How to Treat "Stiff Knee Syndrome" (after Total Knee Replacement Surgery)
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- Опубліковано 10 лип 2023
- In a previous video, I discussed how to avoid developing "Stiff Knee Syndrome" after Total Knee Replacement (TKR) surgery.
But then this question was asked: "What if I'm already developing Stiff Knee Syndrome after surgery. What should I do then?"
In response to that excellent question, I made this video, which includes 7 pieces of advice:
1). Aggressive stretching
2). Aggressive/skilled manual therapy (including taping techniques)
3). Reduce swelling - lymphedema treatment/compression
4). Aquatic therapy if able
5). Cold water therapy
6). Take your pain medications and natural anti-inflammatories (if able, talk to your doctor and/or pharmacist)
7). Determine early if you need an MUA
My overall message in the video is that if you're recovering from TKR surgery are starting to develop Stiff Knee Syndrome, you should utilize as many of these strategies at the SAME TIME to improve your chances for achieving full range of motion in your knee.
In other words, throw the whole "kitchen sink" at the problem!
I hope this video helps you make a full recovery from your total knee surgery!
Please leave a friendly comment below the video before you go :-)
- Luke Gordon, DPT
Doctor of Physical Therapy/Owner of Gordon Physical Therapy
www.gordonphysicaltherapy.com...
This is all well and good, but in my experience I have overdone my physiotherapy and stretches and this has led to 2 set backs and lots of swelling and days to recover … there’s a fine line! Good luck everyone!
Yes, it's definitely a fine line! Rule number one right after surgery is to keep the swelling as low as you can. This makes your stretches much easier. Good luck!
Same! Tried bike riding at 8 weeks post broken knee. Was told to push through the pain. All it did was cause inflammation taking days to recover
I think I'm in the same position. I was doing well by week 2 but since then (its now 5 weeks), I've been in awful pain with stabbing pains around the knee cap and very bad opinion around the ankle. I've come to the conclusion that its best to give the exercises a break for 2 days and see if it improves. I've been walking up stairs but not stretching. The pain's just unbearable.
@@effigy8620 Same here, physiotherapist are not always right.
Great additional info. Thank you!
Thank you for this great information, Luke. I’m one month post op, so your mentions of goals at specific months out was helpful. I’m taking all of this to heart. God bless you!
You're quite welcome! Good luck with the rest of your rehab!
There was no babble! It was a nice approach .. very conversational squeezing a lot of information into a short video!!
Why thank you! I appreciate your kind words :-)
Can I ask u the tisks with me being 67 with osteoporosis that the MUA could crack my tibea or cause a fracture since my bone density is so brittle? IM only at 50% week 4:(.. feels like a belt is tied around my knee so they are proposing MUA very soon!
Had TKR and then got infection in my incision , a risk because I have a blood cancer. Then had to have MUA and was doing fair to good. I then got Covid ! My Covid relapsed and I was very sick for weeks. I got out of the habit of going to PT and haven't returned yet because of fear of the pain to gain progress again. I thought I could do it myself but I now know I can't. My cancer has complicated my surgery and recovery, Covid recovery and even a sinus infection. I'm now 4 months out and I feel so discouraged. I'm supposed to have other knee done but I'm scared to death to even think of it. I'm overwhelmed at this point.
I'm sorry to hear about your unfortunate turn of events! I hope you can get things moving in the right direction again!
At this point can it even be turned around?@@GordonPhysicalTherapy
I appreciate the recap. I'm 4 weeks post-op and was doing quite well, but had a bit of setback with some slight bleeding last week so stopped most exercises, painful getting them going again. good flexion and strength but less than I had before the bleeding
thank you great advice
I think you’re very natural and genuine.. you speak to us not at us.. I appreciate your candor too! Thank you.. for the holistic suggestions! How about MUA with a 67 year old osteoporosis lady? I don’t want my tibia to crack? My thigh is so bruised still that has nothing to do with the kner that results in pain if he decides to use hands to push my knee!! They are suggesting MUA AT 4 weeks at 50 %.. it feels as if there’s a tight rubber band around the lower half of my knee, and across the top that prevents me from bending it at all…
Thank you again for your kind words! If you have osteoporosis, I would just make sure your surgeon knows so they can give you their opinion on the level of risk. With any luck, the bone density in your tibia and femur is still high (compared to other areas that can be weaker, like the neck of the femur). Also, MUAs aren't as aggressive as you might think. When you're completely under anesthesia, you can't guard your leg, so most of the time the surgeon doesn't have to really be that forceful with your knee.
