In this article, Paul Fath, PT will be discussing common causes for postoperative stiffness following total knee replacement and three tools you can use to help decrease stiffness so you can feel relief and move easier.
Why do I have muscle stiffness after my total knee replacement?
If you have ever gotten a good bump on the head, or known anyone who has, you can anticipate a nice lump to form in the spot that was hit. This swelling (inflammation) is our body’s natural healing response, where your body can send in the clean up crew to remove any debris and injured cells, followed by the construction crew to repair any areas of tissue damage. These “crews” travel through increased fluid causing less space in a specific area, resulting in increased discomfort and sometimes inhibits muscles from activating, both leading to the sensation of stiffness.
If we expand on the example above and discuss healing following your total knee replacement, our body responds in the same ways. The difference is that it’s a larger injury with more tissue to repair that needs to take place, from the skin to the bone. This recovery will take time and your recovery is a journey. In addition to the increased fluid in the area of your knee, your muscles may be inhibited and not be activating for a period of time following your surgery. If our muscles are not being used, the muscle fibers can shorten, also resulting in stiffness.
Another important consideration is to understand how our nervous system recovers following surgery. While you are under anesthesia and don’t feel anything during surgery, your nervous system remembers. Your body’s way of naturally protecting itself following an injury is to shorten the length of the muscles as a protective mechanism, resulting in stiffness.
Now that we have discussed some of the reasons postoperative muscle stiffness occurs, let’s take a closer look at some of the best ways to reduce your muscle stiffness.
How Can Myofascial Massage Help Decrease Postoperative Stiffness?
There are times where movement may be a little too uncomfortable. Most people commonly seem to have more stiffness in the mornings and at the end of days where you have been more active. During these times, some gentle self-massage can provide improved mobility and good relief in managing edema and muscle stiffness [1]. I have included some of my favorite tools below that can help provide relief to get you through those tough days.
What makes the Gaiam roller a great choice is its smaller profile and ability to use one hand versus both. Furthermore, this roller is made of stainless steel and made to provide cooling after placing the roller in the freezer. The roller provides cooling for up to 20-minutes. We already know that ice reduces swelling, so having a cooling effect combined with the benefits of soft tissue mobilization can deliver increased benefits. This is a great option, especially for those who are in the early postoperative stages.
The Tiger Tail massage stick roller has two handles and has a broad contact area, allowing for better control of pressure and puts you in the driver’s seat in determining how much pressure you want to apply. The uniform foam layer also makes for a comfortable contact in pressure management. This is also a great tool for higher levels of stiffness and sensitivity.
Lastly, the Body Back massage roller ball provides stability when holding the base in the palm of your hand and a smaller surface area allowing for deeper pressure over a smaller area. This is most effective for those in the later stages of healing where people have increased tolerance to pressure.
How Can Movement Help Decrease Postoperative Stiffness?
Active movement and exercise is one of the most effective ways to decrease and prevent significant muscle stiffness. Research supports the best overall approach is actually a combination of movement and manual therapy when compared to movement alone, following a total knee replacement [2]. Consider incorporating one of the rollers above for initial relief and follow up with getting up and walking for a few minutes frequently throughout the day as a way to improve your mobility and prevent further stiffness.
Cited References:
- Kim SM, Kim SR, Lee YK, Kim BR, Han EY. The effect of mechanical massage on early outcome after total knee arthroplasty: a pilot study. J Phys Ther Sci. 2015 Nov;27(11):3413-6. doi: 10.1589/jpts.27.3413. Epub 2015 Nov 30. PMID: 26696709; PMCID: PMC4681916.
- Karaborklu Argut S, Celik D, Kilicoglu OI. The Combination of Exercise and Manual Therapy Versus Exercise Alone in Total Knee Arthroplasty Rehabilitation: A Randomized Controlled Clinical Trial. PM R. 2020 Dec 22. doi: 10.1002/pmrj.12542. Epub ahead of print. PMID: 33352007.
About the Author
Paul Fath is a Doctor of Physical Therapy and a Board-Certified Clinical Specialist in Orthopaedics. His focus is in fall prevention, post-surgical care and rehabilitation of total knee replacement and rotator cuff repair surgery.
Paul earned his DPT from the University of Miami and completed his orthopaedic residency with the MGH Institute of Health Professions.
Hub Physical Therapy LLC delivers outpatient-level physical therapy in the comfort of your home. Contact your physician or other qualified healthcare provider with any questions you may have regarding a medical condition, medications, or precautions. If you think you may have a medical emergency, call your doctor or 911 immediately. Reliance on any information provided by Hub Physical Therapy LLC website is solely at your own risk.