Saying NO Way to Manipulation!!!

[elmtree777]

I had bilaterial knee surgery on March 31...Have had a really hard time with Pt and pain...I went for my 6 week checkup and the Op wants to do a manupulation "spelling wrong" on both knees...My left is at 110 and the right is at 95 if pushed..I told him NO!!! .He said I have a two week window to decide to do this...I would rather do anything but this...What happens if I don;t do this...Will I never get any more flex...He has me set up for 4 more weeks of PT...I really really really DONOT want any more pain or fighting with him for pain pills...I am sooooo sick of all this...I just want to be done with PT and DR's...What do your Think? Am I being a baby or what?

 

[Texas]

Re: Saying NO Way to Manupulation!!!

Hi elm you are not a baby. I will tell you I just had a manipulation (2 wks ago) I know scary. But I was only bending about 65 . I didnt want it at all. You can read my old posts. I was so scared. But if you choose to I can honestly say it was ok. I didnt really hurt that bad after. The TKR was much different. But yes that is somethig you need to decide. I am just letting you know I am the biggest chicken. And I did do it. I did go from 65 to about 90 now about 100 so it worked for me. After my manipulation the pain let up a lil because I didnt have to struggle that hard to bend anymore. but yes keep doing the excersises. If you need to talk more please post. Before I did mine, I posted to everyone, send private messages. The people on here are amazing... , Will be thinking of ya..............Hang in there......Kim

 

[Jamie]

Re: Saying NO Way to Manupulation!!!

Elmtree, I know this process must seem endless and I understand your desire to have it over with and NOW! I think we all felt that way at about the 5-6 week point, even when a manipulation was not needed. So your feelings are completely normal.

But, if your surgeon recommends a manipulation, you really do need to seriously consider it. It is possible that you will not reach your full potential range of motion without it. It means you have developed scar tissue that cannot be broken up otherwise. That scar tissue is holding you back. You've come this far.....and manipulations in almost all cases are successful in giving you more movement almost right from the beginning.

Try not to focus on what actually goes on during the procedure. You won't know any of that as you'll be peacefully asleep! It does hurt a little when you come out, but if you read previous posts from people who have had manipulations, the pain is NOTHING like the knee replacement and it goes away soon. Most people are so thrilled to have additional movement, the pain is really secondary.

You are the one who has to make this decision. If you are satisfied with your current range of motion and it allows you to do everything you want in life, then I guess you could say no and just deal with it. But, reading between the lines of your post, I think you really WANT more movement in your knees and are just scared of the procedure. If that's the case, keep posting and talk it out with people on the forum who have had this done and are in better shape afterwards.

Good luck to you, hon. These big decisions are soooooo tough!!!

 

[elmtree777]

Re: Saying NO Way to Manupulation!!!

So, Texas, If you only got to 100 after the manupulation, will you have to do it again...as I am about 100 or better with both of mine...Seems to me that the Procedure should have given you much more flex than 100...Also, did yoiu have to go to PT for every day for 2 weeks after to keep the flex like my Pt told me was necessary? Sounds terrible to me! And YES I am scared of another procedure! The memories of the past 6 weeks is still quite raw..

 

[Texas]

Re: Saying NO Way to Manupulation!!!

I am improving every day. I went from the 90 to 100 in one day. But I wasnt able to bend for yrs. It depends on swelling as well , when it is not swollen I can get far. But no I just push Ill get better. But I was only at 68 but the Dr actually got it to 130 so I will get there I had alot of scare tissue stoping me now its just a matter of pushing. I am very happy. I know I didnt want to do aymore I was done, but I had to. I worked myself up pretty good even wanted to jump off the table, but I finally was out and it took 9 minutes thats it..I know I had pictures in my head as well and it was ok really it was...Are you progressing , were you always at 100. I wasnt progessing I was stuck, but now I am progressing........Believe me it sounds worse then it is its, nothing like the replacement itself.........

