MUA Oct 2017 TKR - Hematoma - MUA - Finally past 90!<

[funkymuse]

@Robinmhs88 - That's what I thought but where would I find one if I decided to get it? Where did you find yours? BTW.. how are the meds treating you? Did you have much pain?

 

[Robinmhs88]

I got mine from the hospital but if yours doesn’t have them medical supply stores do but see what your doc says. I know some people don’t use them. I actually am not in anymore pain than I was before the mua. My calf muscle has relaxed, my thigh muscle is tight but I have been using a heating pad while on the machine so it’s not bad. My knee hurts about the same. I just think the movement is better than not- idk I could be wrong but so far it’s working for me. I put ice on top of my knee to help with the swelling and just let the machine work, than after an hour I get up and go sit on my chair bending my legs which actually never was like it is now. So far so good

 

[funkymuse]

@Robinmhs88 - FANTASTIC!

 

[SusieShoes]

Sounds like you’re doing well. Keep up the excellent icing.

 

[kmak81230]

My doc wanted me to use the CPM machine for two weeks - the hospital PT said to use it 6-8 hrs a day and to increase the degrees of flexion 15 degrees per day - I started at 30 after surgery!!! Like @jaschembra there's no way I could have done that due to swelling. From what I've read on here and other sources and from talking to my own PT it does not provide any advantage in recovery. My doc said not to use it in place of getting up and walking around. Because of swelling I was not able to set it past 70-80 degrees and most of the time I was in the 50-70 degree range. It felt good if I was just laying on the couch with the ice machine but mine had some kind of design flaw and there was a bar underneath that was extremely uncomfortable at times. I could not get it adjusted correctly and was worried I was having it move my leg in some fashion that was destroying the implant or setting back my recovery. I also remember being really worried about not setting it to a high enough ROM but knowing what I know now it was wasted worry -- I'm good for that though (a compulsive worrier who wastes a lot of time and stress on worry). I was gleeful when I could turn it in after two weeks.

 

[funkymuse]

I found the article linked below to be a very informative article on an MUA. I'm going to run it by my doctor. I'm wondering about the cortisone shots the article mentions after to reduce swelling? Thoughts? Also my OS does not provide or recommend a CPM machine although he told me they could order me one! LOL I couldn't buy one! Way too expensive!
broken link removed: https://www.perthortho.com.au/resources/keith-holt/MUA-knee.pdf

 

[Robinmhs88]

I read that article right before my MUA- my Dr doesn’t do those nor will he give muscle relaxers. Maybe your doctor will. Swelling has been about where I was before so it hadn’t hindered me to much in PT

 

[funkymuse]

Hello All:

Reporting in. Had a PT today where I was hoping they would massage my tight quad muscles in preparation for the MUA happening in 10 days from now. But instead he talked and talked about what they wanted to do after the MUA and all about not using a CPM and then sat down at his computer to add more exercises to my regime showing me how to do them by me doing them which were some hip abduction raises, straight leg raises and some hip extension kicks. Then he talked about how I was doing my heel slides with a towel (which I'm not doing - I'm only doing some heel slides with my own strength), and the prone quad stretches with a strap that he wants me to push against and then relax into. The truth is I'm only bending on my own and allowing the strap to hold me in place. So he never got around to any massage that I really wanted and said that massage only would not help much.

So once again, I am wondering what it's all about. I have two PT's and they alternate with me and this particular one is nice but I feel like he is a waste of time as he does not seem to listen to me. He measured my flexion and at first it was 75 and then he measured again a few minutes later and said it was 70. I had to stop bending to that extra 5 degrees as I still have that SHARP pain - (like a knife sticking me), that is behind the actual scar that flares up if I push to far into bend. The area is right where they cut to do the Hematoma removal - so that area is slightly behind the rest of the scar in it's healing. But he ignores me when I talk about it and tell him I can't bend any further because of that and the tightness in my knee area.

I then told him I had not been down on the floor since the surgery and would like to get down on the floor to stretch since the floor is harder than the bed and I could really work on my extension better if I could get on the floor. So he told me to try it and I did and it was great! I got up rather easily so I was afraid of nothing! LOL My extension is about the same as my other leg. Neither leg goes flat on the floor but I'm not stuck in a bend of any sort so I'm not sure how important it is to go flat. He mentioned a 5 degree extension.. does that make sense? I can't get my whole hand under but about 3/4 of it. But he got all concerned that I wasn't flat and gave me a rubber strap to use to try and work it to zero. (I was thinking how dumb it all was).

