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Wednesday, March 14, 2007

Manipulation Monday


So, it's going to happen. UCSF. Manipulation. What's that, you ask? Patient (that's me) is put under (probably with a spinal block plus drugs that make you forget and permanently happy). Surgeon takes leg and bends it. He leans his weight onto it. CRACK. Yeah. That's the scar tissue breaking. Then the manipulation is followed by two more days of intensive physical therapy. Will he cut? No. No plans for any cutting. Will this hurt? Yeah. Like hell. As if we knew what hell felt like. It'll hurt. What are the risks? Very, very minsicule risk of something breaking but since the rest of me is in good shape, almost no risk that way. The main risk is that it won't work, or that it will work at first and the scar tissue grows back. So jeez, why do it? I'm at a regular 90 degrees flexion -- maybe 100 to 110 when pushing it. But I can actually FEEL where my knee stops because of scarring. Well, I can't say for sure that it's because of scarring. But I can tell you that something is in the way. Also, there is a high likelihood that it will both hasten my recovery AND give me more flexion overall. So when I'm done, maybe i'll have something like 140. Never thought I'd be fighting for a few degrees. But this is my life now.

Oh and one of the benefits of surgery -- they give you a spinal block for a few days. So I may have something like three pain free days. YAY! I know. Going to the hospital is extreme. I'm not doing it just for the block. But being pain free will be GREAT.

In other news, I just got back from my new bodyworker/accupuncture guy. I will say I really notice the difference. He's doing some massage and I can tell after he's done with me that I can bend more. Who knows? Maybe by Monday I won't need the manipulation at all.

My sister (bless her heart) is coming in to take care of me and to be my bitch. (or maybe it'll be that I'll be hers. . . well, you know what I mean) She'll be the one yelling at the nurses and doctors for meds and all sorts of things. My folks might be back from their trip in time to also be there. I now know to NEVER enter the hospital alone, without an advocate. My co-worker told me all about that and he's absolutely right. Squeeky wheels work. Bitching? Yeah, that's how it's done. Trust me. This is the sister who just had breast reconstruction post mastectomy. So it's a little weird. Breast cancer is a lot more serious than knee stuff. But she's ok and as long as she doesn't lift, she should be ok. It'll be nice to see her.

So if you've been wondering when to call, I'd say now.

Visitors? Yes, I'd love visitors now and in the hospital. I wont' be quite as out of it as I was before -- and I'll be working on bending and stuff. But yes, call first and let me know if you're up for a visit.

--Janet

PS Yes, having a tantrum and crying my eyes out yesterday helped. I never know when the tears are going to come. Sometimes I feel like it's just physical exhaustion. So Beth and others who have been on my recieving end, thanks for being there and not hanging up. It's a mix of feeling sorry for myself and just like I said, a chemical sort of thing.

Photo credit: here

57 comments:

Evelyn said...

Hi - many thanks for your info on knee manipulation! I had a knee replacement on June 23rd. Now seven weeks later I cant bend my knee mor than 60. I am to have the manipulation on Monday and am scared stiff but have to go with it as the only other choice is never to drive again. I am a bit worried about what you said about pain though!
Thanks again, Evelyn

Evelyn said...

Hi - many thanks for your info on knee manipulation! I had a knee replacement on June 23rd. Now seven weeks later I cant bend my knee mor than 60. I am to have the manipulation on Monday and am scared stiff but have to go with it as the only other choice is never to drive again. I am a bit worried about what you said about pain though!
Thanks again, Evelyn

Janet said...

Hi Evelyn, I can't reach you. If you post your email here it will be forwarded to me and then I can respond.

Janet said...

Hi Evelyn, I can't reach you. If you post your email here it will be forwarded to me and then I can respond.

Anonymous said...

Hi - thanks for sharing your painful experience! I had knee replacement on 6/26/08 and manipulation yesterday 9/15/08 (outpatient). Wish me luck, trying to get it to bend more than 70%. Am so tired of hurting. Be glad you have someone to help you. I am alone and my cat, Muffy, can only do so much! ha ha

Anonymous said...

Hello, I had knee replacement on June 12,08 and I am so not happy. I had the manipulation on Sep 9,08 and am in so much pain, can bend it a little more but now cannot flatten it out. They say it is the quad muscle, I need to be back at work, cause no insurance after Oct 6,08 and cannot afford to pay 500.00 a month. Am very frustrated and depressed. Does anyone know about getting disability or social security. I feel after working for 26 years with a school system, that there should be some benefits. An I am not a teacher, just was a busdriver for 15 then a custodian. Could use some help thoughts on the matter. I hope if any else has this done, you think it through and make the right decisions. Thank you Priscilla

Anonymous said...

Temporary disability is available. I hope it works out for you. I may have to have the manipulation. I can get to 70 degrees cold, but with work I can get to about 84. That is still not functional. Man, this knee stuff can be so frustrating

Anonymous said...

