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TKR Stiff knee post op

bobo47

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Hi, I had a TKR on 23rd Oct '21. The physio who i see at the hospital is threatening an MUA because as yet I haven't quite achieved 90 degree bend. Nor can I fully straighten my leg. I had an accident 25 years ago which led to my recent TKR, so on and off I have limped for about 5 years and have muscle atrophy. The leg extensions my physio is trying to get me to do where my knee is lay over a pipe are almost impossible. Same with sitting on a chair with my leg at 90 degree's, its quite painful behind the knee. I've been told I need to be at 100 degree's by next Tue. I simple can't bend it that far at the moment without force. I feel like I'm falling behind her expectations and twice now she has mentioned MUA......I'm scared!
 

Jaycey

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@bobo47 Welcome to BoneSmart! Which knee did you have replaced. We will put the information in your signature for you.

First - no physio can tell you that you are going to have MUA. In fact, not surgeon can demand that either. In any case - it is far too early to be thinking about MUA.

Second, please do not let anyone force that knee. It is totally counterproductive. All that forcing is causing more inflammation. The swelling prevents any increase in extension or flexion.

Finally, there is no deadline for gaining ROM. Some of our members continue to see improved ROM for literally years.

So - don't be scared but do be firm. Tell that PT you don't think her approach is working. Be firm about not doing painful forcing of the knee. If they don't agree, I would find another PT who does.

Here are your recovery guidelines:

Knee Recovery: The Guidelines
We are all different, as are the approaches to this recovery and rehab. The key is, “Find what works for YOU.“ Your doctor(s), physiotherapist(s) and BoneSmart are here to help. But you have the final decision as to what approach you use.

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
ice
take your pain meds by prescription schedule (not when pain starts!)​

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 Activity progression for TKRs

6. Access 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 a 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 history before providing advice.
 

ski_bum

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Hi, I had a TKR on 23rd Oct '21. The physio who i see at the hospital is threatening an MUA because as yet I haven't quite achieved 90 degree bend. Nor can I fully straighten my leg. I had an accident 25 years ago which led to my recent TKR, so on and off I have limped for about 5 years and have muscle atrophy. The leg extensions my physio is trying to get me to do where my knee is lay over a pipe are almost impossible. Same with sitting on a chair with my leg at 90 degree's, its quite painful behind the knee. I've been told I need to be at 100 degree's by next Tue. I simple can't bend it that far at the moment without force. I feel like I'm falling behind her expectations and twice now she has mentioned MUA......I'm scared!
If you have a Hot Tub, sit in it and flex your leg. If I have a stiff log leg from driving or just sitting, I jump in the Hot Tub. Good Luck.
 

DJL1967

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I had bilateral TKR 9 weeks ago and currently have 130/0 and 125/0 flexion and extension with absolutely no physical force needed to get these numbers.

Back in the late 80's I tore both my ACL's and had them repaired. I was in a cast for 6 weeks and when they removed the cast I started physio right away. First thing the PT did was have me lay on my stomach and have me bend my leg as far as I could which was not much. The PT grabbed ahold of my ankle and without warning pushed my heel very forcefully toward my butt. Well I yelled and screamed at him and said that would be the last time he did that. I was told that he would do it every time I came in till I had full range. That was the first and last time I saw him and I did my own physio on my own terms.
At home I would lightly start bending my knee, gradually applying pressure just to the point of slight discomfort, hold for a second then release. I would ice then go on my stationary bike with the seat raised high and start moving the pedals forward/backwards. It took awhile before I did a full rotation but I never had the severe pain or swelling with forceful manipulation. I took the same approach after my knee replacements and have had great success without any pain or increased swelling.

Your flexion will come without force, just be patient and try not to cause pain and swelling to the joint.
Good luck in your recovery.
 

Scaredycat10

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Hi, I had a TKR on 23rd Oct '21. The physio who i see at the hospital is threatening an MUA because as yet I haven't quite achieved 90 degree bend. Nor can I fully straighten my leg. I had an accident 25 years ago which led to my recent TKR, so on and off I have limped for about 5 years and have muscle atrophy. The leg extensions my physio is trying to get me to do where my knee is lay over a pipe are almost impossible. Same with sitting on a chair with my leg at 90 degree's, its quite painful behind the knee. I've been told I need to be at 100 degree's by next Tue. I simple can't bend it that far at the moment without force. I feel like I'm falling behind her expectations and twice now she has mentioned MUA......I'm scared!
If you have a Hot Tub, sit in it and flex your leg. If I have a stiff log leg from driving or just sitting, I jump in the Hot Tub. Good Luck.
and if you haven't got a hot tub, a hot shower works in the same way, as does a hot water bottle behind the knee [NOT on it].
 

Scaredycat10

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Hi, I had a TKR on 23rd Oct '21. The physio who i see at the hospital is threatening an MUA because as yet I haven't quite achieved 90 degree bend. Nor can I fully straighten my leg. I had an accident 25 years ago which led to my recent TKR, so on and off I have limped for about 5 years and have muscle atrophy. The leg extensions my physio is trying to get me to do where my knee is lay over a pipe are almost impossible. Same with sitting on a chair with my leg at 90 degree's, its quite painful behind the knee. I've been told I need to be at 100 degree's by next Tue. I simple can't bend it that far at the moment without force. I feel like I'm falling behind her expectations and twice now she has mentioned MUA......I'm scared!
I'm two days ahead of you, op wise and apparently I'm 'doing well'.

It's nearly 3am and it doesn't feel like it let me assure you. My knee is so stiff when I get up out of a chair, it takes me a bit to get going but that's normal at our stage.
I came across an ogre of a physio at the hospital the day after my op. Long story short, she hadn't read my notes properly and thought I'd had the op two days prior to the actual date and berated me on my lack of progress and was most unkind. I could have raised a complaint about her attitude especially as I was feeling really vulnerable at the time, but didn't as I don't make waves. . Thank goodness I have my own to look after me.
Hopefully, you'll have got some confidence from this site and you will not be browbeaten.
Good luck,
 

ValleyGirl

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I just had an MUA. It has given me a chance to move forward with my ROM. The worse part was waking up to a cramped leg due to muscle guarding, but the meds soon took that away. You have a better ROM than I did though. I worried more about the MUA more than I needed to. Procedure took only minutes.

Good luck to you!
 

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