The Bee's Knees

Elizabeth solved the problem only after finding X10 to recover from her MUA. Ligament Tears were just a part of the damage done to her knee years ago. It is exactly what we were able to do for Elizabeth that gets our whole company up in the morning. Listen and read below.

In this episode, we delve into the recovery journey of Elizabeth, an active-duty Air Force member who has bravely navigated the challenges of knee injuries and multiple surgeries. Elizabeth shares the significant impact her injuries had on both her physical health and her emotional well-being over the past two years. Her story begins with a devastating knee injury sustained during deployment, leading to the unfortunate “unhappy triad” of torn ligaments, which ultimately resulted in her first surgery. Solving Ligament Tears.

Elizabeth Amos

Elizabeth details the frustrations of rehabilitation following her ACL repair, particularly the stability issues that persisted, compelling her to pursue a second surgery. The second surgery, which involved a more complex reconstruction and rerouting of her IT band, was significant. Elizabeth describes her dedicated commitment to physical therapy, attending two to three sessions a week while facing ongoing challenges with knee flexion and stability. Despite her efforts, improvement was slow, leading her to consider further interventions, including manipulation under anesthesia.

Throughout our conversation, Elizabeth candidly discusses the emotional toll that her recovery journey has taken on her. Amid the setbacks and difficulties, her determination to regain her pre-injury lifestyle shines through. She expresses how important it is for her to return to running and her daily activities, highlighting the internal struggle of maintaining motivation while dealing with physical pain. Elizabeth’s resilience is remarkable, providing listeners with insight into her mental strength during this challenging time.

Following her manipulation procedure, Elizabeth faced further frustration with her progress, which led her to seek out alternative options for recovery. It was during this search that she discovered the X10 rehabilitation system. Skeptical but hopeful, she decided to give it a try, curious about how it could facilitate recovery without intensive pain — a stark contrast to her previous experiences in physical therapy.

Elizabeth shares her initial expectations around using the X10 and the resulting positive outcomes. In just a couple of weeks, she reported a tremendous increase in her knee flexion from 95 to an impressive 126 degrees. She discusses how the pain-free nature of the therapy was a game changer, allowing her to incorporate it seamlessly into her daily routine while continuing to engage in life and work without feeling constrained by her past injuries.

Our conversation culminates in Elizabeth imparting valuable wisdom to others facing similar challenges. She emphasizes the importance of exploring all options for recovery, urging those who may be hesitant to invest in their health to consider the significant benefits that come with regaining mobility and functionality. Through her inspiring journey, Elizabeth highlights not only the physical aspects of recovery but also the profound realization that one’s quality of life can vastly improve with the right support and interventions.

Elizabeth’s story serves as a powerful reminder of the resilience of the human spirit, illustrating the dedication required to reclaim one’s life after injury. Her journey underscores the message that recovery is often not a straight path, but with persistence, innovation, and the right mindset, a brighter future is within reach.

Join us for this inspiring episode that emphasizes resilience, the power of modern rehabilitation, and the endless adventures life has to offer even after major surgical interventions. Elizabeth’s journey is proof that with determination, the right tools, and a supportive community, one can indeed reclaim an active and fulfilling life post-surgery.

by Mary Elliott (The Bee’s Knees Podcast)

In this episode of the Bee’s Knees podcast, Mindy shares her experience with knee replacement surgery and discusses the challenges and benefits of using the X10 machine for physical therapy. We explore the importance of emotional well-being during recovery and highlight the convenience and precision of the X10 machine. Mindy’s story emphasizes the need for individualized solutions and proactive muscle strengthening.

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Mary Elliott

In this episode of the Bee’s Knees podcast, we have a special guest, Mindy, who recently underwent knee replacement surgery. She shares her experience of living with knee pain for several years and trying various treatments before deciding on surgery. Despite her apprehension about her age, Mindy chose knee replacement and discusses the challenges she faced during her recovery, including swelling and difficulty achieving flexion.

Mindy also discovered the X10 machine, an alternative to manipulation under anesthesia (MUA) that provided a more gentle and accessible form of physical therapy. Mindy emphasizes the importance of finding a solution that works for each individual’s unique circumstances and highlights the convenience and precision of the X10 machine.

We discuss the importance of emotional well-being during recovery and how the X10 machine helped Mindy find a sense of relief and improvement within days. The ability to track progress and have support from both the X10 coach and her physician was greatly appreciated. Mindy continues to manage swelling through elevation and icing. As a nurse, she found the X10 to be a valuable tool and would consider doing physical therapy beforehand to strengthen her muscles in the future.

We express gratitude to Mindy for sharing her journey with us and assure her that we are honored to be a part of it.

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 this on one ‘Mindy Avoids Manipulation Under Anesthesia.’ READ OUR BLOG.

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 ([email protected])

A story full of heart, dedication and making the most out of a tough recovery.

I was born in Cuba, and moved to Miami at the age of five, where I grew up. I have lived here all my life. I studied psychology and political science in college and became a paralegal. I was always active and athletic as a kid. Although it wasn’t my major, I was on the modern dance team in college.  Because I live near the water, I have always enjoyed all forms of water activities such as swimming, boating, snorkeling, and kayaking. During my marriage, my ex and I also used to go skiing quite frequently. In addition, I enjoy running, dancing, biking, crossfit and boot camp.

