MUA ValleyGirl Recovery

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ValleyGirl

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@BBCG On your knees at 9 months!!..I cannot even think of that, how amazing. How many months total for you now? I am wondering how long this swelling will last? I pretty much stayed in my bed over the initial weeks but am now getting downstairs and trying to sit for periods of time. My leg swelled up so much today...of course I did tasks in the kitchen too. This time my ankle was swollen too which has never happened. Laying with my leg up now and icing it and getting the obligatory nerve voltage pain. But I feel like I improved my ROM today just by trying to sit in my usual way..my leg was being encouraged to pull closer to the chair out of habit. How long before I can sit for long periods and get back to work?
 

earth2lise

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My TKR was a week before yours @ValleyGirl and I am just over 90 flexion. I, too, have been scared to death of my PT and surgeon recommending an MUA. After reading through Bonesmart, I finally sat down with my PT (who is quite the taskmaster) and told her I would not do an MUA and I only wanted to do massage work and gentle bending once a week with her. I asked her to provide an open and honest assessment of my situation and of MUA's in general. She was very reassuring that there was no timeline I need to adhere to and she was not a proponent of MUA's. She stressed that everyone is different and to just keep moving, icing and gentle bending and the progress will come. She also reminded me that I don't personally see much improvement when I live with my knee 24/7, but when she sees me once a week, she sees progress...and that's all she is looking for. I need to let go of the goniometer results and just trust that my knee is healing and improving. I hope this helps.
 
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ValleyGirl

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@earth2lise Thank you for responding! I am so glad I have people to guide me here. I am not so afraid anymore and focusing on Active Daily Living (ADL) rather than pushing my flexion with exercises. I do have several questions for the forum:

Do you measure ROM after several bends where the knee is warmed up? Or do you measure where the the leg naturally falls like when sitting down?

Since sitting and ADL caused swelling yesterday, I am trying to figure out a few things. Should I still add exercises to sitting and ADL and lessen the ADL or sitting to reduce swelling? Today I am trying small stints of ADL, and sitting with elevation and ice.

Did other people have incontinence after surgery too? How long should this last?

I will add more questions later. Thank you again for responding...such a comfort for me.
 
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Jockette

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It doesn’t really matter when you measure the ROM, it is going to vary constsntly, depending on any swelling you have at the moment. Forget about the ROM numbers. Week by week you will be able to bend more and that’s all that counts.

Today I am trying small stints of ADL, and sitting with elevation and ice.
This is excellent.

Did other people have incontinence after surgery too? How long should this last?
Yes, other members have had this, though I did not. It does get better over time.
 

benne68

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...sitting with elevation and ice.

Hi @ValleyGirl You might want to try lying down, rather than sitting, when you ice. My surgeon's PA told me it's important to get the swollen area above your heart, which you really can't do from a sitting position. Also, I find the my knee stiffens and starts to ache when I sit for an extended period. Getting up and walking around seems to help, so I try to walk for at least 5 minutes every hour. It is hard to find a balance between doing enough and not doing too much. It's a process.
 

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ValleyGirl, like you I was threatened with an MUA, not by my OS but by the discharge nurse. And then threatened by the physio who made me push my knee until I reached 90 causing me significant pain, otherwise she would not allow me to be discharged. But once you realise that their threats are just that ‘threats’ and you are the one in control of the situation it eliminates those fears. I don’t measure my ROM for the number outcome, more so for piece of mind. I have marked a set of lines on our patio pavers which are in front of a low block wall. The first mark was placed at a position where I could sit on the wall, feet flat on the ground & only mild discomfort for the knee. I then marked lines towards the block wall 1cm apart for 10 cms. Each day after my routine of morning ADLS, heat packs, foam rolling, floor pedalling & gentle stretches I go out sit on the wall & place my toes on a line where I am only experiencing mild discomfort. Last week I got all the way back to the 10cm line, so I know I am definitely progressing. I am still quite stiff & sore, have swelling & shooting pains, so I no I’m not out of the woods yet. I overdid it again on the weekend & now I’m only able to go back as far as the 6cm line. Regardless of the regression, seeing the progression in my ROM gives me hope for the future. All the best in your journey.
 

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Hi @ValleyGirl, I love @Scanne’s way of measuring! But, I personally think you’re worrying way too much about the numbers… they are there only so someone else can make chart notes! You only need to know that today you can sit more comfortably with your knee bent than yesterday, walk longer with no negative effects, enjoy cooking a favorite dish you couldn’t make last week; Activities of Daily Living… it really isn’t as much about the numbers as it is about the quality of life, for me, at least!

And, getting down on my knees is important to me so I can resume doing a self-care protocol called Melt! It’s a self-care, soft roller massage routine and when I do briefly kneel to get on the floor, it’s on a really, really squishy pad!

For me, working while sitting first happened in my recliner, with a lap board, so my knee was higher than my heart when I tilted the chair back with the legs raised! Week by week, I could go longer, and by 4 weeks, I could work there, ice ON knee, lap board with computer, for about 45 minutes. Then I would get up, walk around a bit, feed a kitty, go potty, change ice pack, then back in chair. I could gradually go longer, then not tilted up so much, then leg not above heart, step by step, every few days testing possible changes to the routine. I would also often nap for a few minutes each hour, too, especially at first.
 
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hawk2go

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You only need to know that today you can sit more comfortably with your knee bent than yesterday, walk longer with no negative effects, enjoy cooking a favorite dish you couldn’t make last week; Activities of Daily Living… it really isn’t as much about the numbers as it is about the quality of life, for me, at least!
For me, too. Thanks for this wonderful reminder that having this surgery was all about regaining my active life, for me at least. ;-)
 
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ValleyGirl

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@BBCG thank you for the advice. I just want to measure my progress over time to prove ADL is working which is why I ask about ROM measurements.