Bottom line: talk to your surgeon about your concerns and make the best decision you can. I hope that helps! Let me know how things work out for you :-)
Since I wrote this comment, it has been several weeks and we are only getting a little range of motion which is concerning… But I think it will come… My muscles are restricting my bend ability..and they say they’re just super tight… My question to you is what do you think of removing scar tissue with arthroscopy? Thanks so much!
Thank you!!
You are correct about PT’s not wanting to massage
Yes, many PTs are pretty hands-off when it comes to TKR rehab, which is too bad.
Thank you
You're welcome!
Great ideas. I’m 2 years out of tKR. I’ve had MUA at 6 weeks and surgery to get rid of scar tissue at 18 months. Still very stiff and sore. My knee looks beautiful and perfect in an X-ray. I would give anything to be able to ride my bike again. I just tell myself…at least you can walk.
I hope you can continue to gain flexibility! Have you tried aquatic therapy yet?
@@GordonPhysicalTherapy I wish that would’ve been tried. Our PT office does have a pool but was never suggested to me. I had aggressive, daily PT after my manipulation and also after they scoped the new knee but aquatic was never suggested. Thank you for your input.
@@GordonPhysicalTherapy I wish that would’ve been tried. Our PT office does have a pool but was never suggested to me. I had aggressive, daily PT after my manipulation and also after they scoped the new knee but aquatic was never suggested. Thank you for your input.
Hey, My mother experienced the same thing as you, can you bend your knees when you are MUA?
Hang in there! I swear it was 3 years before I could ride a bike. The scar tissue ground so bad, but eventually I could, and the more I did the less it bothered me.
I am year and half right Knee TKR, ortho surgeon said I have arthrofibrosis, mine ROM is good, extension is 0 and flexion 120. He said no need for invasive procedure to rid scar tissue. If do surgery to remove scar tissue, scar tissue will return. He said continue with PT, use ice and topical gel on knee. He said may take 2 to 3 years to resolve. I am frustrated and depressed. I hate walking with stiff knee. Any more advise? Thanks Gordon.
I'm sorry to hear that! Here's what I recommend: aggressive PT and stretching, scar tissue massage (such as IASTM/scraping) as well as cupping, and aquatic therapy if you can. If you're able to exercise in the pool, you should be able to really push your knee and work that scar tissue aggressively. I hope that helps!
Two months out and would like to stop taking the Tylenol and aspirin. Glad things are going well in my recovery. Felt that I needed to move around more to alleviate stiffness so I took one hour airplane trip out of town. Dr said I had no restrictions. All is well! m glad I took the trip was starting to feel malaise setting in😊
I am about six weeks out, was doing very well, but then had serious swelling in my leg. Celluitis was probably the culprit. Been sitting with leg elevated, head down, but still unable to get relief. Dr put me on antibiotics for ten days. Still have about three days to go. I want to see some improvement. I am 80 years old, so no spring chicken. I am still on oxy for pain meds.
May 20th will be 6 months ago I had my TKR, and my knee is very stiff. I was cut off pain meds at 3 wks. I'm almost 72 and it was torturous to me. I've had many setbacks. I was down in my back really bad, had a respiratory infection that was going around, had a flare up of gout, and now for the past 3 wks my ankles and feet are so swollen. I've started walking in my pool now and I'm up to 50 minutes, but when I get out , my knee is so stiff. The pool water is like ice water
I'm sorry to hear you're still having some pain and stiffness. Maybe you can find a PT clinic that does aquatic therapy (in warm water), as well as aggressive therapy on land. It might really help, even at 6 months out!
