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MUA One Step at a Time

Jockette

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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.
It only takes one little comment like this to doubt ourselves. This happened to me my whole recovery.

But, you don’t have to work hard on this recovery. Here’s an article from our Bonesmart Library:
 

mainegirl1

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Have you thought about not doing PT and icing and elevating whenever you can?
Those casual conversations are coming from unknowing mouths.. Have they had your surgery?

When the swelling goes down PT may or may not be helpful. It sure is not helpful now. You are allowed to own your own body part and tell therapists what they can or cannot do.
 

jeffjob

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@sectac There are some major butt-head therapists out there. I fired one al sweet for doing the same to me. Telling me I was failing because I was not at 120 flex at 4 weeks. He started mentioning MUA and really made me feel down and like I was not working hard enough. Then I went to my OS and he said I was doing great! He valued extension more and my left let had no issue with extension from very early on.

I had my RTKR 6 weeks after my left and this knee just did not want to extend fully. The OS told me he had to do much more work on it. I did more exercises for extension on this leg but it just really needed time. At 4 weeks I was allowing my new therapist (whom I trusted) to push down on it to get it straight.

I can take a lot of pain but I had to stop he most times. My leg needed more time. After around three months my right leg extended to about 0 it was tight but it could get to 0. Now at 4.5 months, it is even better. Getting extension on a problem leg takes time. It has been said here that MUA will not get you extension and I can tell you that even aggressive PT will not get you extension.

What worked for me was gradually increasing my walking and focusing on longer strides and a proper gate.

You are not a failure, you are not a baby. This stuff is serious and takes time to recover.

Be well.
 
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sistersinhim

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It's true that I improved my extension by walking with longer strides with a toe to heel gait. When I first started this I was still pretty weak, so I used my walker to maintain my balance. The improvement didn't come over night, but it did come and without pain!
 

Roy Gardiner

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OK, that means 110 is possible and that you haven't got 'adhesions'. This is good news.

I know nothing of psoriatic arthritis; I do know that painful 'therapy' is in fact counter-productive. Stretching exercises are good, but only to the point of discomfort, not pain.
I start thinking again that maybe they are right... I'm not trying hard enough
Absolutely incorrect. A set of stretching exercises, pain free, repeated every day, should lead to improvements.
 
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sectac

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@Jockette Thanks for the fantastic article. Totally made a lot of sense. This may sound bad, but it's nice to know others have had comments made to them that were hurtful and not correct at all. It makes me feel like I'm not alone on this journey and that someone else can definitely understand what I'm going through.

@mainegirl1 I'm no longer going to PT. I've stopped it all together. I've been doing some exercises at home, like bending and holding it for 30 seconds. I'm not really sure what other stuff I can do because I saw one of the articles BoneSmart provided about exercises that we shouldn't be doing. And believe it or not, every one of them I was doing because my PT told me to do it. Whenever I would do those exercises my legs would throb all night long. I thought it was normal and didn't question it until I read the articles on this forum. Wow, the damage I was doing to my legs is incredible. I've been icing and elevating whenever I get a chance and really listening to my legs. I can tell when I've walked enough because they feel tight and I usually have to sit and elevate my legs. As for starting PT back up, my supervisor has suggested Aqua therapy but I don't know much about that and if it would be effective or counter effective. Any thoughts on that would be appreciated.

@jeffjob Oh how I wish I would have questioned the MUA but like my therapist, my OS was right on board with him and wanted it done ASAP. I didn't know any better because I didn't have anyone to bounce this information off like I do now (thank the good Lord). I don't know if my OS had a full insight on my current condition (psoriatic arthritis) or not, even though she has access to my medical records and I have informed her many times. But I can tell you, I will never let her do that again. It was worse than the surgery and it really set me back. I have noticed that my right knee seems a little straighter than it did while I was going to therapy but I'm still working on my left knee. I have to keep telling myself that it takes time and it will happen when it's ready. I would like to know what exercises you would recommend to help straighten my left knee. I'm not sure if I should be doing the ones that the therapist told me. I also have noticed that every day is different (which I guess is normal). Yesterday was a great day and I felt like I was able to bend my left knee more while walking than I previously did, but today my left knee really hurts to walk. I've been elevating and icing as much as I can (I'm at work but I can still ice and elevate). And as soon as I get home I elevate and ice.

Also, they say that I should start at the time I had the MUA which would be a little over eight weeks ago. So I need to give myself some time and patience.

@sistersinhim Thanks for the advice. I still need to be conscience of my walking, at times I want to walk like a peg leg with my left leg. As soon as I see I'm walking that way I quickly change to walk the correct way. It's like learning to walk all over again. Crazy!!

@Roy Gardiner So you don't think I had adhesions? When I hear that it makes me angry to think I went through all that pain for nothing. Again, as I previously mentioned I wish I had known about this forum before my MUA because I believe it wouldn't have happened. Do you have any good stretching exercises. Just like earlier I mentioned that all the exercises I was doing I found out on this forum that they were all bad for me and I shouldn't have been doing them.


Thanks so much to everyone that has responded to my posts. You all are lifesavers. I look forward to reading this everyday and I usually read over it many times a day just to make sure I didn't miss anything.
 

