What a difference two weeks can make. Two weeks ago I you asked if I should attempt a taper to try to force my adrenals to wake up. The circumstances were not very good and you advised me to leave it for a while so I took your advice. A few days later I somehow got a tear in the cartilage of my knee, spent some hours in A and E, and am now on crutches under the care of an excellent physio.
It is imperative that I do all the exercises she gave me because if it doesn't heal on its own then I could be looking at a possible knee replacement. At the moment the exercises are purely to get my knee moving, but the physio was insistent that I must also strengthen my leg muscles (which are quite weak after nearly three years of pmr) and I am nervous that I am facing some pretty stong exercises over the next few weeks/months. I will do as I am told, but I don't know what those exercises will do to my thighs which is where the pmr hit me the hardest, and which are the first things that tell me when I am close to a flair.
I see her again in two weeks, and will explain about my pmr hoping that she knows about it. As a precaution I increased my pred by 1mg for the first three days to get over the accident and the first painful days, and and now back on 3mg and feel ok with that and paracetamol. My question is what should I do when I start the really tough exercises to avoid any possibility of a flair, and what should I be telling the physio. And thank you so much for being here.
Written by
jinoadby
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I think you’ll have to wait and see what happens…but be aware that you may need a little extra Pred.
However you do need to discuss with physio, and explain to her about how PMR affects muscles, and that it may take longer for you to recover and to build them up than it would somebody without PMR.
See how you go; you may be fine. You were doing ok before but keep an eye out for feeling excessively tired all over, not just complaining muscle groups that are being put through their paces after a lot of time off. New physio can be very tiring but adrenal tiredness is something else which can come with an upset gut and nausea.
Hopefully the physio will know about PMR, pred and their effects on muscle and encourage you to start your rehab at a low level and build up slowly. To be fair - successful recovery from a knee replacement requires good muscles before and good rehab after so either way, it is all essential.
Strengthening exercises don't need to be tough. You can ask for the gentlest versions and do them little and often. One I did to strengthen knee lately was just to straighten leg, sitting, touch a spot and tense then relax a particular muscle. It strengthened over a few weeks.
I had a meniscus tear years before PMR, it was dealt with by having Arthroscopy surgery. It was keyhole surgery and I didn’t need a complete knee replacement, they just tidied up the tear. Solved the pain and although I have some aches but nothing I can’t cope with. Hope you soon get some relief without need of surgery.
I've never had strong thigh muscles despite a lot of hill-walking etc. Before having a total knee replacement recently I used the exercise bike (when I could) and did the recommended exercises; got through the surgery without increasing the steroid dosage but felt a flare some weeks afterwards, so increased the dose by 5mg for 2 days, decreased by 2mg on the third day and 2mg on the fifth day and two days later was back to the dose I was on before. You HAVE to do the exercises after knee surgery to achieve the range of motion required for your knee to be at least functional - you have a window of approximately 6 weeks to achieve this. I did all I could and achieved a good bend and am now discharged. I never had another flare and my muscles are all fine and functional. However, if you can avoid surgery (for anything) I would do so - I'm perfectly happy with my replacement but no-one wants surgery unless they have to have it.
Chances are that your physio will be aware of PMR and will understand that you can only push so far. Whichever way you look at it the exercises will be good to do as PMRpro says.
I had an MRI several months ago because of pain on the inside of both knees. I was told I have meniscus tears in both knees and am waiting for a date for an arthroscopy on left knee which is slightly worse. I was told to avoid anything that made them hurt more especially squats. I still manage to walk the dogs and work in a care home 3 days a week but it does hurt ☹️ Physiotherapy wasn’t advised so if you’re doing exercises be careful!
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Swelling in one leg and cramped feeling in calf muscle
Is this a start of a flare
I thought I was out of the woods at 7 mg prednisone
Taking my own advice
