MUA Susie2023's TKR Recovery

[Susie2023]

I wonder how the OS knows there are adhesions or scar tissue to warrant an MUA? Do they show up on xray?

 

[JusticeRider]

That’s the part that really got me…they don’t. They don’t actually know at all. So if it IS adhesions then the MUA can help. But if it’s swelling inhibiting your bend and NOT adhesions, the MUA can make your swelling worse and therefore make your ROM worse! And now you’ve had TWO rounds of anesthesia, and TWO invasive procedures and have to start your recovery all over again. To me, it wasn’t worth the risk. Especially since I did have lots of swelling, and adhesions are rare.

 

[Jockette]

@JusticeRider and

 

[sistersinhim]

The scar tissue (which is more correctly called adhesions) is very rare, and one of the easiest ways to develop it is to work your knee too hard. Over-worked knees get inflamed and hot, and hot tissues become drier than normal and more likely to stick together and form adhesions.

This article explains the difference between scar tissue and adhesions:
MUA (Manipulation under Anaesthetic) and Adhesions

You need normal scar tissue. That's what holds your incision together, and it's part of the normal healing process. Without it, you'd always have an open wound.

 

[Susie2023]

Since overdoing it last Sunday and Monday, I've had considerable swelling and pain. I did cancel my pt appointment this past Thursday. I've been laid up since Tuesday, icing and elevating, I'm even swollen in my thigh. I think my lymphs are backed up, can that happen? I called my doctor today, the person recording my concerns did not relay them correctly to the PA. I was phoned back saying swelling will come and go for 6 mos to a year, take anti inflammatories, compression stockings, ice and elevate. I told the person that is not what I called about, already know the time frame, already taking Celebrex, been icing and elevating every day, multiple times a day. So I told her exactly why I called, that I'm not going to call for regular swelling. She read back to me everything I shared with her, offered to make an appointment to come in for the swelling. I told her I couldn't even bend my knee to get in the truck!

So I know I'll get a call to say get compression stockings, keep icing and elevating, blah blah blah. I'm upset.

I've decided I need to look at what I can control. My body is reacting to this surgery differently than others, true. I cannot change that. But what I can control is how I want to proceed with pt. I am going to have a conversation with the pt, no aggressive pt, let's concentrate on getting my quad strong, whatever gentle ROM exercises we can do, and what I can continue to do at home.

I am so beside myself. This is going to be a much longer journey than I thought, which I shared with my husband. While very supportive and taking care of me through all this, he felt I was being negative and unrealistic. So I've decided not to discuss this with him anymore.

So a couple of questions. Has anyone used OTC water pills for this before? Not long term, but just to get the fluid rolling? Also, what are your thoughts on compression stockings?

Sorry to vent/whine. I need to resolve to do what's best for me.

 

[beachy]

I about to purchase a neoprene sleeve for my knee. Hoping the compression will help the swelling. It did last tkr.
You can actually call different PT places and "interview" them. Ask what they do for tkr rehab when knee is swollen. I did that for first tkr.

 

[EalingGran]

I've been laid up since Tuesday, icing and elevating, I'm even swollen in my thigh. I think my lymphs are backed up, can that happen?

I know some people here like @JusticeRider have used massage for swelling and I think there is a special kind called Vodder technique for lymph drainage. She might be able to tell you more about it.

 

[Softsong]

@Susie2023 I am a case in point. My surgeon wisely wrote a few exercises to do, the same as BoneSmart recommends. He said that the first two weeks were strictly for rest and healing. Just imagine if you crushed your leg in an accident. Would PT be trying to force that leg to do things? No. The leg has to heal before it can do much of anything.

My home PT kept trying to add more exercises and I took out my surgeon's instructions. NO other exercises. My surgeon had me at 0 extension on the or table and with my leg held straight in the hospital he said I did not have to put a towel under my ankles or work on extension. I told the home PT who came to evaluate and set up and he said, "Well, you may have been at 0 in the hospital, but I am sure that it is not now." He picked my leg up and bent it backwards and it HURT. I told him and the female PT he sent to never touch me again They fought the whole time to add exercises. I didn't let them.

It turned out unfortunately, that my incision got infected and bending would make it bleed, so I rested. For some reason, outpatient PT never called and I stayed home and took my antibiotics for three weeks. The infection went away and I did not need to go into the hospital for an IV drip.

When I went to my surgeon at three weeks, my bend was 90 degrees. At 7 weeks, it was 114 degrees. I barely did the exercises prescribed, just walked and did my daily life activities. I did not go to outpatient PT. Like BoneSmart says, your ROM is just there waiting for you. It does not need to be worked at, fought for. Those things make the injured leg more injured, and less likely to bend or stretch. Pushing yourself is counterproductive.