About 15 years ago I tore the meniscus in my right knee and had arthroscopic knee surgery to clean it out. No one ever explained to me that this surgery would ultimately have repercussions as I got older and continued an active life style. After my pregnancy I gained a significant amount of weight, and then lost it. I started running 5k’s during and after my weight loss, and continued dancing which was always my passion. The first few years my knee was fine, but after a while it started swelling up and started causing me tremendous trouble. I seemed to always be in pain. I became a regular at the orthopedic doctor’s office. I did endless therapies, took cortisone shots every 6 months, iced the knee, stretched it, did yoga, you name it. But the knee kept getting worse and worse, and the cortisone shots were no longer helping. About three years ago I practically blew out my knee during a 5K run. I had several medical opinions telling me that I would ultimately need TKR surgery, but for the time being it was just “elective” surgery. I finally met my surgeon, Dr. Carlos Alvarado, who gave me a third and final opinion. He ordered an MRI, and when he read the results, he was shocked to see that not only was I bone on bone, but I had also torn my ACL and MCL. He advised that surgery was no longer an option or elective for me; it was mandatory.

Dr. Carlos Alvarado is my guardian angel. I found him through a mutual doctor friend who advised me to see him. It was the best medical advice I ever received. Dr. Alvarado is young, extremely knowledgeable, and well-schooled in the latest technology. He has great bedside manner, and in my opinion, is a brilliant surgeon. My surgery was state of the art and used a new technique. It went very well, and in fact, Dr. Alvarado kidded with me the next morning about how I broke the blade of his saw during the surgery. I was up and walking around just hours after my surgery.

While I was physically in need of the surgery, I was not mentally prepared for what I was about to endure. I really don’t know how anyone can be prepared for this life changing event if they’ve never personally experienced total knee replacement surgery. That said, everyone and every BODY heals and recovers differently. I went to 90º flexion painfully, and sweated every minute of every therapy session. My extension wasn’t much better, as I was between -11º to -8º. I was going to therapy 3x’s a week, every week for an hour. I took five weeks off from work, so I had to take advantage of the time off to recover as quickly as possible. I made it to the 90º mark between the second and third week, and then progressed to about 113º, where I seemed to linger longer than the therapist wanted. The protocol is for a patient to reach 120º flexion and 0º extension by the 6-8 week mark, or an MUA (Manipulation Under Anesthesia) would be the next recommended step.

I didn’t know what an MUA was, let alone what it entailed, but the mere mention of the word sent me in a panic. And my therapist wanted to make sure that I knew what it was. So I got home, depressed, hopeless and frustrated, and got online to do some research. It’s what I do. In an MUA they put you under anesthesia and manipulate (aka “crack”) your knee to 120º. The goal of the MUA is to break up the scar tissue to allow the joint to move freely. With the exception of having a new surgical scar, you are basically starting at almost ground zero all over again, and with new pain and swelling. I saw my surgeon at my four week follow up and he told me he expected me to be Gumby, to which I replied I’m neither green nor made of clay. He said I was one of the youngest patients he had, and because I was in such good physical shape, he had very high expectations of me. I knew what that meant, and I saw where I was headed if I didn’t take immediate action.

During my research on MUA’s I saw the X10 machine kept popping up and without hesitation, I booked a phone conference with PJ Ewing, the developer’s son.  I was in a bad head space and was very depressed. I had so many questions and concerns.  But after talking to him for over an hour, he put me at ease and I felt like this machine was sent from heaven and would be able to get me to my end range quickly and with relatively little pain and discomfort. I really needed to get to my end range by my next post op appointment. I was terrified of getting an MUA, and to make matters worse, I had heard of two cases (friends of friends) who had to have it done. I spoke with my surgeon about the X10 and although he had not heard about it, he read the literature I brought him and he signed off on the medical consent, giving me his blessing. The only caveat is that he required me to do BOTH traditional therapy along with the X10 machine. At this point I was very far from dancing two months after knee replacement as he had promised.

I received the machine a couple of days after I sent in the paperwork. I continued doing therapy, but also started working with the X10 machine. I worked with the machine diligently 3x’s a day, seven days a week. On the days I had therapy, I would do the machine only once or twice, depending on how I felt. Every time I left therapy I was sore and my joint was super tight and I needed to ice my knee. I even used the X10 on those therapy days although I was sore, I would simply adjust it accordingly. I will elaborate below.

I starting using the machine at intervals of anywhere from 30-45 minutes. I pushed myself both up (extension) and down (flexion) with each session. While it was not as painful as therapy, it was uncomfortable because I pushed myself sometimes 5º, 10º or more per session. But it was definitely less painful than therapy. I only told my therapist about the X10 a couple of days after I started using it, because I wasn’t sure how she would react to it. When I mentioned it, she said that Passive Action Machines had been around for decades, but none seemed to be very effective. I told her all about this machine, with its advance technology, and  its many added features to strengthen the muscles and break up the scar tissue,  and because of all the research I had done, I knew the difference between the x10  and its predecessors, so I could make a valid argument in its favor. This machine is state of the art and has a lot of built in added features that speed up the recovery process.

The machine itself is comfortable and very user friendly, and it doesn’t take up a lot of room. I only had to relocate an IKEA size arm chair temporarily to fit the machine in my small two bedroom apartment. Once the set-up was complete, in the comfort of my home, I was given detailed instructions from Dave on how to use it. Then I simply sat on the chair, and pressed the ON button to get started. I had mine placed in my living room in front of my television, so that I could watch TV, read, work on the computer, answer emails, visit with friends and family, or even have a cup of coffee while the machine was doing its job. While it has many amazing features, one of my favorite features is that as the machine is going up and down in its range of motion, it slows down when you are at 10 degrees from your pre-set end range in either direction so that you can brace yourself for the final push.  (It really is a mental thing).