Thank you so much, this is my 5th knee surgery but 1st knee replacement . Never needed an MUA but now I feel I do . Had the surgery sept 28th and had to stay straight for 5 weeks, quad muscle need tighten. Is it too early to do a MUA? I am at 100-105 buts it’s to painful . Going to dr soon. 😊 😊
I would definitely check with your doctor about the MUA, especially since you had the quad tightening after surgery. I've never heard of that before... you'll have to let me know how it goes!
I had a complete knee op 8 years ago really great. But now I am getting a pain in knee at night. Keep taking pain killers
The same leg at the hip is a border line case for a new one.
Is there a connection ?
There could be a connection, yes, especially if your hip pain is affecting your walking pattern, which could affect the knee. I'd have a PT look you over if you can.
I’m 9 weeks out and just ended my pt. I’ve seemed to have kind of plateaued I have about 125/3 range of motion but the stiffness and swelling make it tough to do exercises. I’m going to be starting a gym that has aquatic and bike as I heard that will help. Are there certain exercises for the pool that you know of. Also my pt never even touched my knee except to check range off motion
Aquatic exercises should help quite a bit: this includes various types of walking, as well as deep water exercises (I don't have a video on them, sorry). Keep pushing your stretches as much as you can. Your PT should've helped reduce your swelling with hands-on therapy in my opinion, but you can't change that now. Keep going!
My knee replacement was done on my right knee twice the first one moved out of line so had to have it done again after 9 years. It’s been 2 years now after my second surgery and my left knee needs to be done but I’m not wanting to because my right still hurts both my legs hurt from my ankles to above my knees. I’ve tried the ymca pool going to the gym I’ve tried ice heat and meds nothing really helps so what else can I do
I'm sorry to hear that! I would highly recommend you try some type of anti-inflammatory diet to see if that helps. Something along the lines of "Paleo" or "Whole 30". If you want a 30-day program that can guide you through this, check out this website for more information: spokanevalleywellness.com/
I am in PT and my therapist is great but I have had a lot of issues with my muscles not loosening up and I had massive swelling that I fought for over a year before the surgery that is making it even harder. She is doing some things to try to loosen the knee, which are quite painful. I know it's necessary but how do I know if the pain I'm feeling isn't damage to a muscle? Because that's how it feels is as if I tore a meniscus that isn't there anymore. But I don't think my tears convince her of how much pain I'm in
It's pretty hard to damage the joint and the muscles surrounding the knee, although it can be very painful. If you're still dealing with a lot of swelling, I'd focus on getting rid of that. Lymphedema trained PTs (we call them CLTs) can be very helpful. And following an anti-inflammatory diet can reduce swelling very rapidly. This is a program I run in my clinic that is also offered throughout the country: spokanevalleywellness.com/
I've seen massive improvements in LE and abdominal swelling in the first 5-7 days!
Im 4 weeks after TKR..still swelling above the knee. I'm 65 years old and was very active before. It has been very frustrating not being able to bend fully. I've been doing everything you can think of. As soon as I walk or sit the swelling starts. Also in the morning before I get up the swelling is worse. I pump my feet and try to bend before getting up. I'm only at 8o degrees.
I will try the cold immersion
Also what is the name of the natural anti-inflammatory med.?
Hang in there! 4 weeks really isn't that far along yet, so the swelling is normal. I take Thorne circumin phytosome for inflammation.
I'm in my 2 1/2 month post op, I'm at 87° bend. I'm so worried about scar tissue. I do plan to do aquatic exercises soon. I really could use a great maasage to help relax my stiffness.
Any suggestions?
Aquatic therapy and a good massage sounds like a good start to me. And keep stretching as aggressively as you can, and working on reducing swelling and pain.
I have an update! My surgeon is disappointed with my current bend and stretch. He is suggesting an MUA.
What other natural anti-inflammatory herbs can I take?
I'm a big fan of circumin phytosome, as well as things like boswelia and bromelain
MY Dr. put in an inplant that was too big. I can barely walk now.
I'm sorry to hear that! Are you having another surgery to put in a better fit?
I’m on my going my 9th month and I still have stiffness and some swelling
Sorry to hear that! I hope you're able to get some improvement still.
25% into the video and just blablabla. Get on with it
Haha, thanks for the tip!