The WAITING ROOM => GENERAL KNEE QUESTIONS and comments (good for new threads) => Topic started by: RLE on October 14, 2011, 10:00:41 PM

Title: Regression after manipulation
Post by: RLE on October 14, 2011, 10:00:41 PM
I have read all the posts I can find on here about manipulation but they seem to be all over the place. It would be great to have specific areas for specific procedures.
After 3 weeks immobilized then 3 weeks of PT my knee was just not moving. The swelling has never gone down (after an injury I posted about-dislocated kneecap/torn ligament)
I knew it was scar tissue since my body produces a lot of scar tissue. On Monday I had a manipulation. The surgeon bent my knee all the way to touch my backside. He did nothing else. I had intensive PT daily since then plus a CPM machine in which I can get up to 120 degrees though not for very long. On Wed. I had 120 degrees of flexion. The PT pushed me hard yesterday and I pushed myself after and woke up today with a lot of pain and swelling. I again worked for an hour and a half of intensive physical therapy today and when the PT measured me I was only 101. I've regressed. She said she doesn't know the reason it could be inflammation from yesterday or not.
Has anyone had this happen or know the reason for less flexion today than two days ago? I use the CPM all night and most of the day.
Title: Re: Regression after manipulation
Post by: Rollerblader on October 16, 2011, 12:14:36 PM

Soooo sorry you had to have a manipulation.  I had one @ 9 weeks post op from a patella break.  My OS got my to 120 ROM while I was under.  I did not do the CPM, not sure why as it seems to be typical.  I was scheduled for PT 3x a week for 6 wks.  I just finished my 3rd week.  Regressing is pretty typical from what I've read.  My PT was only able to get me to about 78 ROM the next day after the procedure.  I was soooo swollen and sore for first week I could hardly sit on the PT table.  My OS did not prescribe any anti inflamitories.  My PT was concerned that I had too much swelling to be able to do anything.  I regressed to 60 ROM a week following my MUA.  Started on Aleve that day and swelling went down immediately.  I was back to 70 ROM and then this past friday, my 3 week point I got to 99 ROM.

The  MUA shocked my muscles and i had severe brusing on the underside of my thigh btwn wk 1 and 2 from being clamped down.  This prevented me from moving forward immediately.  I'm pretty sure this is typical.  I'm surprised that your PT doesn't know this.  I think it just takes time.  I have been pretty miserable since  the manipulation.  I've haven't slept at all.  My leg twitches constantly and has shooting pains.  By the way, I was at a ROM of about 45 when I had my MUA. 

Hang in there!!!!  It will come.
Title: Re: Regression after manipulation
Post by: aaa on October 16, 2011, 02:04:44 PM
i know this probably isn't helping things, but i think one should know that immobilizing for 3 weeks after a patella dislocation is the worst thing you can do.

actually, maybe it is helping things to tell you this, because i went through a very similar situation ... and you need to find a new doctor who knows how to help you

its making me furious to read it, because countless people have been made to endure unnecessary pain and difficulty.

see: - quote below regardingj on HOW NOT to manage a dislocated patella

This common problem has been mis-managed for years, with the knee put into a plaster cast for a period of four weeks, after which the patient was basically discharged. What we have learned over the last five to ten years is that the last thing you should do after this kind of injury is to immobilise the knee. Of course the patient should rest their knee for a few days – it will be painful and swollen and difficult to use. Ice, compression and anti-inflammatory tablets may further help reduce the swelling. The patient may benefit from the use of a brace (a cricket-pad splint or some form of immobilisation for a few days) but basically they need to start exercising the knee, and in particular the inner quadriceps muscle (the VMO or vastus medialis obliquus). This medial quadriceps muscle is a key player in keeping the kneecap sitting where it is supposed to sit. If you immobilise the knee in a plaster for a long time this muscle will waste away. It is really important that patients start exercising their VMO muscle.

While the part about the VMO is still argued somewhat, in that the hips are thought to play a critical role in patella stability as well, it is true that the quads waste away very quickly after being immobilized.