Thanks for the info. I'm at 90 degrees and thought I was doing good, but the doc wants me at 110 by Tuesday or he's doing a manipulation. Thankfully, I seem to have a high pain threshold, so not worried too much about the pain, just about the recovery period as I'm about to relocate and that's tough with a broken leg (still not weight-bearing). Good luck to everyone. Nice to know we're not alone.

Mitchikokaili said...

I had double knee replacement on Nov 24 and almost 8 weeks later had to have bilateral knee manipulation. Yes, the physical therapy hurt like hell and this is my first weekend after everything and I am back to feeling stiff. I've been trying to just walk around my house, hang my legs off the side of the bed and I'm scared to death of what may or may no happen now that I've had the manipulation.
I've got to go back to work - I am on short term disability but if I want a job to go back to, then I need to go get back regardless of the progress I've made and still need to make. I'm scared because even after the manipulation, I'm still having pain. I think it's improved my range but now there is so much hard work to do.
Just remember as I have to keep reminding my self that a positive attitude and that you can do it and whatever your therapist wants to try is for your betterment. I sometimes forget that. Is anyone having some of the same fears now that they've had their manipulation and it has been the first week after it?

Anonymous said...

Hi to everyone sharing info on knee replacement and manipulation.
I had a TKR 9 weeks ago and just had a knee manipulation this week. I also have a CPM machine in my home that I am using 6-10 hrs each day as well as out patient therapy several times a week. I am really hoping that this procedure will work for me, as I want and need to go back to work soon! It is painful and today being the 4th day my knee is really painful and swollen. I appreciate any comments on recovery time after a manipulation. Thanks!

Anonymous said...

I had right knee replacement on Dec. 23 '08 and it's likely will have manipulation soon. I'm at 97 - 100 degrees but trying to walk w/o limping isn't working unless I have pain meds. I'm so frightened of the manipulation and the pain and repercussions that might follow but I see no alternative. I understand what the person said about feeling like there is a band behind my knee that keeps me from bending. I'm also tired of hurting and very discouraged

Anonymous said...

Hello again. It has been a week since my manipulation and I am moving back instead of forward. My range of motion is only 85 but the first day of the manipulation it was 105. I am stiff again and also having more pain, however I heard that is has been helpful to others in this situtation. It is so frustrating and depressing but I am still hanging in there. I would like to go back to work soon. Thanks and good luck to all!

Anonymous said...

Hi there, I am 31 years old and towards the end of Nov. '08 I twisted and fell on my right leg which caused it to hyperextend and slightly shatter my tibial spine (knee). I had surgery on Dec. 5th (internal fixation with sutures and anchors) and I was in a straight legged cast from the top of my thigh down to my ankle until Jan. 14th. I started physio therapy on Jan. 19th and have been going 3 days per week since then. At this point my leg is only bending about 40 degrees on a good day and I am constantly trying to bend and do the various types of exercises that my therapist has suggested. One would think that gravity would help in this process but even sitting on a counter height chair, legs dangling and a leg weight strapped to my ankle my leg still does not bend any further. I am getting quite concerned, worried and scared. My surgeon advised that if the bend does not begin to improve within the next few weeks I will have to go into the hospital for a manipulation. Based on some of the other comments and feedback from experiences that I just read on this site, I am now officially terrified out of my mind! I really can not go through another 3 months or more of recovery to get nowhere again. The whole reason why I went through with surgery in the first place is because there was a chance that I may not have been able to fully straighten my leg again, and the result is that now I'm not able to bend my leg....how pointless was this?
I have been performing various exercises such as work with the elastic band, lunges on stairs, and using the chair as mentioned above. Can anyone suggest some additional exercises or tactics that have worked for them? I am willing to try anything. Thanks :)

sarah j said...

HI, MY SISTER IS HAVING KNEE MANIPULATION TOMMORROW, SHE WANT TO KNOW WHETHER TO HAVE IT OR NOT. SHE IS SCARED TO DEATH NEEDS YOUR OPIONION. THANKS SARAH J

Tak said...

Hi all, I had a TKA done on March 24th 2009 I am 53 years old. I had several operations to fix this knee (R) over the past 40 years.I injured it severly when I was 13. Anyway, because of all the previous surgeries I have alot of built up scar tissue. I was making progress after the replacement but apparently I healed too quick for the Physical therapy to do its job. I only have a flexion of 70 degrees and I need much more than that to do my job (paramedic). So tomorrow (7 weeks post TKA) I am going in for a manipulation. As soon as possible I will report back to you all,(it's a 2 day stay in hospital). Fast Healing to everyone.....but not too fast...

Megrette said...

I've had a Right total kee done, and then re-done after 8 weeks because of scar tissue. Friday is a manipulation and I need more info than they're providing. Ice afterwards? I've been doing self pay aquatic therapy for months now, since my insurance benifits ran out. The warmth feels great; will this help afterwards? I have a CPM machine lined up so I keep it moving; also self pay. I was told the insurance no longer covers the spinal routine, so it will be general, and ship me home. Any advice is very welcome. Megrette

D_Atlanta said...

