Scar tissue after knee replacement

Posted by leithlane @leithlane, Jan 31, 2017

I had knee replacement surgery 6 weeks ago . Through PT I have been working on breaking up the scar tissue only for it to regrow by the time I get back to PT two days later. I have been massaging at home, using a hand held massager and roller. It is painful and swollen. I am getting very disheartened. Any suggestions as to what else I can do. Has anyone had laser treatments to break up scar tissue? Were they effective?

@melcpa86

@mylynn I tried deep tissue massage and ASTYM to try and address the scar tissue non-surgically. I got no improvement from either in the long run. The deep tissue massage was helpful on the day I had it done- as long as I limited weight hearing. The ASTYM just bruised my entire leg and the practioner recommended stopping as it wasn’t helping

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Thanx for your repky

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@mari

What does script say (in order for me to get massage therapy) I know that if i could reach and get massaged – it would really help. Are u getting it from a PT? Please answer completely.

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I am getting deep tissue massage fr a pt for ab an hour. Completely out of pocket sorry to say
It helps on the day of and then nothing dramatically changes after that

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@mylynn

I am getting deep tissue massage fr a pt for ab an hour. Completely out of pocket sorry to say
It helps on the day of and then nothing dramatically changes after that

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I would suggest dry needling, rather than deep tissue massage. It uses acupuncture needles, and a tens unit to get deep in the muscle to relax them, and retrain them on proper use.

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@sunshine1124

I would suggest dry needling, rather than deep tissue massage. It uses acupuncture needles, and a tens unit to get deep in the muscle to relax them, and retrain them on proper use.

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Hi is this for scar tissue?

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@rayreich3

Hi is this for scar tissue?

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Graston Technique and Myofascial release Massage is also option this for scar tissue, ROM, and ultimately relieving pain. I did both- Graston hurts like a mother but is probably most effective

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@rayreich3

Hi is this for scar tissue?

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Dry Needling works on the pain from scar tissue but it doesn’t remold so it’s not a “fix”. Grayson and ASTYM are similar. In the case of a TKR, Grayson uses stainless steel tools and is targeted to an area. ASTYM uses plastic tools and the entire leg (toes to thigh- front and back) is treated. I tried all three techniques before I agreed to have the original surgeon go back into the knee and do an arthroscopic lysis of adhesions.

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@melcpa86

Dry Needling works on the pain from scar tissue but it doesn’t remold so it’s not a “fix”. Grayson and ASTYM are similar. In the case of a TKR, Grayson uses stainless steel tools and is targeted to an area. ASTYM uses plastic tools and the entire leg (toes to thigh- front and back) is treated. I tried all three techniques before I agreed to have the original surgeon go back into the knee and do an arthroscopic lysis of adhesions.

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Thank you so much this is the answer I was looking for the only answer is arthroscopic surgery to remove the scar tissue

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@rayreich3

Thank you so much this is the answer I was looking for the only answer is arthroscopic surgery to remove the scar tissue

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I had the arthroscopic lysis done 1.5 weeks ago. Despite a ton of research, I feel like I was unprepared for the recovery. So I’ll let you know how my last week and a half has been.

Prior to the surgery, I was at 105 degrees flexion. The surgery was on Wednesday afternoon and the surgeon got me to 130 flexion. First PT was Thursday at noon. On my own, i could only get my flexion to 105. The PT therapist forced my leg to 130. I was given the following “homework”.

10 mins stationary Bike
10 mins supine leg pull
10 mins prone leg pull
10 mins extensionator
20 mins ICE
1 hour elevated rest
REPEAT 5 times
Walk no more than .25 miles in house only

That’s one hour of stretching, one hour rest for a minimum of 10 hours a day.

Next session was Friday afternoon and I got to 115 on my own pulling – and the therapist forced it to 130. Weekend I was in my own with the homework.

The next Monday, I had PT early in the AM and got to 118 on my own pulling and the therapist forced to 130. I was told then that- since there was progress over the weekend (ie I could move it more on my own – even forced) and the therapist could still get to 130 – I had a decent shot at remolding the scar tissue.

I have PT three times a week and the homework is now

10 mins stationary Bike or eliptical (alternate)
10 mins supine leg pull
10 mins prone leg pull
10 quad sets
20 short arcs
10 mins extensionator
20 mins ICE
30 mins rest
20 mins heat
REPEAT 5 times
Walk no more than .25 miles in house only

The home PT is very painful. It’s hard to pull on your leg for 30 mins every other hour all day long and I am in tears doing it. It hurts to bend and walk any right now and I’m wondering if this was the right answer.

However – I can bend it more for sure and if I’m being honest with myself, the pain is probably surgical mostly since I’m only 1.5 weeks out and will probably ultimately pass. Still, forcing movement like this and this much PT is very very hard.