 

[elmtree777]

Re: Saying NO Way to Manupulation!!!

Yes, I am progrressing...I was at 80 and 75 three weeks ago, and the OS said I needed to get to 95 on each leg by my 6 weeks checkup and I made it to 110 and 95...then he suggested manupulation...I think I can get to at least 110 on each leg...Is that enough? I am 60 years old and don't want to do anything but normal things likes shop and play with my grandchildren...I am comfussed as to what is normal and what most people have...Can I live with 110?

 

[Jamie]

Re: Saying NO Way to Manupulation!!!

Elmtree....normal is not really a number. It's more about your comfort level with the range of motion you have. If you are comfortable where you are and can do the things you want, that's all that is important. You have to ask yourself if you would be fine and happy with the current flex and extension. It's all about YOU.

Actually, if you are continuing to gain ROM, I would ask why the need for a manipulation as long as you continue to get better. Six weeks is not really very far out from surgery. If the OS said you needed to get to 95 by 6 weeks and you met and exceeded that, I'm confused as to why he would suggest you have a manipulation and give you a 2-week window to decide.

 

[elmtree777]

Re: Saying NO Way to Manupulation!!!

Elmtree....normal is not really a number. It's more about your comfort level with the range of motion you have. If you are comfortable where you are and can do the things you want, that's all that is important. You have to ask yourself if you would be fine and happy with the current flex and extension. It's all about YOU.

Actually, if you are continuing to gain ROM, I would ask why the need for a manipulation as long as you continue to get better. Six weeks is not really very far out from surgery. If the OS said you needed to get to 95 by 6 weeks and you met and exceeded that, I'm confused as to why he would suggest you have a manipulation and give you a 2-week window to decide.

Me TOO! Wish I had though to ask him...

 

[loggon]

Re: Saying NO Way to Manupulation!!!

Elmtree
I don't understand your doctor wanting you to have a manipulation when you are at 110/95. At my 6 wk check up I was at 100 and my
doctor said I was doing great.
That was just a week ago and I am now at 110 so I feel I am moving along. My PT said I was doing great. I have not pushed on any of my exercises and neither has my PT. She does not believe you have to have pain to reach a high ROM. It is working for me. I know I would be further if I pushed a little more. My goal is to be 120 by next week so I will do a little push to get there. I still
have swelling and it is very stiff.
Good luck in what you decide, but just know it will get better and
there are great folks here to chat with on any worries you have.

 

[GaryM]

Re: Saying NO Way to Manupulation!!!

Hi elmtree!

I had BLTK in July 08. Had a manipulation done in Septmeber 08 Both knees were stuck at about 90 or so if I remember . Just had another manipulation done a few weeks ago. I'm at about 110 or more with both knees. The manipulation wasn't all that bad. I really looked foward to the last one beacuse I wasn't satisfied with what I had. The pain was minimal. Went to PT for 3 weeks 3 times a week. No pain now. As a matter a fact I just went through 8 hours of physical training yesturday as part of my job and did great. Little swollen last night but nothing ice could't help. Get it done. You will not regret it. I didn't even use crutches after the last manipulation. I was walking on my own.

 

[Jamie]

Re: Saying NO Way to Manupulation!!!

Elmtree....why don't you call your surgeon and ask your questions. I'm assuming it is a while before you have your next appointment with him.

 

[elmtree777]

Re: Saying NO Way to Manupulation!!!

Thanks for all your replies guys...I appreciate all your imput...I have PT three times a week for next 4 weeks and I think I will just let that determine how I end up...I am 60 and just need to shop, travel and play with my grandkids...so whatever I end up at will just have to be "good enough"...

 

[Texas]

I agree when we were talking I really couldnt understand why he said a manipulation, as you said you were improving. I think I would call as well. Your numbers sound good for 6 weeks... Please let us know what he says !!!!!!!!!!!!! Hope you feel better son

 

[Josephine]

(With respect, Mr Surgeon, sir) his 'window of 2 weeks' is rubbish! People even here on this forum have reported that they have continued to increase ROM even up to 12 months later. So I'd put that one aside.