What gets me about this guy is that he really doesn't seem to 'personalize' the PT to each patient. He seems to be a textbook guy. He did talk about looking at photos of bent knees in magazines or on an app you can get on your phone of knees in all kinds of bent positions doing different things and that it trains your mind to know that your knee can do those things. Anybody have any thoughts on this?

I did feel more bendy today and so I guess I'm around 70-75 from my last measurement of 60 at the OS office on 1/3. I have felt that my knee is getting stronger and twice now in the last month it's felt more bendy - but it still does gets quite irritated if I do too much which I know if par for the course in this healing journey.

Who can say if it would continue to move past where it is. I have 10 days before the MUA. Is it a long shot that it would get to 90 in this time? Not sure.. but if it did.. hummm.. I might have to rethink the MUA!!! And that would be a nice miracle!

BUT the PT made sure to tell me a couple of times that even if it did get better, the MUA is most definitely still needed so that I can get on with continued progress.

I have two PT appointments before the MUA and I don't know if they will do me any good. I am thinking of canceling them and using the PT appointments for after the MUA.

Well that was alot. I hope that you all can follow this rambling report and if you have any suggestions at this point, I'm all ears!

 

[Celle]

I was hoping they would massage my tight quad muscles in preparation for the MUA happening in 10 days from now. But instead he talked and talked about what they wanted to do after the MUA and all about not using a CPM and then sat down at his computer to add more exercises to my regime showing me how to do them by me doing them which were some hip abduction raises, straight leg raises and some hip extension kicks. Then he talked about how I was doing my heel slides with a towel (which I'm not doing - I'm only doing some heel slides with my own strength), and the prone quad stretches with a strap that he wants me to push against and then relax into. The truth is I'm only bending on my own and allowing the strap to hold me in place. So he never got around to any massage that I really wanted and said that massage only would not help much.

Sweetheart, one thing you need to learn - and fast - is that you are in charge when you go to PT. You don't have to please your therapist. He has to please you. You know why? Because you're paying his wages, whether you pay him directly or your insurance pays. It's your money, so you are his employer.
If there's even another time, stop him from raving on about what he wants, and say "This is what I would like you to do today . . . " If he won't accept that, then walk out.

In any case, how many times have we advised you to stop all the exercises?
No wonder your knee won't bend if you've been working with this fool!
Saying no to therapy - am I allowed to?
CONSENT: what it means and how it can be used

What gets me about this guy is that he really doesn't seem to 'personalize' the PT to each patient. He seems to be a textbook guy. He did talk about looking at photos of bent knees in magazines or on an app you can get on your phone of knees in all kinds of bent positions doing different things and that it trains your mind to know that your knee can do those things. Anybody have any thoughts on this?

Yes. He's exactly the type of PT that you should avoid like the plague.
You already had one MUA and after therapy like his look where your knee is now. Does his way work? No, obviously not.

I have two PT appointments before the MUA and I don't know if they will do me any good. I am thinking of canceling them and using the PT appointments for after the MUA.

Best idea you've had yet!

And, for goodness' sake, don't let this PT near your knee ever again. If he's down to treat you, walk out and go home!

 

[Jamie]

If I'm reading your post correctly, you seem to have gained some ROM since your visit with the surgeon on January 3rd and it seems like you're saying you're not doing any exercises at home except for heel slides. Is that correct? If it is (and I truly hope you are letting your knee rest with only gentle bends and stretches when you're not at PT), then this should tell you that your knee needs to heal and not more irritation. This is an important point because if you agree to another MUA, you will start all over again with the healing process and lesser ROM. I'm thinking you might want to tell your surgeon you've decided to wait a bit before deciding to have it done. If you do that (and, again, I hope you do), then take the next couple of months and work on your own therapy program at your speed. You don't need more exercises. Heaven knows you've probably been shown way more of them than you need already!

It's perfectly okay to wait. Your knee is not going to "lock up" or anything horrible. And it may just thank you profusely if you let it rest from all that pushing that these therapists are doing. Hunt for a good massage therapist if that makes you feel better. There is no reason on earth you should be paying for service that is not 100% helping you. You wouldn't accept that from your electrician or plumber, so don't accept it from anyone on your medical team.

