The Bee's Knees

Why Knee Surgery Recovery Is So Hard for Women Under 60 The Paradox of the Efficient Body: Pathophysiological, Biomechanical, and Endocrinological Determinants of Compromised Knee Flexion Following Total Knee Arthroplasty in Women Under 60 Intuitively, chronologically younger patients with “efficient body mechanics” should achieve superior recovery. However, the physiological vigor defining a young, healthy female patient translates into a highly reactive immune and inflammatory response to the architectural trauma of a total joint arthroplasty. This biological efficiency acts as a catalyst for rapid soft tissue contracture. Furthermore, this demographic faces a unique convergence of physiological variables: perimenopausal endocrinological shifts, uniquely female biomechanical alignments (a wider Q angle), and a high susceptibility to amplified central sensitization to pain. The X10 Meta-Blog We call it a “Meta-Blog” because we step back and give you a broad perspective on all aspects of knee health, surgery and recovery. In this one-of-a-kind blog we gather together great thinkers, doers, writers related to Knee Surgery, Recovery, Preparation, Care, Success and Failure. Meet physical therapists, coaches, surgeons, patients, and as many smart people as we can gather to create useful articles for you. Whether you have a surgery upcoming, in the rear-view mirror, or just want to take care of your knees to avoid surgery, you should find some value here. Why Knee Surgery Recovery So Hard for Women Under 60 Subscribe to the Blog Here * indicates required Email Address * First Name Last Name

A Knee Recovery Nightmare! Right Total Knee Replacement My Physical and Emotional Fight Against Pain Hypersensitivity and Protective Muscle Guarding – written by Cathy Banovac – interview by Lisa Pelley and Mary Elliott – Cathy was coached by Erin Rempher, PTA My name is Cathy and I reside in Arizona. I am 57 years old, a homemaker, and have had a genetic history of chronic osteoarthritis.  From a very young age, I have always had a very low pain threshold.  Prior to the commencement of pain in my knee, I considered myself a fairly fit and active person…loved gardening, entertaining family and friends, cooking, crafting, playing golf, traveling with my husband, walking our dogs, and playing with our grandchildren. Life was good! Early Summer In addition to the normal aches and pains that come with aging, I began to experience more than usual pain in my right knee.  I was experiencing daily occurrences of popping/clicking, giving out when walking at times, difficulty negotiating steps or stairs, and nightly interrupted sleep due to pain.  Over the counter medications, icing, heat, etc. was no longer managing my symptoms.  Upon visiting an orthopedic surgeon for examination and subsequent imaging, I learned I was over 70% bone on bone in my right knee joint.  I was told I was looking at a total knee replacement.  I was preparing to head to Michigan for a family vacation on the lake with my kiddos in August, so was not happy to hear this news.  I convinced my doctor to give me a steroid injection just to buy me the time I needed to take my vacation.  He was reluctant and told me that he predicted it would do nothing to help my condition at the very least or, at the very most, last for a brief time.  I made it through the trip, yet 3 weeks post-injection the symptoms had returned. No More Injections My surgeon declined my request for another injection, instead reiterating my need for the TKR.  Over previous years, I had witnessed my mother, father, husband and a few friends have knee replacement surgeries.  All came through their surgeries with what appeared to me to be a fairly pain controlled, timely recovery and successful return to their regular daily activities.  I was told I was on the younger side for this type of procedure, nevertheless, would greatly benefit from extended quality of life and return to desired activity, given my current quality of life and daily activity was becoming more diminished by the day. My Knee Replacement I underwent RTKR on September 25.  All went well and as expected with the surgery.  I was up and walking, began some light physical therapy exercises, and maintained post-op range and motion through use of a CPM while in hospital.  I was discharged to home on the third day post-op, with a couple of narcotic pain medications (initially Percocet/Oxycodone and Morphine) and directions to commence in-home physical therapy the following day.  My follow-up visit with the surgeon was scheduled for 6 weeks post-op.  Day one at home began my challenging journey of recovery, both physically and emotionally.  I experienced difficulty managing my pain even with narcotics and over the counter medications.  My swelling was as expected and able to be kept in check with anti-inflammatory meds and icing.  I experienced annoying side effects from the narcotics, i.e., headaches, nausea, constipation, and thus was bounced from one medication and dosage to another, none of which seemed to be the right combination or solution to my pain.  Out of complete desperation and in uncontrollable pain, I went to the emergency room after being home for four days post-op, hoping to get some relief. A Problem with the Surgery? I thought surely there must be something wrong.  A few hours later, together with a lecture from the hospital PT and some morphine, I was discharged back to home.  Back on more medication, I failed to again find relief from pain.  I was averaging about 2-3 hours of sleep per night and little sleep during the day.  My home physical therapist had her work cut out for her.  Over the next 4 weeks (twelve 45 min. sessions of in-home PT), I had yet to reach better than 85 degrees flexion and 10 degrees extension.  My in-home therapist said she spent most of those 4 weeks strengthening my calves, hamstrings, and quad muscles, all which were extremely weak.  Therefore, already I was approximately 4 weeks behind in range and motion advancement.  My pain was still very much out of control, all while I feared becoming more and more dependent on the narcotics prescribed. At the first follow-up appointment (six weeks post-op), my flexion was below 90 degrees and extension still not at the zero degree mark.  I was informed by my surgeon that I needed a Manipulation Under Anesthesia (MUA).  My knee felt very stiff, pain was still unmanageable, and I was stuck without advancement in physical therapy. Manipulation Under Anesthesia He took x-rays and made sure the appliance was not loose or slipping out of placement.  All was found to be in proper order and an examination found no infection that could be causing pain or other symptoms.  My surgeon had done his job.  I was told however, that he believed I was stuck due to scar tissue build-up and thus was in need of the MUA to break up the scar tissue.  This would also permit the ability to continue physical therapy, working towards achievement of the desirable degree of range and motion outcomes.  I underwent the MUA six weeks and one day post-op and immediately resumed PT the following day.  I was told not to worry about a reduction in my flexion and extension after having the MUA.  An MUA tends to put patients back about 3-4 weeks, so it is almost like starting all over again.  However, the idea is that advancement in range and motion should become easier now that the scar tissue has been broken up by the procedure.  I went to PT for 5 days in a row the first week following the MUA, did my home exercises faithfully on my own twice a day, then returned to PT three times a week for the next several weeks. After the MUA At the two week follow-up appointment post the MUA, I was still in unmanageable pain, still getting only 2-3 hours of uninterrupted sleep per night, and running every gamut of emotion and temperament.  My poor husband was beside himself and wondering whatever became of the woman he married 27 years ago.  My flexion was still only reaching in the low 90’s and my extension was no better either.  I was still experiencing great sensitivity to the touch anywhere on or around my surgical knee.  I couldn’t stand wearing pants or having any sheet or blanket covering my knee.  My pain was the worst at night, just when I was settling in for some restful moments on the couch watching TV with my husband.  I would suddenly be lifted off my seat with either pain that mimicked touching a lit match to my knee, or the stabbing of a knife, or the shock of a taser. Dealing with the Pain This pain varied and sometimes was relentless for several minutes.  I was in tears most evenings and headed to bed to ice or apply heat, which calmed the nerve pain somewhat.  I would take meds (Hydrocodone/Norco, Extra-Strength Tylenol, Ibuprofen,  Zofran (for nausea) Vitamins, a stool softener (due to Hydrocodone) and Gabapentin aka Neurontin.  I was soooo sick of taking medications.  I think my surgeon was beside himself as to how to control my pain and sensitivity, therefore, he recommended I seek help at a Pain Management Clinic for possible sympathetic blocks, as well as my medicinal pain management.  Both he and my physical therapist told me I was forecasting pain neurologically before any exerted physical effort on their part was made to cause any pain.  My intolerance for any amount of pain was prohibiting any measurable progress in my range and motion, thus scar tissue was building at a rapid pace.  Physical therapy continued to be a challenge as I protective muscle guarded any force applied by my therapist to get better R&M.  I cried through most of my sessions. Pain Management At my first appointment with the Pain Management Clinic, I met with the doctor.  Most people have sympathetic blocks in their back to relieve nerve pain, but the doctor I was referred to chose to recommend a Genicular Neurotomy, accomplished through a procedure called Coolief Cooled Radiofrequency Ablation.  I first underwent a test which involved Lidocaine injections in four areas surrounding my new knee.  The patient then logs their pain and activities over the following 72 hours.  A follow-up appointment with a Nurse Practitioner then reviews the log and determines eligibility for the ablation procedure.  At this appointment she chose to cut my medication cold-turkey for a couple of days as she deemed I was dependent on them, even though I was getting little pain control.  I experienced severe withdrawal symptoms for two days. A Change in Medication I thought I was going to go out of my mind.  A change in my medication increased the Gabapentin I was taking, and I was found to be eligible for the ablation.  I underwent that procedure approximately 6 weeks post my first MUA, just before the Thanksgiving holiday.  I was told that I would still be experiencing pain for approximately 4-6 weeks, due to the fact that the ablation was going to make my nerves “angry” as they fought their temporary death.  I was also informed that this procedure is temporary as nerve endings most often regenerate themselves over a 6 month to 2 year period.  Some patients must undergo two or three of these procedures to get lasting relief. Unhappy News This was not happy news to my ears, yet I was still desperate for relief and reaching out for anything, and I mean anything, that would control my pain.  I returned to the pain clinic for a follow-u

