MUA Poor Flexion - Does age matter?<

[Jamie]

Oh, some photos would be wonderful. You can either post them here or email them to me at jamie@bonesmart.org.

I'm assuming this exercise isn't causing you any pain or swelling, right? Sometimes the most simple things can be very effective. This, along with your regular activities, should help you see continued improvement.

 

[traceys]

@KDIMATT Glad your doctor is working with you and listening. Had a horrid appointment with mine today and set me back mentally and emotionally. Sounds like you found your track! Keep up the positive energy

 

[KDIMATT]

@traceys I'm so sorry to hear that your appt didn't go well....I honestly don't think many (except all of us on here of course) truly understand what we go through. Its not just the physical pain, its also the mental and emotional exhaustion. Trying to do what's needed to recover and having it not always work out as we planned definitely is cause for some stress. Im thankful my dr understands as my therapists did not!! And really if it were not for this site I'm not sure my dr would have been enough. Reading other peoples accounts and the support from everyone here has made a huge difference in my outlook.

Chin up! Listen to what your body is telling you. I have learned to have patience....more than I have ever had for anything else in my life lol. I do believe that less physical therapy and more of icing/elevating/simple exercise has done wonders the past week.

 

[mickey143]

Wow yes, it certainly sounds like you were doing way too much!!
Looking forward to seeing your progression along with all the others.

 

[Celle]

@mickey143 - I have copied your long post and started a recovery thread just for you, here:
https://bonesmart.org/forum/threads/mickey143s-recovery-thread.51033/
Although your post was addressed to KDIMATT, it contained a lot about your own recovery (which Josephine has now deleted) and the responses to it derailed this thread and took it off topic. This thread should be centred on KDIMATT's recovery.
@andpeaches, I've moved your posts to Mickey's new thread, too.
@Kiwigirl62 - I've also deleted your post to Softail, as it was off topic in this thread.

https://bonesmart.org/forum/threads/forum-etiquette-being-polite-when-posting.20128/

 

[Josephine]

I'd really like to offer you some structured advice but in order to do that, I also need to ask you some questions. Are you willing for me to do that?

@KDIMATT Did you not notice this question I asked you?

 

[KDIMATT]

@Josephine I'd really like to offer you some structured advice but in order to do that, I also need to ask you some questions. Are you willing for me to do that?
Yes, that would be great!

@traceys Ughhhh I wish you were back on here!! I feel our recoveries are so similar and that finally someone on here was recovering about the same pace as I am! Hope to see you back soon...

7½ weeks out from surgery and had a visit with my OS today....

Last time I saw him was about 4½ weeks and I was very disappointed with my ROM which was about 65-70. Seems everyone I saw for pt thought that was horrible and kept hearing about MUA. Well he told me that visit I was doing too much and to stop all PT and not to listen to anyone but him. Gave me the one exercise to do 4x a day and told me to rest, ice and elevate and above all have patience.

So on to today's visit, I am now at about 85 ROM and he explained it was my choice regarding doing the MUA. That he could get me to 120 in a five minute procedure but that afterwards it would be swollen again, not as bad as the swelling from surgery, but that I may or may not keep the 120 ROM initially. It might go down and I'd have to work to get it back again OR I may stay at 120.

He said he usually won't do MUA if the patient can get it to at least 90 by themselves as he feels that is the threshold where after you hit 90 it gets easier to improve your ROM by yourself. He said the best case for MUA was between 6-12 weeks so I still had time to improve. Asked how I felt about it so I told him that I understand this process seems to be going slower for me than most but I'm finally ok with that, well, more so than I was in the beginning lol.

On one hand I'm curious about the MUA because even though there will be swelling again it won't be as bad and at least I think I'll be starting from the 85 ROM I had achieved before the MUA which makes me feel as if I can achieve a much better ROM.

On the other hand I don't know if I'm just being impatient and rushing into thinking about an MUA, that maybe if I just remain patient I can achieve a 90 ROM and gradually improve without it. I'm not sure how much more I can achieve without the MUA as its taken me sooooo long just to get to 85!!!

Either way, he told me to take another two weeks to try and get to the 90 or better ROM and to see how I feel about things then. I seriously could not have asked for a more kind and understanding surgeon!!!

So wish me luck!!! I have two weeks before I have to consider MUA.

And if anyone would like to share their experiences regarding MUA I would love to hear more about it.

Thanks

 

[Softtail]

Kdimatt, I am one of the lucky ones who ended up with good flexion, butconsidering you have two more weeks, I would keep working the flexion exercises , and hope for the best . At 85 you are really close. I believe others will probably support this approach, since the bonesmart way is to let leg heal on its own and flexion will come with it. Not a decision I would want to make, so I am pulling for you to get to the magic mark.