And as you've experienced, you're knee is stiffened up now after immobilzation.  i was fortunate that i didn't have the stiffness, but i did have the severe atrophy and years of frustration.

where are you located?  i would suggest finding someone who specializes in patellofemoral isntability

as for the lateral release, do not rush into this surgery, it is rarely indicated and quite often performed by OS's who do not know what they are doing, so they just take a chance and hope maybe it works.

again, i would suggest someone who specializes in patellofemoral instability, and i would encourage that you read the set of articles, particularly part III -

i don't know how to advise about the stiffness, but if your knee was normal before the injury - i.e. no anatomical abnormalities, no rotatoinal issues,  and the injury happened in an impact as you described , then sometimes physiotherapy is enough ... if physiotherapy fails and the patella remains unstable, then its quite likely the MPFL is damaged and a reconstruction will correct the problem.
Title: Re: Regression after manipulation
Post by: RLE on October 17, 2011, 03:04:08 AM
Thank you for the replies. I live in Los Angeles. I worked on my knee all weekend and today it's all stiff again just like before the MUA. Very demoralizing.
I also tore a ligament which is why I think it was immobilized.(?) I couldn't stand on it for a long time.
I'm wondering if the surgeon shouldn't have removed scar tissue before doing the MUA since I've read some surgeons do that or since it was only 6 weeks and I'm trying to use scar tissue to keep the kneecap in place that wouldn't have been a good idea.
It's extremely inflamed. I wonder if I should try Alleve instead of painkillers? It's just so painful to move without pain medication.
Another odd thing. I use a cold pack for my back-I swear by it. And the doctor and PT insist I use ice on my knee. The ice inflames and stiffens it more so I stopped a week ago and today I put hot wet towels on it instead and it was much better.

I should add that my kneecaps were ok prior to the injury but I had a condition (don't know the medical term for it) where my kneecaps go to the side because they are not cupped and are only held in place by my ligaments. I never had any problems before except this injured knee would ache a bit when I climbed a lot of stairs all day and I wore a brace on it when exercising. I guess at my age (middle age!) I was lucky never to have a problem and probably never would have had I not been run into by a huge heavy dog.
Title: Re: Regression after manipulation
Post by: aaa on October 17, 2011, 10:01:28 AM
when the patella dislocates, typically there is some tearing of the medial restraints / ligaments ... still, i think its becoming more common to rest this for a shorter period and start exercising it, but whats done is done and i don't mean to discourage you , many have gone through a similar situation and end up doing ok long term

i think what you're referring to is shallow trochlear groove, the groove holding the kneecap possibly isn't that deep.  There are procedures to deepen the groove, but that might not be necessary, its really improtant to find a specialist

i'm not sure about patellofemoral specialists in los angeles .... but there is a patello-femoral forum here on kneeguru, i would recommend posting a new thread there about a specialist in your area.
Title: Re: Regression after manipulation
Post by: Rollerblader on October 17, 2011, 12:19:49 PM
I really can't comment on your dislocated patella, but re: the swelling you should call your OS office and they should be able to tell you if you can take Aleve with the pain meds.  I was told I could after my bone was healed.  So you shouldn't have to give up the pain meds...

I mostly use heat now that my swelling has gone down.  I ice if I'm swollen or if I have certain pain.  It kind if freezes the pain, but sometimes it makes the pain worse.  I don't use heat if my knee is hot.  I've used heat mostly on my Quads as they have been very sore.  Alot of times if you over due it, a night of ice and elevation will get you back to where you were.

Re: removing the scar tissue.  I'm not sure what the answer is.  Some tend to think by going in and cutting it loose it just allows for more scar tissue to form if you are prone to scar tissue.  Others think it's the best way.  I really have no idea.

I think you are still early in the MUA recovery and it should get better.  I really didn't feel better and start improving until after my first or second week.

Good Luck!!!
Title: Re: Regression after manipulation
Post by: RLE on October 18, 2011, 03:08:22 PM
On Monday I hung my knee over the table and the PT measured the angle. I asked what it was and her face got tight and she slammed away. She told me to lie down and without giving me a chance to bend my knee she shoved it backwards as hard as she could. I screamed and she measured it. It was 95. I then moved it slowly back myself and asked her to remeasure. It was 100-same as last week. After the manipulation it was 120 and it went down to 100 and has stayed there.