It adapts and adjusts to your body accordingly. If the machine feels too much pressure is being exerted to get you to the next degree, it automatically stops at the furthest degree it could comfortably get you to, and continues the up and down movement while slowly pushing you further along. As you move the joint, it will naturally loosen up and you get a better bend. This is very different from having a therapist bend your knee while you’re in therapy and “tapping out” to no avail. And you can also manually adjust your end range in either direction while you’re in the middle of a session so that you can push yourself comfortably to the next level, or pull back if you feel any discomfort. You are given an instruction manual on how to use the X10, it has all the pertinent numbers to call, and a grid where you keep track of your own progress. Since you are always in control, it is in your best interest to push yourself forward as frequently as you can even if you feel some discomfort. Kind of like the old gym adage: “no pain, no gain.”

I began using the X10 machine at about week six. After a few sessions on the machine, my therapy sessions started getting easier and far less painful. Prior to the X10, whenever my therapist would bend my knee while I was on my stomach, I would brace for the pain, and tap out while tears streamed down my face. Within a few sessions on the X10, the therapist’s manipulation got easier and easier to bear. Even my therapist noticed that my knee was bending more easily. She saw the swelling and inflammation starting to go down, and felt the muscles waking up, while the scar tissue started to break down. My therapist mentioned how she could totally feel a huge difference in the anatomy of my knee joint and the surrounding tissues, and how impressed she was with my improvement. By the eighth week (two weeks after starting the X10) I saw and felt a remarkable improvement overall in my mobility, strength, and flexibility. I only had the machine for 2 weeks, but I achieved my end ranges, and went from a starting point of 5º extension/90º flexion to 0º extension/130º flexion within that small time frame. I never felt more than a discomfort during the entire process.

With the X10 you are assigned Tricia, your X10 coach. She is your coach, virtual therapist and a Zumba instructor all in one. She is amazing and has a great personality. We had our first virtual phone therapy a few days after I started using the machine.  And from that point on we would text each other almost on a daily basis. She was a burst of energy and super inspirational. This was especially helpful on those days when I needed the “quit feeling sorry for yourself” speech. Since the machine has readings that are recorded and automatically sent to her for monitoring, I would frequently get texts messages from her, out of the blue, cheering me on. I even got emojis, which totally made my day!!! Thanks Tricia!

She was my biggest cheerleader and motivator. She kept me grounded and hopeful.  And she always brought a huge smile to my face.  Actually, the whole team is amazing.

My surgery was on April 3, so I am now just over 12 weeks post-surgery. I am beyond thrilled that I was discharged from therapy almost 2 weeks ago, at almost 11 weeks. My therapist said that I was off the charts and had exceeded all my milestones. I did a total of 26 therapy sessions at just under 11 weeks. I’m walking without a limp, and I’m dancing again. I take public transportation to get to and from work, so I walk over  3-4 miles a day just commuting. I have to go up and down escalators, and many times the escalators are broken, so I end up having to walk up and down the stairs. I’m slow and careful, but I can do it.

The therapist started transitioning me to regular gym equipment at eight weeks post op, and by the time she discharged me, I was doing leg presses/extensions of over 60 lbs with my surgical leg, leg curls at 45 lbs, I am also doing 20 minutes on the stationery bicycle at a low seat level, with high resistance. I’m using the elliptical machine and I’m doing wall squats with a medicine ball on my heels and on the balls of my feet.  I’ve also been cleared to do aquatic exercises.

Knee replacement surgery is a long journey no matter what your age or physical ability is prior to the surgery. It is as much mental, as it is physical. You have to mentally prepare yourself for this temporary setback. You will have a new metal joint in place of where you had your knee joint, and your muscles are cut during surgery. You will have little to no strength where you once had some or alot. You have to re-learn how to walk and “wake up” the quads, glutes and hamstring muscles. You had the surgery in the hopes of a normal life going forward with your new knee joint.

If you can, get the X10 machine. For me it was a great supplement to my therapy, and it helped transition me to the next level in a short period of time and with little discomfort. I don’t think I would have gotten so far so fast without it.

Don’t give up mentally or physically. It is not an overnight process. It will take time and you have to have patience and faith in yourself and your team.  Keep working at it and you will get to your happy ending.  I’m not completely there yet, but with continued hard work I know I will get there.  I have already overcome 100% of my worst post-surgery days. For now, I’m thrilled to be walking, dancing, swimming, biking, and gymming. And I look forward to many more milestones.

Thank you X10 and Team!!!

Every day will present you with a new challenge, especially at the beginning. You will wake up with pains and stiffness, and you’ll curse the day you had the surgery. It is up to you to rise up to the challenge.  At first it will be painful, it will be difficult, but with hard work and a positive attitude, you will get through it. Just when you think you can’t go any further, you keep pushing forward and within a few days (maybe even a week), you will see your hard work pay off. Get out of your head and stop telling yourself you can’t do it.  Even baby steps are steps in the right direction. The difficult and painful moments are only temporary.

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 ‘Dancing Two Months After Knee Replacement?’.

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 ([email protected])

Quick Summary

Donna reached out to X10 in the spring to talk about using the program for a single total knee replacement planned for later in the summer. She did some exploration on doing both knees at once and ultimately went in that direction. Donna discusses deciding on bilateral knee replacement and her recovery here.

One Highlight

This was one of the best decisions I’ve ever made ever. If I had known then everything that I was going to have to go through, everything that my family was going to have to go through, I would have thought harder about doing two knees at once from the beginning.

Favorite Quote

“When I go to physical therapy now the therapist is like, “Oh my goodness, you are our star patient,” because my flexion is at 120º and my extension is at 0º. I’m walking with a cane now instead of a walker. And they’re like, “We wish everybody could be like you.” So I feel successful.

