For several years, I have worked through a multitude of physical therapy sessions. I have done so because I am a person who has suffered many injuries. Injuries that are a direct result of playing sports and being physically active for well into my forties – without addressing my injuries right away in an effort to appear strong. But if I could sit down and talk to my younger self, who prescribed this silly notion, I would tell her to, “Sit this one out, kid. You’ll thank me later.”
Throughout all of the years in recovery, I have implored the following:
- Chiropractors
- Orthopedics
- Physical therapists
- Acupuncturists
- Massage therapists
- Cortisone shots
- Taking it easy
- Sports rubs
- Epsom salt baths
As you can see, I have tried just about everything short of getting surgery, and unfortunately, it looks like I will end up needing knee surgery after all.
There are a lot of things to think about prior to and after knee surgery. For example, one thing that concerned me was having to go under anesthesia again immediately after surgery to manipulate my knee manually if I can not get it to a certain level in my recovery. If I am able, I would like to utilize whatever methods I can exhaust to prevent manipulation under anesthesia. I want to recover as fast as possible; I am a busy, single, full-time working mama!
Apparently, after knee surgery, doctors want to see that my knee can bend and straighten well and as they should. It is crucial to make sure the healing process is happening correctly without needing another medical procedure. During the procedure called Manipulation Under Anesthesia or MUA, the knee is moved in many ways while the patient is under anesthesia.
Orthopedic doctors like to see that you’re able to bend your knee to at least 110 degrees as well as straighten it to at least -5 degrees after surgery and physical therapy. Typically, most physicians agree that an MUA should be done within twelve weeks after surgery if it is needed. My goal is to avoid it altogether! Occasionally, some patients, up to 25% of them, may require a second MUA.
According to the National Institute of Health, “Joint stiffness following knee arthroplasty is a disabling complication. One treatment option is manipulation under anesthesia (MUA). However, there is no consensus on what amount of reduced motion indicates MUA, as reflected by the varying amount of stiffness and incidence of MUA reported. In a meta-analysis from 2019 the prevalence of stiffness after primary total knee arthroplasty (TKA) was 4% but varied between 0% and 18% in the 35 included studies with 48,873 TKAs,”.
In other words, joint stiffness after knee replacement surgery can be quite a debilitating issue for a substantial number of patients. However, there isn’t a universally agreed-upon threshold for how much-reduced motion necessitates an MUA.
How long does it take to recover from knee manipulation?
Doctors suggest that there may be pain and swelling in your knee for a few days, but it is probably inevitable. It reminds me of the saying, “Pain is inevitable; suffering is optional” (this quote has been attributed to the Dalai Lama, Haruki Murakami, and M. Kathleen Casey).
Especially if you are my age (51), it will most likely take several weeks for your range of motion and stiffness to improve. The key to avoiding stiffness is to start physical therapy immediately the day after knee manipulation.
To put it in perspective, while most patients don’t experience severe stiffness necessitating an MUA, there’s still a significant portion who might. Given this, I’ll be making a concerted effort to stick to the rehabilitation protocol diligently, possibly incorporating all the therapeutic techniques I’ve already explored—from chiropractic care to acupuncturists—to enhance recovery.
I’m committing to a robust and consistent rehabilitation plan that includes physical therapy, possibly supplemented by other non-invasive treatments I am familiar with, such as Epsom salt baths and massages. By proactively managing my recovery, I aim to ensure that the healing process progresses smoothly without setbacks.
Alternatives to knee manipulation
Through my research, I found that there are devices that can be utilized to assist in pre and post-surgery rehab. They help patients quickly regain two crucial functions after knee surgery: range of motion and strength. And the best part? There’s no pain involved! And when it comes to range of motion, these devices significantly speed up recovery. While standard therapy might take six months or more, the device gets the job done in just three to four weeks.
While there’s no absolute consensus on the threshold for MUA, understanding the statistics and potential risks underscores the importance of dedicated post-surgical care. I’ll be leveraging my extensive experience with various recovery methods and devices to optimize my post-operative outcomes and get back on my feet as soon as possible.
Additionally, it’s essential to keep open communication with your healthcare team. Regular check-ins with your orthopedic surgeon and physical therapist can help identify any issues before they become significant setbacks. They can also tailor your rehabilitation plan based on your progress, ensuring that you’re on the best track to recovery.
Nutrition also plays a critical role in healing. Consuming a balanced diet rich in vitamins and minerals supports tissue repair and overall health. Incorporating foods high in anti-inflammatory properties, like fatty fish, leafy greens, and nuts, can be beneficial. Lately, what’s been working for me is a gut-healthy diet, as it decreases my inflammation dramatically. Drinking a lot of water is equally vital, as it helps maintain the elasticity of your muscles and joints.
Another consideration is mental health. The stress of surgery and the subsequent recovery process can be taxing both physically and emotionally. Practices such as mindfulness or meditation and surrounding yourself with a support system can provide the emotional boost needed during challenging times. Another thing that has helped my mental health state is not to be hyper-focused on the pain or injury. Not to ignore it but to not give it so much attention that it’s all I can think about. I’m that person, so the advice to “move a muscle and change a thought” works phenomenally well for me!
What is knee manipulation under anesthesia?
In conclusion, while knee manipulation under anesthesia remains a viable medical option, a comprehensive and multi-faceted approach to recovery can significantly enhance outcomes. By combining physical therapy, technological aids, proper nutrition, and mental health practices, the journey to recovery can be both effective and fulfilling.