I don't know why she did what she did? Is this standard procedure? She's never done it before. She then proceed to tell me that this is all my fault because I'm "afraid" of the pain (yeah, I am it's excruciating) and so I'm babying myself. My knee is very stiff even after I've just exercised it. Aside from the pain sometimes it just gets to a point where it doesn't move. And the pain while on the bike is out of this world or if someone forces it.

And it's extremely swollen after 8 weeks. First because of the accident now because I assume of the manipulation. She keeps me 2 hours and sometimes when she finishes my knee is hugely swollen, hot and painful. The next day she tells me it's my fault because I'm not pushing through the pain. I've lived with pain the last 12 years and this is absolutely the worst. I'm really struggling. Am I wrong or is it her? She's a good therapist, cares about her patients but is very high strung and gets angry easily. I have this week 4 days of PT and next week 3 days and then I'm done. What if I can't move my knee more than 100?
Title: Re: Regression after manipulation
Post by: aaa on October 18, 2011, 03:41:17 PM
Find another Physiotherapist.  She should not be getting angry with you.  Geez, its making angry just to read this ... I would've probably lost my cool if that happened to me

Title: Re: Regression after manipulation
Post by: Lottiefox on October 18, 2011, 10:23:52 PM

**** me. I am seething! I agree - find another physiotherapist. This is not right. I think that you need to have a read of the approach to rehab after an MUA in the Information hub where scar tissue is involved and print off the pages and give them to your PT. It sounds like you are being pushed to the point of extreme inflammation (through the pain) and then the whole cycle of pain, inflammation, swelling, and loss of motion sets in. The key to regaining motion after an MUA (with or without a removal of the adhesions through surgery) appears to be a slow, steady program that does NOT set up the chain of inflammation in the joint. I would recommend having a read of some of the diaries on the Arthrofibrosis board to review some experiences. By forcing your knee into a hot swollen state there is no way you are going to retain the ROM that was gained when you were asleep. Yes, some pain is to be expected. You need to stretch, you need to work, but you MUST balance this with what your knee is telling you. Be careful with the whole heat-ice thing. Heat when you're swollen and inflamed isn't generally a good idea, it causes the blood vessels to dilate more and that isn't great for swelling. Ice is generally accepted as useful for swelling but be careful not to overdo it, if you find it creates more pain then stop and just try a cool (fridge temperature) compress to soothe the pain. We have a lot of nerves in the knee and they are responsive to extremes of temperature.

I am so angry for you at your PT's lack of professionalism. NO it isn't standard procedure. It isn't your "fault". I hope you can get someone to listen a little more to what you're telling them. You sure don't sound like you're afraid of the right type of pain - but pain regardless after an MUA isn't right/

Title: Re: Regression after manipulation
Post by: Stergios on October 19, 2011, 12:13:01 AM
There are 3 kinds of ROM: Active ROM, Active-Assisted ROM and Passive ROM. What counts most? Of course Active one. The PT usually use PROM to inform each other about. Regression is logical, as your knee is so much swollen after your manipulation. Adhesions usually are getting grown up again, as your knee is so much inflammed and your manipulation torn some adhesions. Maybe they did it again. You should avoid as much as you can to irritate your knee more. Ice is a good solution, even some theory says that it can inflamme the injury. If you use it not more than 15 min., I think it can not harm your knee. My PT says the max. time should be 20 min.
About the measurement that PT tried: ROM is different in a supine or a  prone position. Obviously she tried to take a PROM measurement, but to turn you upside down and measure, it is a bit bizarre to me. I think she should push in  only one position. About professional behaviour: Well, I think it is not much professional, but the result counts most. If she is good and effective, if I was you, I could be patient to wait the result. Our knee counts most after all:-)
Title: Re: Regression after manipulation
Post by: RLE on October 19, 2011, 02:34:09 AM
I ice my back religiously and have never used heat for anything but I think what's happening is my quads are freezing up from the pain and getting stiff and the warm water relaxes them. My PT sent me to the pool before the manipulation and the water was very nice.
I'd like to know other people's experiences with their PTs post-manipulation since mine said that we have to use the first week after MUA to get the range of motion and to keep the scar tissue from growing back.