 

[Jockette]

You are still early in your recovery, your flexion is improving.

You do not have to be at a certain number by a certain date. Our body does not work that way. It does not recognize your surgeon’s timetable, only it’s own.

Keep in mind, 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.

One of our members, Bertschb, kept a record of his ROM process. He agreed for us to post it for those of you that are afraid you're stuck. The key is to have patience! Bertschb says:

“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.”

 

[Josephine]

@Josephine I'd really like to offer you some structured advice but in order to do that, I also need to ask you some questions. Are you willing for me to do that?
Yes, that would be great!

KDIMATT, you need to read this so you can make mini-quotes like others do! How to use the quote feature

Either way, he told me to take another two weeks to try and get to the 90 or better ROM and to see how I feel about things then. I seriously could not have asked for a more kind and understanding surgeon!!!

Oh that guy is feeding you a line! You are only 7 weeks out and the likelihood that you have adhesions is pretty small.

Having said that. here are my questions which should give me a better idea of what's going on.


It would be very helpful if you would answer each one individually - numbered as I have done - in as much detail as you can then I'll come back as see where you are ....

1. what are your pain levels right now? (remember the 1-10 scale: 1 = no pain and 10 = the worst you can imagine. And don't forget to factor in other forms of pain such as soreness, burning, stabbing, throbbing, aching, swelling and stiffness).

2. what pain medications have you been prescribed, how much are you taking (in mg please) and how often?

3. how swollen is your leg compared to these?

4. what is your ROM - that's flexion (bend) and extension (straightness)

5. are you icing your knee at all? If so, how often and for how long?

6. are you elevating your leg. If so how often and for how long?

7. what is your activity level? What do you do in the way of housework, cooking, cleaning, shopping, etc., and

8. are you doing any exercises at home? If so what and how often?
This is the most crucial question so please help me by using the format I have left as an example
(which means please make a list and not an essay!)

Exercises done at home
- how many sessions you do each day
- enter exercise by name then number of repetitions of each
etc., etc.

Anything done at PT
- how many times a week
- enter exercise by name then number of repetitions of each
etc., etc.

 

[KDIMATT]

@Josephine

1. At rest I would say about 3, after doing errands or on my feet for a while it would be about 7 (more so as a soreness, stiffness and throbbing pain)

2. I take oxycodone/acetaminophen 5mg/325mg 1 tablet twice a day.
I was taking it 4-6 caplets a day but just recently started taking less

3. moderate swelling - I feel like my calves are sometimes swollen especially the back of my calves

4. 85/0

5. Icing once or twice a day for about 45 min

6. elevating once or twice a day for about 45 min

7. I cook small meals, general tidying up of house, shopping a few times a week.
I have three dogs so taking care of them.

8. Exercises done at home
10 heel slides in bed
4 sessions of 10 minutes x12-15 reps
stand up and hold for 10 seconds, sit back down again for 30 seconds.

Anything done at PT I have stopped going to PT as I felt it was not beneficial



@Jockette
Thank you soooo much for including the ROM measurements that Bertschb achieved. I know we are all on our own journey and should not compare to other people, but it is very helpful to see someone who started off slow, as I have, to then be able to reach a great ROM. Patience, I am learning, is key!!!

 

[DIYSteve]

So wish me luck!!! I have two weeks before I have to consider MUA.

I hereby wish you luck!

FWIW, I was at 90 flexion at 8 weeks, suffered anxiety about it and got some solace by reading about other people's experience on this forum. My progress with extension and strength was great, but sooooo slow with flexion. I'm now 4 months out and around 100-105 after warming up, and I'm confident it'll continue to gradually get better.

Again, good luck!

 

[traceys]

Hoya @KDIMATT

Just popped in to see some people and post an update on my thread. We are mirroring each other incredibly. You can do this if I can!!

 

[Josephine]

1. At rest I would say about 3, after doing errands or on my feet for a while it would be about 7 (more so as a soreness, stiffness and throbbing pain)

okay ...

2. I take oxycodone/acetaminophen 5mg/325mg 1 tablet twice a day. I was taking it 4-6 caplets a day but just recently started taking less

Why are you taking less? At 8 weeks and with a declared pain score of 7, you need to take more than that. I would suggest you take at least 1 oxy 3-4 times a day. But you could also supplement that by taking 2 regular Tylenol (325mg) with each dose. Alternatively, you could try taking 1,000mg Tylenol 3 times a day in between times you take the oxy. Just as long as you keep tabs on the overall dose and make sure it never exceeds 4,000mg per 24hrs.

