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MUA One Step at a Time

Celle

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Since I had an MUA at week 6 I feel like I started back at ground zero, how should I approach my weekly healing time.
THe MUA does set you back. for some people, it sets you back as far as your original surgery date. For others, not quite so long.
We usually advise you to consider the date of your MUA as your starting date.

When did you have the MUA, by the way? Was it on both knees? If you tell us that, we can add it to your signature, too.

Did the MUA help at all? If it did, that's good. If not, it pretty much proves you don't have adhesions and it's swelling that's preventing your knees from bending more.
 
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sectac

sectac

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@Celle
My MUA was on 08/07/2019 on both knees and it didn't do anything in regards to furthering my ROM except make me depressed and feeling like I was a failure. PT didn't help with that feeling because my first PT (who I no longer go to) told me if I wasn't going to work hard at reaching my ROM then what was the point of having the MUA. I'm currently not going to PT (the advice of my OS) but I plan on going back to a different location that offers Aquatic Therapy.
 

Celle

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I'm sorry the MUAs didn't help. It would have been great if they had.
But, their failure to help does prove that you don't have bad scar tissue (adhesions). That's a gold thing, because now you know that there's nothing permanent stopping your knees from bending.

What's preventing the bending now is soft tissues irritated and swollen by exercises and over-zealous PT therapy. Your first PT therapist was brutal and I think your knees are still suffering as a result.
Your poor knees need time, rest and gentle treatment, with lots of icing and elevation, so they can calm down and get rid of the swelling.

It's not exercising that gets you your ROM - it's time. Time to recover, time for swelling and pain to settle, and time to heal. Your knee is capable of achieving good ROM right from the start. Its ROM will gradually increase as your knee heals and the internal and external swelling decrease.

There's no need to rush to get ROM (Range of Motion) because it can continue to improve for a year, or even much longer, after a knee replacement. There isn't any deadline you have to meet:
Myth busting: the "window of opportunity" in TKR
You're only 3 months into a year-long recovery, so those knees have at least 9 more months in which to gain ROM.

Have a look at these two examples and see how a couple of other members had slow, but successful improvement in their ROM:

This is from Campervan. As you can see, her flexion continued to improve for a long time.
"I had a slow recovery. Here's my flex measurements at various points:
92 - 8 weeks post op
105 - 10 weeks
107 - 5 months
110 - 6 months
112 - 7 months
116 - 9 months
119 - 11 months
118 - 1 yr
120 - 1yr 2 months
125 - 1 yr 8 months
128 – 6 years "


And this one is from bertschb:
I'm 12 months out from my surgery and have some advice based on my experience:
1- Stop going to PT (all it will do is make your knee swell and reduce ROM)
2- Don't worry about your ROM
3- Be patient - VERY patient!!!

Here is my ROM history (more or less):
1 month - 60 degrees
2 months - 80 degrees
3 months - 85 degrees
4 months - 90 degrees
5 months - 90 degrees
6 months - 110 degrees
7 months - 120 degrees
8 months - 125 degrees
9 months - 130 degrees
10 months - 135 degrees
11 months - 140 degrees
12 months - 140 degrees

I spent waaaaay too much time worrying about ROM. I thought I'd be riding my bike a couple months after surgery but it took SIX months! Looking back on my surgery, if I knew then what I know now, I wouldn't have wasted my time with PT and I wouldn't have worried about ROM.
 
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sectac

sectac

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@Celle Thank you for that information. The breakdown by months really helped with my anxiety level. I needed to read this to fully understand this is completely normal. I do have a question, I recently read someone else's post and one of the advisor's asked if this person when bending if they felt tightness or felt like they were hitting a wall. I feel tightness when gently bending and was wondering what that meant and how I go about getting past that point? Also, since I had the MUA it really means I'm only 9 weeks out from starting over again. However, I'm back to work but I have a wonderful supervisor and manager that's allowing me to rest as often as I need. I would like to know if I can go to the mall and walk or will this set me back. I was told by a friend that walking is one of the bests things to do. Is that correct? Thanks!!
 

Celle

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Almost everyone feels tightness when bending. That's normal for many months post-op.

Feeling like you're hitting a wall is called a "hard stop" and it may indicate that the person has adhesions and does need an MUA.
However, you've had an MUA and it didn't improve your ROM. Therefore, you didn't have adhesions.

Time and gentle treatment of your kines, with lots of elevation and icing are your best way to increase ROM.
 

Jockette

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My ROM was not impressive my whole first year, but it improved the second year, and is still improving at 2.5 years post op. Try not to worry.

Walking is good, but at your stage, not to excess. I think it might be too soon for the mall. I took walks at my local Target. Early on it was just short shopping trips, then later it was a good place to go that was air conditioned. The shopping cart made an awesome incognito walker. My local Target is usually not crowded, so that was a bonus for me.
 
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sectac

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@Celle Hi, Not sure if you'll be able to answer this or not but since the surgery my left knee has always had a sharp pain when I walk or bend too much. It's locate on the "inner" side of my left knee (if that makes sense). I've told my surgeon and PT (when I was going to PT) and neither could explain the reason. They kept blaming it on scar tissue but how can it be scar tissue if I had this pain right after the surgery. I can stretch it out and it feels a little better but when I get done stretching and my leg relaxing it stings/burns in that area. Not sure if anyone has ever encountered this issue before. Thanks!!
 

