Surgery and Massage: A Focus on Total Knee Replacement

Healing from a Total Knee Replacement (TKR) is a demanding process that requires patience, discipline, and professional post-op care. It can be a grueling journey that extends far beyond the operating room.

Recovery from a knee replacement is a long-term endeavor; while basic mobility returns within a few weeks, achieving 85% to 90% recovery often takes 3 to 4 months, with full healing spanning up to a year or more.

Many patients report lingering symptoms that can persist for months or even years. The good news is a well-trained massage therapist can address pain, muscle stiffness, swelling, and sensory changes.  

Stiffness

Range of motion both flexion (bending) and full extension (straightening) is the primary focus of your physical therapy and the measure of your recovery process. But what attention is given to the muscles that are doing the bending and straightening?

The quadricep muscles on the upper thigh attach at the kneecap and are significantly impacted during surgery. Quads can lose up to 60% of strength and function after surgery. The hamstrings, the large muscles on the back of the upper leg, can shorten and become excessively tight to compensate for weakness in the quads, making it difficult to fully straighten your leg. Massage improves range of motion efforts by working directly on the muscles in the upper leg to reduce hypertonicity (excessive stiffness), increase circulation thereby restoring tissue damage, and improve overall leg function.

Improved muscle function leads to restoration of gait mechanics which leads to the confidence you need to resume living your best life!

Sensory Changes

Nerve damage after TKR can cause numbness, burning, tingling or heightened sensitivity to touch (clothes or sheets rubbing the area). Small sensory nerves are severed and larger nerves can be inadvertently stretched or compressed during surgery. Inflammation and scar tissue can cause further nerve irritation. Massage therapists trained in myofascial techniques and scar tissue release can permanently reduce nerve-related numbness and irritability. Scar tissue release also improves fascial glide significantly aiding range of motion and lymphatic flow.

Swelling

Swelling after a Total Knee Replacement (TKR) is a completely natural part of the body's inflammatory response and usually peaks in the first few weeks, though mild swelling can last for up to six months. Lymphatic drainage clears metabolic waste, reduces inflammation, and increases positive immune response.

Common Questions

When should I begin massage therapy after surgery? As soon as possible. Why wait?

Should I complete PT first and then do massage? No. PTs are solely focused on range of motion and exercise, which are important. But the leg also benefits from soft tissue massage, scar tissue release, and lymphatic drainage provided by a massage therapist.

How often should I receive therapy? In the beginning, every week or two is recommended. Tapering off to once monthly as you progress.

I’ve told my doctor I’m still in pain, they ordered an Xray and say everything looks fine. Is my case hopeless? The body can heal at any stage of recovery. If you feel your recovery has stalled, do not give up. You can experience greater ease and less pain and regain your confidence.

My surgery was a long time ago, is it too late to make a difference? Never. It is never too late to soften and lengthen muscles or release scar tissue. I’ve even worked on 35-year-old scars with great success!!  

Are these therapies - massage, scar tissue release, and lymphatic drainage beneficial for other types of surgery? Absolutely. My clients present with back and neck surgery, hand and foot surgery, c-section, elective surgery, and breast cancer related surgeries.

“After my knee replacement surgery, I experienced constant discomfort that kept me from sleeping for more than 2½ months. Within just a few sessions, I noticed a remarkable improvement. My knee began to heal, the discomfort decreased, and—for the first time in months—I was finally able to sleep through the night.

I am incredibly grateful for Megan's expertise, compassion, and the positive impact her therapy has had on my recovery. I highly recommend her to anyone struggling with surgical related pain or healing.”

Monica L.