After reading the comments I'm scared as hell of manipulation. I'm 28 years old and I had knee surgery on 4/7/09 and I can only bend my knee 55 degrees and thats with a lot of pressure being applied. My PT mentioned it and I scheduled it with my doctor which I go on 7/6/09. Is there anyone out in the world that has had any luck with it manipulation?

Anonymous said...

My surgery for tkr on my left knee was 6/01/09. This has been the most painful operation and complications I have ever experienced. Now after physical therapy three days a week and endless exercising, I am facing manipulation. This pain is far worse than any pain I experienced with osteoarthritis. Not being able to drive, having to quit my part-time job, has made me feel as though I have made the worst decision of my life. I am 55 years oli and feel like I am 100. Yesterday my therapist had to insert a 1/2 inch heel pad in my shoe to make it easier to walk. I am still using a walker, elevated commode seat and shower seat. Can anyone give any info, as to, will manipulation make these things better? STILL HURTING!!!!

Anonymous said...

Thanks for Manipulation Monday. My tkr was on June 9th,2009 and after several weeks of PT I too was given the manipulation ultimatum by the doc. Surprisingly in PT the therapists get me 112 active and 105 passive flexion. But the doc wants the measure off the street rather after PT. My recommendation is to get a really good PT tech and push the therapy to the max. Make sure they dont sugar coat your progress (sometimes I think they provide more psychological (tea anyone?)than physical therapy. Set weekly objectives with the knowledge of what you doc expects and when they expect it.
I have until August 13th to show improvement or do the manipulation. Worried yes! JK

Jeff said...

Hello all,
I had a LTKA on March 17th.
No luck on the extension/flex & had to have manipulation on June 1st. I am prone to scar tissue & this manipulation did not work either. I was diagnosed with Arthrofibrosis (stiff knee syndrome)I am scheduled for a 2nd manipulation on Aug. 3rd. Only this time they are going to put me in a full leg cast(for 3-4 weeks) from ankle to groin to keep my knee/leg straight. They say they have to do this because the limp I have is taking a toll on my body. Has anyone ever had this done the cast thing? Good luck everyone!!

Anonymous said...

Hi!
I had my tkr on June 29th and 6 weeks later I can't get my knee past 84 degrees. At my last post op with surgeon he said I had 3 more weeks to get it to bend or he would have put me out and bend it for bend. OUCH! This scared me to death. I've been doing pt 2 times a week and home pt 2 times a day trying to get this thing to bend, but it just won't go. I too feel as if my leg as something very tight around it that is preventing me from bending it. I've been out of work for now 6 weeks and I hate it. I want to go back. I thought I'd be back after 4 weeks, but I never expected to have this happen. I'd heard nothing but good things about tkr,so I was really excited about the prospect of walking without pain, going up and down stairs again, getting up out of a chair,heck getting off the toilet was a big one for me. Now I'm at the I regret doing this stage. I don't know it this was worth it now. I will try the manipulation,but I'm scared to death now that this will also fail me.

Janet said...

Hi folks. Janet here. . Listen, this has become quite the topic and I've meant for a long time to update. (I just updated the blog itself). I'm really glad people have found this place and are using it to communicate. I want to say that I still have complaints about my knee (see post). . but I couldn't be happier that I did the manipulation. It worked like a charm and I can bend my knee really well. . Now, part of teh reason I think it worked was that I stayed in the hospital while they medicated (i.e. drugged) me so I could continue to bend. That was the key. Also, the first hospital I was in was TERRIBLE. They had NO pain management. Please -- make sure the hospital you're going to has good pain management. Like a team. I can't stress how important that is. Even my doctor said I would have healed better had I had good pain management. I think I'll post another topic on that. Good luck folks and keep posting!

Anonymous said...

So as I stated in an earlier post, I had my knee done on June 29th of this year and on August 24th I will be put under to have my knee bent. As I said before I'm scared to death, but fear I must give this a try as I feel there is no other choice. I want my life back. After this is done I will come back and post how it all came out.

Anonymous said...

It's been just over a week since my manipulation, which was very easy. They did take pictures of my knee being bent. So I have proof that at that time it did bend as far as they got it. So later that day we worked as instructed to, bending it and doing certain exercises. I never could bend it as far as they got it. My leg was still quite numb, especially on the inner thigh and inner lower leg. This was suppose to wear off in 24 hours, it took more like 72. Once that happened the pain of the muscles kicked in. They are now very weak and it now hurts to bend it farther then it does on it's own. Pain pills only made me feel sick so I stopped taking those totally on Monday night. I go in today for a post op visit and I will see if they can give me something else or if he thinks I can get through this without pain meds. After PT one day after the procedure my flexion was 118 degrees, as of this past Monday, I'm at 115. I'm happy about the move from 86. I can do more now. My walking is getting much better. My straightening is coming along I'm at 3 now and holding. This one as been hard to. It's very painful, but my therapist assures me that it will get better. So at this time I hopeful that I will recover and be glad that I did this in time. For any one facing a manipulation, I'd say do it. It helped me get more bend. It was a good experience for me. Not very painful and I have a very low pain tolerance, it was very managable. (Didn't really care for how the pain meds made me feel though. )

Anonymous said...