Joyce Jackowski’s Journey to a New Knee Recovering with Agility: Joyce Jackowski’s Journey to a New Knee In the latest episode of The Bee’s Knees Podcast, host Mary Elliott sits down with Joyce Jackowski, a Florida resident and competitive dog agility enthusiast who recently reached the four-week milestone following a total knee replacement on her right knee. For Joyce, the surgery wasn’t just about ending pain; it was about reclaiming a lifestyle defined by movement. After temporary injections failed to provide lasting relief, Joyce realized that to continue running with her dogs, she needed a permanent solution. Her story is a testament to the power of preparation, discipline, and finding the right technology to aid in recovery Choosing a recovery path was a deeply personal decision for Joyce, influenced heavily by her husband’s difficult experience with a traditional recovery that required a painful “manipulation under anesthesia”. Determined to avoid a similar fate, Joyce followed the advice of a friend—another dog agility competitor—and looked into the X10 machine. Despite her surgeon’s initial skepticism, Joyce was drawn to the results she saw online and decided to take charge of her own rehabilitation by bringing the X10 into her home. “My goal was to get back to being able to do all of my dog sports… I have been past the curve for all my measurements this whole time.” – Joyce X10 Therapy The first two weeks of recovery were a significant mental and physical struggle, marked by intense post-surgical pain. Joyce found herself questioning the decision to have surgery as her daily schedule became entirely consumed by a rigorous cycle of X10 sessions and physical therapy exercises. However, her discipline paid off quickly. Her home physical therapist noted that she was “way above the curve,” reaching normal range-of-motion measurements much faster than average. Today, Joyce’s flexion is at 122 degrees, firmly within the normal range of 120 to 125 degrees. “The X10 machine really helped, but the component that makes this program above the top was having the coach support.” – Joyce Overcoming Challenges | The Human Element of Recovery Beyond the technology of the X10, Joyce credits her success to the human element of her recovery: Coach Kim. Having a dedicated coach to provide emotional support, technical advice, and even simple lifestyle tips—like listening to music during sessions or taking a drive to escape the “cabin fever” of recovery—made all the difference. This support system helped Joyce navigate the “down times” and corrected her when she was over-extending herself, such as the time she mistakenly tried to walk down the street the very night she returned from the hospital “Do your exercises. Do them even if you don’t feel like it… Give yourself a break, but do not take a cheat and do not do it at all.” – Joyce Now four weeks out, Joyce is walking without a cane inside her home and looks forward to returning to the dog sports she loves. Her advice to others facing a similar journey is simple: stay disciplined with your exercises. While it is okay to give yourself a mental break on tough days, she emphasizes that you must never “cheat” on the work required to heal. By combining the right tools with a relentless drive, Joyce has turned a daunting surgery into a successful first step back toward her passions.

Get Quick Answers About X10 Based on Published Research Below you can get quick answers about the X10 based on numbers research studies that have been published over the years. Visit our research page to view and download research studies to share with your surgeon or PT team. & X10 Recovery Knowledge Master the science of Pressure Modulated Knee Rehabilitation Core Concept The Rehabilitation Gap Click to Reveal Fact / Definition The critical disparity between a mechanically successful surgery and the patient's actual functional recovery. Shuffle Reset Card 1 of 12 Sources: X10 Knee Recovery Research Claims.docx Continuous Passive Motion after Knee Replacement Surgery – X10 Therapy, https://x10therapy.com/continuous-passive-motion-knee-replacement-surgery/ The effect of continuous passive motion after total knee arthroplasty on joint function STUDY Are Computer-Controlled, Pressure Modulated Knee Rehabilitation Machines Valuable Following Knee Arthroplasty? – Iris Publishers, https://irispublishers.com/gjor/pdf/GJOR.MS.ID.000510.pdf A New Non-Surgical Alternative to Manipulations Under Anesthesia Following Knee Replacement | Iris Publishers, https://irispublishers.com/gjor/fulltext/a-new-non-surgical-alternative-to-manipulations-under-anesthesia-following-knee-replacement.ID.000528.php X10, In-Home Prehabilitation Increases Post-Surgical Range of … https://irispublishers.com/gjor/fulltext/x10-in-home-prehabilitation-increases-post-surgical.ID.000538.php X10 Therapy References and Resources,  https://x10therapy.com/x10-therapy-references-and-resources/ X10, In-Home Prehabilitation Increases Post-Surgical Range of Motion, Quadriceps and Calf Strength – Iris Publishers, https://irispublishers.com/gjor/pdf/GJOR.MS.ID.000538.pdf A New Non-Surgical Alternative to Manipulations Under Anesthesia Following Knee Replacement – Iris Publishers,  https://irispublishers.com/gjor/pdf/GJOR.MS.ID.000528.pdf Open Access online Journals | Reprints | Eprints | Iris international Publishers, https://reprints.irispublishers.com/view-reprints.php?rid=17 X10 Research | The Clinical Evidence Behind X10™ – X10 Therapy https://x10therapy.com/research/ The effect of prehabilitation on the range of motion and functional outcomes in patients following the total knee or hip arthroplasty: A pilot randomized trial – ResearchGate,  STUDY Manipulation for stiffness following total knee arthroplasty: when and how often to do it? | Request PDF – ResearchGate

Quick Summary Tools, resources, and articles related to knee replacement surgery and recovery here. We cover meeting with your surgeon and questions to ask, pre-surgery email series, the many resources in our KNEE LIBRARY, and a number of patient accounts of their recoveries. 2026 Knee Replacement advice here. Is this for you? If you or someone you know is even just thinking about knee replacement this is the article you want to read and share. Millions of people do this surgery each year, but you want to go into it “eyes wide open.” This article helps allay fears and prepare you for a life-changing event. 2026 Knee Replacement We have nine musts here for anyone planning on knee surgery recovery. You may want to bookmark this page for future use as it will be valuable all through the process of having a knee replaced. So, let’s get started. Online Knee Assessments – Should You Have a Knee Replacement This short written test will give you some answers and guidance when it comes to knee replacement surgery. There are twelve questions. Carefully consider your answers. You cannot go back and change them once you have made your selection. You do not need to share your name or email address. Although, if you do, we will send you some helpful information about knee replacement and recovery. Click here to explore this further: Should I Consider Knee Replacement Questions to Ask Your Surgeon To be honest we don’t care how impressive your surgeon is. How esteemed is his schooling. And how many of your friends told you to pick one particular surgeon. This is your knee and recovery problems come from even the most recognized surgeons. We have first-hand experience with patients from the biggest name surgeons out there. Be confident and persistent and inquisitive… make sure you get all your questions answered. Click here to explore this further: Questions to Ask Your Surgeon The KNEE LIBRARY THE KNEE LIBRARY is Open 24 Hours. You don’t knee a library card and you never need to return a book. All we ask is that you learn about your knee, surgery alternatives, and the best surgery and recovery solution for you. We want you to be the smartest person on the block when it comes to knee health. Click here to explore this further: The Knee Library 2025 Knee Replacement Preparation Email Series Did you prepare for your school tests? Plan for your wedding? Book your hotels and plane tickets in advance of your vacations? It is exactly the same when it comes to knee surgery. Once you have your surgery date you want to sign up immediately so you do not miss any of the series. It begins about six weeks before surgery and runs right up to your surgery date. You need some knowledge and specific tools before you enter that operating room. We have you covered right here. It is our business to help you recover well after knee surgery. Sign up below… It’s free and could make a big difference in your recovery. Click here to explore this further: Pre-hab and Pre-Surgery Email Series Preparing for 2026 Knee Replacement Surgery – with PTA Yvonne LaCrosse A must-see 10-minute video included here. There are many things you can do prior to surgery to help yourself be as prepared as possible and therefore help to make your recovery process as easy as possible. We have for you here and now what you need to know before knee replacement surgery, broken up into three parts. Part 1 Prepare Your Body Part 2 Prepare Your Home Part 3 Make a Plan Click here to explore this further: Preparing for Knee Replacement Surgery What about Going for Two? Sometimes it may be that you actually need both knees replaced. That was the case with Donna. She thought long and hard about it and decided to do a bilateral knee replacement instead of just one knee at a time. This is not right for you if you have other important health concerns, but if you are healthy there are millions of good examples of happy bilateral knee replacements out there. Here is one. Click here to explore this further: Donna’s Decision to Go for Two Gather Practical Information from Actual Knee Patients We have many wonderful private discussion groups, but this is the one of you are considering a 2026 knee replacement: Knee Surgery Recovery & Rehab. Lovely people who are happy to share what they have experienced. If you have already decided to do two knees at once we also have a Bilateral Knee Replacement group that you can find at the link below. Click here to explore this further: Join Knee Surgery Recovery and Rehab Asses Your Knee Condition (Early and Often) We have crafted numerous online knee assessments that you can do yourself to get a handle on your knee condition. These are tests that you can do now, just prior to surgery and afterwards to track your progress. A talented development team built these tools… take advantage of them. Click here to explore this further: Assess Your Knee Condition The Bee’s Knees Podcast Stories, articles, interviews of knee surgery and recovery… and life after surgery. We focus on the patient in this weekly podcast. Our objective is to improve the whole knee replacement (and other knee surgeries) experience from months before surgery to months afterward. In the pod, you will also learn about the pre and post-surgery tool, The X10 Knee Recovery System™. Click here to explore this further: The Bee’s Knees Podcast SCHEDULE A CALL WITH AN X10 KNEE COACH One last thing to do prior to booking your 2026 Knee Replacement is to call us at X10 Therapy. We’re not here to convince you to use the X10 for your recovery, promise. That said we are here to help you in any way we can with the expertise that we have developed for those having a knee replaced. Don’t hesitate… in 15 minutes we can give you peace of mind and some great tips for your recovery. Click here to explore this further: Schedule a Call with an X10 Knee Coach The Meta-Blog We call it a “Meta-Blog.” We step back and give you a broad perspective on all aspects of knee health as with this article on ‘2026 Knee Replacement.’ In this one-of-a-kind blog, we gather together great thinkers, doers, and writers. All our work is related to Knee Surgery, Recovery, Preparation, Care, Success, and Failure. Meet physical therapists, coaches, surgeons, patients, and as many smart people as we can gather to create useful articles for you. This is for you if you have a surgery upcoming, or in the rear-view mirror. Or maybe you just want to take care of your knees to avoid surgery. Executive Editor: PJ Ewing To subscribe to the blog click here. Subscribe to the Blog Here * indicates required Email Address * First Name Last Name The link to the research study as presented in the blog episode is here: Conversion to TKA from UKA Risk Factors. Two resources for you below. Both are email series that we created to help those who need some additional thinking for pre-surgery and post-surgery.

