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Physical torture ... I mean therapy

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  • Physical torture ... I mean therapy

    Anyone have any advice for how to get through the pain during therapy?

    I am 6 1/2 weeks out from a lateral meniscus transplant/ACI (Autologous Chondrocyte Implantation) surgery. I have been non weight bearing, but can start putting weight on the leg May 4th, and see the surgeon again May 14th - and he wants me off crutches. Haha yeah right.

    But that's not the point ... The past 3 weeks I haven't gotten past 95 degrees flexion. Well, today the PT got me to *almost* 110 .. HOWEVER - I was yelping, "ow"-ing, and was brought to tears today. The last 2 weeks it's been like this every visit (2x week). Everything else is fairly easy or at least bearable. But having him flex my knee is SO painful.

    I work on flexing my knee at home religiously. I ice it. I take 2 percocet before PT. Still have so much pain everyone in the office is staring at me yelping. And I'm not a wuss.

    Any tips? I've had 6 surgeries on this knee, and never EVER had PT be this awful. Even when I had a ligament tightened and it was slowly stretched over weeks.. I was not having this much pain.

    Surgeon has threatened a MUA if I'm not at full ROM by 3 months post op (about 5 weeks from now).. PT says I don't want to do that, BUT today I was pretty sure I'd rather have them knock me out, crank my knee, and deal with the pain after.

    Sorry for rambling - I just have never experienced this level of pain with PT. Getting very frustrated and embarrassed for being a "wuss" during each session

  • #2
    Are you icing it before PT? I would use heat before and ice afterwards.

    I was going to suggest taking pain meds beforehand, but I see you are already doing that. Maybe make sure you are taking them ah hour beforehand.

    What's an MUA?
    2012 goal: learn to ride like a Barn Rat

    A helmet saved my life.


    • Original Poster

      The therapist has been putting heat on my knee before he touches it. And then ice at the end of the session. I ice at home, haven't put any heat on myself...
      And I take the Percocet about an hour before therapy, some people say to do it more like 45 minutes, but I've tried that and it's all the same. Then I just feel out of it and get carsick. Wondering if it's worth taking at this point
      A MUA is manipulation under anesthesia, so they take you to an OR, put you under, and then just crank whatever joint has been stuck due to scar tissue. It's supposed to be effective for getting the motion back, but super painful when you wake up, and they send you directly to PT to not lose any motion. It doesn't sound pleasant but right now I'd rather do that than another 5 weeks of PT


      • #4
        You know, my 4-part humeral fracture (basically shattered my shoulder) resulted in an MUA (my surgeon didn't call it that, but same idea). It was AWESOME!! seriously--the pain afterward was nothing, and it finally moved. We couldn't get me past my plateaued degree of ROM, and it hurt like a bitch all the time. The procedure was quick, recovery simple, and PT really took off afterward. YMMV....
        Proud member of the "Don't rush to kill wildlife" clique!


        • Original Poster

          Calvincrowe- That is good to hear! I'm seriously all for it right now, even with the PT warning me of pain. I'll have to keep in mind having a MUA isn't going to result 100% of the time in serious pain.


          • #6
            PT sucks. I had a torn rotator cuff - got jerked backward quicker than I could let go by a fractious horse - and had surgery, then PT. When people ask me what it was like, I tell them the surgery was fine, it was the PT, and "I would rather give birth in a ditch in the dark in the rain to breech twins, alone, than have to go through that PT again."

            I too have a high pain tolerance, did my exercises diligently, etc., etc. I laid on the table and shook at the therapist walked toward me to take my arm. More than once I cried out, I cried every time, I wet on myself twice. It was awful. Nothing worked.

            This isn't what you want to hear, I'm sure, but there wasn't any way for me to make it easier. I just had to force myself to keep going, and slowly, eventually, it got better. I would think about the MUA if I were you, and it got things over with sooner. I still hate the memory of that much pain.


            • #7
              Think about the MUA but go for the 5 weeks. Once this starts to finally loosen up, it goes pretty quick. However, the path to that point is tears and h*ll.

              I dislocated a knee that had to be rammed back into place in the ER, and then was set in an immobilizer for 8 weeks because I had a head/back injury that had to heal before I could start pt. My first day of pt they dropped my knee off the table and I almost went through the roof. Then they bent it and it got me to a whole 30 degrees. Crying and hysteria set in. Then I had to be manually bent for the next few sessions. Then it was work, work and more painful work. It took me three months to make it to 124 degrees, most of it coming in the last couple of weeks. I cried every day for three weeks straight during the bending exercises. I used an organ bench to sit on, as it is high enough to swing the leg under, and also had to lay on my stomach, place a strap beneath my ankle, and pull it up towards my head and hold it there to get rid of some of the scar tissue. At home I used a lead rope for this. Hated it, but it was what worked. Cried my way through that one for a few weeks as well. Then it was back to the bench.

              You may find progress goes faster if you do pt three times a week, and put in a good session at home every day. On non pt days, I had 3 hours of work to get done. On pt days it went up to 4.5--5 hours. Because it was my leading leg that was injured, I had to relearn to walk with it along the way, which was a real sight, and it took me a lot longer to rehab it than it would have had it been the other leg. Pt sessions went from 1 hour to 1.5 hours each. I did 33 of them before being released.

              Always heat your knee for 5-10 minutes before you do your exercises, and ice afterwards. It will help a lot. There is also a pt massage cream that helps to loosen up muscles/tissue after a workout called Free Up. It's about $21 a jar. After you are finished your exercises massage it into the knee, always massaging towards your heart. That helped, too. I got it at Amazon.com
              "The difference between genius and stupidity is that genius has its limits." Albert Einstein



              • #8
                I form a lot of scar tissue after surgery. had TKA early Oct and whined and complined my way thru PT.. they could work me into flexing above 110 and extending to 2 but it would not stay. My doc has me wear a Dyna splint to straighten my knee. Gues what? I can now flex to 112 . So freeing up the extension also freed up the flexion I can now extend to 5 . Before the splint I could only extend to 8 I have worn the splint for 1 month and will wera it for 2 more as that was the recommendation.
                vintage eventer


                • #9
                  When I broke my wrist, & my fingers stiffened & I went to PT, they also hurt me (two of them, alternating). After nothing but pain & NO improved flexibility, in fact feeling that they'd only damaged me further, I quit. The one good thing was the warm, liquid paraffin treatments.

                  I've heard from others that they quit theirs, as well. There seem to be a lot of sadists in that line of work. Be very sure that you're being helped instead of hurt more!