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[MUA] So much contraction over my incision!

katpkatp

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hi there! Brand new at this. I’ve had constant contraction in the extended position since the beginning.

I go to PT 3x a week, 2 hours a pop. We work hard, I cry, I get to 60 degrees on a good day. I walk out the door and my leg is stiff in 5 minutes. Sometimes the contractions are so hard that I cry, I take an oxy, and I go to sleep. I wake up and it's back.

At home I do my PT faithfully. I’d say my ROM is 50 degrees after 4 weeks. I’ve read people describe the contractions as bands. Mine get stronger and stronger so I call them contractions. I can’t lift my leg, my quads are still dead.

I’ll post my progress, but it is so slow. Anyone have something similar? I get so depressed. Thanks k
 

Jockette

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Hi and Welcome to Bonesmart!

I’m sorry you are having such a hard time. :console2:

I’m sure you are doing your PT as advised, but I honestly think you are working too hard and your new knee just can’t handle it. 2 hour PT sessions are way too much and the fact that you are crying proves it.

Bonesmart recommends a much gentler approach to recovery, which allows our body to heal and give it the gentle mobility it needs.

Please tell us the date of your surgery.

I will leave you our Recovery Guidelines. Each article is short but very informative. Following these guidelines will help you have a less painful recovery.

Knee Recovery: The Guidelines
1. Don’t worry: Your body will heal all by itself. Relax, let it, don't try and hurry it, don’t worry about any symptoms now, they are almost certainly temporary
2. Control discomfort:
rest
elevate
ice
take your pain meds by prescription schedule (not when pain starts!)
don't overwork.
3. Do what you want to do BUT
a. If it hurts, don't do it and don't allow anyone - especially a physical therapist - to do it to you
b. If your leg swells more or gets stiffer in the 24 hours after doing it, don't do it again.​
4. PT or exercise can be useful BUT take note of these
5. At week 4 and after you should follow this
6. Access to these pages on the website

The Recovery articles:
The importance of managing pain after a TKR and the pain chart
Swollen and stiff knee: what causes it?

Energy drain for TKRs

Elevation is the key

Ice to control pain and swelling

Heel slides and how to do them properly

Chart representation of TKR recovery

Healing: how long does it take?

Post op blues is a reality - be prepared for it
Sleep deprivation is pretty much inevitable - but what causes it?

There are also some cautionary articles here
Myth busting: no pain, no gain
Myth busting: the "window of opportunity" in TKR
Myth busting: on getting addicted to pain meds

We try to keep the forum a positive and safe place for our members to talk about their questions or concerns and to report successes with their joint replacement surgery.

While members may create as many threads as they like in the majority of BoneSmart’s forums, we ask that each member have only One Recovery Thread. This policy makes it easier to go back and review the member’s history before providing advice, so please post any updates or questions you have right here in this thread.
 

Celle

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Hello @katpkatp - and :welome:

Please will you tell us the full date of your knee replacement, whether it was a total or a partial replacement and which knee it is, so we can make a signature for you? Thank you.:flwrysmile:
 

Josephine

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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?
 
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katpkatp

katpkatp

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Hi all, my surgery date was May 17, 2019. It was a total, left knee replacement. I had at home pt for the first 2 weeks. I already had slow progress according to those pts. The contractions just keep getting stronger. I had a phone call from the hospital today. Next Thursday I am scheduled for MUA and will get final evaluation for the need of it on Tuesday, June 25. My surgeon is said to do his MUAs in week 6 which is exactly where I will be. I just want some relief from this contracting. My I. Ision is warm and it hurts when touched.
 

Jockette

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Josephine can help you if you agree to answer her questions.

Personally I would not consent to an MUA at only 6 weeks, the healing process is still in early days and has lots of time to improve.

3 two hours sessions of PT per week this early in recovery has kept your knee swollen and upset and that’s why you can’t bend it much right now. Give your knee a rest and ice and elevate so your swelling has a chance to come down, that will also help your pain level to come down.
 

sistersinhim

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Many of us never took formal PT or did exercises. I am one of them. I had 11 knee surgeries, 2 of them kneecap removals and 1 tkr. Even after those I never took PT. But, I didn't just sit around and do nothing. I took care of myself, my house and yard as my knee allowed me to do. As I healed, I did more. But, my knee was always in control. This was enough therapy for me and would be for any tkr patient. All the awful pain of PT is so unnecessary.

All you have to do is use it in your daily living. Your knee knows how to rehab itself and doesn't need anyone telling it how. Just use it and it will come back like new. You have to be patient, though, it doesn't happen quickly. ADL,(activities of daily living), going to the bathroom, brushing your teeth and bathing, fixing a light meal, getting something to drink and or a snack, those kinds of things will be all the exercise your knee needs. If you just use it daily in your living, you can have a less painful recovery. We know what works, we've been there:yes:.
 

eaglemom

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Let me echo what the other's have said - you are using that brand new baby knee too much. I can't image that much PT. Of course its not happy. Scale back, elevate and ice - give it a chance to heal.
 

9 of 11

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I also struggled with extension within the realm of ROM, I wish you much luck and support, I see your sporting a Rock tape web, I assumed that your PT has used it , it worked miracles to improve my gait and decrease some lower leg discomfort, I still use the tape 6 out of 7 days ( one day to give my skin a breather) I hope you eventually get the same help from this treatment as I did
 

lisabl

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I got those contractions or spasms early on. I massaged them and applied magnesium oil and within a week or so they had calmed down for me.
 