An MUA in NYC A TKA and then a Struggle [PJ Ewing] This episode of The Bee’s Knees features a compelling discussion with Dan Heaney, who shares his personal journey through knee surgery and the ensuing recovery process. Dan’s surgery took place on March 24th, and he recounts the initial challenges he faced, including complications with scar tissue that hindered his mobility post-operation. Despite expectations of a smoother recovery, Dan found himself struggling as his knee remained locked at 85 degrees, leaving him frustrated and uncertain about his future. As Dan describes, he sought guidance from his surgeon, but was met with disappointing advice that seemed to leave him at a standstill. His determination drove him to research alternative recovery solutions, leading him to discover the X10 therapy machine. After a pivotal weekend of frustration and desperation, Dan took matters into his own hands and reached out to the X10 team, initiating a turning point in his recovery journey. X10 Therapy Throughout the episode, Dan emphasizes the dramatic impact the X10 machine had on his rehabilitation. Upon obtaining the machine, he diligently committed to using it three times a day, which quickly translated into notable progress. The support he received from his physical therapist, Candice, further fueled his motivation. With consistent use of the X10, Dan saw his knee range of motion improve from 85 to 125 degrees in a relatively short time, radically transforming his outlook on recovery and life post-surgery. Overcoming Challenges | Advice for Future TKA Patients The conversation touches on the mental and emotional strain of navigating the uncertainties of rehabilitation. Dan shares the profound sense of hope that emerged from his experience with the X10 machine, contrasting this with the despair he felt when relying solely on traditional physical therapy. He vocalizes a desire to inspire others in similar situations to seek solutions and maintain hope during difficult recovery processes. As the episode progresses, Dan reflects on the relationships he built during his recovery and the emotional rollercoaster associated with the fear of losing mobility. His story encapsulates not only the physical challenges of post-surgical recovery but also the psychological battles that accompany them. By the end of the episode, Dan celebrates his newfound ability to return to daily activities, including running and surfing, highlighting the life-altering effects of taking charge of his rehabilitation. Dan’s Recent Wedding – Congratulations!!! In conclusion, Dan’s success story serves as a powerful testament to the importance of persistence, innovation, and self-advocacy in recovery. His experience illuminates the potential for rehabilitative technologies like the X10 to yield transformative results, urging listeners not to hesitate in exploring all options available for their recovery.

BACK TO FLYING AFTER KNEE MANIPULATION A TKA and then a Struggle [Mary Elliott] In this episode of The Bee’s Knees Podcast, I have the pleasure of speaking with Richard Tienan, who shares his candid journey through knee surgery and the complexities he faced during his recovery. We dive into Richard’s experience, starting from the initial surgery on May 7th, which presented unexpected challenges that led to a manipulation under anesthesia. This procedure was essential for improving his mobility, and Richard reflects on how pivotal it was in his recovery process. Richard’s insights on the X10 therapy machine are particularly valuable. He describes how this innovative device assisted him in achieving and tracking his progress post-manipulation. Unlike traditional methods that leave you guessing about your range of motion, the X10 provides real-time feedback on degrees of bend. Richard emphasizes the importance of understanding your limits and recognizing progress, which not only aids in recovery but also boosts motivation. Through his detailed recounting, listeners gain understanding on the physiological and psychological aspects of knee rehabilitation. X10 Therapy We delve into Richard’s struggles with both bending and straightening his knee, highlighting how he found particular comfort in the X10’s monitoring capabilities. His revelation that he reached a remarkable 123 degrees of knee flexion within three weeks of his surgery illustrates an inspiring turnaround, especially after hitting a plateau at 110 degrees prior to his manipulation. Richard discusses both the emotional highs and the physical discomfort of this journey, stressing the significance of resilience and the role of goals in rehabilitation. Overcoming Challenges | Advice for Future TKA Patients In addition to Richard’s story, we explore the supportive role of his wife, Patty, and emphasize how having a support system can make a notable difference in recovery. Through her encouragement and the advice from his telemedicine coach, Richard stayed focused and driven. This episode provides practical tips and shared experiences that can guide anyone facing similar surgical challenges. Richard’s journey exemplifies the power of determination, the importance of professional guidance, and the necessity of tools like the X10 in recovering mobility post-surgery. The episode wraps up with Richard sharing valuable insights to motivate others undergoing knee surgery. His suggestion to massage the thigh during therapy sessions to alleviate discomfort is particularly noteworthy, showcasing adaptation and resourcefulness. As Richard now looks forward to returning to previously enjoyed activities, including flying, he leaves listeners with an uplifting message about reclaiming freedom and joy in daily life. This episode serves as an essential resource for anyone navigating the complexities of knee surgery, offering hope, practical advice, and the reassurance that positive outcomes are possible with the right tools and support.

WALKING DOWN THE AISLE AFTER TKA A TKA and then a MUA [Mary Elliott] In this episode, I speak with Dawn, who shares her personal journey navigating the challenges of knee replacement surgery and the hurdles she faced during her recovery. Dawn, only 55 years old, initially experienced a meniscus tear and osteoarthritis, which led her orthopedic surgeon to recommend a knee replacement to prevent further issues down the line. Despite her initial reservations about being so young for such a procedure, she chose to move forward, seeking relief from her increasing pain. Dawn outlines her struggles post-surgery, particularly with bending and flexing her knee, which became a significant roadblock in her recovery. After multiple home therapy sessions and outpatient treatments, she found herself regressing instead of making progress. This period of frustration was compounded by her timeline—her daughter’s wedding was approaching, and she felt a pressing need to improve her mobility quickly. X10 Therapy As our conversation unfolds, Dawn reveals that after a manipulation under anesthesia, which was necessary due to the stiffness and scar tissue buildup in her knee, she discovered the X10 machine. This device promised a gentler approach to therapy compared to traditional methods that left her in pain. Once she started using the X10, her progress transformed dramatically. With its programmed gentle movements, she was able to achieve improved flexibility in a supportive manner. Overcoming Challenges | Advice for Future TKA Patients Reflecting on her experience with the X10, Dawn highlights the significant progress she made in just a few weeks. From starting at 55 degrees of flexion post-manipulation, she reached an impressive 110 degrees shortly after, which was a major milestone for her. The emotional and physical journey culminated in her ability to walk her daughter down the aisle without assistance, a moment deeply cherished amidst her recovery challenges. Dawn’s story is one of resilience, determination, and the importance of finding the right tools for recovery. She advocates for the X10 machine, emphasizing that its gradual approach to motion can significantly aid those struggling with post-surgical rehabilitation. As we wrap up, she encourages others facing similar hardships to remain open-minded and proactive in seeking out effective solutions that can help reclaim their independence and quality of life. Her journey illustrates that sometimes, the right tool can make all the difference in promoting healing and regaining autonomy.

