Scar tissue after knee replacement

Good evening @krenn. It is great to be able to welcome you to Connect. Our purpose here is to help each other by sharing. And to support that mission, I will now cut to the chase about scar tissue post-TKR. I have had two of those surgeries. After the first one, I developed excessive scar tissue and all my great exercise and strengthening efforts went right out the window.

Imagine how thrilled I was to be introduced to MFR, Myofascial Release Therapy. It took about six weeks to get the restrictive fascia and scar tissue released and then it was over.

And then came TKR #2 and I was ready. My PT, worked closely with my MFR therapist from day one after the surgery. The result.........this time I did not have scar tissue build up. It didn't have a chance with those two ladies being on top of it.

Are you familiar with MFR? Here are two links to get you started. One explains what fascia does and how it can become restrictive. The second one is written by a fellow mentor @jenniferhunter. She and I are both huge supporters of MFR and this is an introduction.
https://connect.mayoclinic.org/discussion/myofascial-release-therapy-mfr-for-treating-compression-and-pain/

Chris,
Thank you for the information. I am afraid I do not know really much about Myofascial Release Therapy. What do you mean by "It took about six weeks to get the restrictive fascia and scar tissue released and then it was over"? Do you mean that the therapist was able to correct your issue and pain? At my initial PT after my TKR, I left therapy with flexion of 116... I have now regressed to 82... with extreme pushing and pain they can get me to 95 but it regresses back to 82 to 90. Its stuck!! and in so much pain daily. I just want to be out of pain daily. I have shed so many tears. I feel hopeless.

@krenn I think I can explain a bit how MFR works. Imagine that your leg is bound up in so many rubber bands that it is really hard for you to move and walk and the bands also connect up through your hips and back. There are layers on top of layers and it all wraps around your replaced knee joint too. What if you could stretch those rubber bands so they will allow you to move without cutting them?

Think about your habits like always sleeping in the same position, or posture. Are you a person with perfect posture all the time? How flexible are you? We all have habits, and if we don't stretch and move, our bodies can get stuck in positions of what we do all the time.

Fascia is like interconnecting cobwebs that stretch except that they also get tied up in knots and kinked, dehydrated, and then start pulling and putting a lot of pressure on the body. This fascia weaves through the muscles and organs. It is part of connective tissue that holds everything together. The video Chris shared shows how living fascia unwinds and reorganizes itself. It lengthens and changes state between being a semisolid and a liquid and then back to a semisolid again. That is what happens when you apply a gentle stretch and just hold it, and give the tissue time to respond. If you stretch too forcibly, the fascia can tear, and create scar tissue within it making things worse. Have you removed the skin from a raw piece of chicken and seen the cobweb stuff under the skin? That is non living fascia. It is a bit stretchy, but in life it can expand so much more than what you see there. Watch the video and you'll see. You can skip the first part and get to where you see the video like the still photo displayed on the video link.

Releasing fascia restrictions lets the body move better, allows body fluids to enter, and can reduce pain a lot actually, if tight tissue is the cause of that pain. It takes patience and working with the right therapist who has been trained in the John Barns methods. Surgery creates scar tissue, and myofascial release can mitigate that. I had a great recovery from spine surgery because I was doing MFR before and after the surgery, and Chris has a similar success with her knee replacement and she had a better recovery for the second one because of MFR. MFR shouldn't be painful. It feels like a yoga stretch that you just hold for awhile and wait.

This member @golfshrink also describes a similar situation of struggling after knee replacement and that MFR was the solution.
https://connect.mayoclinic.org/comment/247122/
Here is a link to a short article written by John Barnes explaining how fascia works as a lever.
https://myofascialrelease.com/downloads/articles/FasciaAsALever.pdf
I helped Chris discover myofascial release and at the beginning, she didn't understand why it helped, but she tried it and was patient, and it gave her back mobility. @artscaping, Chris can tell you how much it helped her. I was lucky to find an expert level trained therapist ten years ago who has helped me and taught me how all of this works. MFR has done a lot for me as well. There is an MFR provider search at http://mfrtherapists.com/

Do you have any questions about myofascial release?

@krenn I think I can explain a bit how MFR works. Imagine that your leg is bound up in so many rubber bands that it is really hard for you to move and walk and the bands also connect up through your hips and back. There are layers on top of layers and it all wraps around your replaced knee joint too. What if you could stretch those rubber bands so they will allow you to move without cutting them?

Think about your habits like always sleeping in the same position, or posture. Are you a person with perfect posture all the time? How flexible are you? We all have habits, and if we don't stretch and move, our bodies can get stuck in positions of what we do all the time.