Jockette

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It could be something inside the surgical area that is still healing. There will be all kinds of pains that come and go, or ones that stay a while, because of the trauma done to your knee/leg during this surgery. Eventually it settles down. :console2:
 
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sectac

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Thank you so much for that information. That totally makes sense.
 
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sectac

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@Jockette I am back to work since my 3 months are up even though I had a manipulation just 8 weeks ago, but my management has been super and I normally get to sit at my desk doing paperwork, but occasionally I have to register a patient so I will walk around the ER and stand in the patient's room (I try to find a stool to sit down on). And then once I'm done I will go back to my office and elevate my legs on a Rubbermaid container. I do have access to ice packs which I use when I can. Do you think this is alright when it comes to walking around? I can tell when my legs have had enough because they will get tight and start to ache. That's when I know I need to sit down, elevate and ice.
 

Jockette

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What you’re doing sounds good, we have to do the best we can in our circumstances. I’m glad you found something to put your legs on while at your desk. It was months before I was remotely comfortable with my foot on the floor.
 
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sectac

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@Jockette Thanks for the boost of confidence. These days I'm needing all I can get. I've noticed when I don't get much sleep my mind likes to torture me with all the negativity.
 
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sectac

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Anyone that would like to offer advice it would be greatly appreciated. As I mentioned previously, when I don't get much sleep the night before my mind starts playing tricks. In other threads it was mentioned that if there was scar tissue then it would feel like I've hit a wall. Is there an explanation as to what it feels like to "hit a wall" in regards to the knee exercises. My knees (mainly my left knee) feels super tight and I can't go any further at a certain point. It worries me that I may think it's only tight when it could be hitting a wall. I'm sorry for all the questions. But once again, my OS called me the other day to tell me if I wanted to go back to therapy I could go back whenever I wanted. When I explained that I might wait a little bit she mentioned that if after a while I don't reach my ROM I might need to get another MUA. I became angry and told her that there was no way she was doing another MUA on me every again. I don't think she liked that response but considering how very painful (and unnecessary) it was when I had it in August I will never do that again. And so now when I'm tired, all I think about is that I may have to have another MUA. This has really played a mental head game on me and I believe this is the reason for my sleepless nights. Again, I'm sorry for going on and on but I feel like I don't have anyone else to talk to about this that would fully understand what I'm going through. Thanks!!
 

sistersinhim

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Not getting enough sleep really affects your whole body. Your energy level is already down because of the surgery. Add not enough sleep to that and it just compounds things. Sleep anywhere and any time you can. It doesn't matter when you sleep as long as you do sleep. I've always been a light sleeper and had a terrible time after this surgery. I took morning, afternoon, and evening naps to try and get enough. My nighttimes would be only a few hours at a time. Very frustrating. The daytime naps helped a lot.
 

jeffjob

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I struggled early on when trying to gain flex or bend and determine the difference between being able to bend more or hitting a wall.

The best way I can describe it is that I knew it was the pain stopping me from flexing more if I held me biggest flex for 30 seconds. I usually felt that I could bend more after that, even if I choose not to because it would hurt too much.

Hitting a wall is like not being able to bend your knee any more no matter how much it hurt, or not being able to bend more even when it doesn’t hurt.

Now I am not encouraging anyone to bend to the point of pain and I did not do that. I would bend until it was uncomfortable, hold it and then I could usually tell that I could bend more, but it would bring me to the level of pain.

My understanding is that hitting a wall is not being able to bend, even though it does not hurt.if it hurts to bend you probably have more bend.

Hope this helps.
 
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sectac

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@sistersinhim Thanks for the advice. My problem even with naps is I can't get comfortable and so I toss and turn which wakes me up and then my body says "hey it's time to use the bathroom" because of all the liquid I drink to stay up on the pain medicine. It definitely seems like a vicious cycle.

@jeffjob Yes that totally makes sense. I agree with Jockette, that was a really good explanation. Once again, I am so thankful to have found this forum because to this day the therapist is still in my head and I feel like because I'm not bending to 120 (wishful thinking) that I'm a failure not wanting to try. The therapist that I "fired" would actually say this, that I wasn't trying hard enough and if it wasn't hurting to the point of feeling sick then I wasn't pushing myself enough and would never reach my ROM and would have to have another MUA. But hearing your explanation makes me have hope in humanity once again. Thanks so much!!!
 

Roy Gardiner

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Did your surgeon report to you on what happened during MUA? Did they 'break' scar tissue and get your knees to a good bend, or what?
 
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sectac

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@Roy Gardiner Hi... supposedly she wasn't able to get my left knee (my trouble child) completely straight and she said she got it bend to 110. I don't know if the psoriatic arthritis would cause my knee not to completely straighten all the way or not, but I do know the therapist had a really hard time getting it straighten. That's why he had always pushed (very painfully) really hard on both of my knees. This entire experience has been horrible. Anytime someone asks a question about how come you can't do this or do that I start thinking again that maybe they are right... I'm not trying hard enough.
 

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