THREE MONTHS AFTER TKA: POOR FLEXION A Podcast Featuring Chuck Penny and Mary Elliott (host) In this episode of The Bee’s Knees, I have the privilege of hosting Chuck, who shares his transformative journey through total knee replacement and subsequent challenges he faced with recovery. Chuck’s story underscores the complexities of knee surgery and rehabilitation, and it’s a vital conversation for anyone facing similar challenges. He recounts that his surgery in April initially seemed routine, but soon spiraled into a hurdle-ridden path marked by complications like excessive scar tissue and pain. The key turning point in Chuck’s recovery came when he was introduced to the X10 therapy machine after experiencing significant setbacks post-surgery, including the denial of a necessary manipulation procedure by his insurance company. It was alarming for him as the pain returned and mobility decreased dramatically, dropping from an initial success of 113 degrees of flexion to merely 95 degrees. In this challenging moment, Chuck, fueled by anxiety about his quality of life and desire to return to an active lifestyle, researched mechanical knee therapy options on platforms like YouTube, leading him to discover X10. He explains how this machine operates on the principle of offering feedback while also ensuring that recovery remains within a manageable comfort level, moving beyond the idea of traditional, painful rehabilitation. X10 Therapy Chuck delves into details about his misgivings at the start and how the X10 machine fundamentally shifted his experience, enabling him to engage with the rehabilitation process on his own terms. The therapy allowed him to perform sessions multiple times a day while receiving real-time guidance from his coach, Candice. This personalized support proved to be instrumental in recalibrating his expectations and accelerating his progress, eventually leading to a breakthrough session where he achieved an impressive 120 degrees of flexion. Furthermore, he emphasizes that having control over his recovery without the excessive pain typically associated with rehabilitation has been a game changer. Overcoming Challenges | Advice for Future TKA Patients The discussion transitions to Chuck’s reflections on his initial decision to undergo knee replacement surgery. He shares heartfelt advice for potential patients, stressing the necessity of patience and persistence. Emphasizing that even though the surgical path is daunting, the rewards can be life-changing, he endorses the value of being informed and seeking additional resources like X10 therapy to enhance recovery. Chuck’s optimistic approach, despite the setbacks, serves as an inspiring reminder that the journey of healing, particularly after major surgery, is often fraught with obstacles but can ultimately lead to the lifestyle and activity levels one aspires to regain. As this episode concludes, Chuck’s story not only provides insights into the importance of innovative rehabilitation solutions but also highlights the role of community support in navigating the often-overwhelming journey of recovery. I hope his experience resonates with listeners and offers encouragement, reminding them that they are not alone in their struggles and that with the right tools and support, recovery is indeed possible.

An Interview with Lisa Alarcon, Director of Physical Therapy Understanding Swelling and Scar Tissue After Knee Replacement The composition of the swelling that occurs in the knee depends on how long it’s been there. The longer the swelling is in the knee the more likely you will have to deal with stiffness. If you’ve ever noticed you can push on someone’s skin and it stays ‘dipped’, those patients have a lot more protein in that fluid. And so what happens as you get that fluid in the knee structure that supports it (the joint capsule,) it swells like a balloon. Swelling and scar tissue after knee replacement are the two biggest challenges you will face. So the more swelling that’s in that knee, the tighter the balloon gets. Once that balloon gets too tight, you have a significant limit in how much you can move your knee. When that happens, you don’t move your knee because it hurts, it’s uncomfortable, so you keep it still. Keeping it still only creates kind of this vicious cycle. Now it doesn’t move, so you can have scar tissue start to set up. Anytime you put your body in a certain comfortable position and then you start to move out of that position, everything’s like, oh wait a minute, that doesn’t feel so good. And that’s also what’s happening in a fresh knee joint, especially immediately following surgery. Those structures are not happy that they’ve been disturbed. They like to be where they are. They don’t want to be cut, and that has all happened with the surgery. The body’s natural system says, “I’m going to limit how much motion I want this knee to have, and so I’m going to send the swelling in.” Fibrosis Fibrosis is another way to look at scar tissue. It’s ‘scar tissue plus.’ You can kind of think of the tissue surrounding the knee like spider webs. And so we can move the knee joint a little bit, or the shoulder, or whatever joint it happens to be, and we can break those spider webs, and we can get some range of motion back. With fibrosis the tissue is more like duct taping the joint. The components that make up something that’s fibrotic versus something that’s strict scar tissue is that the tissue is a little bit more intense. The tissue is stronger, the tensile strength is stronger. It’s thicker. So fibrosis compared to kind of what I would consider normal scar tissue is just really kind of ‘scar tissue on steroids,’ and it’s a lot harder to break through. Usually those with this thicker scar tissue are the people that need the Manipulation Under Anesthesia (see: Julie Avoids an MUA) because they’ve had that fibrotic tissue start to set in, and so that’s the difference really between kind of general scar tissue and something that’s gone fibrotic. You may have seen people that have those really big, bumpy kind of gnarly looking scars. Those patients are more likely to have that same kind of body response on the inside. Fibrosis depends on genetics, it depends on how long you want to sit still for, it depends on things like: ‘I had a knee replacement, and then I had an injection, and then I had another knee replacement.’ So if you have some or all of these other factors, that limit your ability to move that joint, you’re going to get that fibrosis a lot faster. And so the ‘when and the why’ of fibrosis kind of combine, and based on genetics and these other extenuating circumstances recovery can be more challenging. Certainly the less you move the knee, the less frequently you move the knee, the more likely you are to build in that kind of block, and it really feels like a block. The X10 Knee Recovery System™ I think the X10 helps prevent scar tissue in general.  If we can prevent general scar tissue, we certainly can prevent scar tissue on steroids, when you talk about something like a fibrosis, because you get in and you get moving early. We’ve had physicians who love the progress of their patients so much, they don’t want to put the CPM in the hospital, they want to bring X10 into the hospital, okay? And that’s amazing, to take someone who’s an orthopedic surgeon who’s been an orthopedic surgeon for a long time, who’s relied on the CPM for a long time and have them say, “I don’t want to do that anymore. I like the X10. I like how it works so much, I’m going do it even sooner. I want that patient on the X10 the hour after they come out of surgery or in those kinds of parameters.” And so X10 as far as preventing fibrosis I think is absolutely what it does. But beyond that, I think if you have a patient that has fibrosis in their knee, or has some kind of a contracture, you can also bring X10 in in that situation, because of the ability to alter the hold times on the machine. On the X10 you can hold in a challenging but not painful position for three seconds, or for longer than that. With the fibrotic joint, I just need to hold longer. So even if a joint is fibrotic, we may not have to worry about a manipulation. In those situations, whether it’s preventing the fibrosis or taking the fibrosis and trying to kind of break through it and get some more stretching out of it, I think is very possible to succeed using the X10. And I think we’ve seen it, certainly in the prevention stages … in the prevention stages, and we’re just starting now to kind of use it in patients that have contractures and have fibrotic joints to see how well it works in those situations. And it’s certainly not just for total knees. We’ve seen young kids with ACLs, young athletes. We’ve used it on a variety of different patients. It was created to help patients who had a total knee replacement, but I tell my physicians, I tell my patients, if you have an issue with your knee and range of motion is a problem, let’s start here. Flexion and Extension Contracture Contracture is a shortening of the muscle itself. So, fibrosis is something that sets up, like we talked about, as a spiderweb, and it connects bone to bone. Contracture is an actual shortening of the muscle, the tendon, because it’s been in a short position for so long. You know that whole ‘use it or lose it?’ That’s real. That really happens. And so if you don’t move that muscle, it’s going to contract, it’s going to stay short, because that’s all it ever had to do. And that’s why sometimes strengthening after a knee replacement takes longer, because you most likely didn’t have that range of motion before surgery. If you had a knee, and that knee was only bending to 70 degrees, then the quadriceps knew that it had to work from 70 to zero, and that’s all the quadriceps had to do. And the hamstrings only pulled the knee back to 70 degrees. They didn’t pull it back any further, right? So, those muscle fibers that exist after 70 degrees on either side of the joint, they’re on vacation, and they like being on vacation. And when you ask them to start working again it takes a little bit of time for them to remember what their goal was, what their target was, what their job is. If we can get that range of motion faster, we can get those muscle fibers to start firing a lot faster. And certainly in our patients that get to outpatient with the X10 in a clinic, who really were significantly limited in their range of motion prior, we see that strengthening over that longer range happens faster, Because with the X10 we can focus specifically on this particular range, and be very accurate with it because of how we can set the X10 machine. Scar tissue and swelling after knee replacement are the biggest challenges for most patients. Do your homework and make a plan for your recovery. With a good physical therapist and the right approach to recovery you will get back to your life in no time. The X10 Meta-Blog We call it a “Meta-Blog” because we step back and give you a broad perspective on all aspects of knee health, surgery and recovery and such subjects as Understanding Swelling and Scar Tissue After Knee Replacement. Voted Top 10 Knee Blog of 2018. In this one-of-a-kind blog we gather together great thinkers, doers, writers related to Knee Surgery, Recovery, Preparation, Care, Success and Failure. Meet physical therapists, coaches, surgeons, patients, and as many smart people as we can gather to create useful articles for you. Whether you have a surgery upcoming, in the rear-view mirror, or just want to take care of your knees to avoid surgery, you should find some value here. Executive Editor: PJ Ewing (info@x10therapy.com) Subscribe to the Blog Here * indicates required Email Address * First Name Last Name

