Therapy after knee replacement surgery - who doesn’t cringe at the thought?
Recovery can be quite challenging, and meeting range of motion goals takes a lot of work (as well as management of pain). As a physical therapist working directly with patients after total and partial knee replacement surgery, I witnessed firsthand the challenges and difficulties of this recovery process.
What I did not know, years ago, is that manual lymphatic drainage (aka MLD, lymphatic therapy, or lymphatic massage) is a key component to recovery after surgery - because it gently moves inflammation/swelling away from the joint, so that the knee is able to heal more quickly and bend/straighten easier. Less inflammation also means less pain.
I recently worked with a 65(ish) year old male client, “Bob”, who was receiving physical therapy after a knee replacement. He unfortunately had some additional medical complications during his first week after surgery, returning to the hospital for several days. As a result, he was far behind in his ability to bend his knee (flexion). At almost two weeks after surgery, with the goal being approximately 95 to 100 degrees of flexion, he was only at approximately 55 degrees.
I began providing MLD (manual lymphatic drainage) therapy, per his wife’s request, at 12 days after surgery. When his physical therapist saw him two days later, he gained 18 degrees of flexion!
I provided a total of four MLD sessions over a 12 day period, at 4 days apart. As a result, Bob went from being 40 degrees behind his physical therapist’s expectations and goals, to 4 degrees ahead of schedule - gaining a total of almost 60 degrees!! These are huge gains in a short amount of time!
His P.T. stated it was obvious that MLD made all the difference. He also said no doubt that MLD was a major contributor to putting Bob ahead of schedule.
Why does MLD make such a difference for post-op rehabilitation?
Because - when provided by a CERTIFIED MLD THERAPIST with experience and proper training - MLD reduces inflammation (swelling). Swelling not only in the knee, but also the entire leg, hip, and body.
Swelling is excess fluid in the tissues. It fills up spaces in the knee that aren’t normally filled up. And this means that, no matter how much therapy a person does, their knee can only bend as much as the swelling allows it to.
Swelling limits the amount of movement in a joint, causes pain by putting pressure on tissues and nerves, and slows down the healing process.
And the sooner that the excess fluid moves out of the knee joint, the more quickly a person can heal - AND the more quickly a person can gain range of motion!
What is wonderful is that MLD actually relieves pain. It is gentle, noninvasive, relaxing, and calms the nervous system. Most post-op clients usually fall asleep during my sessions!
I cannot be clear enough - post-op patients MUST find a certified MLD therapist with post-op training. MLD is all the rage, and I have seen firsthand the damage caused when people receive deep tissue massage by massage therapists claiming to offer lymphatic massage. Be cautious, ask questions, and keep searching until you find a certified MLD therapist with post-op training and experience. Period.
Ideally, I recommend starting MLD around one week after surgery (with the surgeon’s permission). And, ideally, having MLD sessions twice a week for the first 4-6 weeks post-op will deliver the best results.
Schedule your appointment online (donnabettin.com), and I look forward to seeing you soon!
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