Is this for you?

Listen to the podcast or read the text below if you are considering knee replacement and want to make sure you know about the latest recovery technology. The audio interview provides a very detailed explanation, from a patient’s perspective, about how the X10 can make quick work of a bilateral knee replacement recovery.

An interview with Donna Groce by PJ Ewing

Donna had bilateral total knee replacement surgery. What follows is an interview with Donna conducted by PJ Ewing from X10 Therapy.

My name is Donna. I live in Winston Salem, North Carolina. I am 65 years old. I have a son and a daughter and am a grandmother of four.  I have three granddaughters and one grandson ranging from ages nine down to three. They are the joys of my life.

I am a born-again Christian. Praise the Lord for watching over me, taking care of me during this process. He’s been so good to me. That’s probably my number one praise, and I think that’s why I’ve been able to do as well as I have.

I’m exactly four weeks out from bilateral surgery, four weeks ago today. I was in the hospital for four days and came straight home. I am doing wonderfully, wonderfully well. I have been able to rest and relax, do some things that I’ve been wanting to do. I’ve done a lot of reading in the last four weeks, a lot of studying and things like that I don’t usually have time for.

This has kind of slowed me down somewhat and giving me a little bit of personal time to do some things that I wanted to do. I am very thankful for that. So even though it has been quite a journey so far, not being completely pain-free, but it’s not been an unhappy or bad journey, that’s for sure. And I’m super-glad that I’m four weeks on this side of the journey instead of four weeks on the other side.

Life was very painful. I had two really bad knees, bone-on-bone, both of them. One was a little worse than the other. I had meniscus tears in both knees, arthritis in both knees. Every step I took was a jolt of pain. I endured it for probably two years. It gradually got worse and worse. I have done everything possible that I could have done leading up to the surgery. I’ve had physical therapy. I did cortisone shots, two different sessions of the gel injections, everything that I could to prevent having surgery.

Finally, it just got so bad the doctor said, ‘you just have no other choice. You’re going to have to live with this pain, or you’re going to have to have it replaced.’ At the time I was only going to do my left knee, which was a little bit worse. I went into all the preparations. At the very last minute, I decided to do both at the same time and get it over with.

I had done a lot of research. I’ve done a lot of reading about the surgery, about what was going to happen, about the recovery, and about the physical therapy. I am not the type of person that likes to go into something without my eyes being wide open. So, I knew that there were things that I needed to plan for. There were things that I needed to do ahead of time.

Actually, this is kind of funny. You, PJ, were the first one that mentioned to me that maybe I should look at bilateral surgery instead of just doing one. It was in a conversation that you and I were having one time. You said, ‘well, have you ever thought about doing both knees at once?’

It kind of opened my eyes a little bit because I never had even thought about it. And, I said, no, not really. But after we hung up I talked to my husband about it and I thought, ‘Man, what do you think about this?’

I realized that it would make a difference. I would need more help, I wouldn’t have a good leg to stand on, so to speak. I did a little bit more research on the bilateral process. Fortunately, I had the perfect situation as far as coming home after the hospital. My mom lived with us for 10 years before she passed away earlier this year. My husband made her an apartment downstairs on the ground level of our home. So everything was already set up. We have a handicapped bathroom and a bedroom and a little kitchen all on the ground floor.

Then I went to the doctor for my pre-op visit. I told the PA that I was speaking with that I want to do both legs. And he quite frankly said, ‘No, we won’t do that.’ And I said, ‘well, I want to do both legs. I want to get it over with.’ And he said, ‘well, your surgeon will not do that. He doesn’t do both legs at the same time.’ And so I just said, ‘well, if I have to change surgeons, if I have to change practices, I want to do both legs at one time. I want to get it over with and do what I need to do and be well and not have to repeat the process in six months or a year.’

So at the very last minute, the week before my surgery was scheduled, I switched surgeons. People told me I was crazy, but it’s what I wanted to do. I had prayed about it and I had peace about it and I’m looking back now, would not change it for anything. I know it was the right decision.

When the PA told me at my pre-op visit that my original surgeon would not do two knees, he said, ‘let me speak to one of the other doctors here in the practice. We really normally don’t do two knees at one time, but let me speak with him.’ So he went and spoke with Dr. Calvin Maxwell McCabe. Dr. McCabe looked at my history. Fortunately, praise the Lord I am, other than arthritic knees, very healthy. I am not diabetic. I don’t have problems with my blood pressure, my sugar. I don’t have anything else wrong with me other than my knees. So Dr. McCabe took a look at everything and said, ‘yes, I’ll do both knees for her.’

I actually only met him the Friday before. He did my surgery on Monday.

He was wonderfully patient. He explained why he chose to do both knees when it’s something that they normally don’t do within their practice. He said, ‘the only reason that I’m going to do your surgery is that you are as healthy as you are’. I felt quite confident with him.

One of the maybe more humorous things is that my sister-in-law actually works for that practice. She was on vacation and I called her and said, ‘are you sitting down?’ And she said, ‘Oh my goodness, yes.’ And I said, ‘I just talked to Dr. McCabe and we’re going to do both of my knees Monday morning.’ And she’s like, ‘have you lost your mind?’

I left the office that day. after speaking with a PA but before talking to Dr. McCabe. By the time I got home, which was a 20-minute drive, they had already switched my surgery date to two weeks later so they could be on Dr. McCabe’s schedule. All my physical therapy already switched all of my other appointments. They took care of everything for me before I could even get home.