A Knee Replacement Recovery Gone Wrong (and then gone right again!) by Mike Wyckoff My name is Mike Wyckoff. I underwent total knee replacement surgery (which included a lateral release) on May 18. Here’s the story of the XIO Knee Machine and how it affected my life.  A Tough Recovery My post-op recovery had been very difficult. I was using the routine CPM (continuous passive motion) machine three times a day for two hours each session. And my knee had swollen almost to the size of a bowling ball. I saw the doctor for the first time two weeks after my surgery. He was surprised to see so much swelling. He told me to stop all physical therapy for a few days to rest my knee. I then began a full PT regime with a therapist three days a week. And I rigorously followed all instructions to perform several exercises at home every day. I never missed a day, and I pushed hard. I still had much residual swelling, and a large hematoma on the side of my knee where the lateral release was performed.  Five Weeks Post-Surgery Five weeks after my knee replacement surgery, I had severe prostatitis and had to be hospitalized for IV antibiotics. Fortunately, the bacterial infection did not affect my knee replacement. This was thanks to the quick, diligent response from my surgeon and an infectious disease specialist. But I lost nearly two weeks of real physical therapy, and my knee was not progressing in its extension and flexion. Ten Weeks Post-Surgery Ten weeks out from surgery, the orthopedic surgeon said we needed to schedule an MUA (manipulation under anesthesia). He said he was concerned that in my case, the manipulation might be counterproductive considering my post-op difficulties with such intense swelling. Nevertheless, my MUA was scheduled for the next week. My wife came home from our doctor appointment, prayed, and went to the internet to search ‘alternatives to MUA.’ The X10 machine popped up. She spoke with PJ Ewing (while I was at PT). And when I returned home, limping in the door from my PT, she asked me to look at the on the internet site and call PJ. To say the least, I was skeptical, exhausted, and discouraged.  Getting the X10™ I spoke with PJ and he said a machine could be sent to my home. But it would be five days in arriving. My MUA was scheduled in seven days. PJ said they could get an X10 to Georgia by the next day. I have a nephew who lives in Georgia. So my wife and I got in the car, drove almost all night to Georgia. We met the technician who delivered the X10 to my nephew’s home the following day. I used the X10 for four days in Georgia and, with PJ’s consent, took it back to Oklahoma. I then asked for an appointment with my doctor the day before my scheduled MUA.  The orthopedic surgeon was shocked at my progress and cancelled the MUA. I had progressed in my flexion from 96 degrees to 112 degrees, and my extension was also much improved. By the time I saw the surgeon again ten days later, my flexion was at 125 degrees and my extension was at O degrees. God answered our prayers, I avoided the MUA, and my knee continues to improve daily.  The X10 Team From Dave Lahmann, who delivered the XIO to my nephew’s home in Georgia and showed me how to properly to use it, to his wife (and my recovery coach) Tricia, who provided excellent advice and timely encouragement throughout my time with The X10 to the entire support staff – all were wonderfully instrumental in the success I had. And PJ, not enough thanks can be spoken for his understanding of my struggle and his flexibility in allowing me to transport this machine back to Oklahoma. Finally, I cannot speak enough praise for the X10 machine. It is like a progressive, controlled, measured manipulation, rather than an MUA administered in a few minutes in surgery by the doctor. With the machine, I gradually broke up the scar tissue without increasing swelling at all. Further, the discomfort of “pushing to the next degree” of flexion was accompanied by absolutely no residual pain. It was truly amazing. I offer the strongest encouragement to anyone to try this machine. Just maybe, the X10 will be the answer to your prayers too! The X10 Meta-Blog We call it a “Meta-Blog” because we step back and give you a broad perspective on all aspects of knee health, surgery and recovery and such subjects as knee replacement recovery gone wrong. Voted Top 10 Knee Blog of 2018. In this one-of-a-kind blog we gather together great thinkers, doers, writers related to Knee Surgery, Recovery, Preparation, Care, Success and Failure. Meet physical therapists, coaches, surgeons, patients, and as many smart people as we can gather to create useful articles for you. Whether you have a surgery upcoming, in the rear-view mirror, or just want to take care of your knees to avoid surgery, you should find some value here. Executive Editor: PJ Ewing (info@x10therapy.com) Subscribe to the Blog Here * indicates required Email Address * First Name Last Name

PT PUSHING TOO HARD (Knee Replacement Recovery) A Podcast Featuring Rebecca Hart and Mary Elliott (host) In this episode of The Bee’s Knees, I engage in a conversation with Becky Hart, who recently navigated the challenging journey of total knee replacement surgery. Becky, equipped with a PhD in chemistry, brings a unique analytical perspective to her recovery process, sharing insights that can help others on a similar path. We delve into the difficulties she faced post-surgery, particularly during her physical therapy sessions, which she felt were too aggressive and left her in considerable pain. This experience propelled her to seek alternative solutions, ultimately leading her to discover X10 therapy, a treatment that changed the course of her recovery. As we unpack her experience, Becky describes her initial physical state just three weeks after surgery—limited to a range of motion between zero and 80 degrees. Her desire for a quicker and less painful recovery is evident, and she emphasizes the importance of having control over her rehabilitation. The convenience of X10 therapy, available at home and featuring remote physical therapist support, played a crucial role in her journey. With this approach, Becky was able to gradually increase her range of motion to an impressive 120 degrees in just over three weeks, avoiding the need for more invasive procedures like manipulation under anesthesia. X10 Therapy Becky is keen to impart her hard-earned knowledge to anyone considering knee replacement surgery. Her advice veers towards preemptive action—setting up the X10 therapy in advance of the surgery to hit the ground running upon returning home. She underscores the urgency of early movement to prevent complications like scar tissue buildup. Our discussion shifts towards practical steps listeners should take, including consulting with their surgeons and potentially advocating for insurance coverage to make therapy more accessible. Becky’s conviction is clear: the investment in a healthy knee is invaluable and can pay dividends in terms of quality of life. Overcoming Challenges As we conclude the episode, Becky reflects on the transformative nature of her journey and the gratitude she feels for overcoming her challenges. The conversation serves as both a source of encouragement and a call to action for others to remain hopeful and proactive in their recovery processes. This episode encapsulates not only the potential hurdles of knee surgery but also highlights the successful strategies that can lead to a more resilient and empowered recovery experience.

