I am 13 weeks post op on TKR. I have perfected straightening of the knee - no issues. My ROM is 113and still working on it.. Saw the surgeon yesterday as a follow up and I still limp a little and am still swollen with stiffness - he recommend a MUA in 30 days if no improvement ( I thought 113 ROM was good - he does too) but said I have scar tissue that needs to be broken up to get rid of pain, swelling and stiffness - any “other” ideas besides MUA - any advise is appreciated ( I do PT 3 times a week and ride the bike for 15-20 daily )
Yeah...this...
https://patient.info/forums/discuss/tkr-rom-work-at-home-620053
...then this...
https://patient.info/forums/discuss/post-tkr-exercising-565527
...and finally this...
https://patient.info/forums/discuss/mastering-post-tkr-stairs-552728
Questions? No? Good...get to work. The whole thing takes a year. Believe it...
Massage the scar with your thumbs and e45 or bio oil. If it hurts it’s working!
Your numbers are fantastic! Due to post op complications of LTKR May 2017, my ROM was stuck at -45 and 90 and I spent 5 months in a wheelchair as I couldn't walk with a bent leg.To avoid surgery I had massage therapy weekly with a therapist experienced in the use of a Gua Sha tool used with castor oil to break up scar tissue that was keeping my leg stuck. I also began Epsom salt baths daily to help muscles relax and gradually stretch my leg and I started taking magnesium supplements which also support muscle relaxation. On the advice of a former boxer, I began wearing full leg warmers 24/7 to keep muscles "supple" (I was surprised to see how much difference it made!) and I still wear them now. It's winter here so I sit in front of a portable heater to do daily leg raises and heel slides. I set up a massage table and did stretching exercises throughout the day/ in between chores. I had a home physical therapist who came out three times weekly for 2 months and did knee mobilizations and used a Gua Sha tool and magnesium lotion to also break up scar tissue. It worked slowly, but within 8 weeks my ROM improved to -0 and 115. My leg is straight enough now and I am walking with crutches or a walker to rebuild muscles and stamina. Neither my doctor or therapist believed I could recover this far without surgery so I am an example that it can be done. I am 67 and live alone with three dogs in rural mountains. My daughter and friends have driven me to appointments and picked up groceries for me but I have also learned to be self sufficient as much as possible while in the wheelchair and very grateful after 9 months to have improved without surgery. My right knee will also have to be replaced, but I got a Synvisc injection a week ago hoping to delay surgery for a year.
You are doing great, best wishes for continued recovery- it seems scar tissue is not holding you back and you will continue to improve with your current routine.
I had hard scar tissue at the top of knee, my p.t . massaged it out, it is gone now. I also had some below the knee which she used ultrasound to get it out. No Surgery btw I'm 14weeks out and this was about a month ago. Good luck
Start massaging the area yourself using BioOil or similar.
Also find a good sports injury masseuse/masseur in your area who will help to get rid of it for you.
Good luck
Marilyn
XX
I am really surprised your Dr. is recommending MUA with your perfect straightening! I have heard that is what they are the most concerned about for you to walk without a limp. I go to my ortho Dr this Thursday--my flexion is 115 and my extension is 1--I will see if he recommends a MUA--I probably wouldnt do it--I will continue with OP therapy and my home exercises for awhile--I seem to improve with each PT visit. If anyone has had as MUA let us know how bad it is and the recovery time--I hate the thought of starting over again. I am almost 8 weeks post op.
Thanks Bubbles, I Am not doing the MUA - I had a friend who did and said it set in back for weeks. I just have to get this remaining scar tissue out myself - seeing a sports massage guy tomorrow - sure its gonna hurt but none of this has been easy.. thanks for the reply !
