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Author Topic: knee pain from using cpm machine  (Read 11818 times)

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Offline fourscrews

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knee pain from using cpm machine
« on: February 21, 2005, 06:20:43 PM »
I am ten days post op and have a question.  I use a cpm machine for getting back motion in my knee and am currently around 110 degrees.  When I am done, my knee hurts by the quad.  Not the actual quad but a little more towards the outside.  Why is this?  Swelling?
I am one of the lucky one's with bad knee genetics!!!!
7 knee surgeries between my Dad, sister, brother, and myself.
Insurance has got to love us..........

Offline GeekGal

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Re: knee pain from using cpm machine
« Reply #1 on: February 21, 2005, 06:48:55 PM »
Even though I quickly regained flexion (I had 115 degrees 3 days post-op), I didn't use my CPM above 90 degrees for very long.  When I slept, it was at 90 degrees, and most of the rest of the time as well. In fact, I'd been told to leave it at or below 90.  As I neared 2 weeks post-op, I used it more often at 100, 110, 120 degrees, but not for the full 3 hour sessions I was prescribed. At above 90, I tended to get muscle fatigue in my quads and even my hamstrings after 1.5 or more hours of use.

What ROM did your surgeon or PT tell you to set the CPM to?  I was at 90 my first night in the hospital, and yet that's all they wanted me to do.  It was only when I was feeling much better and had been bending my knee well beyond 90 in PT sessions, that I felt safe exceeding the 90 degrees on it.
- Shannon

** My Knee Journal: ** http://geekhabitat.com/topics/wellness/knee-health/

Hamstring autograft ACL reconstruction
Tears of Medial (40% removed) & Lateral (Repaired w/Bioscrew) Meniscus
Surgery: February 4, 2005

Offline imnotpunk

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Re: knee pain from using cpm machine
« Reply #2 on: February 21, 2005, 07:05:18 PM »
A CPM is by no means a comfortable thing to be strapped in. It is common to feel discomfort while the machine is in use, and also common for the knee to feel sore upon getting OUT of the machine. However, I'm just wondering, what ROM does your OS/PT want you to achieve? It is very important to abide by their "rules", if you push the knee too soon you can risk re-injury or further damage to the knee. So, as Shannon stated above my post, if your OS or PT wants you at a certain ROM, do not go further than that until they give you the green light to do so.

Best wishes,
Patricia :)
R knee:
08/03-meniscal repair, LR
01/04-MUA, LOA
03/04-MUA
08/04-patellar tendon reconstruct. w/hamstring, menisci repairs, lateral/medial releases
10/04-MUA, LOA, debride., marsupialization, lateral release
12/04-MUA, LOA, meniscectomy
L knee:
09/05-meniscectomy, chondroplasty, microfracture

Offline fourscrews

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Re: knee pain from using cpm machine
« Reply #3 on: February 21, 2005, 07:46:31 PM »
My OS told me to set the CPM at 40 degrees the first day and try to progress five degrees.  He also said that I could progress more if my knee felt comfortable with it.  The day of surgery I had it bending at around 80 degrees, however the next I had it at around 50-60.  That might have been because the drugs wore off.  My knee feels fine now, I think it just might be that I still have some swelling in it and am pushing it maybe a little too far.

Shannon--How did you get to 115 degrees so soon? 
I am one of the lucky one's with bad knee genetics!!!!
7 knee surgeries between my Dad, sister, brother, and myself.
Insurance has got to love us..........

Offline Heather M.

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Re: knee pain from using cpm machine
« Reply #4 on: February 22, 2005, 08:37:48 AM »
A CPM really isn't accurate or even meant to go much above 100 degrees.  My OS told me I was to be in it at 0-70 when awake, and 30-70 when aslee.  The main reason he wanted me to use it was to keep the knee moving gently and to prevent any fluid from settling in the knee undisturbed, where it could later turn into scar tissue.  So really, my CPM wasn't for gaining ROM it was for maintaining fluid movement, keeping the body's production of lubricating synovial fluid going, and to make the knee and the muscles around it feel beter.

For ROM work, I mainly did wall slides, spinning on a recumbent bike with zero resistance, patellar mobilizations, and other gentle techniques.

As for why the CPM might be hurting your quad, I imagine that it's torquing the joint pretty hard trying to get you to 110, and that the position of your leg in the unit is less than ideal.  What you may want to talk to your OS or PT about doing is using the CPM at much lower settings, and then doing the exercises I listed above hourly or something to work on improving ROM.