Avoid MUA 12 Weeks Post Surgery (Dianne’s Story) “The Dianne Story” – Part II We are pleased to share this interview from The Bee’s Knees Podcast and KNEE RADIO 1. We share the account of Dianne Smith’s recovery after total knee replacement. Dianne avoided a manipulation under anesthesia after 12 weeks struggling in outpatient PT. Avoid MUA 12 Weeks Post Surgery Dianne faced an additional challenge in that she had three blood clots in her calf when she started on X10. At the end the blood clots were gone. Details in the article below and on the podcast. This is part two of a two-part series. From the blood clots, her leg had swelled up. She was suffering from swelling from quite a long time, her leg was very tender, and wasn’t getting anywhere with range of motion. PJ on our team first talked to her just said, “Listen, whether you get the machine or not, you just have to stop doing what you’re doing. Ride the bike three times a day. Just stop this forceful stretching. This pain mechanism is not going to stop.” So she decided to get the X10. Before she got the X10, she already had gained nine degrees from doing what PJ had told her to do. We were so happy. We’re all a team here, so we want the best for the patient. We were happy that she was able to gain that much range. And then 23 days after her blood clots were gone. Dianne said, “I don’t know. I don’t know what happened. I don’t care how it happened, but they’re gone. My leg is no longer swollen. It’s not painful. I can touch it. You know, anybody, you know, my grandkids touch my leg. I don’t jump. It’s l like, it’s a miracle, you know? And she was so thankful of finding X10. From Dianne’s PT: And we had our doubts. We had our honest talks about, “Hey, you know, I can’t promise you that this is going to get you to where you think you want to go, where want to be. But I can guarantee you it’s going to get you better than what you were.” I told Dianne, “You trusted that process and you did it!” KNEE RADIO 1 (powered by The Bee’s Knees Podcast) This interview is available exclusively on The Bee’s Knees Podcast and on KNEE Radio 1, a new radio station engineered to help the millions of knee surgery patients each year. You can listen to KNEE RADIO 1 right here: KNEE RADIO 1 CLICK TO SIGN UP FOR KNEE RECOVERY BASICS Subscribe to Knee Recovery Basics * indicates required Email Address *First Name Last Name State

Avoid Manipulation Under Anesthesia (12-weeks after knee replacement) An Interview with PTA, Kim Sajewski “The Dianne Story” – Part I We are pleased to share this interview from The Bee’s Knees Podcast and KNEE RADIO 1. We share the account of Dianne Smith’s recovery after total knee replacement. Dianne was able to avoid manipulation under anesthesia after 12 weeks of struggling in outpatient PT. Dianne faced an additional challenge in that she had three blood clots in her calf when she started on X10. At the end, the blood clots were gone. Details in the article below and on the podcast. This is part one of a two-part series. Hello, my name is Kim Sajewski, and I was fortunate enough to be the recovery coach for Dianne Smith. When I first spoke with her, she was about 83 days post-surgery. Typical patient that I talk to are frustrated, struggling, dodn’t know where to go. Dianne found us at at x10therapy.com: and she did her research. She was a great patient. She wanted to know what else she could do. And I was upfront and honest with her. We talked about where she was in her recovery, what she had been doing. She was in outpatient therapy. She was zero degrees extension, which she had full, and she had about  103 degrees flexion. The unique thing about Diane and I have not seen before with X10 is Diane had three blood clots in her calf. She still had them when she came to us, and I told her I was concerned. I had never seen it before, but she had been in outpatient therapy. The surgeon told her there’s nothing that they can do about them. She, she was on blood thinners; they didn’t give her any restrictions. Kim Sajewski In going through what she was doing in outpatient therapy, I knew the X10 would be way more gentle than the outpatient therapy was for her. She was being forced into manual stretching to the point that she was like, “Kim, I was smacking my hand on the matt / table, tapping out. I’m tapping out like in a wrestling match.” And I said I understood, and it’s not the way to go, but it is what it is. We both said the same thing. As soon as I started saying it, she started finishing it for me. I said, “You know, when patients continue, you have your trust with your therapist and things are going okay, but then things don’t go so well. But then they keep doing the same thing over and over again and expecting a different outcome.” And she said it right with me. She said, “That’s a definition of insanity, to keep doing the thing, the same things over and over again, and expecting something different, an outcome, something different.” And we laughed. She’s like, “I knew I couldn’t keep doing this anymore. I was a young 60-year-old grandmother who wanted to play with the grandkids. I had places to go. I wanted to travel. I did this for a reason. You know, my knee was so painful before surgery, and I did this because I wanna get back to life.” Unfortunately, this happened. From the blood clots, her leg had swelled up. She was suffering from swelling from quite a long time, her leg was very tender, and wasn’t getting anywhere with range of motion. PJ on our team first talked to her just said, “Listen, whether you get the machine or not, you just have to stop doing what you’re doing. Ride the bike three times a day. Just stop this forceful stretching. This pain mechanism is not going to stop.” So she decided to get the X10. Before she got the X10, she already had gained nine degrees from doing what PJ had told her to do. So I was, I was so happy. We’re all a team here, so we want the best for the patient. And I was happy that she was able to gain that much range. Now she’s excited, right? She is gaining this range, and now she’s getting a little bit ahead of herself. So that’s where the coaching with my patients, what all the coaches do: ometimes we have to pull the reigns back. It’s a slow process. It’s the slow not forceful process that works. And the knee takes some time to slow down. It takes some time to get used to that, and it’s not going to happen overnight. And I told her that, I said, “It’s not a miracle machine. You have to give the knee some time to calm down. It has to reset itself again. And it has to realize that you are not doing something that is going to make it hurt and is not going to be painful. So once it starts to calm down and realize that it’s okay, what it’s doing, and it’s okay to go one degree at a time, everything starts to follow through.” And so she did that. She was re respectful of that. She trusted the process. She trusted that this was the road for her. She knew she couldn’t get any worse than what she was. Maybe she could, I don’t know if they caught forcing her, but she knew she wasn’t going to go back to that. I had spoken to her about her outpatient therapy as well. And I said, you know, if you have a good relationship with your therapist, just tell ’em that you have this machine. You can or cannot, you know, but just say, you know, let’s just try not forcing my knee into, into a bend. Let’s just try doing other things. Let’s, let’s focus on the strength. Let’s focus on hamstring flexibility, but not, not the bend. Let’s not do that. And her therapist was very respectful of that. He listened and he said, okay. And soon all of these things started taking place, and her knee was calming down.,she started to notice that she was walking better. Then when she went into her outpatient PT clinic, everybody’s like, “Wow, you’re walking so much better. You’re more fluent. You know, you’re not stumbling. You’re getting that full stride.” And so, that really made her happy, and she wanted to do more. But I, once again I reminded her, “Diane, let’s pull the reins back. We talked about it going slow and steady. Dianne continued that progress as the days went on. The numbers were going up, she was gaining. She was progressing well. She was progressing as she should. One degree at a time. And the knee was accepting it. However. To me the numbers, yes, they mean a lot. But… functionality meant even more. She was now able to get in and out of her car. Her husband said, “You bounced out. You bounced out of the car. Like it was nothing.” She was walking. She got to go down on the floor and play with her grandkids. And on the phone I could hear the tears in her voice. She was just so happy that she was able to be down on the floor playing with her grandkids. I think 19 days after she had the machine, she got to zero degrees extension and 130 degrees flexion (that is traditionally full flexion for most of us). She literally texted me that night, a picture of her screen, and she’s said, You have to celebrate this with me!” I, of course, called her and I said, “Oh my gosh, who would’ve thought this happened ?? !!” And then 23 days after her blood clots were gone, she called me once again. Dianne said, “I don’t know. I don’t know what happened. I don’t care how it happened, but they’re gone. My leg is no longer swollen. It’s not painful. I can touch it. You know, anybody, you know, my grandkids touch my leg. I don’t jump. It’s l like, it’s a miracle, you know? And she was so thankful of finding X10. And we had our doubts. We had our honest talks about, “Hey, you know, I can’t promise you that this is going to get you to where you think you want to go, where want to be. But I can guarantee you it’s going to get you better than what you were.” I told Dianne, “You trusted that process and you did it!” So it was amazing! Now we’re just friends. I told Dianne, you’re not only my patient, but you’re my friend. So she’s sending me pictures of her grandkids and everything. And it was, it was pretty. It’s an amazing story. I’m so happy for her. KNEE RADIO 1 (powered by The Bee’s Knees Podcast) This interview “Avoid Manipulation Under Anesthesia” is available exclusively on The Bee’s Knees Podcast and on KNEE Radio 1, a new radio station engineered to help millions of knee surgery patients each year. You can listen to KNEE RADIO 1 right here: KNEE RADIO 1 The X10 Meta-Blog “Avoid Manipulation Under Anesthesia” We call it a “Meta-Blog.” We step back and give you a broad perspective on all aspects of knee health as with this article on ‘Avoid Manipulation After Anesthesia (12-weeks after knee replacement)’. In this one-of-a-kind blog we gather together great thinkers, doers, and writers. All our work is related to Knee Surgery, Recovery, Preparation, Care, Success and Failure. Meet physical therapists, coaches, surgeons, patients, and as many smart people as we can gather to create useful articles for you. This is for you if you have a surgery upcoming, or in the rear-view mirror. Or maybe you just want to take care of your knees to avoid surgery. Executive Editor: PJ Ewing To subscribe to the blog click here. GET HELP NOW – TWO FREE EMAIL SERIES BELOW Two resources for you below to help with knee replacement pain management. Both are email series that we created to help those who need some additional thinking for pre-surgery and post-surgery.

