MUA Stiffness - hard to do exercises

[BBCG]

Hi @LINYKnee,

Oh, gosh! I don't suspect the PT being too light was the problem. I suspect it has been that you are doing TOO MUCH! I was also threatened with a MUA, but I declined, said I would back off everything after finding Bonesmart, and did not go back to my doc at the 12 week mark and instead waited until I had the 90-120 degree bend and then went back. Thus, I did NOT get a MUA as I thought that sounded just brutally ridiculous! So, didn't do it!

You can choose not to do it, and back off the work in the location, elevate more, ice more and do everything you can to baby your knee, which it does not sound like you did yet, am I right? MUAs are not a magic fix, and not everyone who has one gets great benefit form them, although some do.

When suggestions were made to you, you thanked the person, but I'm not sure if you followed any of the advice... at 8 weeks out you were already back at work 3 days for 4 hours, but to be honest, I was not able to do that and still keep the internal swelling down, so I backed off and worked only from home WITH the knee elevated on a recliner, for most hours of the day still at that point! And I iced at least 6 hours a day still at that point...

Perhaps a moderator will chime in, too, but at 16 weeks getting a MUA seems very quick, as I'm not sure you gave your knee any opportunity for that internal swelling to go down, which I suspect is hindering your bend. You can decline a MUA. It is your knee, and you can back off and allow it time to recover without going in for such a procedure, which seems counter productive if your knee still hasn't healed from the TKR yet... in my opinion.... It is very easy to listen to the docs and PTS if they are of the "No pain, no gain" school, but that is NOT the only path through this, and, in my opinion, having been through it twice now, not the best way at all!

I'll check back in later, but this is still within your option to try to do the gentler way if you choose to do so....

 

[patriciad]

So very sorry to hear that you are booked for an MUA next week. It really does seem early in the healing process. Is it possible for you to get a 2nd opinion before undergoing the procedure? Have you increased your icing and elevating and backed off exercise. I am sure your need for an MUA has not been brought about by too little PT. I am one of those people who didn’t do any PT (with my surgeons approval) after an aggressive 1st session that set me back 3 weeks of recovery. I have full ROM and extension and little swelling or pain by taking the Bonesmart approach. Good luck I assume you will have to have more time off work and that alone will bring about improvement to your swelling and ability to bend the knee.

 

[Rubyroo]

@LINYKnee Sorry to hear you are having difficulty. Thinking of you & sending healing vibes & wisdom as you decide which course to take for your knee.

 

[BBCG]

Hello
12 weeks out and very stiff.

I followed a light to med PT program, any other way was killing me…

did all I could at home with stretching etc..plus walking , and a very good amount of daily activity….

I wonder now, did I take it too light , meaning the PT….

Much longer road than I expected….

Very depressed about this all.

Dear me, @LINYKnee!

It certainly sounds like you were OVERdoing it, not under doing it, from the little you have said about what you chose to do after getting feedback from people here.

I made some of your statements bold, since these are way too many activities if you want your knee to heal well!

If you do choose to go forward with the MUA, I do hope it helps… I’m not sure you believed or followed any suggestions that have been made here, so I’m not sure if it’s helpful for me to chime in. But I was told I would need a MUA if I didn’t get to a bend of 90 degrees by a certain date, but I followed what was recommended HERE, did NOT undergo a MUA and that knee is rock solid, I have a squatable bend, and that was my strong leg while I waited for my spouse’s health to settle down for me to have TKR #2!

You really probably don’t need a MUA, but it’s the only thing they can offer if you don’t take matters into your own hands…or legs, in this case…and try a different path, by backing off your too-intense a path.