I'm really struggling with pain and stiffness. Today is Tues and my MUA was done last Monday. During physical therapy with a lot of pain medication (about Percocet 8) I can bend my leg still to 100 (hasn't changed) and finally after 8 weeks with a fantastic new brace-Bauerfeind-I can walk on my right leg a small amount. I can step down and bend it somewhat normally but it tires quickly.
Title: Re: Regression after manipulation
Post by: Rollerblader on October 19, 2011, 07:04:26 PM

I'm sooo sorry for you!  Did your OS prescribe this particular PT?  I had to find my own.  I would change Therapist and when you make your appt, ask for someone who has worked with knee manipulations... 

I have a post, kind of a diary, under Bone Breaks around the Knee section.  Just look for my ID under the authors. 

I was at about 45 ROM at 9 wks, the OS got me to120 ROM during MUA.   The PT got me to 78, the day after my MUA.  I regressed to 60, about a week later.  I was so swollen and sore in my thigh, the PT was pretty easy on me until I got my swelling down with Aleve.  The day I was at 60, PT encouraged me to get on an anti-inflamatory or go to the OS and have him look at my swelling and bruises, which showed up about 5 days post
MUA.  That was an awful couple of weeks.  My quad was like concrete and and felt like it was being pulled to the ground.  The quad stiffness, knots were the limiting factor for to bend.  I'm a little over 3 wks post MUA and I got to a ROM of 113 assisted today and 97 unassisted.  I've been gaining ROM everday.  Therapist is very happy with my progress.  I do wake up stiff every morning and my ROM is sbout 65-70 until I tide my stationary bike.

My PT sessions are 45 min for knee and 15 min for broken elbow rehab.  My therapy originally was massaging the knots out of quad and then PT would push my leg.  Now I riide nustep for 10 min, stationary bike for 10 min, then PT massages around the knee, and then pushes...  Today we started some balance board, and  steps.  Used to end PT with ice, but now we end with heat.  As long as I'm not swelling, i prefer heat at this point.  The heat is also for my quads.  I'm not sure people without a MUA understand the SHOCK the MUA does to the thigh.  My knee was not sore in PT until about a week ago.  My PT said that most people dont have all the knots in the quads.
Your PT is right in in that you have to keep the scar tissue at bay and keep the range of motion, but the problem is that there is regression the week after MUA due to swelling and your never expected to reach what the OS reached the week after the MUA.
The MUA was a total set back for me.  I was getting out, feeling good and painfree.  I had the MUA, and I was back on pain killers, haven't slept more than 3 hours at night and My leg just aches all day with some sharp shooting pains in my knee, thigh, shin.  I got off percoset, it depressed me and made me weepy.  I'm now taking vicodin only to sleep. 

I hope this helps.  The post mua pain was worse than my original pain from patella and elbow surgery.  I just wasn't expecting it to be so bad.  Hang in there and find a PT who knows what to do with a MUA. 

Take Care. I think you have another couple of days before you turn the corner, but you have to get your swelling reduced.
Title: Re: Regression after manipulation
Post by: RLE on October 19, 2011, 07:21:25 PM
Wow, my PT is so different. I've told her about the quad stiffness and nothing. I do leg swings, leg bends on the wall, the bike, forwards and backwards on the treadmill, practicing walking with the crutches and a walker.
She keeps me an hour and a half for my knee. When she forces my leg I think I'm going to go out of my head with the pain. Does your forced ROM hurt? The stationary bike also the pain is crazy. I took aspirin for a few days but I have an ulcer (from taking aspirin for my back) and can't tolerate it. It helped a bit with the swelling. My knee is still very swollen.
I think the CPM is what's saved my sanity. It bends my leg gently and the pain is not bad and has kept it from stiffening since when the PT finishes with me the pain is excruciating.
This is week 2 after the MUA. The PT is part of the surgeon's office. This whole thing has been so painful. I can't say the post-MUA was worse since the pain has just been bad period.
I hope you're right that it will settle down and start getting some ROM. Thanks for sharing your experience.
Title: Re: Regression after manipulation
Post by: Rollerblader on October 19, 2011, 10:43:22 PM
Yes, our PT is very different.  My PT definitely pushes past what I think is my breaking point and then she holds it.  After my swelling went down, she moved me to table in another room where very few people are and she put a seatbelt type strap over my thighs and put a cuff on my foot.  The cuff has a strap that hangs down.  She faces me and puts her foot in the loop of the strap and pushes my foot under the table until I'm about to hop off the table.  The first few time it hurt soo bad.  Since my ROM has improved so well over the past week, she hasn't used the cuff every time.  She did use it today, she couldn't seem to push my leg under the table very well without it.  It also hasn't been as painful the last few days.