I'm 4 months post op and your ROM is better than mine and I didnt have a MUA. I still have a slight limp but the surgeon said its because my quad and hamstring are weak. He lifted my leg out straight when I was sat in a chair and told me to keep it there. When he let go my foot dropped slightly which indicated this. He told me to build up on the amount of walking I do and he said it will go eventually x
Thanks Marilyn, I had a masseuse work on it today, feels better and going back again next week - gonna research and see if I can find some BioOil. Thanks !!
Glad you are feeling an improvement already, it's well worth sticking with to help get ride of pesky scar tissue.
There are quite a lot of oils & creams you can try, VitE oil, Emu Oil, Almond Oil is quite nice on unbroken skin & smells nice. Ask what your masseuse uses.
Marilyn
XX
TKR on June 3rd 2017 and an MUA 5 1/2 weeks after. Hurt a lot and the surgeon only managed 100 degrees. Thereafter, with the help of a CPM (bending machine) I kept the flex to around the early to mid 90's over the following 4 weeks. As soon as I returned the rented machine however, the ROM started to decrease and is now at -10 and 65.
Ive read A LOT about ROM, MUA and all the other acronyms we suddenly find in our vocabulary. My understanding is that 90 degrees is considered satisfactory and is the threshold for an MUA. Surprised therefore that at 113 an MUA is even being discussed. I would be delighted with 113 and as such wouldnt go near a manipulation.
Im going in for another MUA on Wednesday, as 65 degrees is useless. My TKR leg does little more than provide symmetry and some balance, so I have to try something...Im aware that hoping for a different outcome whilst repeating the same procedure, is defined as madness, but that is what a TKR does to you !
Will let you know how it goes.
Epsom salt baths help relax leg muscles for easier stretching and massaging scar tissue to break it up. My physical therapist used a Gua Sha tool with castor oil or magnesium lotion to break up scar tissue. I also had weekly massage therapy to break up scar tissue and stretch muscles. Leg warmers and sitting in front of a portable heater made heel slides and leg lifts a lot easier this winter. Like Chico Marx wrote, I have to stretch daily to maintain and progress. I've learned a lot for an easier replacement of the right knee next!
Best wishes for a full recovery!
LTKR May 2017-67 y/o
How long did you rent the CPM for? I rented one for 4 weeks because my ROM was only 60 degrees, I had the machine on maximum setting which was 120/-10 but I've not been able to get near that since I stopped using it. I presuming the same would happen after having a MUA not being able to keep the flexion you have achieved. I'm now going down the DIY route and I'm making small progress. Can get it bent as far as 110 which I'm happy with. Means I can get up and down stairs, ride a bike etc
I too did 4 weeks. Twice a day for a couple of hours each time. Problem was that after each session my leg went back to 65 from the mid 90's as indicated by the machine.
Im also going the DIY route this time. If I think a CPM
is required its 24 hours away. Im hoping that my exercise bike will achieve the same result.
Its amazing what you have done!
I used sauna and lots of stretching in my rehab, plus massage.
I don't think they emphasise the importance of regular stretching post op enough. Because I do yoga, it wasc already my routine.
Best wishes to you for the strengthening. It's a labour of love this knee business, for sure!
I left the CPM on over night and still managed to sleep😂 The only problem with that is that your muscles are so relaxed when you get out of bed there was no strength in my legs
I actually broke up a lot of my own scar tissue by being bullheaded and determine I would do stairs like a normal person. I forced my replaced knee to bend so I could step off a curb with my good leg coming down first. Cracked so load it startled me. Hurt a little for a couple of seconds and then I was good to go.
Although I don't know if I should or should not have done that, I was fed up with the restricted movement caused by scar tissue. I am an active 52 yr. old who at this point really wishes I had not gotten my knee done at all. I still need my other one done, but will wait indefinitely.
I still do stairs the same way I did pre replacement a couple times a week to try to prevent new scar tissue from forming. I am at 113 degrees at 6 months, have a ton of shin pain, and my surgeon just said he would see me in September. So, just wondering what is really acceptable? Good luck!
Look at my first reply all the way at the top and then the first link. Maybe some of that will help...