It’s not clear that you followed any of the suggestions here, so it’s disappointing to hear about your MUA, since I think lots of us here think you could have done differently and avoided it. Good luck and I hope it works out you…

 

[LINYKnee]

Hello
My bend is much lower than 90. 50 at times.
I did listen to all on this site. At 12 weeks I have severely lost any bend from the past. I couldn’t squat if my life depended on it. Not even close. Everyone is different. It’s unfortunate This is the case. You chiming in is welcomed.
light pt and daily activities were my main for of therapy. Very hard to take matters in my own hamds , which I did. And here I am.
my question to you is what is your medical training back ground ? MD, surgeon , PA , PT therapist. Im
Just curious.

 

[LINYKnee]

Here’s a pic

 

[BBCG]

I think you just need to do whatever works for you. I wish you good luck with the MUA, and hope it helps.

 

[Jamie]

Hi, @LINYKnee .....I'm sorry to hear you are struggling with your ROM. Knees can sometimes be very sensitive to not only exercises, but also activities that we think should be "no big deal" such as going back to work, running errands, sitting in a chair for extended periods of time, or even walking. Resumption of normal activities is usually best done on a gradual basis after the first month or two in recovery.

Am I understanding that at some point in this 12 weeks you had more ROM than you do currently? The image you posted does appear that your knee and thigh might be a bit swollen. Where ROM is concerned, it doesn't take much swelling at all in the knee compartment to cause problems. Your knee is a very tight space and a little fluid there can make a big difference. That "tight" feeling you mentioned could indicate the presence of swelling.

If you choose to go ahead with the MUA, you can expect some soreness and swelling afterwards. That's pretty normal following the manipulation. You will want to take care to try and reduce that swelling as quickly as possible with ice and elevation. The fact that you'll be on a CPM machine for 6 hours a day should do that for you. Be sure and ice when you use it. Be kind and gentle to your knee in the weeks following the procedure to allow your soft tissues to heal. Even though it's not surgery, it's still a trauma to your knee since it's purpose is to break up any adhesions that may have formed.

Best of luck to you and let us know how things go.

 

[Jockette]

I’m sorry that you are still having such a tough time with this recovery. While it does seem that often an MUA is done too early, when the basic issue is “just” swelling, but sometimes they really do help, and I hope that is the case for you.

Like Jamie said, be prepared for possible pain and swelling afterwards, as it’s a forceful procedure, by nature of what it is trying to accomplish, which is why you are given some type of anesthesia to have it done. While your doctor will want you to go to PT afterwards, remember to not do anything there that causes pain and/or additional swelling. Don’t let them force your knee to get a better bend. Yes, you want to give your knee mobility, but it will also need time to heal again, after this latest procedure.

Do what you can with the CPM machine, just be careful with the settings. Don’t set it to a number that is too high for you, and if/when you increase that number, do it very gradually. You want enough motion without causing additional pain and or swelling. If you find your leg is not handling it well, check with your doctor about slowing it down, or reducing the hours you use it.

We all wish you the best and hope this works out well for you.

 

[LINYKnee]

Good Morning,
Hope you are well.
let me clarify exactly what is happening.
This Wednesday I will be 11 weeks out. I seem to be progressing okay over the past weeks. As time moved on ,after and during PT (not crazy aggressive ) I always had gotten most bend. Close to 80-90. Once I left PT, 20 mins later , my knee would stiffen up. I would never get the bend I did as I would during or after PT. The problem is that on the left bottom side of my knee there is a spot of about the sizeof a half Dollar that is still numb. This is the area where it feels hung up. As if there is a poking feeling in that area. Always as if something is going to pop out of the side of my knee. This occurs with or without activity , it’s always there. Also I should add I am NEVER in pain. I am on zero meds. I’ve been very fortunate from the beginning of this journey in regards to not having pain.
As I eventually went back to the office , sat at my desk and did have my knee raised while there. My boss provided me with anything I needed. While there I was able to elevate , ice and even use a heating pad if necessary. I would be there for a total of 4 hours. With a 15 min ride home in the car , which I drive myself. That with DLA and maybe a trip to the market once a week. While home I iced , elevate ( even when sleeping ) regularly. I don’t not over do it. Again still NO pain. Sleeping well.
But , that little spot was and still there. I didn’t go to see my OS till last Wednesday.He suggested a MUA. He stated I am in the 1% of people this happens to. Lucky me.
i don’t want to do the MUA mostly due to the set back. There is definitely something not right. Since then I have stopped my PT and all stretching at home. I ice , elevate etc … Still the same issue.
believe me , I’m frustrated. I did everything right.
i even have purposely dropped weight to help with any extra pressure on my knee. I thought this could only help. With this procedure there is NO difinitive
protocol. Many different thought from people , doc’s , therapist and those on BoneSmart. I regret doing this procedure. I would never recommend it to anyone. I have spoke to several Docs , but no one is on the same page. It’s either aggressive PT (old school mentality ) or some that mirror the BoneSmart way in some , not all ideas on what to do.
anyway I am here with that nagging little corner of the world on knee that still has that spot where it is not cooperating and causing me not to bend.
That’s the story. This week I am going for a second opinion.