110 is kind of ok but 120 would be better. However - heck, that's only 15 and 25 to get. You could do it if you were prepared to work on it. On the other hand, why not take the easy option and get a jump start on it? People have a strange idea that an MUA is as painful as the original op which just isn't true.

 

[Simon]

ElmTree

At about 2 months I was about 104 in the right knee and 106 on the left and really had not made much gain in the previous month. My OS also mentioned a manipulation and the PT was not sure we would get anymore. I was happy with what I could do at that point and just elected to go for more aggressive PT. Well after 7 months of PT and lots of work at home I did get to 120 on both. I could be the exception as most people do find the manipulation works just fine. My knees were a real mess so I did not think I would even get to 100.

The question would be do you feel you can do what you want to do with the current ROM or even a few more degrees.

It is a hard decision so good luck

Simon

 

[Nana55]

I had manipulation at 8 weeks and was stuck at 75 -80 with PT stretching the life out of me. I was 90 the first week in PT and am at 110 so went to 90 fast and then gradually up to 110 but I can't consistently get past that after being in PT for 5 months.

As Jo said, the manipulation wasn't that difficult and I really wasn't in anymore pain than I had been before. I have no regrets and I would like to be 120 so I really would consider it again but I don't think my OS would. He said he got me to 130 during the MUA and feels I could still gain more in the next 6 months if I work harder at it.

Nana

 

[Josephine]

Yes, I've seen cases like that, Nana. Where we can get a really good flexion under GA but the patient can't seem to when they wake up. Even worked with a surgeon who used to bandage the leg flexed to it's max so the patient could see when they woke up, like they were doing it on purpose or something!! But under the influence of a deep GA, the body can do things that aren't possible when the patient's awake.

However, I seem to remember Doug posting in here recently (he's over 1 yr) that he's still increasing his ROM even now. Anything's possible.

 

[backbay38]

Elmtree -- I imagine at your stage of recovery there is still quite a bit of swelling that - as everyone has said - impedes the ROM. As for manipulation vs not -- if there is a way to jump start the bend and everyone who has had a manipulation here says it works and isn't really painful -- why not do it? That is if you don't make gains with your PT in the next few weeks. If you are only 60 -- you have decades of active life ahead of you. Why set limits on yourself? You may find some activity you want to do in 2 years or 5 years that needs more ROM than you have. Why not get the full potential out of all the pain and effort you have put into your new knees? Grandkids run around a lot and want to go places and do things. Don't you want to go with them? And you know "travel" is not a sit in the bus kind of activity; If you go somewhere new you want to walk and climb steps to the tops of towers and do hills in little seaside towns nestled against mountains (most of Europe). So set your sights for the best you can achieve. And remember no matter what your goals -- you have to work at the PT for some months to get to them. People on this forum say their ROM increases right through the first year with exercise and normal activity. After the first 3 months or so when your exercise regime is usually most intense. Give it all you've got for a few months Elmtree and you'll see -- your life will get SO much better!!!!

 

[Jamie]

Excellent post, Backbay....my thoughts exactly.

 

[elmtree777]

Just wanted to update you on my decision...I am scheduled for manupulation on June 1...so guess I will find out what it is like and if it turns out to be for the good...I have no swelling now and no pain, expect when the PT tried to flex my knees...
Please answer a couple more questions for me if you all will...
Do you have PT more often after the "Man" to keep the flex tghe DR. got?
My PT said I would need it every day for 2 weeks to maintain it.
Does the flexing the Pt does after the "man" hurt more or less than before the procedure?
Finally...do I have to start at where I am flexing now and work up to what the Dr. got during the "man"?
Sorry for all the questions guys...I have tired to ask the PT and the Dr., these questions, but can't seem to get a direct answer from either of them....