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Had a TKR in March 2010, ROM currently 110 to -4, registrar has advised MUA to increase ROM to 130? I am hesitant about this, another op and recovery.
He has advised sitting on my haunches on a soft surface to try to improve flexion.
Is this a joke, any advice would be gratefully recieved.
Steve821
I think when it comes to range of motion it is a case of "how long is a piece of string?"
Many people are quite happy with 110 degrees flexion and you already have excellent extension. But if you want to be more mobile that is another matter.
Has he told you about the risks and benefits of an MUA? You need to make an informed choice about this procedure.
Sitting on haunches as an exercise. Sounds a bit on the radical side if you do it in an uncontrolled manner. Going into a squat in a slow controlled manner where you are really using your muscles to work into that range of knee flexion could be beneficial.
Have you had physio for your knee since the op?
GCOE -Thanks for your informed response, I have had some excellent physio since the operation form the NHS and a private rehab programme to get back to work, however at 12 week check up with registrar he advised the MUA which I declined, as you said what were the benifits to me. He then advised "Sitting on my haunches" as an exercise to increase the ROM to 130.
Like a good patient I went home knelt on matress and tried the exercise, it was crippling I had to scream for help to get up etc, since then I have a massive lump on the exterior (fluid I think) and the pain is back 24/7)
Now stuck on what to do, GP has referred me back to a consultant but I cannot wait and work are pushing.
Was this good advice?? I think and feel not.Any further comments would be welcome, thikning of going to local A & E.
Steve821
The exercise is then ridiculous for you.
May I ask what your line of work is? this is often a key issue. If your job is not particularly manual and doesn't involve squatting, kneeling or other activities where a lot of knee flexion is required and if you don't need that extra 20 degrees for what you want to do when you are working then it doesn't need to be a big problem.
As an alternative you could always get some more physio if you wanted to work at getting a bit more. But to be honest you can do a lot of things with 110 degrees knee flexion.
GCOE
Thanks again exactly what I thought.
I am a training development manager, I sit in the office, stand in front of classes and assess trainers in their workplace which could be a field, class, office basically anywhere. I drive 100/150 miles a day.
I am currently trying to speak to the surgeon to advise him what his registrar is doing I hope it is recieved in the way I want it to be.
Thanks again.
My current exercise regime is limited because of the swelling and pain but I manage 10mins bike, leg raises, sliding knee bend, small squats, calf streches and walking for about 30mins. This is spread over the day with icing between. I have 30mins physio massage one a week.
Steve821
This all sounds good and you should be fine.Quote:
I am a training development manager, I sit in the office, stand in front of classes and assess trainers in their workplace which could be a field, class, office basically anywhere. I drive 100/150 miles a day.
sounds like you are doing lots exercise-wise. One comment though - as you are 3 1/2 months down the track one usually find the pain and swelling has settled a lot. So when you talk to the surgeon do ask him why he thinks you are having so much problem.Quote:
My current exercise regime is limited because of the swelling and pain but I manage 10mins bike, leg raises, sliding knee bend, small squats, calf streches and walking for about 30mins. This is spread over the day with icing between. I have 30mins physio massage one a week.
My mother-in-law recently had back surgery and she was advised to stand or lay down for a few weeks. She couldn't sit. After 3 weeks, her doctor told her to sit for about 30-minutes at a time. She's now to the point where she can sit for long periods of time.
Sitting on haunches.....always a bad exercise :eek: registrar should have known!!!
Was your post surgical pain and swelling mild before commencing that exercise and then aggravated after it? Just think, the prosthesis takes months to get really well healed into the bone.
There are two ways you can most safely exercise to improve flexion if the knee is settled enough. One is to place your foot onto a footstool or chair and hold under the front of your knee with your hands. then lean forewards keeping your hips low to gently stretch into flexion. In this way you can control the load your knee is under and you should feel a firm stretch but dont go into pain. Hold for a long slow stretch and dont walk too soon after you finish. Sit on a stool and do some pendulum swings to get everything moving again.
Also using the bike Start with 5 mins on a comfortable setting to warm up and then lower the seat so that it is a little uncomfortable to go around. Work for another 5 minutes.
Although 110 deg is OK for everyday life you need more to get up and down stairs and get in and out of car easily.
Does your knee get warm or hot after exercises?
Is there pain behind your knee with the flexion stretches?
Hi VAM44
Thank you for the very full and comprehensive reposnse, I really appreciate your time and trouble.
In answer to your points can I deal with each in order of your mail.
POST OPERATIVE SWELLING - Huge but at 9 weeks had reduced considerably, lots of rehab including physio, hydro, lower limb strengthening and balance (all from my employer)
The event occured after my 12 week visit with consultant, not the surgeon but his registrar, he wanted more flexion and said if I refused the MUA I should do the SOH exercises.
At the first attempt knackered the knee, a nightmare, swelling, extreme pain and has set me back 6/10 weeks.
Have seen the man again he fully admits the error I am now getting more physio etc for the pain, then some for swelling, registrsr still adamant about MUA in 2 months??
I have tried your exercise not able to do without pain currently, YES knee hot after exercise and there is a lot of pain behind the knee and down calf muscle area.
Further X Ray last week joint was okay.
Should I seek a scan?
Yours
Steve
You should definitely seek more review of your knee. It should not be hot after exercise nor as painful. Have they excluded infection, autoimmune reaction to the prosthesis, microfracture around the prothesis. I would be more worried about these things than the actual range of motion. I certainly hope that you have none of the above!