The upright bike is miserable...  I just got around this past week.  I've gotten around on my recumbant bike at home.  It takes me about 4 min to get to where I can get around, and then I just go around slow.  I keep thinking it will get easier, but it seems to about the same.

It sounds like you are doing some quad strength.  My PT has mostly been ROM.  She wanted to get me over 90
 before we started on strength.

When is you next OS appt?  My OS prescribed aggressive ROM, but mine is not near as aggressive as yours.  You might want to share your PT experience with your OS.  You also need to figure out a way to get your swelling down, so you won't be in so much pain.

Good luck, keep us updated.  Hopefully someone else will tell of their experience.

Take Care,

Title: Re: Regression after manipulation
Post by: RLE on October 22, 2011, 02:20:09 PM
I'm seeing the OS on Tues. I went to the pool yesterday. I had complained to my PT that the PT at the pool doesn't do anything (he just sits at his computer the whole time and doesn't talk to patients.) And his assistant is too busy supervising 3-4 people in the pool to do much so when I got there she was there though she left before I started.
 Somehow the workout was different (better than the times I had been there before) One thing I noticed was that when she finishes with me I'm so exhausted I can barely lift my legs but my leg is soft and loose after. Hurts like heck the next day but I'm progressing. The pool was not much of a workout. I wasn't tired or sore the next day and the worst thing was the stiffness and tightness I've been fighting came back two hours later after the pool. On the days I see my PT the stiffness/tightness doesn't come on. I used the CPM machine until hurts and that works on the tightness. I don't know what I would have done if they had taken the machine after the first week as they were going to.
I hate the stupid bike too. Hurts like anything. I still can't sit normally and pedal.  :)
How is your ROM now? Thanks for all the details it's very helpful! I hope your pain level is better.
Title: Re: Regression after manipulation
Post by: Rollerblader on October 22, 2011, 09:48:02 PM

I haven't had any pool therapy or been to the pool yet.  I've been told it's great to get in warm water.  I have taken a hot bath with sea salt.  It felt very relaxing.   :)

I had my first followup OS appt this past Thurs which was a little over 3 weeks post manipulation.  The OS was very pleased and prescribed 6 additional weeks of PT.  He did not measure my ROM but my leg was hanging straight down and I could lift my leg into a straight line.  He commented "wasn't it worth it" and I said "it was awful". He said, "i told you it would be painful".  I was also realeased to start driving  and go back to work.

I drove to PT on Fri and my unassisted ROM was 103.  She didn't really push, except while I was laying on my stomach with my knee bent toward ceiling.  My assisted ROM from Wed was 113.

It seems like my progress in the past week has been fantastic.  Ever since I was able to get a full revolution on my recumbant bike and now, i've started riding for 10 min 3 x a day, my leg strength has really improved.

I only took one Aleve this morning and I've felt tighter and a little more swollen than previous days.

The upright bike is awful.  Can you work on a nustep or a recumbant bike.  The seat is not a bike seat, it's more like a chair.  I have found it very comfortable.
 I do feel like I tighted up after I excercise or sit for a while or sleep. 

I hope you start to feel some progress and your appt goes well!

Takr care,


Title: Re: Regression after manipulation
Post by: RLE on October 25, 2011, 03:18:04 AM
Glad to hear your progress. It's been really helpful to hear the details of your rehab. I wish others would post as well. I'm stuck at 100 which is ok (but I'm cheating because I use the CPM daily) but the inside of my knee and the top are getting worse. Feels like a band is tightened around my leg and leg is getting weaker. When I bend it it moves but weird, slowly like a tight  wire is attached. I know this isn't normal and isn't progress. I know my body. I have to find a doctor who will help me. My PT changed my therapy to gain some strength in my leg. She's gone far out of her way for me-keeps me an extra half hour and tried all kinds of things.
Let me know your details as you continue progressing. It gives me an idea of "normal"
take care!
Title: Re: Regression after manipulation
Post by: Rollerblader on October 27, 2011, 11:39:45 PM

Curious to know how things are going???  I hope better!! 