Bilateral Knee Replacement for Olympic Cyclist an interview with Chris Nowacki Chris Nowacki spends time with us discussing her husband’s bilateral knee replacement. Wallander (Wally) Nowacki was an Olympic cyclist for Team Poland early in his life. However, finding himself in need of two new knees at age 65, he took the leap and did both knees at once. Chris and Wally did extensive research on how to best prepare for knee replacement surgery. They examined how to best recover afterward. Click the Play button above to listen to the interview. And look for a special bonus at the end of the interview – a nice surprise there for you. The Impact of Cycling on the Knee Cycling is a great low-impact aerobic activity. Cyclists are usually more efficient on both hills and flat terrain when they pedal quickly (at about 80-85 rpm) rather than at slower cadences. And cycling is considered a knee-sparing exercise. This is because it does not require an impact with the ground. However, the repetitive motion of pedaling can lead to a variety of overuse knee injuries. The majority of cycling injuries are indeed caused by overuse. This leads to cumulative tissue microtrauma and consequent symptoms. In overuse injuries, the problem is often not acute tissue inflammation, but chronic degeneration. Source: Chester Knee Clinic More Bilateral Knee Surgery Articles Below Click here for Ray’s Story. Here is the article. Click here for Tom’s Story. Thank you Chris and Wally for your commitment to getting the X10 for recovery. This bilateral knee surgery for  Wallander Nowacki, was a great success. The X10 Meta-Blog We call it a “Meta-Blog.” In these articles, we step back and give you a broad perspective on all aspects of knee health. We explore surgery and recovery and such subjects as ‘Bilateral Knee Replacement for Olympic Cyclist’. This is a one-of-a-kind blog. We gather together great thinkers, doers, and writers. And it is all related to Knee Surgery, Recovery, Preparation, Care, Success, and Failure. Meet physical therapists, coaches, surgeons, and patients. And as many smart people as we can gather to create useful articles for you. You may have a surgery upcoming. Or in the rear-view mirror. Maybe you just want to take care of your knees to avoid surgery. In all cases, you should find some value here. Executive Editor: PJ Ewing (info@x10therapy.com) Subscribe to the Blog Here * indicates required Email Address * First Name Last Name

Knee Replacement Recovery for Women: Your Guide to Strength & Renewed Mobility The Bee’s Knees Podcast | Susanna In this episode of The Bee’s Knees, I have the pleasure of sitting down with Susanna, a vibrant individual who shares her inspiring journey through knee replacement surgery and recovery. Susanna recounts her experiences leading up to her full right knee replacement on December 19th. Having managed a knee that had been previously injured for 45 years, she faced the difficult decision of replacement surgery after realizing the extent of the wear and tear on her knee joint. What stands out in her narrative is not only her courage to undergo surgery but also the distinct contrasts in recovery experiences between her and her husband, who had his knee replaced a year earlier. As we delve into her recovery process, Susanna highlights the initial challenges she faced with pain and limited mobility, specifically her struggles to bend her knee beyond 90 degrees. She details ongoing consultations with her orthopedic doctor, which culminated in undergoing a manipulation under anesthesia to improve her knee’s flexibility. Susanna’s commitment to recovery shines through as she explores various approaches to physical therapy, ultimately discovering the X10 Therapy machine, which she enthusiastically describes as a transformative tool in her rehabilitation journey. Knee Replacement Recovery for Women: Susanna’s Story Throughout our conversation, Susanna emphasizes her approach to recovery, wherein she committed to using the X10 machine and engaging in personalized physical therapy. Her dedication to this alternative method, in conjunction with traditional rehabilitation techniques, has significantly improved her range of motion, allowing her to achieve 115 degrees on her own within just three weeks after starting with the machine. We discuss the vital role of motivation and determination in her recovery process, as well as the importance of having professional support from coaches who provide guidance and adjustments along the way. As we reflect on her progress, it becomes clear that Susanna’s story is not just about physical recovery; it is also about attitude and resilience. She encourages others who are going through similar situations to keep an open mind regarding unconventional recovery options and to actively seek solutions that resonate with them. Susanna’s newfound appreciation for her capacity to recover and regain strength serves as an inspiring example for anyone dealing with the repercussions of orthopedic surgeries. In closing our episode, I express my gratitude for Susanna’s willingness to share her journey and insights with us. She embodies the spirit of resilience and the continuous pursuit of a more active and fulfilling life post-surgery. This conversation is a powerful reminder of the possibilities that lie ahead and the importance of tailored recovery plans that align with individual needs and circumstances. Join us as we continue to explore more inspiring stories and expert advice on knee surgery and recovery in future episodes.

Stiffness After Knee Replacement | Secondary Research Literature Review (MUA After TKA: Women) We have done some research recently on the incidence of MUA with a focus on women. This is considered a Literature Review. Literature Review: This is a comprehensive summary and analysis of the existing scholarly literature on a specific topic. A literature review seeks to identify what has already been written on a subject, identify key themes and debates, and point out any gaps in the current research. It is often a preliminary step in a larger research project but can also be a standalone publication. To get the full story in the easiest way possible, listen to the podcast for a full rundown on our learnings. MUA after TKA: Women This infographic is an easy way to digest the findings. It provides a quick look at the incidence and risk factors of Manipulation Under Anesthesia (MUA) following Total Knee Arthroplasty (TKA). This review has a specific focus on women and MUA. Identifying At-Risk Patient Profiles The Critical Window: Early vs. Delayed Intervention The MUA Paradox: A Solution and a Signal MUA After TKA: Women | Works Cited Manipulation Under Anesthesia After Knee Replacement – OrthoInfo – AAOS, accessed on June 10, 2025, https://orthoinfo.aaos.org/en/treatment/manipulation-under-anesthesia/ Manipulation under anesthesia after total knee arthroplasty: a retrospective study of 145 patients – PMC, accessed on June 10, 2025, https://pmc.ncbi.nlm.nih.gov/articles/PMC9214639/ Manipulation under anaesthesia post total knee replacement: Long term follow up | Request PDF – ResearchGate, accessed on June 10, 2025, https://www.researchgate.net/publication/51248496_Manipulation_under_anaesthesia_post_total_knee_replacement_Long_term_follow_up Risk Factors for the Need for Manipulation Under Anesthesia …, accessed on June 10, 2025, https://pubmed.ncbi.nlm.nih.gov/40180278/ Manipulation Under Anesthesia – Oxford Clinical Policy – UHCprovider.com, accessed on June 10, 2025, https://www.uhcprovider.com/content/dam/provider/docs/public/policies/oxford/manipulation-under-anesthesia-ohp.pdf Manipulation under anesthesia after primary knee arthroplasty in …, accessed on June 10, 2025, https://pmc.ncbi.nlm.nih.gov/articles/PMC6746267/ Younger age is associated with increased odds of manipulation …, accessed on June 10, 2025, https://pubmed.ncbi.nlm.nih.gov/31471257/ Factors predicting manipulation under anaesthesia after total knee …, accessed on June 10, 2025, https://pubmed.ncbi.nlm.nih.gov/39849219/ Factors predicting manipulation under anaesthesia after total knee replacement, accessed on June 10, 2025, https://www.researchgate.net/publication/388326048_Factors_predicting_manipulation_under_anaesthesia_after_total_knee_replacement After Manipulation Under Anesthesia – X10 Therapy, accessed on June 10, 2025, https://x10therapy.com/after-manipulation-under-anesthesia-failed-knee-recovery/ Risk Factors for the Need for Manipulation Under Anesthesia Following Total Knee Arthroplasty: A Systematic Review and Meta-analysis. – FirstWord Pharma, accessed on June 10, 2025, https://firstwordpharma.com/story/5948557 Manipulation under anesthesia for stiffness after total knee replacement: A systematic review, accessed on June 10, 2025, https://www.researchgate.net/publication/269807965_Manipulation_under_anesthesia_for_stiffness_after_total_knee_replacement_A_systematic_review Influence of Gender on Age of Treatment with TKA and Functional Outcome – PMC, accessed on June 10, 2025, https://pmc.ncbi.nlm.nih.gov/articles/PMC2882007/ Outcomes of Early Versus Delayed Manipulation Under Anesthesia for Stiffness Following Total Knee Arthroplasty: A Systematic Review and Meta-Analysis – PubMed, accessed on June 10, 2025, https://pubmed.ncbi.nlm.nih.gov/38797451/ Timing of manipulation under anaesthesia for stiffness after total knee arthroplasty – PMC, accessed on June 10, 2025, https://pmc.ncbi.nlm.nih.gov/articles/PMC4669325/ This infographic synthesizes findings from peer-reviewed medical literature on MUA following TKA. It is for informational purposes only and does not constitute medical advice.