I’m telling you they were phenomenal and have been ever since. I can’t say enough about the care I’ve gotten from them. His physician’s assistant, oh my goodness, phenomenal. Her name is Laura. She came to the hospital several times. I have absolutely no complaints, none whatsoever. I couldn’t have asked for anything any better.

He did my left knee first, which was supposedly my bad knee. He told my husband after the surgery was over, ‘I am so glad she decided to do this because her right knee was just as bad as her left, if not worse.’ He said, had I not done both knees I would have had more problems with the other knee, possibly affecting my hip and my ankle. It could have done a lot of damage. And then we’re talking about other surgeries down the road. In the x-rays, my right knee did not look as bad as my left knee did. He said so. But when he got into the knee, it was as bad if not worse than the other.

Well, praise the Lord. I made the right decision.

Yes, definitely. When we spoke that day, you said to me, now, don’t take my word for it. Let me get you hooked up with this bilateral knee group, and you did that same day. And, oh my goodness, I’ve read everything there since then. It’s been so very helpful. And I hope that the comments that I’ve made there make sense about my surgery, I hope that I’ve been able to help somebody else. When people go on there, pre-surgery, they’re nervous and they’re afraid and don’t know what to expect. And it just so very helpful to have somebody say, okay, I’m a week out or two weeks out or six months out or whatever… and this has been my journey. It’s just been so very helpful to have had somebody literally walk in my shoes.

The people there have gone through what you’re getting ready to go through. I think this gives you the peace and calmness that you need knowing that they’ve gone through this. They’re doing well. They got past this. This thing helped them. This other thing didn’t help them. Maybe I should do that. It was just so very helpful, and it still is helpful. I check it four or five times a day.

My recovery has been really good. I’ll just start that way. Of course, not pain-free, but pain-manageable. I was in the hospital for four days; a wonderful hospital, by the way, Clemmons Hospital here in Winston Salem, North Carolina. And I felt like I was in a four-star hotel. They took such great care of me.

They kept my pain under control, kept me comfortable. Of course, I had two Iceman machines constantly going. The nurses and the doctors there were phenomenal. I felt like the queen of England or something.

I came home to the perfect setting, on a Thursday with all kinds of medicine. I had pain medicine, an iron supplement, nerve medicine, so my surgeon kept me quite comfortable. I wasn’t pain-free. I don’t want to give anybody false hope that you can do something like this and not have any pain. But it was quite manageable. On Friday morning, David delivered my wonderful X10 machine and set it up for me, educated my husband and me on how to use it and what to do. I got on the machine immediately that day and started using it. I used it two to three times a day.

It really helped with my flexion and extension, and it was completely pain-free. It felt really good to be able to move my legs like that. I had a friend that stayed with me, to give my husband, some relief from the 24/7 care that I needed. She stayed the first couple of nights here with us. And, my wonderful church family has been delivering meals to us every other day since I’ve been home. So that’s another blessing. Dr. McCabe had physical therapy come here to me for the first two weeks and then I started going outside for physical therapy. So I’ve done my X10 machine, my physical therapy, and the exercises that they have given me.

X10 sent me a lot of information about exercises to do. I’ve tried to keep up with doing all that. I think that’s one of the reasons why I’ve done so well. Movement is so very important. After you get home, you have a tendency to want to sit or stay in bed, but you’ve got to get up and move your legs. And I have done that. So when I go to physical therapy now the therapist is like, “Oh my goodness, you are our star patient,” because my flexion is at 120º and my extension is at 0º. I’m walking with a cane now instead of a walker. And they’re like, “We wish everybody could be like you.” So I feel successful, yeah.

I give the praise to the Lord, that’s for sure.

Yes, I did. She is such a joy. Oh my goodness. We had the best conversations. She would call to check on me and find out how I was doing. She would look at my results on the machine and things like that. And then we would end up staying on the phone for an hour just talking to each other. Yeah, I feel like I’ve got new friends. She and David are jewels.

So I’m very, very involved in my church, doing different activities, I work with our children at church. I work in a hospice ministry where we deliver food to hospice. My husband used to say to me, ‘Donna, you are going to have to slow down.’ But I have slowed down. These four weeks have been slow. So like I say, I’ve been able to do a lot of reading. I’ve been able to get into my Bible and do some Bible studies that I was really interested in that I hadn’t had time to do before.

I’m not doing steps yet. I haven’t gone upstairs yet. They’re not allowing me to do steps. I do walk without my cane, as long as I have something to hold onto or as long as I’m close to something. I’m being very careful. The last thing I want to do is following through with any damage, but I am practicing walking on my own. So, I do have a ways to go. When I go to physical therapy now, we’re working on my walking and my gait. I do strengthening work at physical therapy and at home. I have a band now and several exercises that I do. Before I get up I do exercises in the bed, and once I get up and I do exercises in the chair. And then I’ll walk. It keeps me busy.

Christmas is my goal. I realized it is a slow process. I do kind of push myself sometimes and I have over-done it and have paid for it a couple of times. I just had to back off for a day or two. The reality is that this is not a quick process. It is going to take time This time next year when I look back and I’m completely recovered and completely myself again, I’m going to look back on it as a year-long experience.

This was one of the best decisions I’ve ever made ever. As much as I say I researched it and had decided to do one knee, I think going back and doing the other knee would have been difficult. If I had known then everything that I was going to have to go through, everything that my family was going to have to go through I would have thought harder about doing two knees at once from the beginning.

This has not been just Donna’s journey, this has been my family’s journey. It’s taken time and effort on their part, and willingness to come and help me. So, I’m glad that I don’t have to put them through that again. We’re past that.

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 ‘Deciding on Bilateral 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.

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.