I'm doing very well.  My PT hasn't messured my ROM lately.  I was able to ride an upright static bike for about 10 min today with the seat at a pretty low position.  I think my ROM is about 110 to 115. 

I had real tightness for a while and then it changed to this rubberband type knee, where it felt very unstable when I would walk.  I was compensating by locking my knee joint when it was straight.  My PT wants me to slightly bend my leg when I put my weight on it and when I walk.

I had a different PT for a couple of days.  She is actually my PT's boss.  It was as different as night and day.  My PT does deep maasage and aggressive ROM, while her boss was very gentle.  I almost felt like I hadn't had my PT....  But the results were still good.

Hope you are improving!!!
Title: Re: Regression after manipulation
Post by: RLE on October 28, 2011, 12:01:40 AM
Saw my OS today. He said I have a stiff joint and there's nothing more he can do for me. I have to continue PT and the CPM and work on it. I'm stuck at 100. It feels like I'm shoving a refrigerator when I try and bend my knee. Even when it bends its hard and slow. I wonder if I should post about this since I'm scared it will stay this way. The OS said I have to break through the scar tissue (I had a manipulation 3 weeks ago) said there's no point in removing scar tissue since it will only grow back.
I'm feeling sort of hopeless right now and like I don't want to go on.  :'( It's been so much pain and now I don't know what to do.
Title: Re: Regression after manipulation
Post by: Rollerblader on October 28, 2011, 04:20:17 AM

So sorry to hear that your OS is giving up on you!  I'd keep working at it and try to stay posative.  There is a section on the board, I think it's called "soft tissue healing problems, arthofibrosis". You may want to search there and possibly post a question there.  There are specialists that deal with this problem.  If you stay stuck at 100 for several more weeks you may want to get a second opinion.

Do you feel like you've gained anything since the manipulation?  Anything, meaning ROM, more or less pain?

I'm so sorry.   :-[. I wish I knew what to tell you. 

There is a Fannyfatigue who posted on my "blog" or whatever you call it.  She had a manipulation and seemed to have  very slow progress, but eventually her ROM came back.  I post under Bone breaks around the knee.

It seems to me like you still have time.  Stay posative!!! Hoping you have a good week!

Take Care!
Title: Re: Regression after manipulation
Post by: RLE on October 31, 2011, 08:55:44 PM
Hi RB,
Here's an update for any lurkers like I used to be. Last week my back gave out-I posted about it on another thread. Total breakdown. 3 weeks at 100. My leg is stiff and keeps freezing. Really my lowest point. So had a week off of therapy (went Wed and did a couple of things for my back)

Went to PT today-all the PTs dressed up for a contest. Anyway, got on the bike and was able to sit normally and pedal for the first time since I started. No pain. Before couldn't even push the pedal without lifting my entire body up each time and excruciating pain.

Was doing some exercises and trying to bend my knee when the PT came by and measured, her eyes got big and she looked surprised. She measured it again and it was 125. She said my leg is very weak which is why it is stiff-the brain is afraid the knee will give out so it locks up. This is week 10 since my accident. 3 weeks immobilized, 3 more weeks of not being able to bend and this is week 4 since my MUA.
We are working on strengthening my quads. I also can't bend and put weight on it because it's too weak.

So there is some light at the end of the tunnel. I've been through hell and really broke down last week. Won't know if my kneecap is tracking properly for 6 months but at this point things are much better so if anyone reading this is worried, really I didn't believe I'd get to this point.

RB, thanks for continuing to post in response I really appreciate it. It turns out that my doctor has never explained one single thing to me everything I've learned has either been intuitive (i.e. stiff muscles because of pain/weakness) or from this website. Had I known how slow and painful this would be and that it is NORMAL to be slow, painful and stiff I would have been much less frightened and unhappy.
I am going to see Dr. Teige (sp?) if anyone has any info on him I'd appreciate it before spending huge amounts of money traveling across country.
Title: Re: Regression after manipulation
Post by: Lottiefox on October 31, 2011, 10:22:59 PM

I have lurked on your thread. I am really pleased you've made some gains. Shame on your OS for saying you have a "stiff joint" and giving up on you. Definitely have a look down on the AF section. I think you may have discovered accidentally that sometimes the key to progress with AF is to go really slow and steady - that week break you had from PT seems to have helped so be VERY careful to pace extremely slowly now if you can. Have a look at Rennschenke's posts and tips on rehab after MUA or AF. She has excellent knowledge and is making progress many months after extreme AF issues. It is a LONG process.