I saw my PT therapist on Monday and explained to him I will never be the client who going to be pushed to pain. I told him I am following this forum and that ROM can be increased beyond 6 weeks even just through ADL. He said it isn't true, that he sees lots of knee clients and it simply isn't the case. Then he said "Well you have 70 degrees ROM," as is to say.."see what you are stuck with." So of course I became a bit afraid. But I am still pushing through with ADL and exercises. I am continuing PT as well, but do not want to be injured.

They are letting me use the NuStep on my days off from PT. I went in yesterday and somewhere along the way I pushed the envelope with my knee...it was smarting and hard to walk. I felt like I may have ripped scar tissue? Inflammation set in and I kept icing last night.

This morning my knee was sore and not very flexible. I did complete some stretching and ADL, albeit painfully in some cases. I have been icing...but feel like this recovery process is always feeling great one day and then exercise messing me up for several days in a row. Is this normal? Is everyone getting inflamed over and over?

Just weary... Thank you everyone!

Patty
 

BBCG

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Hi @ValleyGirl... yes, it does get wearisome and worrisome, both, when you keep hearing scary stuff! I have been there, too.... healing from my first TKR had me in a similar place as you are, too... until I found Bonesmart and really backed off listening to the scare tactics and staying away from the scare mongers! (How appropriate: it's scary Halloween time!)

I think YOU really need to decide what YOU want to do; it will be really hard to be pulled back toward the scary side then back toward a more natural and normal, slower but steadier recovery, in my opinion. I finally had to stop going to PT, and I canceled one of the followups with my OS, so I could allow my knee more time to heal. And, it worked out perfectly, as I was where I felt was good by the 6 month mark for the third follow-up (I skipped the 2nd at 3 months).

But, there is LOTS of evidence amongst people here that your ROM continues to improve gradually over time. I think my left (#1) knee got better over at least a 2-year period, in fact. I just didn't track it and measure it.

And, you've joined the ODIC, too! The Over-Did-It-Club! It is SO easy to do, because your new knee is not your old knee, and it gets cranky way easier than old knee did, plus you and this new one aren't best buddies yet, so you don't always hear it's signs and messages about what's too much! I know this, and I've been there, oh, maybe a dozen times?! Just keep up with the icing and elevation! Elevation was harder for me to remember to do after a while, since if by then I wasn't sitting much with my leg up... it still happens once in a while and I'm 6 months out. When I first got my puppy and he was such a leash puller, my quads and new knee were really pushed! (I solved the pulling problem mostly now, so not usually having trouble...)

Hang in there! Yes, overdoing it IS normal, annoyingly so!! Sending virtual support!!
 

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yesterday and somewhere along the way I pushed the envelope with my knee...it was smarting and hard to walk. I felt like I may have ripped scar tissue? Inflammation set in and I kept icing last night.

This morning my knee was sore and not very flexible.
Cause and effect. You did more than your knee is ready for and the soreness and less flexability is resulting swelling.

Too much is blamed on scar tissue when the issue is more likely “just” swelling.

You might want to consider looking for another PT office that has a gentler approach to rehab. This one doesn’t sound very supportive, and that’s not in your best interest.
 

kneeper

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Some PTs think there is no happy medium between boot camp and lying around like a lump. :hissy: Personally, had lots of swelling and my PT recognized that a knee that swollen just wasn't going to bend much. We focused on icing, elevating and heel slides. No cranking or forcing.
I hit 90 at 6 weeks and continued to gain as the swelling subsided.
 
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ValleyGirl

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Heard from my PT tonight...after I compared myself to others and their progress.

There is no timeline for recovery. Everyone is different.

YES!!
 
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ValleyGirl

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Got a CPM machine to see if it will help move the ROM dial. Just finished my first session. Only went to 50 degrees tonight. A bit swollen afterwards and only used it for 20 mins. Will pick it up again tomorrow.
 
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ValleyGirl

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I don’t measure my ROM for the number outcome, more so for piece of mind. I have marked a set of lines on our patio pavers which are in front of a low block wall. The first mark was placed at a position where I could sit on the wall, feet flat on the ground & only mild discomfort for the knee. I then marked lines towards the block wall 1cm apart for 10 cms. Each day after my routine of morning ADLS, heat packs, foam rolling, floor pedalling & gentle stretches I go out sit on the wall & place my toes on a line where I am only experiencing mild discomfort. Last week I got all the way back to the 10cm line, so I know I am definitely progressing.
I have done something similar with measurements on the ground. I put down some white masking tape with ruler measurements marked out on the tape. I have seen some improvements but am afraid to jinx myself by saying anything...but I feel like I am making some movement forward! Thank you for your letter!
 

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Improvements are improvements, big or small. Just remember it’s not about the number but the progress you make whether it’s every day, every week or every month.
 

hawk2go

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it’s not about the number but the progress you make whether it’s every day, every week or every month.
I agree with this except I sometimes see small degradation day to day depending on my activity but every week I expect to expand my world.
 
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ValleyGirl

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I too see degradation on some days...those are the worst!
 
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ValleyGirl

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Getting scheduled for an MUA, hopefully next week. My ROM is getting worse everyday. Meds will be better managed this time as I changed the PA I was working with in the office. I am scared but want to be able to walk again!

Had first therapy session for my PTSD from the mismanagement of meds for my TKR recovery. It felt good to get the fear and pain out on the table.

Just a quick update...
 

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