Jockette

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I would wait on the aqua therapy. My PT put me in the pool at 4 weeks post op, on the recommendation of my surgeon. It was a 50 minute session with countless bending exercises. It took me 3 days to recover. That was when I started googling stopping therapy and thankfully found Bonesmart.

Granted, I was only 4 weeks post op, and you are further along than that, but I still think in your situation you should wait. They will very likely give you more things to do than you can handle.

You’ve been through an aggressive regime and had an MUA which caused another big set back. I honestly think that just doing your daily activities will give your knee all the movements it needs to recover. Later on when your whole leg feels better you can always do more “rehab” type things.

It’s not exercising that gets our range of motion back, it’s Time:

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. Exercise as in strength training is counter-productive and in the early weeks does more harm than good. Normal activity is the key to success.
 

jeffjob

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@sectac What I did for extension exercises was sit in an upright chair and extend my leg to another chair of equal height. I would let gravity pull the leg straight as I held the position until it became too uncomfortable. In the beginning my right leg could only take 5-10 seconds at a time!

Once my leg got reasonably comfortable with this I would do some quad contractions while the leg was extended.

And then finally once the leg got more comfortable I would I would bend at the waist over the extended leg. This would put more pressure on the hamstrings.

And again, I really needed to go slow and I could only do this once to twice a day. Too much and it became counter productive.

Small steps my friend!

I did only some of the exercises PT wanted me to do in recovery. What I did do was keep moving and tried to do most things by myself. I was able to take daily showers at day 5 for each knee. I really had to be careful of the right knee. I was off the walker in 4 days for my left knee but was on the walker for 12 days for my right. I listened to my body and only pushed it a little, trying to do more each day.

I am now 5 months for my left knee and 4 months for my right. Both are at 125+/0 for ROM. I can walk quickly with long strides and heel to toe. I still tend to take stairs the old way and have to remind myself to do the foot over foot, I can do it but it's not "normal" yet. And, I do still have some pain in my knees, especially my right knee. These are not OEM parts and they will never be perfect but I can do so much more then I could have for a long time.

Be well.
 

marieltha

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When my OS suggested pool walking, he said to start very slowly, say 5 minutes (Possibly 10), wearing supportive water shoes, and be conscious of good posture and heel-to-toe walking. Then increase 10% a week.
 
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sectac

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At night when I'm in bed both of my knees hurt on the sides. Does anyone know why that would be happening? It seems like I can't get comfortable no matter how I lay. I am icing and elevating whenever possible and my knees don't seem to be swollen like previously. Thanks!
 
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sectac

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@Roy Gardiner Thanks for all the great exercise information and FAQ, they were very helpful. I worry sometimes that I might have come back to work too soon. I don't have pain (per se) in my knees just tightness when I've walked too much. But I had to go back to work after my three months posts op but I was only 6 week post MUA. Will I cause my knees to have more issues. I know I've asked this question before but I'm very worried because my knees are completely straight yet and my bending in my left knee is much to be desired. My right knee I can get to 90 degrees if not better. But I feel like I can only get my left knee to about 60 degrees and this is where it was at when I was going to therapy. I am no longer going to therapy but I am continuing to do my exercises (at work and at home) whenever I get a change. I am also elevating and icing them (more so at home) I can ice them at work but I can only put my legs on another change for the elevation effect. Is this all wrong???
 
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sectac

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Has anyone experienced stuff moving in your knee when you bend it back and forth. I can put my hand on my knee and feel like a swishing (no other way to describe it) feeling. What does that mean and is it alright to have that??
 

Celle

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What you're feeling is the artificial knee components moving over one another. It's normal, but you're more aware of it because, you now have hard metal and plastic inside your knee, instead of the relatively softer bone and cartilage.
 

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All I can say, having had big problems with my first knee and a successful MUA at 12 weeks and now again ROM issues with my second, my surgeon said absolutely no point in doing MUA until necessary. Until for sure there are adhesions / scar tissue to break. I understand this logic. Seems way too soon for you to have done such radical assault on your knees. But I’m no expert.
 
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sectac

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@Celle Thanks so much for the information. It just feels odd but I guess I'm going to be feeling a lot of odd things for a while now.
 
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sectac

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@Didot It feels so nice to have someone that actuals feels the same way that I do. If I had known about this forum before my MUA I wouldn't have had it done. It really upsets me to think this has set me back and I totally agree with your surgeon's logic. Did your knees finally start cooperating? Did you have any issues with extension and did you have to end of having another MUA? That seems to be a problem with me and when I mentioned it to my surgeon she said we can always do another MUA. I was like what the heck... are you out for more money (it just surely seems that way). They don't seem to understand that the PT I was going to was cracking on my knees the day after the MUA and this went on for several days before I changed my PT.
 

Jockette

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MUAs are not usually done for extension issues, they are primarily done for bending issues.

Extension can take a while to come in, mine took months and it’s fine now. My surgeon never mentioned a surgical procedure for it.

You have lots of time to improve as you heal, this is a year long recovery and there is no set time by which you must regain your ROM (bend and straight)
 
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sectac

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@Jockette You don't know how happy that makes me feel to hear you say that, because (once again) the PT I had after my MUA said that was one of the reasons for the MUA. He said that they straighten my leg to zero during the MUA and he would get mad that I wasn't working to maintain this zero rating.
 

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