 

[Jockette]

Always as if something is going to pop out of the side of my knee.

I had this same thing, in the same spot. I could literally feel something pop in there with certain unavoidable movements in my daily activities, which eventually I assumed, in my case, was swelling. With mine, it eventually went away, as I healed.

And that numb area can last for many, many months. It’s been 5 years since my partial and it still doesn’t totally feel back to normal.

It seems the MUAS that don’t help are the ones done in the first month or 2, as often in those cases, the problem is still surgical swelling, and the person’s own healing timeframe. It’s good that your doctor gave you all this time to heal, so hopefully the resulting setback will be a short one and you will see good improvement after it.

Just keep in mind that this recovery takes an average of a year, even without an MUA. 11 weeks is about 25% healed, and some of us still need a second year to fully heal. I actually had a lot of improvement in my second year, and I “only “ had a partial, promoted to have a quicker recovery.

Sending lots of hugs and prayers for a successful procedure!

 

[sistersinhim]

Is it possible that your doctor did a lateral release on your knee during surgery? I had a problem on my medial side for months after my tkr and couldn't figure out why. That's when I decided to ask for my surgical report. While reading it I discovered that my OS had done a medial release during the surgery. That explained that problem area.

As for numb areas, they are totally normal for years or more. I had my tkr 5.5 years ago and still have a numb area. Of course, I had 5 other surgeries on that knee so it's bound to have numb areas! Anyway, try not to worry about the numb spots. Most people have most or all of the feeling to return to the knee are.

How blessed you are to not have had pain.

 

[Jockette]

I had a lateral release done during my surgery, and that’s where most of my discomfort has always been, even now, 5 years later. I didn’t know about it until I read my surgical report at one year post op. It might be a good idea to ask for a copy of yours. I thought mine would be an interesting read, and I understood more than I thought I would. I was surprised to learn about the lateral release, as I don’t remember my surgeon ever mentioning it in any of my checkups.

 

[kneeper]

Hopefully the MUA will do the trick for you. As others have said the numb area is totally normal and will gradually reduce to almost nothing.

 

[Susie-Q]

The problem is that on the left bottom side of my knee there is a spot of about the sizeof a half Dollar that is still numb.

This is exactly where I have a numb spot still too. It will go away with time. The nerves need time to regenerate. Good luck with your second opinion.

 

[patriciad]

Good luck with your 2nd opinion. Keep us posted - we are all rooting for you and agree totally that this is a tough recovery for some. If it helps I still have a numb spot on the front of my right knee from my first TKR 5 and a half years ago. Sending healing wishes.

 

[kneeper]

As someone who manages to bang into my coffee table periodically--the numb spot has its advantages!

 

[Jockette]

Thinking of you today as you have your MUA tomorrow. Sending best wishes for success!

 

[patriciad]

Good luck with tomorrow’s procedure.

 

[sistersinhim]

Good luck tomorrow!