Thanks for all the post. I'm scheduled for a manipulation in two weeks. This will be my 4th knee surgery. The first one was 13 years ago to correct constant knee dislocation. After the surgery I had a manipulation and am happy to report that I haven't had problems since.
That was until the other knee started dislocating. So I had surgery at the end of June but have come to a stand still with PT. I'm only at an 85 ROM. Though I've had manipulation before I'm nervous about how the recovery and pain will go.
Thanks!

Anonymous said...

Howdy folks,

I have had multiple manipulations. It is worth it, you will gain something, but there are diminishing returns if you do it again. The process itself is not much fun b/c they put a nerve block in your spine and/or crotch, which is awkward, but the good news is that if you are staying the night then they give you enough drugs that you don't feel much for 24-72 hours. If you are in-and-out, you may go home with drains in your knee (only if they are also doing a scope), and the pain comes later that evening. After the meds wear off your leg will hurt a lot for at least a few days, and be sore for a couple of weeks. During that time suck it up and do as much flexing as you can do. Get your PT or spouse or friend to really lean on you. Cry if you have to. The more you suffer the more you will retain from the manipulation. It stinks but you have to ask yourself -- how badly do you want those degrees? You've suffered through the procedure, now get the max from it. Sometimes I measure my success in they gym by whether or not I am about to cry. It stinks but again, I have to remind myself that I have to really really want it.

I had a broken leg and after 8 weeks I was only at 65 so they did a scope (cutting scar tissue) and a manipulation. They got me to 135 and then 9 days later they did another manipulation without the cutting -- they say I am a fast healer -- but the best I got a few days after the 2nd part of this double-punch was 100 and that slowly receded to 90-95. BUT as many of you now know, 90 is way better than 65. 65 is a leg sticking out all the time. 90 is sitting normally, getting into a car, etc. Then, a month after the second manipulation they did another b/c I was only getting 105, despite lots of therapy. In this manipulation they got me to 125. A week later I was getting 120 under pressure in therapy. With time that has reverted to an actual 110, or 115 under pressure. My case was complicated by a badly broken leg so I could not do weight-bearing exercises until after my 3rd manipulation. They also probably had to be a bit more gentle (yeah, right!) when bending me at the first go-round b/c of the leg. But I am glad I did it. By the third time I was a pro. My main regret is that my extension is bad -- only about 15 -- and I can't help but wonder what I could have done differently. But living in the past is a dead end so I try to force myself to work with what I have and face the future, not the past. Best wishes to you all. Sometimes life throws bad things our way and if we persevere we can overcome them or at least adapt to the "new normal."

Mindy said...

I had a knee manipulation one week ago today and can still only get my knee to bend about 65 on my own, about 90 with my PT pushing me after an hour of therapy. I had minor surgery in July to repair a torn meniscus, some torn cartilage, and to clean out scar tissue. The doctor and my PT were very surprised that my knee locked up like it did after a relatively minor procedure. I had ACL reconstruction 17 years ago and have had bad arthritis ever since. At 28, I was told my knee was bad enough to make me a candidate for knee replacement surgery, but due to my young age, that wasn't an option. I am now 34 and basically feel that I have no quality of life. I can hardly go up stairs and keeping up with my 4 and 6 year old daughters is really tough. I go back to the doctor in two days and am worried about what he will suggest since I still can't bend my knee well after the manipulation. He's mentioned maybe partial knee replacement for me as an option, but I'm praying that I have other options besides that. For those of you who didn't have luck with your first manipulation...what other options did your doctor give you? Thanks, Mindy

Anonymous said...

It's now been more then a month since my manipulation and I'm back at work. It's been tough, but in time I feel that it will all be great in the end. At my last PT appt on Wednesday my flexion was at 121. I was thrilled to hear that number. So my ROM is really improving. Today I was actually able to stand up from my desk chair using just my legs. That hasn't happened in 9 years. So woohoo! My degree of straigthening is now at 2, that is down from 3, so things really are improving with time and PT. I still have alot of discomfort in the knee, like it's really tight and it still feels like there is a band around it. And nights in bed can be horrible with pain, but I have hope that that will someday fade away. Oh and just so you know my replacement was on June 29th. I am one of the anonomous folks here.

patt said...

Hd replacement on july 1 and 2nd on juy 15 with a manipulation at that time.Here it is almost Novemebr and I am going in for the 4th time for another manipulation.
Very painful and frustated,the doctor tells me to go back to my primary care doc for the pain. I want to scream all thge time with pain,and help?

Lois said...