We share below excerpts from an interview with Kathie Delgado about her knee replacement and eventual recovery. It was when Kathie’s insurance company cancelled knee rehab due to poor results that she knew she had to take matters into her own hands.

After four and a half months of physical therapy, nine days on the X10 and I got to 130 degrees.

My name is Kathy. I’m 64 years old and I had a total knee replacement. Right now I am about five months out from my surgery. I expected to be the wonder woman of recovery and unfortunately that turned out not to be the case. In spite of my best efforts I actually endured 38 outpatient physical therapy sessions.

I would work as hard as I could and endure the pain to the point where I would literally cry. It sounds gross, but sometimes I literally actually vomited just from the pain of pulling on my leg. I gave it the best effort possible, but after a while it became really plain to me that what we were doing was not working and in fact, my insurance company agreed and decided that it was not efficacious to continue outpatient physical therapy.

I also knew that I was just literally going to have an emotional breakdown if I had to continue doing what I was doing. I said to myself, I sure hope my left leg holds out because I am never going to do this again because it was honestly the most awful experience of my life. And not because of the pain, cause you expect the pain, but because of the debilitation, the loss of independence. And then in my case when I got stuck, the lack of hope and the frustration.

It’s at that point that I decided I needed to look for something different. I came across a testimonial. Someone had done this thing called the X10 and then once I had that word, the X10, X10 Therapy, then a whole world came tumbling open to me. And I realized it was a real thing. And I realized that it was helping people. It ignited something in me which had been lacking for a long time, which was hope that there was something that could help me.

Get your questions answered now. We have assembled a full library of resources for you. It’s free and recently updated. And we have carefully curated the content to make sure that the information is updated and of the highest provenance. Links, surgeon reports, patients accounts, research studies. We have the best thinking in knee surgery and recovery for you to read. Click here or on the picture to visit the Knee Library.

I was very comfortable. I actually felt like crying as I was sitting there on the machine because I knew that the hope I felt when I first discovered the X10 website wasn’t false hope.

One of the most important things is that the X10 comes with a whole team of professionals who are very much like family to you. And they watch over your progress because the technology of this machine is so amazing that it sends your progress directly to them. It’s hard to believe if you haven’t experienced it, that there could be such a difference in such a short time.

Four and a half months of pain and suffering, and in nine days I feel like myself again.

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 how Katie’s Insurance Company Cancelled Knee Rehab.

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.

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.

In this episode, we discuss knee surgery recovery and the role of physical therapy in optimizing outcomes. We challenge the “no pain, no gain” notion, emphasizing the importance of understanding the body’s responses to injury. Through real-life experiences like Luis’s journey with innovative technology, we highlight the benefits of personalized rehabilitation methods focusing on comfort and gradual progress. By advocating for a balanced and individualized approach to knee surgery recovery, we aim to promote sustainable healing and improved outcomes for patients undergoing physical therapy.

I have been in physical therapy all my life, and I have treated a lot of knee patients particularly over the last few years. In the physical therapy world it is not uncommon for the P.T. abbreviation, which is supposed to stand for Physical Therapy, to also be referred to as Pain and Torture. Unfortunately this is a very common reference for those who have gone through a total knee replacement. But is the “no pain no gain” approach really the best? I explore the possibility of no rehab pain more gain in this article.

There are a couple very important things to consider during this difficult recovery. While range of motion is the immediate focus, there are some barriers to achieving this goal. There are several reasons that range of motion can be limited. In this podcast I discuss the variables that can be directly affected by your therapy sessions. Click the Play Button above to listen to the full article.

Reflecting on the benefits of a “no rehab pain, more gain” approach, I advocate for a personalized and communicative relationship between patients and therapists to tailor rehabilitation strategies to individual needs. Emphasizing the importance of balancing persistence with tolerance in physical therapy, I encourage listeners to consider a holistic approach to knee surgery recovery that prioritizes comfort, steady progress, and open dialogue with healthcare providers.

To subscribe to The Bee’s Knees Podcast click here: The Bee’s Knees

We all want to (wink wink) BE LIKE MIKE. An interview with Mike Kranis six years after knee replacement surgery.

We share today a chat with Mike Kranis about his inspiring journey from knee replacement surgery to becoming an avid hiker. Mike shares his experiences with knee troubles from basketball, the challenges of recovery, and how the X10 Knee Recovery System™ helped him achieve a remarkable 130-degree knee flexion. His story emphasizes that knee replacement can open new avenues for an active lifestyle. We discuss the importance of resilience, effective rehabilitation, and the adventures that await post-surgery.

Mike Kranis

Hi, this is PJ Ewing. I interviewed Mike Kranis for the Bee’s Knees Podcast in the summer of 2024. Mike had a total knee replacement in 2018, and lives an incredibly active life today.

Mike Kranis is a remarkable individual whose journey from knee replacement surgery to peak physical performance exemplifies the potential for recovery after such a transformative procedure. I aim to shed light on real-life experiences that inspire listeners who may be facing similar challenges. This episode strays from the ordinary discussions of knee surgery, focusing instead on remarkable success stories that defy expectations and redefine recovery.

Mike, a retired postal worker turned avid hiker, shares his compelling narrative that began decades ago with a series of knee troubles resulting from a love of basketball. Despite undergoing multiple knee surgeries throughout his life, including a crucial knee replacement in January 2018, Mike’s journey took a pivotal turn when he decided to embrace hiking fully. Transitioning from basketball to a hiking enthusiast, he recounts how his passion for the outdoors led him to become a hike leader within his local county park system and expand his adventures to trails around the Appalachian Mountains.