I have another complication, an inflammed bursa (bursitis) because I was so knock kneed and so much work needed to be done to straighten my leg that the muscles are different and irritating the bursa sack where three tendons join. I can't have a cortisone injection yet, but I am to rest it. I'm using a walker again to relieve weight. I'm not worried about losing my ROM. I am going to go to PT just to see about some exercises to help the muscles that are tight stretch a bit. If they hurt me, I am out of there. My surgeon and even the PT that I saw to set up the exercises for my muscles to help the bursa were amazed. No PT and you're at 114 and 0. As far as my doctor was concerned, I don't need PT for my replacement.

So, relax a little. Let your knee heal. Your bones were sawed, and a metal thing was hammered into your tibia bone. Plus everything was moved, cut and pushed around. How can it bend when so much trauma has happened. Forcing it with PT will slow your recovery. I see it every time. I had to wait three years for my TKR due to Covid and other family situations. The people hurting the most and with the worst bends are those that beat themselves up over the need to push themselves more. Let your husband know that the more you push, the longer it will take to get there. You will get there, but it will take more time, and more pain. And when you get there, PT will say it was all the hard work. You would get there anyway with less trouble.

 

[EalingGran]

am so beside myself. This is going to be a much longer journey than I thought, which I shared with my husband. While very supportive and taking care of me through all this, he felt I was being negative and unrealistic. So I've decided not to discuss this with him anymore

Don't worry about ventilating here- especially if your other half is a bit unsympathetic/ unrealistic.
Pretty much everyone here has found this a tougher journey than we expected and has had some negative feedback from people who don't have a clue!
I have had well meaning friends and family expressing surprise that I am not 100% fit at 3- 4 months.
They have shut up now because recently I was quite seriously ill in hospital with unrelated sepsis. In fact I feel totally better from that but happy that it has at least taken the emotional pressure off my knee rehab journey!

 

[beachy]

@Susie2023
I just re read your "venting/whining" post.
You are not whining and we've all vented here.

I think (IMHO) you've come to realize that aggressive PT is slowing down your recovery.
Sadly, this happens to more tkr patients than we can ever realize. I was lucky to find Bonesmart prior to my first tkr.
Without finding Bonesmart, I would totally have listened to my doc, physical therapists, well meaning friends, etc.

It takes a lot of courage to have the "resolve to do what's right for me".
You will have a lot of Bonesmarties cheering you on. And please remember this is a year long recovery, give or take, for all of us. In the end your knee will heal with gentle movements, be stronger than the old one.

 

[Flashlight]

Have you been elevating higher than your heart level? I had to buy a wedge and even though I didn't need it for long it was well worth the money to get the swelling down. I also used an ace wrap to wrap my leg up to my thigh and would wear that while elevating. There wasn't any way I could get my compression stocking on. The celebrex made me sick and I got better results from ibuprofen. At 8-weeks I also had difficulty getting in and out of the car. At 10-weeks I was doing better and driving with an ice pack on my knee. It was better for me to drive because I could extend my left leg. You will get there too! I think our husbands just want us to feel better and get back to what was normal. Hang in there!

 

[WillB]

Since overdoing it last Sunday and Monday, I've had considerable swelling and pain. I did cancel my pt appointment this past Thursday. I've been laid up since Tuesday, icing and elevating, I'm even swollen in my thigh. I think my lymphs are backed up, can that happen? I called my doctor today, the person recording my concerns did not relay them correctly to the PA. I was phoned back saying swelling will come and go for 6 mos to a year, take anti inflammatories, compression stockings, ice and elevate. I told the person that is not what I called about, already know the time frame, already taking Celebrex, been icing and elevating every day, multiple times a day. So I told her exactly why I called, that I'm not going to call for regular swelling. She read back to me everything I shared with her, offered to make an appointment to come in for the swelling. I told her I couldn't even bend my knee to get in the truck!

So I know I'll get a call to say get compression stockings, keep icing and elevating, blah blah blah. I'm upset.

I've decided I need to look at what I can control. My body is reacting to this surgery differently than others, true. I cannot change that. But what I can control is how I want to proceed with pt. I am going to have a conversation with the pt, no aggressive pt, let's concentrate on getting my quad strong, whatever gentle ROM exercises we can do, and what I can continue to do at home.

I am so beside myself. This is going to be a much longer journey than I thought, which I shared with my husband. While very supportive and taking care of me through all this, he felt I was being negative and unrealistic. So I've decided not to discuss this with him anymore.