Heather
Scope #1: LR, part. menisectomy w/cyst, chondroplasty
#2-#5: Lysis of adhesions/scar tissue, AIR, patellar tendon debridement, infections, MUA, insufflation
#6: IT band release / Z-Plasty, synovectomy, LOA/AIR, chondroplasty
2006 Arthrofibrosis, patella baja
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Offline GeekGal

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Re: knee pain from using cpm machine
« Reply #5 on: February 23, 2005, 05:01:22 AM »
Shannon--How did you get to 115 degrees so soon? 

I don't know. I suspect it's equal parts LUCK, YOUTH (I'm 31 -- not a youngster anymore, but still in the ballpark), CPM and MORE LUCK.  I suspect my OS did an excellent job of placing the graft, as well (he does about 5 surgeries a day -- not all ACL reconstructions, but the bulk of his work is those and other knee-issues).

I was as shocked as the next person on my first PT appointment 3 days post-op to get to 115 degrees. I suspect I may now be to 135 degrees but I haven't been measured this week. At this point, it doesn't matter to me as much as building up my muscles. My strength in the left (post-op) leg is noticably less than my right leg, and since my pain levels seem to have subsided the past 36 hours or so, I've been doing more walking and exercising (slightly beyond the rep counts and sets recommended by my PT during my non-weight bearing weeks #1 and #2.)

I wish I could offer a magic bullet, like "Eat spinach 5 times a day, and voila!" or "Do your exercises at home while facing to the Southeast" but sadly, like all KneeGeeks know, it just isn't that easy. Nothing about any of this is easy, although I am the first to admit I seem to be having an easier run of it that others with the same type of surgery.  I hope and pray everyone reading this will have less pain, more flexibility and mobility, and lots of love. I know the latter is what keeps me motivated and through any rough spots or painful days.
- Shannon

** My Knee Journal: ** http://geekhabitat.com/topics/wellness/knee-health/

Hamstring autograft ACL reconstruction
Tears of Medial (40% removed) & Lateral (Repaired w/Bioscrew) Meniscus
Surgery: February 4, 2005

Offline Teresa_S

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Re: knee pain from using cpm machine
« Reply #6 on: February 24, 2005, 02:55:05 AM »
Remember the speed of the CPM will also affect the soreness and fatigue as much as the amount of flexion. IT is also important for it to be well padded and the leg secure at the right heights . GOOD luck, Teresa
On going instrumentation failure, chronic infection,
Arthroscopes Left 11 Right 2, MRSA, L TKR  ,  Revision, LR x5, Medial and lateral meniscus repair, Broken prosthesis
Osteochondral Fracture,untreated 6 mths. Revision new tkr 01-07 awaiting new hip and right knee
R TKR pending

Offline fourscrews

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Re: knee pain from using cpm machine
« Reply #7 on: February 24, 2005, 05:29:56 PM »
So should I bend it even though it hurts when it bends far?  I think that I maybe should because then I am getting through the scar tissue.  My take from this is that if I bend it, it will hurt, but I will be getting somewhere as far as flexion goes........?  I can manage the pain and fatigue, I just want to get my motion.
I am one of the lucky one's with bad knee genetics!!!!
7 knee surgeries between my Dad, sister, brother, and myself.
Insurance has got to love us..........

Offline imnotpunk

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Re: knee pain from using cpm machine
« Reply #8 on: February 24, 2005, 06:24:45 PM »
fourscrews 0

Only you can know when "enough is enough", but you should experience a decent amount of discomfort and even pain when you are bending the knee. It's the only way you will regain that ROM. There's nothing wrong with pushing the knee, a good idea is to make five degree gains each time. If you can increase your ROM by a consistant five degrees each stretching session, you should be able to regain your ROM fairly easily. And as previously noted, it is true that a CPM isn't the best gauge of measuring ROM because your hip is being moved. Generally, if you reach 120 degrees flexion in your CPM, it will only measure out to be about 80 or 90 degrees (which is still good).

Hope any of this helps, and good luck with regaining your ROM! :)

Best wishes,
Patricia
R knee:
08/03-meniscal repair, LR
01/04-MUA, LOA
03/04-MUA
08/04-patellar tendon reconstruct. w/hamstring, menisci repairs, lateral/medial releases
10/04-MUA, LOA, debride., marsupialization, lateral release
12/04-MUA, LOA, meniscectomy
L knee:
09/05-meniscectomy, chondroplasty, microfracture

Offline fourscrews

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Re: knee pain from using cpm machine
« Reply #9 on: February 27, 2005, 07:38:45 PM »
Thanks for all the help everyone!

Adam
I am one of the lucky one's with bad knee genetics!!!!
7 knee surgeries between my Dad, sister, brother, and myself.
Insurance has got to love us..........















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