I was so happy to find this site. I thought there was something wrong with my manipulation procedure ( Jan. 7 --- 6 days ago) because of the pain and stiffness. I did well with the machine - but as soon as I started regular P.T., my range of motion has lessened. I'm trying like heck to hang onto it, but I also feel like I am pushing through something - scar tissue already?? My therapist says it is not normal to have such a hard time and so much pain and stiffness. Next Monday I see my dr. I wish you all luck - and would love to hear how you are doing.........Lois

Lois said...

Thought I'd add a P.S. My dr. suggested renting a CPM machine. I did and used it for less than 2 days - fews hrs. a day and right before bed for 60 - 90 minutes - increased range of motion 9 degrees my next therapy session. I find that when I get up from the machine, I can move my leg easily; 10 minutes later it's tightening up already. Dr. said something about "connective tissues", that I am one of the 1% that has a problem with this. Maybe that's what we all have. Remember the CPM machine - they made me a deal to rent it long-term; otherwise it was too expensive by the day.

fran said...

I'm so glad I had Knee Manipulation (KM). I had it done on Friday, a week ago. Not knowing what to expect I had dreaded the pain that would follow. But! It was not painful!!! Before the doctor does the KM they numb the leg. The numbness wears off after 36 hours. The afternoon of the operation, at home, my knee still numb, I got down on the carpet and was bending the knee to the same degree as the good knee. I was so happy. The knee was heavy and I had to lift it with both hands, but I was determined to keep bending. All weekend, with the aid of a stretch strap and an exercise ball, I did my exercises. Before KM it was at 90 degrees. On Monday PT measured it at 130 degrees!!!

I still can't straighten the knee though. KM is not a procedure for taking care of the that. It feels like there is a band around it, maybe from being unable to straighten(?). PT gave me exercises to straighten. I wear a knee immobilizer at night, (only at night). The doctor said to wear it until the leg fully straightens. I find that the immobilizer keeps the pain away, without it I can't sleep.
A little history: I had Partial Knee Replacement, May 13th. The KM was done July 23rd. The worst part of the KM was trying to use crutches—hard to handle, hop on the good leg, with the numb leg flapping like an uncontrollable rudder; I fell two times. Finally I switched to a walker, using it only for two days. I use a cane now when out in public. I'm very hopeful now and feel it's up hill from here.

fran said...

I'm so glad I had Knee Manipulation (KM). I had it done on Friday, a week ago. Not knowing what to expect I had dreaded the pain that would follow. But! It was not painful!!! Before the doctor does the KM they numb the leg. The numbness wears off after 36 hours. The afternoon of the operation, at home, my knee still numb, I got down on the carpet and was bending the knee to the same degree as the good knee. I was so happy. The knee was heavy and I had to lift it with both hands, but I was determined to keep bending. All weekend, with the aid of a stretch strap and an exercise ball, I did my exercises. Before KM it was at 90 degrees. On Monday PT measured it at 130 degrees!!!

I still can't straighten the knee though. KM is not a procedure for taking care of the that. It feels like there is a band around it, maybe from being unable to straighten(?). PT gave me exercises to straighten. I wear a knee immobilizer at night, (only at night). The doctor said to wear it until the leg fully straightens. I find that the immobilizer keeps the pain away, without it I can't sleep.
A little history: I had Partial Knee Replacement, May 13th. The KM was done July 23rd. The worst part of the KM was trying to use crutches—hard to handle, hop on the good leg, with the numb leg flapping like an uncontrollable rudder; I fell two times. Finally I switched to a walker, using it only for two days. I use a cane now when out in public. I'm very hopeful now and feel it's up hill from here.

lakeisha said...

I'm 54, and I felled on ice on Jan. 30 2010. I had to have a knee scope on Feb. 5. The pain was weight bearing, so I had to have a TKR on May 5. I couldn't bend my knee but up to 75 degree with extensive PT. My knee had build up a lot of scar tissue and it was very painful,so I had to have a manipulation on July 13. Immediately after my manipulation surgery,my anesthetic wore off and I was in so much pain.I had to go to PT right afterwords. My PT forced my knee to bend 120 degree. I screamed so loud because I couldn't bear the pain but they wouldn't stop bending my knee. My knee began to swell up so big. After that, I decided not to return to PT. I decided to use the CPM machine at home and to work on my own knee.I can bend my knee with the machine up to 125 degrees. My scar tissue has come back and I am still in much pain. I don't know what else to do to get rid of the scar tissue. Putting vitamin E oil on it has help some but its still preventing me from bending my knee. I definitely don't want to have another surgery. I am physically and mentally tired, but I am continuing to pray everyday.

Maureen said...