 

[KarriB]

I went to two different PT groups. One did not personalize treatment at all. My dad, best friend and I all had the same type of treatment. When I had an infection and second surgery I changed PT groups because I was unhappy with the treatment I was getting and my complication meant I needed non-aggressive therapy. Even being in a immbolizer for 4 weeks, I was able to achieve good ROM that continued to improve after I was released from PT with a ROM of 109. The only exercise I did daily was riding my exercise bike with 0 resistance a few minutes a day.

As Jamie said, an MUA will start your recovery over again with soft tissue that will be swollen and sore. You will want to baby the knee and not do any aggressive therapy for a while.

 

[Tanya76]

Am pleased you have made progress Christina and feel knee is getting stronger. I'm sorry you had a poor experience with PT today. I'm surprised that PT thinks you will still need MUA even if you make progress. You must be so fed up.

I'm not sure that looking at pictures of bent knees will help. If anything it may make you feel more frustrated. I wish your PT was listening to what you want and need.

Stay strong, we are here for you. Keep us updated.

 

[Jockette]

Looking at pictures of bent knees is like looking at pictures of food and expecting that to satisfy our hunger.

Where do they get their “education”?

 

[sistersinhim]

You are improving, why get a MUA? Stop your exercises and you'll improve even more! If you get that MUA, you will be right back where you started from and the PT you have been working with will keep you swollen and a low ROM. Give your knee a chance to heal!

 

[liam2015]

hi there...well that seemed a bit of a waste of a p.t. session when all he did was talk about what he wanted you to do and didn't do any hands on physio therapy. that reminds me of the dog trainers i read reviews about that come to your home, show you videos and tell you what to do for $600. or more. you wanted some comfort or relief from massage ~ he should have done it and while doing it, he could have talked to you about the other things. talking is no substitute for actually showing you anyways, and getting you to do it. you're not going to remember everything after the m.u.a. if you do have it. sorry you went through that today.

i think it is a stretch for you to get to 90 degrees within the next 10 days, of course, only based on my own experience; however, your experience may be different. after my 6 week post op when i was at 76 degrees, i only gained a couple of degrees every week and that was going to physio with all the treatments. i have a concern if you do have the m.u.a. in 10 days time, that it will aggravate that area where you had the hematoma removed, which is still healing, and you said you still feel a sharp pain there when you bend your knee past a certain degree. you might be a good candidate for m.u.a. but i would wait a little longer than the 10 days from now appointment and see how you're doing.

in the meantime, if you do go to p.t., i would insist on treatments, not exercises. at least the treatments feel good and they may help with the inflammation and healing. these are just my opinions, having been there to an extent. i didn't have the added complication of a hematoma as you had. good luck in the next 10 days and i hope you do have some improvement with less inflammation, less pain/stiffness and range of motion.

 

[Robinmhs88]

We are all praying for you whatever you decide. I don’t feel like I started over after my MUA, the pain I had before still ligers but I can bend my knee and with that confidence I am moving forward better than I ever did after surgery
Stop PT and see how you do... a bad PT does not help it will hinder your progress. And seeing pictures of other people’s bended knee is as frustrating as hearing someone consistently telling you to bend your knee. Big hugs

 

[kneeper]

Most PTs don't massage. If that's what you want, investigate if there are therapeutic massage therapists in your medical group. Massage might help if you have muscle soreness.
Otherwise I'd say cancel PT and just let the knee chill out. It sounds like your PTs range from over aggressive on-site (thus leading to more swelling) or advocating over aggressive home exercise. It seems to me that simply giving you a list of exercises is not worth paying the money. You know what you need to do (or not do) by now.

 

[Angiebabe]

Are physio sin US different to UK? I've had a lot of massage therapy here and if you get a talented physio found it really helped with the bend. I've also had ultrasound to reduce swelling. The focus has been much more hands on with some additional advice about stretches or rest as they see necessary.

Can you find a new physio

Having had an MUA I think they can help but on the right situation.

Good luck

 

[liam2015]

@Angiebabe ...same here in ontario, canada, at least at the physio i went to ~ massage, laser, tens, acupuncture and exercises suggested for home. it might be different in the u.s.

 

[sistersinhim]

We have some good, gentle PT here, too, but you have to search for them. So many are still believers in the old way. I think your younger OSs and PTs that were trained in more recent years, go with the gentle approach.