Check out these simple, yet effective method to break up excess scar tissue and reduce joint pain after total knee replacement surgery. Learn the best exercises for knee arthrofibrosis below.
Written by: Coach Todd
That tightness you feel with every step or rise from the couch grows more fierce and painful every day… wasn’t the surgery supposed to help?
So, why is your knee acting this way?
Arthrofibrosis is like scar tissue on steroids.
What is Scar Tissue?
When our bodies go through trauma like an injury (or even surgery), the brain sends signals to the area releasing inflammation and healing structures called scar tissue.
As scar tissue forms, it is remodeled over time, and the scar tissue starts behaving like your normal healthy tissue. (verywellhealth.com)
This process is your body’s normal response to healing, failure for scar tissue to remodel properly can lead to loss of mobility and joint contractures. That basically means your knee no longer bends and straightens fully anymore.
But wait, there’s more.
As scar tissue builds up, it recruits other connective tissues to help support the cause. This connective tissue is harder to break up. It’s what is known as Fibrosis.
In the simplest of terms, scar tissue is like a spider web – a delicate structure that can easily be broken up and restrung if needed. Fibrosis, on the other hand, is like making that same spider web out of duct tape so it’s much tougher to break up.
The Cause of Knee Arthrofibrosis
Often after any type of knee surgery, excess swelling occurs to protect the knee… but then scar tissue, and eventually fibrosis, can set in as rest increases. Depending on the site of scarring, the age of the patient, or their previous range of motion, Arthrofibrosis occurs in approximately 10% of total knee replacement surgery.
The statistic increases as patients resist movement. The duct tape of Fibrosis binds tighter and tighter to the joint, meaning the less you move the joint the faster Arthrofibrosis sets in.
However, there are 3 strategies you can use to help alleviate the stiffness and break up the fibrosis. Be sure to not skip the last step!
3-Step Strategy to Help Break Up Arthrofibrosis In Your Knee
Flush The Area With Fluid & Nutrients
The first step in this strategy is to apply some moist heat for 5 minutes to your knee.
This can be in the form of a heating pad, a hot damp towel, or a sauna/steam room.
It’s important to warm up your soft tissue surrounding the knee before moving on to the next steps. This helps flush the soft tissue with fluids and nutrients necessary to set the healing process on the right track.
Thigh Shaking/Picking for Scar Tissue Management
Although it sounds almost overly-simple, knee or thigh shaking, which is also called soft tissue mobilization, allows the body to break up the unnecessary scar tissue. This will help to loosen things up at a microlevel… preparing your knee for the next strategy for encouraging healthy tissue formation.
The key here is vigor. Prop your leg up either on your bed or on another chair, keeping your spine neutral. Take either one or two hands to vigorously shake/pick up your thigh to create results at the microlevel.
Isometric Knee Exercises for ArthrofibrosisScar Tissue
Dr. Jennifer Reed wrote in “The Principles of Sports Rehabilitation,” that isometric exercises can help break up scar tissue after knee surgery without putting to much strain on the joint itself. The following are 2 isometric options to try at home:
3-Angle Isometric Knee Extension
Sit in a chair facing (and close to) a wall with your knee bent at 90-degrees.
Extend your leg out against the wall and hold for 10 seconds.
Then, slide your chair back so your knee is at a slightly larger angle, and again, extend the knee for 10 seconds.
Slide the chair back one final time and repeat for 10 seconds.
3-Angle Isometric Knee Flexion
Now you’re going to activate the muscles in the back of leg. Using a similar concept as above, start in the position that you last left off on.
Instead of using a wall, we’re going to use the floor and press your heels down/backward for 10 seconds.
Move your leg back towards the chair and again press down/backwards for 10 seconds at this new angle.
Move your legs into a 90 degree angle and for the last time, press down/backwards for 10 seconds.
Repeat these two exercises through 3 cycles.
This routine can help break up the build-up of fibrosis and should be performed daily.