We do understand here and keep us updated. Your story will go a long way to helping someone else going through it.

Good luck and well done again on the good progress,

Lottie xx
Title: Re: Regression after manipulation
Post by: Rollerblader on October 31, 2011, 11:42:56 PM
 ;D ;D ;D YIPPE!!!   ;D ;D ;D
So Happy for you!!!!  Like Lottie said, the break/rest was good for you!!! 

My leg is very weak too!  My PT has been focusing on me not locking my knee when I put weight on it.  I've done all of these weight bearing exercises with my knee just barely bent to strengthen my muscles around my knee.  The first time I started the strength exercises about a week ago, my knee would click when I would go from straight/locked to bend.  It was very uncomfortable.  But the next time I had less clicking and then today I had very little clicking.  I'm not sure if this is tracking or not, but I've read on these posts and my PT has told me that as my VMO muscles get stronger the clicking will go away.  The VMO are on the sides, I think, of the knee.  These get stronger doing balance type exercises.

I've been stuck at about 110, after my 2 weeks of great progress.  My PT has not been pushing my bend like she was before.  I'm hoping to continue gaining ROM as I have heard my PT say their goal for me is 120 ROM.  I want to get farther than that.  I still have 6 wks of PT so hopefully I'll get close to full ROM.

I'm so happy for you!!! ;D. I couldn't imagine going through a MUA and not getting better!!!  So, so happy for you!!!

Keep up the good work!!!!

P.S.  I agree, the upright bike is awful if you can't get around, it's such an odd feeling.  Now that you can get around, your quads will get stronger!  One thing that I've found is that it takes me a minute or so to still get all the way around, so don't get discouraged.
Title: Re: Regression after manipulation
Post by: RLE on November 01, 2011, 07:18:20 PM
Lottie and RB,
Thanks for the info. My back is in spasm today and can't sit too long. Will read all the threads/posts when I am able (I find this site hard to navigate) My back and leg went crazy from the intense PT session yesterday. It's two steps back for each step forward and OS says it will take 6 months to see if I need surgery. But important thing is that all this is NORMAL and takes a very long time and we'll just do our best.
Will write more when I can sit longer.
Title: Re: Regression after manipulation
Post by: RLE on November 12, 2011, 04:18:28 PM
One problem I've had on here is people post and then don't follow up and I'm left wondering what their outcome is. Since I can't write a blog I'll post here and hope I get some comments-RB?

Sunday is my 3 month anniversary of my accident. I had an MUA on Oct. 10. My ROM was 125 and I think it's still about there. My knee is extremely stiff and can't bend normally (i.e. fast-I have to work it slowly. ) It doesn't bend at all when I walk. My therapist said this means I don't have arthrofibrosis or else it wouldn't bend at all. But even after an hour in the pool it's like a monster leg-feels heavy and when I forced it to bend while walking I had to do it marching and in slow motion. This is not even close to normal.

When I sit up in bed I can bend my left knee all the back but there's still about an inch gap when I sit up and try and match the right foot to the left (if this makes sense) it just won't go all the way back. My right knee is extremely weak still.

My PT insisted yesterday I get a cane. I am going to use a crutch (when she's not looking) and try and walk on just one crutch. The pain is better and the tightness is better. I'm going twice a week to the pool and once a week to the office. I am able to do lunges and kick in the pool, neither of which I can do on land. My PT says this is good news since I'll then be able to do these on land. When??

She also said I only need 4-6 weeks more of physical therapy and I can't imagine that from this point in 4 to 6 weeks I'll be walking normally. I had to beg her for 3 days a week of therapy instead of 2. I do like her. She pushes me and I know she cares and she's been very kind on the other hand when I fell apart from stress but I also feel like she's not being realistic.

So I guess to sum it up, my pain level is better and the leg is slowly getting stronger but it's still stiff and still doesn't bend anywhere close to normally. I'm still on crutches and can't get around well. On the plus side as a result of the pain I've lost my appetite and have lost 30lbs.
Any comments, thoughts etc appreciated.