Throughout our conversation, Mike recounts various challenges faced during his recovery process. He candidly describes the initial struggle of limited mobility and the emotional toll it took on him, particularly when he was unable to achieve proper flexion in his knee. After undergoing a manipulation under anesthesia, he came across the X10 Knee Recovery System™. This innovative tool played an instrumental role in his recovery, allowing him to regain strength and mobility that many after knee replacement surgery find elusive. Thanks to this adaptation as well as his relentless spirit, Mike has achieved a flexion of 130 degrees, an impressive milestone that showcases the effectiveness of focused rehabilitation.

We delve deep into Mike’s ongoing adventures since his surgery, which are nothing short of extraordinary. He recounts tales of breathtaking hikes in the Catskills, ascending towering mountains like Hunter, and even traversing 27 miles during the Great Saunter in New York City. His Instagram-worthy adventures don’t stop there—he shares experiences from international hikes, including climbing the Duomo in Florence, traversing the Galapagos, and his upcoming fourth trip to Iceland. His story illustrates not only the physical achievements he has made but also the emotional highs that come from immersing oneself in nature and exploring new landscapes.

Moreover, we address the broader implications of his story. Mike’s journey is a testament to the belief that knee replacement does not mark the end of an active life but rather opens the door to new possibilities. His determination to remain active, combined with the support of effective rehabilitation technologies and a dedicated exercise regimen, positions him as a beacon of hope for others navigating their recovery. The very act of hiking has become Mike’s way of life, emphasizing the importance of strength maintenance as one ages—a critical component in ensuring lifelong health.

Join us for this inspiring episode that emphasizes resilience, the power of modern rehabilitation, and the endless adventures life has to offer even after major surgical interventions. Mike Kranis’s journey is proof that with determination, the right tools, and a supportive community, one can indeed reclaim an active and fulfilling life post-surgery.

After a total knee replacement, your body will go through several different stages of healing. One of those stages is the inflammatory response, the first step of tissue repair in which your body sends extra cells to help repair and protect the area. As you continue to heal, you will go through the proliferation phase (the rebuilding phase) and then the maturation phase (the final stage of remodeling). Unfortunately, this process doesn’t always go to plan. You may experience an increase in inflammation, and/or a hematoma (a collection of blood under your skin), both of which can restrict motion and hinder the repair process of your body and cause an increase in pain, spasms and atrophy. Your body will try to limit how much pain you experience, which results in protective muscle spasms, or muscle guarding.”

A protective muscle spasm happens when trauma is induced in the muscle. It is an involuntary contraction of the muscle fibers intended to protect and splint the area of trauma. The body is locking down the area to lessen the chance of re-injury.

For example, if you burn your hand your body will involuntarily contract your bicep to take your hand away from the fire or thing that elicited trauma.

If you’ve had trauma to part of your quad muscle of your thigh following surgery, you may have muscle guarding in other parts of your quad (remember the quad is a group of 4 muscles), or your body may even contract other muscles in the area including your hip flexors or hamstring.

In theory, protective muscle spasms are a good thing. Your body is trying to protect the injury so that you do not injure yourself further. However, after a total knee replacement, protective muscle spasms often cause pain, which can impede necessary gains of range of motion, cause loss of function, and muscle atrophy. The protective muscle spasms cause more pain, which then produces more spasms, which in fact will cause more pain – and we have a vicious cycle. Getting rid of muscle spasms as soon as possible will help prevent further these negative consequences (decreased ROM, loss of function, muscle atrophy).

The muscle spasm is caused by direct trauma (over pushing the knee into pain), decreasing oxygen available to the muscle. This initiates secondary cell death, as well as neurological dysfunction. As muscle tissue is disrupted, your nerve fibers get disrupted. And that means they are not firing the way they should. They no longer sense the environment the way they should when not injured.

So the body goes on lockdown through the use of the muscle spasm. While helpful in protecting the muscle, this process causes new issues. Spasms stimulate mechanical and chemical pain receptors and stimulate pain. The more pain we have, the more we’re going to spasm. The more spasm we have, the more pain we’re going to have.

Eventually we must start moving this body part to get to normal function. Moving the is also crucial to achieve normal lymphatic drainage… that’s why PT’s like you to do ankle pumping and passive motion. If we experience excessive muscle spasming, that drainage is just not going to happen. We cannot allow muscle spasm to hinder this essential process. We need to get rid of that spasm as soon as possible. 

What do the PT’s do? If you have a spasm challenge, your PT team might put you in an ankle brace, a cast, or on crutches. Of course this gets in the way of a good recovery. Any knee recovery program is supposed to advance you from passive to active motion, and then to strengthening. If you cannot get to these recovery stages soon enough, if the spasms continues too long and you cannot push your muscles into proper movement, the result is muscle atrophy and weakness.

Muscle Atrophy. If you muscles becomes atrophied and weak, your PT really can’t start rehab. You have to go back and re-strengthen that muscle first. 

Inflammation. Edema and inflammation end up stimulating the golgi tendon organs (GTO)*. so they feel the inflammation (it feels pressure from the edema) and that tells the body to try to relax and that this tissue shouldn’t move.

Muscle Atrophy as a Condition

We get this increased rate of atrophy when we’re not using a muscle. When we don’t use a muscle, it can lead to reflex inhibition which means that it can actually shut down our reflex function. Additionally there is a condition we call Arthrogenic Muscle Inhibition (AMI) which is a presynaptic reflex inhibition. This too gets in the way of proper muscle response.