So a couple of questions. Has anyone used OTC water pills for this before? Not long term, but just to get the fluid rolling? Also, what are your thoughts on compression stockings?

Sorry to vent/whine. I need to resolve to do what's best for me.

Your journeypretty much mirrors mine. At 8 weeks I still have a swollen stiff knee and a swollen thigh. Unfortunately my lymphatic drainage massage appoint was cancelled Friday as my therapist was ill. Was really looking forward to it as I think it would have made a difference. Still lots of discomfort at night.

 

[LD of Michigan]

Don't worry about ventilating here- especially if your other half is a bit unsympathetic/ unrealistic.
Pretty much everyone here has found this a tougher journey than we expected and has had some negative feedback from people who don't have a clue!

That's right. I vented and posted here alot in the middle of those sleepless nights my first TKR and with my last one. We're here for you. And some of us have had a few set-backs!

 

[LD of Michigan]

...Let your knee heal. Your bones were sawed, and a metal thing was hammered into your tibia bone. Plus everything was moved, cut and pushed around. How can it bend when so much trauma has happened. Forcing it with PT will slow your recovery. I see it every time.

That's right. When we stop to think about what the TKR entails, rather they send you home same day or not, it is no wonder it takes time to heal. PT has to be gradual on your schedule (even if frequent - as was my choice twice a week) coupled with lots of restorative rest and ADL (activities of daily living). Keep us posted.

 

[Axx72]

Wow! That would be incredibly frustrating. Maybe get your husband to watch a TKR procedure. They are very invasive and considerably violent. There is so much damaged/healing underlying tissues, muscles, tendons and ligaments that are in desperate need of rest, ice, compression, and elevation.

I believe that you should never let anybody make you do what you’re uncomfortable with. Also, your knee will tell you if you push too hard because it react and protect the joint with inflammation and pain. I am almost a year post-op and my knee still tells me when I’ve pushed too hard.

Your therapists and advice givers will provide you many different types of therapies/exercises and like everyone else, you will find the ones that work the best for you. The key is to be consistent over the long term.

We all started off, feeling like this is just an injury that will relieve itself after a few months. It’s so important to realize that this is not a quick heal and will take time. Not a sprint but a marathon. Recovery is up and down and full of reversions. Be positive and celebrate your successes and be patient when recovery isn’t progressing like u want it to. When your family sees your positive attitude moving forward, they will celebrate your successes as well. Stay strong and listen to your body

 

[Jockette]

@Axx72

 

[Susie2023]

Happy Sunday all!

My husband coaxed me off the couch yesterday (I was icing and elevating). It was a beautiful day here. He was going to take a ride on his new motor bike, said he was going to ride to a neighboring town, grab a sandwich. But then added, he'd rather have lunch with me. So I made myself presentable and strapped on the ice packs while we drove in the car. I was concerned how long I'd be able to sit at the table before pain set in. I brought trusty ocxy in case. We had an enjoyable lunch, I even walked a block to the car, using cane and his hand. It was wonderful getting out of the house and spending time with him. We love to travel and eat at new places.

He has seen the damage aggressive pt and overwork has done, and I shared with him how I want to move forward with healing. He is supportive of that ❤️. I started thinking how concerned he might be, even a bit anxious, watching me in pain, not being able to do anything, swollen, etc. There's always that thought you might end up being a caregiver a lot longer than you think.

Today the swelling is reduced where I can bend a bit, my skin feels looser over my new knee. I'm going to try very light exercises. I'm not back to where I was but I know I'll get there again.

Thanks to all for your support. Pt is Tuesday. I do look forward to working on my quad strength.

 

[EalingGran]

That all sounds great! It is good to get out and start doing normal things again. It really helps with staying positive.
Glad the swelling is getting better too.
Just don't overdo it. You are still in the early days.

 

[Axx72]

The ODIC is a tough road…1yr out and I still have trouble staying away from it

 

[JusticeRider]

@Susie2023 I’m so glad you had a nice outing with your hubby and he is coming around and more understanding of where you’re at! I sympathize with your thought that caregiving can be daunting, especially the fear that it might last longer than anticipated. I injured my knee in 2020 and 2.5 years and 3 surgeries later, my husband is still caring for me. Thankfully though, the last couple months I’m requiring much less care! But I’m sure at the beginning, he never would have guessed what a long gig this would turn out to be. BUT that’s what you sign up for when you marry someone! Try not to feel guilty…after all you know you would do it for him in a heartbeat