Thank you for all the comments on manipulation. I had my right TKR two months ago and have been in constant pain. I have attended therapy sessions 3-4x week. In these eight weeks I have gone from 75 degrees to 105. I still feel like someone poured cement in my knee because I can barely move it without having severe pain. I went to see my doctor on Friday and he said that I need a manipulation. As most of you have shared - I too am scared to death to have this done. I am about to lose my mind. I can't imagine being in more pain than I am in now. I am scheduled to return to work in two to three weeks and I don't know how this is going to happen. My husband has been so supportive of me throughout this whole ordeal and I don't know what I would have done without him. I do however feel that people wonder why is she still in pain. I think that they almost don't believe me. So, reading this blog has helped me to know that its not just me. The pain is real and there are many of you with the same issues that I am going through. I hope that this manipulation works because I am not quite sure what would happen next. I'll post how the procedure goes. Thanks for all your help.
Maureen

fiona said...

hi, its very informative, Knee Physical Therapy , thanks

RalphS said...

Thanks for all your comments. I had TKR on 8/17/10, and my doctor sent Home Health/PT for the first few weeks. This was a mistake, as I did not get the right/enough therapy. I finally begged my doctor to send me to an outpatient pt, and the paperwork took over a week. So the first 3 weeks after surgery, I only had 4 home visits from a PT. She kept telling me that I was "high functioning", and I did every exercise recommended to me. However, when I arrived at the outpatient PT, my knee would not straighten past 30 degrees. After 2 weeks of PT, it was down to 15 degrees. However, after another 2 weeks of the PT pressing down so hard that I could scream, I was still at 15 degrees. My doctor recommended the MUA, but I panicked. He gave me 2 more weeks of therapy, but I finally realized that things weren't getting any better. I go in on 10/14 for the MUA and hope it works. Several people act like it's my fault for not doing enough bending and stretching, but I feel like I was doing what I was told. I will post back next week.

donna m said...

Okay everyone, I have a positive comment about knee manipulations. I had a total knee replacement of my left knee in September 2008 and did great with flexion at 140 degrees. November 1st of this year I had a total knee replacement of my right knee. I experienced greater pain this time and after 6 weeks of physical therapy could flex to 100 degrees with great pain. I am 60 years old, still working, and very active. My surgeon felt I needed a knee manipulation. I was terrified to have the procedure done after reading all the negative blogs. I almost cancelled the procedure the day before. However, I had it done December 15 and am very glad I did it. I had a femoral block and my surgeon injected 20cc of Marcaine. Once I felt some discomfort I started the pain medication. My post surgical total knee replacement pain is gone. I only have tightness in the lower muscles of my thigh. After only 2 days of physical therapy I am at 111 degrees with little pain.
I get swollen, but I ice and elevate daily. I am happy I had the procedure done and would do it again if I had too. I am confident my flexion will continue to increase with hard work and it is well worth it.

april said...

hi,
I had complete tendon tear in my knee and after 10 weeks iam only at 45 flexion. I am having surgery friday to remove scar tissue and to have a knee manipulation. Has anyone ever experience this?
Thanks,
April

april said...

hi,
I had complete tendon tear in my knee and after 10 weeks iam only at 45 flexion. I am having surgery friday to remove scar tissue and to have a knee manipulation. Has anyone ever experience this?
Thanks,
April

april said...

hi,
I had complete tendon tear in my knee and after 10 weeks iam only at 45 flexion. I am having surgery friday to remove scar tissue and to have a knee manipulation. Has anyone ever experience this?
Thanks,
April

Steve said...

I had bilateral TKR surgery 12/01/2010. After 9 weeks of pt I have hit a plateau of approximate 95 deg flex during pt.
The dr has reccomened mua and I will be getting procedure next week. Will post again after MUA.

Caren said...

Caren
I shattered my patella November 4 2010 into 6 pieces, had surgery 4 days later (too swollen) to remove 3 small pieces and wire the 3 large pieces back together. Spent 6weeks in a leg splint not allowed to do any exercise as I could have broken the patela again.

It is now 14 weeks since the operation and I only have movement of 65°. I see the surgeon on 15 February 2011 and I have already been told by my PT (about 4 weeks ago) that I would probably need a manipulation, I spoke to the surgeon about it then, and he wasn't surprised the PT thought so.

This is major operation is No. 4 on this knee (I've had another small one to remove a screw from a previous op) as I suffered recurrent dislocations and my tendons have no stretch left in them. Also the Surgeon said that the muscles etc in my knee are very different to any he had seen before, a lot smaller and a different shape. He wasn't sure if that was what had caused all my problems or was the cause of the problems.

I work very hard to bend the knee. I was stuck at 45° for about 3 weeks with no improvement so 65° is fantastic to me, but as we all know is not enough to make life easy.

Will let you know what the surgeon (and I)_ decide to do.

Good luck to everyone, its nice to see we're not alone in this, especially when the people around you don't understand why it won't bend and you can't do things.

Maureen said...

The manipulation (in my case) was a great help. It was not as painful as I had anticipated. Within 24hrs I saw a remarkable difference - positive. I then had to attend therapy every day because I was told scar tissue would grow rapidly if I didn't. Things seemed to be going very well and then 3 months post manipulation the pain was back. Not as bad, but it had returned. It is now 6 months since my surgery and the movement is great. I am walking up and down the stairs with little to no difficulty. I do however, have pain all around the knee which is being attributed to scar tissue. I am going back to the surgeon in two weeks and I believe I need another manipulation. I am hoping that this will be the cure all -- I hope.