3. moderate swelling - I feel like my calves are sometimes swollen especially the back of my calves

You did remember to factor this swelling into your pain score, didn't you? Swelling is a form of pain.

4. 85/0

That's not too good and it is being impeded by the swelling. Therefore you do need to take better pain medication and deal with your swelling more diligently.

5. Icing once or twice a day for about 45 min

That's not good enough. You should ice for at least 40-60mins and more than 4 times a day.

6. elevating once or twice a day for about 45 min

Same here. Elevate when you are icing. You need to get on top of this.

7. I cook small meals, general tidying up of house, shopping a few times a week. I have three dogs so taking care of them.

Okay

8. Exercises done at home
10 heel slides in bed
4 sessions of 10 minutes x12-15 reps
stand up and hold for 10 seconds, sit back down again for 30 seconds.

Don't know what the standing and sitting down is all about but it's unnecessary! And you could quit the heel slides as they won't do you any good.

I have stopped going to PT as I felt it was not beneficial

Pleased to hear it!

So in summary:

1. you need to adjust your pain meds as suggested
2. you need to be more diligent with your icing and elevating
3. what 'exercises' you are doing are useless and likely to be causing your swelling, in part at least. So stop them​

 

[KDIMATT]

9½ weeks and had a check up with my OS today....

Still only at 80-85 flexion

We discussed having the MUA done and I decided I am going to do it....so scheduled for this upcoming Tuesday the 27th.

I tried PT in the beginning but it was too aggressive so eventually stopped that and seemed to progress better with icing and elevation and gentle exercise....but I've basically been stuck at this same ROM for a while and when I try to push past it it feels like I have hit a wall. I feel as if the swelling in the knee has come down some and I have finally gotten 6 continuous hours of sleep the past two nights woohoo!!!! But my flexion has not improved.

Work has been very good with me being out and unfortunately I cannot perform my job unless I am doing much better. I work private security as a bodyguard and work 16 hour shifts (2 days on and then 4 days off) and cannot ice or elevate at work. Ive been receiving some compensation while I've been out sick but I really need to get back soon. I wish I could afford to stay out 6 months but unfortunately I cannot. So hoping that the MUA will put me in a position to recover more quickly.....fingers crossed....

 

[Josephine]

So hoping that the MUA will put me in a position to recover more quickly.....fingers crossed....

Well will you take a bit of advice? First get your flexion measured and noted before the MUA and then make sure you ask the surgeon what he got it to after the done the job. The results will be interesting and I'll be looking forward to seeing them!

 

[traceys]

My appt is tomorrow am. We have same range, same weeks out of surgery so will be interesting to see what happens

 

[KDIMATT]

Ten weeks today....and my MUA is scheduled for tomorrow....I just can't seem to get past a certain point. Physical therapy, no physical therapy, ice/elevate, daily activities and won't get past 80-85.

I know one thing...I will NOT be doing any pt this time around. I realize now that it didn't improve my ROM much at all, if anything, and the pain and swelling that followed did me no good.

I've heard others on here mention massage. Is that something your pt person does? Or is that a separate treatment? Just thought of it the other night as when I woke up in the middle of the night with soreness the first thing I think to do is rub my leg to make it feel better, mostly thigh right above the knee and the back of knee and calf. I'm wondering if maybe this time I should seek out a massage therapist and if that would be better than pt.

Looking forward to having more mobility, hopefully, but certainly not looking forward to swelling and pain. Seems it was just this past week that I've been getting more sleep at night finally lol

Waiting for the call from the pre-op to see what time I have to be there tomorrow....

 

[traceys]

I’m thinking if you! Fingers crossed it helps you get where you are comfortable with things. 80-85 is my stick point but today pt got me to 88 so one day it will get there.
I have massage once a week right now where she works on my quads ITB and hammies. Have noticed such a huge change.
Some pts do it as well- depends.

I find it really helps with the fluid from swelling for me and lengthens out all my contractures. I hate the days she does my deep tissue treatments - I’m all bruised after those!

 

[KDIMATT]

@traceys Yes!!!! My brother did a great massage on my leg the first week after my surgery (he's a licensed massage therapist, but lives an hour and a half away). It hurt like hell but I really think it moved the fluid out and I felt so good after, although there were certain points (like around my ankle) where I still felt it days afterwards lol

My pt would give a brief massage for about five minutes before we did "work" but I think I would totally benefit from going to someone who will just do massage. Especially since I still have the tightness in my leg right above the knee and in my calves. Definitely going to try it this time.

Will be great to see your progress without the MUA....ill still wonder if it would've gotten better had I waited longer....