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TKR too soon for MUA?

I accidentally let the new PT do too much on Wednesday afternoon. We agreed no forced bending, just massage. I was distracted by our conversation so didn’t notice he was gently but insistently trying to force more bend until all of a sudden I noticed, wow, pain, what!! Stopped him right away but it was too late.

Was in all kinds of pain starting that night and my poor knee was so tired yesterday I could only drag it. Had to spend Wed evening and all day yesterday mostly resting and icing. Thank goodness for my Breg! Had to take high doses of meds for the first time in two weeks. A tendon that had ached weeks ago now ached again. My knee feels more constricted than ever, like it’s surrounded in a vise. He had also moved the knee around on Wed.

At noon today I reported all this and more to the PT. I said, “You crossed that line that we had discussed avoiding, the line where pain starts.” He didn’t deny crossing that line. Just said “but” and then shrugged helplessly.

Then he measured ROM. In the supine position, where I had increased ROM from 55-65 in the past two weeks it was now only 52. But much scarier is that ROM while seated, which had always been 70, now, for the very first time, was only 53. Am now back home icing for 45 minutes. Knee feels the most frozen it has since the first week out of the hospital. Am scared but hopeful I’ll get the ROM back resting, icing, avoiding stairs. Poor knee, I’m sorry.

The only things good about this weeks PT is for the first time I saw a glimmer of hope in discovering thst the heel slides were actually able to increase ROM, not just a fruitless exercise. The beautiful thing is it felt natural, didn’t hurt, yet I gained ROM. So my doc was mistaken in saying an MUA was the only way I’d be able to increase ROM. And I can’t think of any better evidence of what Bonesmart says “no pain no gain is a myth” than the documented nosedive in ROM from just one session with a PT. The PT looked baffled by the evidence which no doubt contradicts his training.

My mood coming out of that session today was the hell with that MUA!!! I’m scared there might be lasting danage from this week’s PT. But also relieved now that I have what I consider to be solid evidence that an MUA right now is just too soon and too risky.
 
I'm terribly sorry you suffered this setback.

I'm glad that it points the way forward.

Slow and steady.
 
So sorry to read this, @russny. Sounds like your PT forcing the bend caused new inflammation -- and that's why you lost some bend.

Give that poor knee some love for a few days. Once the swelling goes down, you can get back to the heel slides.
 
One other thing that I found helpful in regaining bend with my knees that you might want to try once your pain is back under control:

I would sit on my kitchen stool, which is high enough so that my feet don't touch the floor and gently swing my foot back and forth. Nothing forceful -- just lazy swinging to provide a gentle stretch. (If you don't have a stool, you could put a couple of cushions on a firm seated chair, just enough so that your feet don't quick touch the floor.)

Another option: a friend of mine used a rocking chair and found that she got the same effect by keeping her feet flat on the floor and rocking gently back and forth.
 
Agreed - not exercising at all ‘til my knee doesn’t hurt or feel like it’s in a vise. That’s what I did yesterday and am doing today - except for the trip to PT, where we didn’t do any exercise. Just measured, talked, and left early. Thanks for the tip about swinging - will keep it in mind for when am way more recovered.
 
This is the second time I’ve had to take days to recover, not even doing ADL, because a new PT hurt me. The first time was just over two weeks ago. Instead of returning I took two weeks off resulting in, for the first time, increased ROM. Who knows? It’s possible that, had I been measured two days after that hurtful episode, we would have seen a nosedive in ROM, like the one I saw today.
 
My doc not only wants me to do an MUA, he wants aggressive PT starting the day after.
 
I just now tested my new Lounge Doctor. It’s the only pillow I’ve bern able to tolerate. Is it ok that my knees are resting on a bend? I thought the backs of the knees weren’t supposed to touch anything.
 
This may sound odd but I tried stairs the other day for the first time (I'm ten weeks bilateral) and I found that going down backwards, with a death grip on the railing, was much less strain than the "usual way." I'm only suggesting this as a temporary solution for Russny to get to ground without being exhausted. Might be worth a try?

Any way you can get comfortable and get away from the pain, in my book, is OK. I cannot stand spending all day stretching and hurting although I do ice and heat throughout. Every time I return from physio I am swollen and hurt the next day and I am making sure that they are gentle. I have stopped all the pushing and pressure and that really helps. I think MUA is a nasty process and I will never have it. It strikes me that if there are surgeons who need to do this lots, they are not the best at this procedure. It would be interesting to compare how many surgeons routinely do MUA...

Bear up Russny, it will get better.
 
russny said:
I just now tested my new Lounge Doctor. It’s the only pillow I’ve bern able to tolerate. Is it ok that my knees are resting on a bend? I thought the backs of the knees weren’t supposed to touch anything.
Click to expand...
On my Lounge Doctor, my thigh was supported and my calf was supported, my knee bend area was sort of mid air.
I believe a very light touch is ok, but definitely no pressure.
 
Am glad I checked. I thought my knee would be up in the air, not touching. Will contact Amazon to try to exchange for a smaller size. Thanks.
 
xsbank thank you for the support! This week, when I came down the stairs for the first time in two weeks, discovered it’s no longer exhausting. What a difference two weeks makes in healing! It was just slightly tiring. And oh so slow. Am going to continue to avoid stairs because they are hard on the knees - causing swelling. How many steps do you have?
 
russny said:
I just now tested my new Lounge Doctor. It’s the only pillow I’ve bern able to tolerate. Is it ok that my knees are resting on a bend? I thought the backs of the knees weren’t supposed to touch anything.
Click to expand...
bonesmart.org

Elevation: Doing It the Right Way

Updated June 11, 2024 by Jockette Proper elevation is one of the best ways to help with pain and swelling following either hip, knee, or ankle surgery. Many people elevate improperly, which can dramatically lower the effectiveness. In the weeks following your surgery, make sure you elevate...
bonesmart.org bonesmart.org
 
At yesterday's noon PT session I used a tape measure to measure swelling in my knee - the knee was 18 inches round. At midnight, after resting my leg most of the day, no exercise, and multiple 45 minute sessions on icing machine, I measured it and couldn't believe my eyes - it was only 16 inches round! I've been scared to ice more than 20 mins but seems like the longer session is really paying off!
 
And all that swelling is why you can’t bend your knee further than you can. As that swelling goes down, the bend will improve, but it will take time. Patience is what we need to exercise the most in this recovery.
 
The swelling went down another inch overnight thanks partly to a good night’s sleep. So now, in the seventh week after surgery, my right knee, which had always been larger than the left, is only one inch larger compared to the 4.5 inches larger two weeks after surgery. At this point I don’t know if there’s any swelling left but am icing anyway just in case and because of pain.
 
There wil cotinue to be swelling within the knee joint that may not be easily visible - there's not much open space in that joint, so minimal swelling will create discomfort and reduce range of motion.

Many of us continued to ice regularly, if reduced times per day, for a few months before just "as needed."
 
Be grateful it's summer: my first TKR was mid winter and I adored my Breg but had to be swathed in fleeces my body would chill so much!
 
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