Janet said...

Caren --

I'm so sorry you've had to go through all of that. Have you thought of getting a second opinion? I don't know about manipulations when they aren't related to knee replacements. Mine turned out great. But it's always a good idea to get more than one opinion and I bet your insurance company would pay for it. Good luck!

Caren said...

Thanks Janet, well I saw the Dr on Tuesday and I go in on Friday to have the scar tissue removed and manipulation done, he is also hoping to remove some of the wires as they are also giving me trouble.

He is putting me on a knee bending machine in hospital for 3 days to get it all going. Really not looking forward to it.

I'm hoping mine turns out great like yours Janet. My son is getting married in May and I really want to be able to walk properly well with as little a limp as possible and no walking stick would be great.

Caren said...

I've had the scar tissue removed and the manipulation done and couldn't be happier. Woke up from the surgery is very little pain (I would say no pain)Surgeon got it to 120 in theatre, he tried to move it prior to removing scar tissued and it wouldn't bend. That made me feel great, as it meant I wasn't bludging with what I was doing.

Was bending it on the CPM machine to 105 on the first day, was allowed to go home on the 2nd day as I can bend it myself to between 95 and 100.

Surgeon said you normally loose 10%from what they get in theatre, so I'm pretty happy with my progress so far. I got on my exercise bike when I got home and was able to go all the way around.

The pain I have now is in the muscles that haven't worked in such a long time, so hopefully if I continue as well as I have been with the physio all will be good. I don't believe I'll be lucky enough to ever get to 140 but I'll be happy with 110.

phil-morrison said...

Not sure if this blog works anymore. I left a comment maybe 2 months ago and don't see it on the page. Hope this one makes it. When last I blogged I was just over 90 and struggling and was considering minipulation. Since then I have tried to ride the bike every day and done a stretch where I lay on my back with my feet on the wall and try to slide my feet down to get more bend. I have had to use my other foot to force it down and push my hips up to force the bend. I am now at 130 when I push it and am gaining very slowly. Don't give up. As the pain from the surgery goes away I have been able to push harder and harder. Still very painful and a lot of work, but you will make progress if you just keep working at it. Don't get discouraged. Try different things if what you are doing isn't working. Golfing actually helps limber me up in a way even though I don't bend it much when I golf. Just the rotation and flexing seems to help.
You will get through it. Your body is made to adapt to pressure if you just keep putting pressure on it. If you keep pushing your body will adapt. Some of our bodies are just a little more stubborn than others. Good luck to you all!

Nae said...

Hi, I had a Bone Lengthening operation done and afterward my knee cap dislocated. The only choice was to do a medial patellofemoral ligament reconstruction and having 3 surgeries within a year on the same knee the scar tissue has built up to a crazy extent. I can only bend to 70 degrees so i go in for a manipulation on the 24 of July. I am a very active girl and i just want to know if weight bearing is allowed with in the first two days?

JAMAICA said...

HAD KNEE REPLACEMENT TO MY LEFT KNEE IN 2008, COUGHT MRSA, HAD TO STAY IN HOSPITAL UNTILL BETTER AND THEN PT FOR SOME WKS. IT WAS SUGGESTED THAT I GO FOR KM SO I AGREED TO IMPROVE MY RANGE OF MOVEMENT.THE REULT OF THE KM WAS A BROKEN TIBIA AND PATELLA WITHOUT THE DOCTORS EVEN REALISING WHAT THEY HAD DONE. IWAS IN PLASTER FOR SIX WKS AND THEN A BRACE FOR A FURTHER SIX WKS.AS A RESULT TO THIS DAY I HAVE LITTLE RANGE OF MOVEMENT.

Tish said...

Hi everyone, I had a patella realignment on 6/1/2011. I also had some tendons replaced. I am now doing my pt just like everyone else and can bend my knee to 79 on my own. My pt loves to push thru scar tissue and its very painful. They say this is done to give me a couple more degrees. I recently seen my surgeon on 6/8/11 and he said if I didn't get to 110 by 6/19 then he's sceduling me for a manipulation. I really don't know about this due to me already being in so much pain. I think pushing thru scar tissue is so cruel even though it does help a little. I am just so fustrated at this point, like most of you I wish I never had the procedure done. My patella was totally dislocated so I guess there was no choice. I'm so ready to get back to work and my regulary sceduled program. At 29 I feel so worthless i can't do anything now with this knee. My husband has been great with taking care of me and the kids. I'm just wondering is this manipulation really worth it, and is there any numbing medicine I can take before pt since they love pushing thru my scar tissue. I just don't know what to do?

Caren said...