More Than a Knee: Overcoming a Blood Clot, Surgery, and Setbacks A Podcast Featuring Kevin Evans and Mary Elliott (host) In this episode of the Bees Knees Podcast, I have the pleasure of speaking with Kevin, who shares his personal journey following knee surgery and a manipulation under anesthesia. Originally from the UK and now residing in the U.S., Kevin opens up about the challenges he faced throughout his recovery process, providing an inspiring insight into not only the physical hurdles he overcame but also the mental resilience required to push forward. Kevin recounts his initial knee troubles that were exacerbated by his passion for motorcycle riding. The dynamics of stopping quickly on a bike led to his eventual decision to seek medical help. Following a cortisone injection and unfortunately facing an infection that necessitated surgical intervention, Kevin found himself in a hospital setting longer than anticipated. His hospital stay involved not just surgery but also battling a blood clot, which added complexity to his recovery journey. Despite these obstacles, he approached his rehabilitation with determination, gradually moving from a limited range of motion to notable improvement with physical therapy. More Than a Knee: Overcoming a Blood Clot, Surgery, and Setbacks. Just Bending the Knee After his initial recovery period included at-home therapy, Kevin transitioned to external physical therapy, where he faced the daunting task of regaining the full functionality of his knee. Each milestone in this journey was marked by pain and effort, especially as he attempted to bend his knee to the desired angle. His perseverance paid off as he shared his progress, reaching a range of motion that spurred his motivations to keep striving for more. He emphasizes the importance of finding the right therapist, which proved pivotal in achieving further improvements in his recovery. Knee Manipulation Under Anesthesia As Kevin shares his experiences, he reflects on the moment when he decided to undergo a manipulation procedure to assist with the tight scar tissue that was hindering his mobility. This decision came with its own set of fears, but upon reflection, he found that the manipulation was instrumental in loosening his knee and providing the much-needed range of motion he sought. This episode stands out as a testimony to the trials and triumphs of rehabilitation, capturing the emotional and physical battles faced in such recovery processes. Personalized Assistance and the Trusty X10 Machine We delve into the specifics of the innovative X10 therapy machine that Kevin used during his recovery, which offered personalized assistance in his rehabilitation. He highlights its intuitive technology that adapts to the user’s movements, empowering him to regain control over his physical therapy. Kevin’s excitement about using the machine and the positive changes he experienced in just two weeks is palpable, demonstrating the integration of technology and personal effort in recovery. Ultimately, Kevin’s journey unveils a powerful message about not accepting limitations. His love for biking, which motivated him through difficult times, serves as a reminder of the importance of maintaining passions and chasing an active lifestyle, no matter the challenges that arise. As he approaches a full recovery and anticipates getting back on his bike, he shares valuable insights for others who might be in similar situations, encouraging them to keep moving forward. MORE ABOUT MUA More Than a Knee: Overcoming a Blood Clot, Surgery, and Setbacks. An interview with Kevin about his knee replacement, MUA and X10 recovery.

KNEE RECOVERY IN NORTH CAROLINA A Podcast Featuring Debra Conti and Mary Elliott (host) In this episode of the Bees Knees Podcast, I engage in a deeply insightful conversation with Debra, a registered nurse from North Carolina, who shares her personal journey through the challenges of post-operative recovery following a total knee replacement. Debra provides an honest look into her experience, detailing not just the surgery but her difficult recovery process plagued by the development of excessive scar tissue. She candidly recounts how initial physical therapy fell short of addressing her complex pain management needs, particularly the nerve injuries that arose during her treatment. Debra describes her pivotal decision to reach out to me after conducting her own research on recovery solutions. She discovered the X10 Therapy, an in-home therapy machine designed to facilitate recovery under the guidance of professional therapists. In our discussion, she emphasizes how this innovative tool became a game-changer in her healing journey. The ability to perform tailored therapeutic exercises from the comfort of her home allowed her to regain mobility and improve her range of motion significantly—with personal touches from her X10 Recovery Coach, Halima, who provided consistent support throughout the process. X10 Therapy We dive into the technical aspects of how the X10 Therapy operates, highlighting its unique mechanism that safeguards against overexertion. Debra describes her experience enhancing her range of motion by 20 to 30 degrees, while the machine’s thoughtful design provided real-time feedback on pain levels, a feature she found particularly empowering. Through her narrative, listeners will gain insight into the importance of personalized care and the ongoing adjustments that one must navigate in their recovery journey. Emotional Support As her story unfolds, Debra reflects on how vital emotional support is throughout recovery. She appreciates the care she received, not just from the X10 Therapy team but also from others in the medical community. Her fondness for the machine and her therapists radiates through her words, marking a poignant connection between patient and caregiver that transcends traditional clinical boundaries. As we move towards closing the episode, Debra expresses both gratitude and a bittersweet sense of loss as her time with the X10 machine comes to an end. Resilience and Determination In wrapping up our conversation, I invite listeners to take inspiration from Debra’s resilience and determination. Her story is a testament to the power of seeking help, leveraging technology in healthcare, and the value of community support in navigating the complexities of recovery. We hope her insights resonate with anyone facing similar challenges, encouraging them to remain hopeful and proactive in their healing journeys..

THREE CHALLENGING KNEE RECOVERIES A Podcast Featuring Robert Douglas and PJ Ewing (host) PJ and Robert discussed the challenges of adapting to frequent changes in technology and software updates, as well as their personal backgrounds and experiences. They also shared their experiences with knee surgeries, the importance of range of motion in recovery, and the role of AI tools in their work. The conversation also touched on the benefits of subscribing to email series, podcasts, and books, with a focus on those related to health and technology. In the meeting, PJ and Robert discussed their personal backgrounds and experiences. PJ shared his interest in jazz guitarists, particularly Pat Metheny. Robert, a 57-year-old from Fort Worth, Texas, shared his military service as an army nurse and his current life with his wife and three daughters. The conversation then shifted to Robert’s knee recovery experiences, which will be the focus of future discussions. Robert Douglas’ Knee Surgery Experience Robert shared his experience with knee surgeries, starting with a torn meniscus and cartilage in 2016. After a steroid injection, his knee became septic, requiring two back-to-back incision and debridements. The infection destroyed all soft tissue, cartilage, and bone, leaving him unable to walk for six months. He received his first knee replacement, which failed due to misalignment and scar tissue. After a revision surgery, he used the X10 therapy device to improve his range of motion from 70 degrees to 125 degrees. He emphasized the importance of an experienced surgeon and proper physical therapy. He has used the X10 three times for his knee surgeries and found it helpful in his recovery. Robert discussed his experience with knee replacement surgery, emphasizing the importance of range of motion in recovery. He praised the x10 machine for its precision in tracking progress and its role in his rehabilitation. PJ acknowledged the challenges Robert faced and the x10’s effectiveness in such situations. PJ also asked Robert about his experience with the dark period of his recovery, seeking insights for others in similar situations. Robert’s Knee Replacement Recovery Journey Robert shares his personal experience with depression following knee surgery and his journey to recovery. He emphasizes the importance of finding hope and a competent surgeon, as well as the critical role of range of motion in rehabilitation. Robert credits his faith, the X10 machine, and a rigorous therapy routine of using the X10 three times a day for 35 minutes each session as key factors in his successful recovery. He strongly recommends prioritizing range of motion exercises and considers the X10 an invaluable tool for knee replacement recovery. Overcoming Challenges With Faith and Action In the meeting, PJ and Robert discussed the importance of maintaining hope and taking action to overcome challenges. Robert shared his personal experience of overcoming a knee problem through faith, hope, and action, including finding a good surgeon and physical therapist, and using tools like the X 10. They emphasized the need to find the right tools and strategies to manage recovery effectively. Robert also shared a recent setback in his recovery process, but expressed confidence in overcoming it with the guidance of his coach. Knee Surgery Recovery With Coaching Robert discusses his experience with knee surgery recovery and the importance of having a coach. He explains how his coach, Kim, advised him to reduce his range of motion from 95 to 80 degrees, which helped alleviate bruising and improve his overall recovery. PJ emphasizes the value of coaching in the X10 program, stating that it is instrumental to patients’ success. Robert agrees, noting that he wouldn’t have had the confidence to adjust his approach without Kim’s guidance. They both stress the importance of not giving up and seeking proper support during recovery, with Robert adding a final tip about the benefits of pre-surgery strength training. Robert and PJ discuss podcasts and books they enjoy. Robert recommends “Genius Foods” by Max Lugavere, which explores the impact of food on the body, and its accompanying podcast “The Genius Life.” He also mentions a podcast called “Cold War: Prelude to the Present.” PJ then enthusiastically recommends Dan Carlin’s “Hardcore History” podcast, praising its in-depth historical content, particularly the episodes on Genghis Khan. They both express interest in exploring each other’s recommendations. Email Series and Podcast Recommendations In the meeting, PJ and Robert discussed the benefits of subscribing to email series like Knee Surgery Preparation and Knee Recovery Basics. PJ also shared his appreciation for Robert’s talent as a host and his ability to make people feel comfortable sharing their stories. They also discussed their shared interest in podcasts, with PJ recommending several shows including Pivot, Macbreak Weekly, Conan O’Brien Needs a Friend, and science-focused podcasts. The conversation ended with PJ encouraging Robert to revisit podcasts and find new shows to enjoy.