Moderators could you change the title of my thread to:
Christina's Slow Bender Journey
Thank you and everyone - appreciating you all more than you know!!
Today I woke up and besides the stiffness my knee is hurting a bit which is unusual. BUT for the first time I was able to sleep on my sides for longer and it didn't bother me.. so maybe there was some deep internal swelling from not being elevated most of the night. Yet again, another 'knee mystery!' I'm finding they are all impossible to figure out!
I have my 3rd PT today (I've managed to cancel several!), and I'm going to just check it out, see if I can talk the guy into a gentle session, and to see what I stand as far as my ROM numbers. I'm going to start a progression list as follows for flexion only since my extension is fine:
10/17 - LTKR
10/19 - 2 days surgery post op - Unknown
10/31 - Hematoma Removal Surgery & MUA - Unknown
11/8 - 1st PT evaluation - 45
11/14 - 1st actual PT session - 60
11/29 - OS 6 week post op - 60
Moderators could you change the title of my thread to:
Christina's Slow Bender Journey
Thank you and everyone - appreciating you all more than you know!!
Christina, I have changed your thread title to "Christina's Slow and Steady Progress".
I don't like that you consider yourself a slow bender - I wish that the person who started using that phrase hadn't done it. It's a rather negative description and you are not a slower bender at all. You're just expecting too much, too soon, of your knee.
You had a little setback with the haematoma, but considering you had an MUA very early, you are making good progress. Having an MUA usually sets the recovery clock back to zero, so you're only about 5 weeks into recovery.
Stop comparing your knee to other people's knees. No one else's knee has been through the same things as yours has. It's on its own recovery journey and it knows what it's doing. Did you ever read this article?
Where are you in recovery?? (TKR)
Please stop worrying about ROM. You have all the time in the world to get an acceptable result. There's no need to rush. Stop looking for things that will speed up your progress - just allow your knee to heal. The poor thing has been cut open,sawed and hammered, had two huge foreign bodies inserted, developed a haematoma, and been subjected to an MUA. It's wounded and it needs a lot of TLC, so it can heal. It won't be ready to dance the can-can for a long time yet!
@Celle Thank you reminding me that we are not slow bending, and that each recovery has it’s own journey due to what it has experienced.
I have considered myself slow but that is because, even after all these months of reading Bonesmart, I am still comparing myself to others. It is so hard to put aside the things people off Bonesmart tell us.
Thanks again for this forum!
I have considered myself slow but that is because, even after all these months of reading Bonesmart, I am still comparing myself to others. It is so hard to put aside the things people off Bonesmart tell us.
Thanks again for this forum!
OP
OP
funkymuse
senior
- Joined
- Oct 22, 2017
- Messages
- 464
- Age
- 67
- Gender
- Female
- Country
- United States
@Celle - YES!! I like the new title! I wasn't trying to be negative at all.. just accepting the fact that I'm in with the other people who have titled themselves that - I just picked up on it and went with it. But I'm very happy to take on the more positive Slow and Steady!! All the points you make in your post feel right on to me!
Here's my new update:
10/17 - LTKR
10/19 - 2 days surgery post op - Unknown
10/31 - Hematoma Removal Surgery & MUA - Unknown
11/8 - 1st PT evaluation - 45
11/14 - 1st actual PT session - 60
11/29 - OS 6 week post op - 60
12/06 - 2nd PT session - 67
So at todays session I measured 67 on my own! I did push myself to get back as far as I could through the tightness but that's where I could go with no push from the PT. So I'd really like to know if that is good progress for a week? Shoot.. I feel it's better than being stuck at 60!
I did no exercises on my own this morning except when I took a warm bath I did a few bends on the bathtub wall and then iced after my bath. I also iced my knee during the drive and while I waited in the waiting room. Then the PT warmed me up on the bike with some half turns at which point that stabbing knife pain that is in my scar started in - (I'm thinking maybe i've torn or irritated the scar healing inside the scar line somehow???) Then we went to the table and he did some ultrasound therapy - (I think that's what it was - where he puts lotion of some sort on my knee and rubs it around with a wand like tool?). He also did some massage on my kneecap which he says is very tight near the scar line, (which I would expect since that's where they had cut it open again to remove the Hematoma). From there he massaged he back of my knee and the front part below the kneecap area that he says is tight. Then we did some gentle bends and then we measured ROM.
I liked the session but walking out my leg felt like a stiff log. I immediately put ice on it in the car and we drove to the post office where I had to do a bit of business.
Between the trip to the PT and the Post Office thing, my leg has been in STIFF LOG mode since I got home. I've iced three times and now I'm sitting in the living room, leg up taking in some sun (it's not been sunny here for 2 weeks!).