Fascia is like interconnecting cobwebs that stretch except that they also get tied up in knots and kinked, dehydrated, and then start pulling and putting a lot of pressure on the body. This fascia weaves through the muscles and organs. It is part of connective tissue that holds everything together. The video Chris shared shows how living fascia unwinds and reorganizes itself. It lengthens and changes state between being a semisolid and a liquid and then back to a semisolid again. That is what happens when you apply a gentle stretch and just hold it, and give the tissue time to respond. If you stretch too forcibly, the fascia can tear, and create scar tissue within it making things worse. Have you removed the skin from a raw piece of chicken and seen the cobweb stuff under the skin? That is non living fascia. It is a bit stretchy, but in life it can expand so much more than what you see there. Watch the video and you'll see. You can skip the first part and get to where you see the video like the still photo displayed on the video link.

Releasing fascia restrictions lets the body move better, allows body fluids to enter, and can reduce pain a lot actually, if tight tissue is the cause of that pain. It takes patience and working with the right therapist who has been trained in the John Barns methods. Surgery creates scar tissue, and myofascial release can mitigate that. I had a great recovery from spine surgery because I was doing MFR before and after the surgery, and Chris has a similar success with her knee replacement and she had a better recovery for the second one because of MFR. MFR shouldn't be painful. It feels like a yoga stretch that you just hold for awhile and wait.

This member @golfshrink also describes a similar situation of struggling after knee replacement and that MFR was the solution.
https://connect.mayoclinic.org/comment/247122/
Here is a link to a short article written by John Barnes explaining how fascia works as a lever.
https://myofascialrelease.com/downloads/articles/FasciaAsALever.pdf
I helped Chris discover myofascial release and at the beginning, she didn't understand why it helped, but she tried it and was patient, and it gave her back mobility. @artscaping, Chris can tell you how much it helped her. I was lucky to find an expert level trained therapist ten years ago who has helped me and taught me how all of this works. MFR has done a lot for me as well. There is an MFR provider search at http://mfrtherapists.com/

Do you have any questions about myofascial release?

Thank you, I am understanding how it works. I would love to investigate more.
I did check the list of therapist.. there is none in my area. I am in Washington NC

Hi, I am in the same spot you are. 3 surgeries on my right knee, been dealing with since 2018
1st... Meniscus Repair.... found out after the fact that it was an "experimental" surgery. Spring 2019 2nd... PKR Spring 2020
3rd... TKR Oct 2021
Now I have large thick scar tissue... that my surgeon is going to do a 4th surgery to take out.
I am scheduled for him to reassess Sept 7, 2022. If inflammation has "settled down" he will schedule to take out the scar tissues. Not arthroscopically he is going to open my knee back up.
He says it is too large that it would take too long to do arthroscopic surgery. I am hopeful.
I have bee so frustrated and depressed. I am a strong woman and want to push through this but I am growing very weary.
Has anyone ever had scar tissue removed other than arthroscopically?

Recommend you look into myofascial release therapy and shock wave therapy, the latter a small jackhammer like tool that sends sound waves in to break down scar tissue. It doesn’t hurt like the MFR but don’t mind the MFR as long as it’s working.

@mpirruccel Myofascial release isn't supposed to hurt, and it doesn't use aggressive tools. I know there was something called a fascia blaster, but that wasn't MFR. If it hurts and forces are too aggressive, you risk tearing the fascia causing more scar tissue and just making it worse. MFR is very gentle pressure and you just wait for the fascia to unwind itself. This is how the John Barns methods work as the inventor of the method through the skilled hands of the therapist who can feel the pathways of tight tissues and apply gentle pressure, like pushing to kneed bread dough, except you push and hold the pressure and just wait.

What were the methods that you were describing?

Good evening @krenn. It is great to be able to welcome you to Connect. Our purpose here is to help each other by sharing. And to support that mission, I will now cut to the chase about scar tissue post-TKR. I have had two of those surgeries. After the first one, I developed excessive scar tissue and all my great exercise and strengthening efforts went right out the window.

Imagine how thrilled I was to be introduced to MFR, Myofascial Release Therapy. It took about six weeks to get the restrictive fascia and scar tissue released and then it was over.

And then came TKR #2 and I was ready. My PT, worked closely with my MFR therapist from day one after the surgery. The result.........this time I did not have scar tissue build up. It didn't have a chance with those two ladies being on top of it.

Are you familiar with MFR? Here are two links to get you started. One explains what fascia does and how it can become restrictive. The second one is written by a fellow mentor @jenniferhunter. She and I are both huge supporters of MFR and this is an introduction.
https://connect.mayoclinic.org/discussion/myofascial-release-therapy-mfr-for-treating-compression-and-pain/