Well I finally had the wires removed on 20th May 2011, 2 days after my son got married. I got the knee to bend to 130° before the surgery, was so please considering they never thought I get passed 110°.
Had my very last physio visit last week and the knee is bending to 137° so extremely happy with the result, it still feels a little weak the thigh muscle is pretty much gone, so now to work on that and see how I go. Just wanted to give you an update. Thanks Caren

old woman said...

Right knee done 6-l, was easy, therapy only two weeks, hardly needed any pain meds. Left knee done 7-18, extreme pain,in nursing home 22 days, then out patient therapy, can only do 78. Dr. has ordered manipulation on MON. I am so afraid it will make it worse. I'm at the end of my rope, I can only get through the day with meds every 4 hours. Wish I would have never done second knee,

tina said...

I had two knee replacements on the same knee, due to a staph infection. My first surgery was last year, July-8-10., and again this year, Aug-1-11. It's been very frustrating 15 months,I just want my life back. I had my second munipulation on Oct-17th, went home the same day. I went to therapy the next day, was very happy to bend it to 105, before manipulation was bending it only 80%. I was also able to go on a bike, but now week latter I can only bend 90 to 92. What's going on?? I will be done with my benifts,after this week, so I will have to go to the gym and aguatic therapy. I just want to be pain free and be able to walk . Is that too much to ask??

tina said...

I had two knee replacement surgeries on the same knee,due to staph infection. My first surgery was on July-8-10 (the day I will never forget), and the second surgery was on Aug-1-11. I just had my 2nd manipulation on Oct-17th(outpatient). I am also sick of pain and theraphy, that's has been my life the past 15 months, and I am wondering if I will ever be the same? The second day after manipulation I was able to bend to 105(before manipulation was 80%)and go on the bike, and week latter, I can only bend 90% and ca't go on the bike. I feel like I am going backward. The worst part is that I am done with my benifts after this week, so i will do my own therapy, go to the gym and do water aquatic. Thank God I can afford it.

Vera said...

I had a tibial tubercle transfer on my knee, a scope and all my muscles/tendons tightened to align my knee cap, which was so far canted to the outside of my knee that it was rubbing bone on bone. I'm only 44, so this seemed like a good option for me instead of having my knee replaced. After my surgery I couldn't lift my leg and we found out that my quad muscles had completely shut down. After using a electronic muscle stimulator every day for several times a day (and a lot of fervent prayer) my quad muscle returned after 8 weeks. My leg is still very week, but I'm sure that I'll regain 100% use of it with much work, so I'm not too worried about that part. But, I've had such extreme stiffness with my knee it feels as if I have a very tight band around my knee that prevents me from bending it. Walking on it makes it much worse. I read on the web that to get rid of stiffness, I need to elevate my leg nearly all day and night for 2 weeks and ice it for 20 minutes every hour. I did manage to try this for a few days and it really helped, but I'm the mom of 4 kids and couldn't keep it up, so wouldn't you know it, the stiffness has returned with a vengeance. I stopped going to physical therapy a few weeks ago because my therapist could only help me to bend it to 90 ROM, for 3weeks in a row. He keeps on making comments, hinting around that I'm not trying hard enough - so its becomes so disheartening and frustrating to go to therapy, because I'm trying hard at therapy and I'm going to the gym on my own. It just felt like I was working so hard on it everyday with everything that I had to get it to bend to 90, only to wake up in the morning to complete stiffness again. I just feel like the therapist doesn't believe that I have such severe stiffness at my age, but I can't help what people think. So, I've been working on it alone for a couple weeks, so I don't run out of p/t visits (I only have 20)per year. But it's still not getting any better, so I talked to my surgeon about a manipulation. He scheduled for 2 weeks from now, if I can't make any progress..I'm going to go ahead with it. He said he does about 300 knee operations a year and only has to do about 1 manip. per year. I'm sad that I'm that 1 that has to have it done. He's says that if it won't bend freely, than he'll scope it first to see if there's something in the way. I know that I can overcome this with a lot of hard work, I just hope that the swelling/& stiffness with go away soon, this has been one of the most emotionally taxing situations that I've ever had happen to me. I have to have a tibial transfer done to the other knee as soon as this one recovers, but I don't know if I dare. Good luck to us all - we can overcome. "No grief is so great, no pain if so profound, no burden if so unbearable that it is beyond the Lord's healing touch." Quote by: James E. Faust

Carol said...

I've read through most comments looking for others who experienced a lot of quad and hamstring muscle strain after manipulation. I couldn't find anyone who has. It is a very frustrating development. On the one hand, you are supposed to rest a muscle strain - 3 weeks, I'm told. On the other, rest is exactly what is not to be done in order to get more knee bend. At this point, I had the manipulation done 5 days ago and still have screaming pain from the muscle strains. So, I gently bend until I cannot take it any more, even with having taken pain killers. The depressing result? My bend is less than before the manipulation with this screaming pain in my muscles. I had been walking in the swimming pool every second day, with good results. Over the past two days, progress has digressed. So, what to do? Should I rest and risk losing ground on the knee bend? Can anyone help?