Good Luck

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@melcpa86

I had the arthroscopic lysis done 1.5 weeks ago. Despite a ton of research, I feel like I was unprepared for the recovery. So I’ll let you know how my last week and a half has been.

Prior to the surgery, I was at 105 degrees flexion. The surgery was on Wednesday afternoon and the surgeon got me to 130 flexion. First PT was Thursday at noon. On my own, i could only get my flexion to 105. The PT therapist forced my leg to 130. I was given the following “homework”.

10 mins stationary Bike
10 mins supine leg pull
10 mins prone leg pull
10 mins extensionator
20 mins ICE
1 hour elevated rest
REPEAT 5 times
Walk no more than .25 miles in house only

That’s one hour of stretching, one hour rest for a minimum of 10 hours a day.

Next session was Friday afternoon and I got to 115 on my own pulling – and the therapist forced it to 130. Weekend I was in my own with the homework.

The next Monday, I had PT early in the AM and got to 118 on my own pulling and the therapist forced to 130. I was told then that- since there was progress over the weekend (ie I could move it more on my own – even forced) and the therapist could still get to 130 – I had a decent shot at remolding the scar tissue.

I have PT three times a week and the homework is now

10 mins stationary Bike or eliptical (alternate)
10 mins supine leg pull
10 mins prone leg pull
10 quad sets
20 short arcs
10 mins extensionator
20 mins ICE
30 mins rest
20 mins heat
REPEAT 5 times
Walk no more than .25 miles in house only

The home PT is very painful. It’s hard to pull on your leg for 30 mins every other hour all day long and I am in tears doing it. It hurts to bend and walk any right now and I’m wondering if this was the right answer.

However – I can bend it more for sure and if I’m being honest with myself, the pain is probably surgical mostly since I’m only 1.5 weeks out and will probably ultimately pass. Still, forcing movement like this and this much PT is very very hard.

Good Luck

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That is very aggressive physio indeed. My flexion was 70 degrees under General anaesthetic before the arthroscopic arthrolysis and the surgeon got it to 120 degrees after surgery. I had hydrotherapy on a weekly basis for the next 6 weeks. My knee flexion now is between 96 and 100 degrees, and my surgeon has discharged me. Thankfully I am still having physio every 2 to 3 weeks. Certainly they never forced the flexion

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@melcpa86

I had the arthroscopic lysis done 1.5 weeks ago. Despite a ton of research, I feel like I was unprepared for the recovery. So I’ll let you know how my last week and a half has been.

Prior to the surgery, I was at 105 degrees flexion. The surgery was on Wednesday afternoon and the surgeon got me to 130 flexion. First PT was Thursday at noon. On my own, i could only get my flexion to 105. The PT therapist forced my leg to 130. I was given the following “homework”.

10 mins stationary Bike
10 mins supine leg pull
10 mins prone leg pull
10 mins extensionator
20 mins ICE
1 hour elevated rest
REPEAT 5 times
Walk no more than .25 miles in house only

That’s one hour of stretching, one hour rest for a minimum of 10 hours a day.

Next session was Friday afternoon and I got to 115 on my own pulling – and the therapist forced it to 130. Weekend I was in my own with the homework.

The next Monday, I had PT early in the AM and got to 118 on my own pulling and the therapist forced to 130. I was told then that- since there was progress over the weekend (ie I could move it more on my own – even forced) and the therapist could still get to 130 – I had a decent shot at remolding the scar tissue.

I have PT three times a week and the homework is now

10 mins stationary Bike or eliptical (alternate)
10 mins supine leg pull
10 mins prone leg pull
10 quad sets
20 short arcs
10 mins extensionator
20 mins ICE
30 mins rest
20 mins heat
REPEAT 5 times
Walk no more than .25 miles in house only

The home PT is very painful. It’s hard to pull on your leg for 30 mins every other hour all day long and I am in tears doing it. It hurts to bend and walk any right now and I’m wondering if this was the right answer.

However – I can bend it more for sure and if I’m being honest with myself, the pain is probably surgical mostly since I’m only 1.5 weeks out and will probably ultimately pass. Still, forcing movement like this and this much PT is very very hard.

Good Luck

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Thank You for posting your experiences- I have been diagnosed after TKR in July, MUA in September and months of painful PT. Don't know what to do…

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@damewocane

Thank You for posting your experiences- I have been diagnosed after TKR in July, MUA in September and months of painful PT. Don't know what to do…

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Hi @damewocane – Welcome to Connect! I'm sorry to hear about your painful recovery. It does sound frustrating to have worked so hard and feel like you are not getting anywhere. Can I ask what led to them doing the manipulation under anesthesia in September? It sounds as if that was just 8 weeks or so after the TKR. I don't have any experience with MUA's so I'm curious what triggers their decision to use this technique?

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