As swelling sits in the joint, it interferes with how the motor neurons of these muscles (that cross the joint) are recruited, which also leads to atrophy. Swelling hinders the rehabilitation process by delaying strength gains. It interrupts joint proprioception. That’s why we do all these balance activities after a lower extremity injury. We want the tissue to know where it is in space so that it doesn’t injure itself anymore. But if there’s a lot of swelling in there, it puts artificial pressure on those receptors and it can’t sense position anymore and they become disused. And then we’re at a bigger risk of injury because now we’re more likely to put ourselves in positions where we can be injured again.

And – if you read between the lines – this is the opposite of “no pain no gain.” You do not need to go into pain to make yours a highly successful recovery from knee surgery.

The X10 Knee Recovery System™ completely negates a protective muscle spasm. 100%. Patients relax immediately and their muscles ease up and they make progress daily. We have solved this condition. If you are experiencing guarding… reach out to one of our specialists.

Bruce (Avoid MUA) – In the end Bruce blew away his goals… getting to 126º range of motion. He was able to avoid a third MUA… and then some. In his own words you can see Bruce approached this knee bending problem like he approaches life… with perseverance and hard work… the result being success! Watch our brief interview  to learn more about Bruce’s journey. – Read More

Kathy (Avoid MUA) – I decided I needed to look for something different. I came across a testimonial. Someone had done this thing called the X10.  It avoids painful physical therapy. Then a whole world came tumbling open to me. And I realized it was a real thing. And I realized that it was helping people. It ignited something in me which had been lacking for a long time, which was hope that there was something that could help me.- Read More

Jeanie (Avoid MUA) – Just two more weeks. That is all she asked for. Before agreeing to go ahead with a return trip to the hospital, more anesthesia, swelling, pain and a new round of rehab Jeanie wanted to solve this problem on her own. In the end she found the X10 which came with a great remote coach and, finally, hope. In two weeks… no MUA… click the picture to watch Jeanie’s story. – Read More

Christine (Avoid MUA)  – At six weeks post surgery Dr. Scott and Christine’s favorite physical therapist were talking about a Manipulation Under Anesthesia. The CPM had failed in helping with range of motion. P.T. was getting nowhere. The clock was ticking. Learn how Christine avoided an MUA in just a few weeks by clicking on the picture here. – Read More

Nancy (After MUA) – Depression. Frustration. Tears. The CPM machine had failed to help. The Biodex machine caused excruciating pain. The physical therapist (who was doing his best to be caring) pushed Nancy so hard, she had to “vocalize” her discomfort to the alarm of everyone in the facility. She promised herself that after the Manipulation Under Anesthesia things would be different. – Read More

Carol (After MUA) – Both of my knees were injured on 9/11. I was crushed in Tower Two when it collapsed. I had immediate surgeries, right after 9/11. And then with all the other surgeries and injuries, I was in a process of recovery for a very long time. In fact, I’m still in the process of physical recovery from 9/11. I have neck injuries, back injuries, knees, shoulder, and foot. This knee is a 9/11 injury that I’ve just been dealing with over the years. – Read More

Allen (After MUA) – Allen avoided painful physical therapy. Allen’s surgery by Dr. McLawhorn at HSS was spot on. No problem there. It was just the nature of his physiology that derailed his recovery after total knee surgery. But even after the MUA Allen was still stuck in the 70’s… at least in terms of his range of motion. He needed some help to make this knee surgery a success. – Read More

Robert (After MUA) – Unlucky. A dirty needle on a routine Cortisone shot. And then a three hour surgery to remove infection, a difficult rehab that ended up failing, and then a Knee Manipulation Under Anesthesia. Yet, you just get the feeling that Bob smiled his way through all of this… at least you will once you watch this interview. You will cheer for Bob like we did… and we were the ones who worked with him after that MUA to get him well and back to the sports he loves. – Read More

One of the great recovery stories in our 12 year history at X10. Nancy’s sister, Stacey, spent 12 hours online searching for a solution to Nancy’s sticky knee. Why, you may ask. Why not trust traditional PT? Why not leave this to the professionals? The answer is poignantly described in the video here. A sister in trouble… and a sister to the rescue; her recovery after knee manipulation.

It took Nancy 13 days to get well. Without the Biodex machine at the clinic. Without a physical therapist. Nancy followed our program, worked daily with her X10 Patient Recovery Coach, dedicated herself to her recovery.

We received a call one year after this inspiring recovery from Nancy. All of 45 seconds on a voice mail. “Hi PJ, I am doing great. In September I bought a Fitbit to track my steps. I can report to you that in the past 6 months I have walked 120 miles with my puppy dog. I am all good… thanks to you and the X10.”

Nancy is like so many X10 patients: a person in need who is just not getting there with P.T. Stacey and Nancy’s story may be inspiring to you… but we can report that she inspires our whole organization each and every day. We are on a mission to help all the “Nancy’s” out there with our X10 program.

An interview with Ron about knee surgery recovery using the X10. As published on The Bee’s Knees Podcast with Mary Elliott.

Ron was able to have both knee replacement surgeries done within three months of one another. He felt so confident and happy about the results and his experience with his first knee that he was enthusiastic to have his second knee replacement done. His results were fantastic! Ron was able to achieve a range of motion of 0/128 degrees within three and a half weeks post-surgery.

With his second knee, he achieved a range of motion of 1/124 within 20 days!! Needless to say, he is very happy and shares with us what worked so well for him in the podcast we recorded together.  

Ron explains in this 28-minute podcast episode what the challenges were and how the X10 solved the problems. A great listen for anyone facing a difficult knee surgery recovery.

Now in its fourth year, you can listen to the Bee’s Knees Podcast on any and all podcast platforms. 

Our big thanks to Ron for granting us an interview.

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 ‘Double TKA | Knee Recovery Done Right’.

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 ([email protected])