Atlas_aus

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This is exactly what I have been doing and so far so good. Perhaps slow down a bit and see how you go. Good luck.
 
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katpkatp

katpkatp

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Hi everyone. Thank you all. I read all your posts. I had the MUA. So, so much pain. And here I am 5 days after. I went back to PT today and they got me back to 66. That’s what I was pre-MUA. I found a machine online called the X10. Has anyone used it or know of someone who has? It’s a lot of money, but sounds like an alternative that might work for me. PT tells me that I have incredible guarding. That’s the massive contraction I get around my knee that totally undoes any of the ROM I might earn during PT. Help , please.
 

Celle

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Hi @katpkatp
If you tell us what date you had the MUA, we'll add that to your signature.

Your poor knee has been wounded again by the MUA, so don't go overworking it at PT. All it needs is to be kept moving gently - no forcing, no aggressive or multiple exercises. It will be more swollen again, so give it plenty of rest, ice and elevation.

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 ROM is there right from the start, and it will gradually increase as your knee heals.

Don't waste your money on an X10 machine - it would try to force your knee too quickly.
Instead, give your knee lots of TLC, - and trust it to recover. It knows what it's doing.
 

Rockgirl4

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Back in 2015-16, I did the aggressive PT 3X a week for hours where they forced my knee to bend and made me scream/cry/beg. We did it for months because I bought into the "if we don't do this, it will never bend fully and you won't walk normally again" mentality that is simply WRONG! All it got me was a knee full of adhesions because the joint was never allowed to calm down and just heal. My TKR surgeon (my NEW surgeon!!) did my TKR 6 wks ago and made a point to tell me and my husband how my knee was absolutely full of scar tissue---even after it was cut out in 2016 and then manipulated again (8 days later) in 2016 ....all because of aggressive PT after both of those procedures that were "supposed to fix me." .:headbang:

Fast forward 3 yrs----after my recent TKR 6 wks ago, my new surgeon was strongly against anything more than PT 1-2X a week and ONLY for 1 hr, maybe 75 minutes----and NO FORCED BENDING!!!!! :bignono:It just makes the joint angry and causes a cycle of inflammation/pain that is hard to break and limits range of motion. I thought I was doing fine, but at my 4 wk checkup, he had me cut PT even more and do less repetitive bending because the joint was too angry/swollen. I was going 3X a week for 2 hrs each time, but she was not forcing the bend, as she knew he and I were both against it. We aren't even doing much strength training this time around in order to gain range of motion first and not anger the new joint. No daily exercises except using my knee in daily life--and I'm 46 with a 12 yr old, so I have plenty of "daily life" to help rehab this knee. :)

Guess what this has gotten me???? A much happier knee and more bending in just days time. :) Less pain, much less swelling, less pain medication, better sleep, better range of motion across the board. All from doing less. :)

My surgeon has been doing TKRs for 20+ yrs and is a revision/reconstruction specialist, so he sees it ALL---the good, the bad, the weird. In the last few years, he's told more and more patients that less PT is better after TKR, and he has a lot of patients stop PT after 4 wks. He's simply tired of dealing with the problems overly forceful and overzealous PTs are creating for him.

Also keep in mind I had complications after this TKR where I was on forced bedrest form Days 5-9 with no bending allowed, no standing allowed---only bathroom visits. This was because of severe swelling and too much mechanical stress in the joint (his words, not mine). At 3 wks post-op, I was only at 66 degrees flexion and +6 extension.:yikes: He wasn't worried though. :) I was only at 89 degrees at 4 wks, and am now around 98-100 degrees at 6 wks post-op. He's still not worried, as long as I'm making progress. It's coming slowly and THAT'S OK!! I'm off almost all the pain meds except at night, and my flexion is getting better every 2 days or so. I finally rode a bike normally today for 7 minutes. That's progress, regardless of the ROM number. It's better than 3 days go and night/day from 2 wks ago.

Please don't keep buying into the "more is better" and "no pain, no gain" mentality. I think it has already done you a huge disservice.:bawl:
 
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Josephine

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Don't waste your money on an X10 machine - it would try to force your knee too quickly.
Actually I would disagree with that about the X10. I've watched a lot of videos on it and it doesn't 'make' your knee bend like a CPM, you are in control of it all the time and can adjust the strength and so on of what's being done. I see now that you can rent these machines for home use and when I get my revision done, I am definitely going to give it a try!

See this site

https://x10therapy.com/
 

Benay

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This is what I heard after asking my OS. He said insurance no longer covers because studies show no quicker recovery time after using. I did Independent research as I'd heard good things, but I think it was a Harvard study that verified his same information.
 
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katpkatp

katpkatp

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The x10 comes tomorrow. I don’t care how much it costs. If my leg stops hurting and I get ANY rom I will be happy. I won’t have pt till Friday morning. I will not allow them to hurt me, actively or passively, any longer. I promise to post my x10 results.
 
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katpkatp

katpkatp

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I am wrapping up day 4 with my x10. I can not say it is painless. I make some progress in flexion in my early day session, but my later sessions are not so fruitful. Still less than 50 degrees comfortably.

I need help from this community. I have this horrid feeling of tight cables or wires around my patella. It runs down the front of my leg, my calf feels like there’s netting under my skin, and it just won’t give! As soon as I finish up any exercise, this net like constriction surrounds my joint and prohibits any bending. I had the mua June 27. Doc just started prednisone yesterday and said that if it is swelling we will know by the end of this coming week. I intend to call for an appointment come Monday morning. This is painful and so discouraging for starting week 8. Has anyone had this weird wirelike feeling? Thanks, k
 

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