I did talk with him and tell him that obviously I'm going to be slower time wise than many of his other patients at achieving ROM because of what I had been through with the 2nd surgery and all AND because when we first started the session he started in on the dreaded MUA talk. So I told him I was well aware of all that and how I was a member of this forum and that there are many people that achieve ROM slower than others. Then he mentioned that it seemed that his younger patients, guys in their 40's and younger women take longer to achieve ROM. He said the younger guys can be the biggest babies! So that was interesting!
So overall I feel like I like the support but it comes with a price because all that travel and walking and doing all the PT work in a short span of 45 min is too much for my knee. Working on my own, I spread all that throughout the day and so I don't usually get STIFF LOG leg from my gentle exercises.
I'll try it again next week and see if I'm any better.
Thanks for any feedback and support.
Here's my new update:
10/17 - LTKR
10/19 - 2 days surgery post op - Unknown
10/31 - Hematoma Removal Surgery & MUA - Unknown
11/8 - 1st PT evaluation - 45
11/14 - 1st actual PT session - 60
11/29 - OS 6 week post op - 60
12/06 - 2nd PT session - 67
So at todays session I measured 67 on my own! I did push myself to get back as far as I could through the tightness but that's where I could go with no push from the PT. So I'd really like to know if that is good progress for a week? Shoot.. I feel it's better than being stuck at 60!
I did no exercises on my own this morning except when I took a warm bath I did a few bends on the bathtub wall and then iced after my bath. I also iced my knee during the drive and while I waited in the waiting room. Then the PT warmed me up on the bike with some half turns at which point that stabbing knife pain that is in my scar started in - (I'm thinking maybe i've torn or irritated the scar healing inside the scar line somehow???) Then we went to the table and he did some ultrasound therapy - (I think that's what it was - where he puts lotion of some sort on my knee and rubs it around with a wand like tool?). He also did some massage on my kneecap which he says is very tight near the scar line, (which I would expect since that's where they had cut it open again to remove the Hematoma). From there he massaged he back of my knee and the front part below the kneecap area that he says is tight. Then we did some gentle bends and then we measured ROM.
I liked the session but walking out my leg felt like a stiff log. I immediately put ice on it in the car and we drove to the post office where I had to do a bit of business.
Between the trip to the PT and the Post Office thing, my leg has been in STIFF LOG mode since I got home. I've iced three times and now I'm sitting in the living room, leg up taking in some sun (it's not been sunny here for 2 weeks!).
I did talk with him and tell him that obviously I'm going to be slower time wise than many of his other patients at achieving ROM because of what I had been through with the 2nd surgery and all AND because when we first started the session he started in on the dreaded MUA talk. So I told him I was well aware of all that and how I was a member of this forum and that there are many people that achieve ROM slower than others. Then he mentioned that it seemed that his younger patients, guys in their 40's and younger women take longer to achieve ROM. He said the younger guys can be the biggest babies! So that was interesting!
So overall I feel like I like the support but it comes with a price because all that travel and walking and doing all the PT work in a short span of 45 min is too much for my knee. Working on my own, I spread all that throughout the day and so I don't usually get STIFF LOG leg from my gentle exercises.
I'll try it again next week and see if I'm any better.
Thanks for any feedback and support.
I agree--going to the post office and so on right after PT was too much.
I'm not sure what the PT was doing to your knee but perhaps that was too much as well.
I'm not sure what the PT was doing to your knee but perhaps that was too much as well.
Last edited:
SusieShoes
Former BoneSmart staff member
Space out your errands and PT. If you do PT, don’t do errands that day or anything much by way of housecleaning. Run your errands one a day (or bundle them so you don’t overdo). You are still in EARLY recovery and should spend most of your time elevating and icing and getting good healing rest.
And I think your one week gain is wonderful. :santaclap: Just keep in mind it might go down next time. Or maybe it will go up again. Don’t fixate on a number, because they can be all over the place. Look for a general trend of improvement.
And I think your one week gain is wonderful. :santaclap: Just keep in mind it might go down next time. Or maybe it will go up again. Don’t fixate on a number, because they can be all over the place. Look for a general trend of improvement.
OP
OP
funkymuse
senior
- Joined
- Oct 22, 2017
- Messages
- 464
- Age
- 67
- Gender
- Female
- Country
- United States
@SusieShoes did I remember you posting somewhere that you said your Mother recovered by only doing the bike and walking? Did she not do any other PT? Just curious because I love the bike and walking but the heel slides drive me batty and somehow I feel like they cause me swelling... of course truly I think everything I do at this stage causes that!
