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Not every knee injury or condition requires surgery.
It's generally understood by doctors and surgeons that surgery will introduce more scar tissue into your knee. This added scar tissue will be problematic, requiring physical therapy and conservative treatment options post-surgery. If not dealt with properly, your knee could end up in worse condition than before the surgery! This is why surgery is only performed as a last resort.
Most doctors, surgeons and orthopedic specialists will recommend conservative therapy for minor knee injuries before even considering surgery.
Some of the most effective conservative treatment methods you will find are:
- Rest - This is important for intial healing because without an appropriate amount of rest you are at risk for increased inflammation, pain and re-injury to your knee. This can make your knee injury even worse, turn an acute injury into a chronic case, or even damage other soft tissue in your knee.
- Avoid Activities that Caused Your Injury - While resting your knee it's also important to avoid all activities that may have caused your injury in the first place (especially if you are active in any sports or activites that require pivoting or twisting of your knee). Continuing on with regular activities will not only make your injury worse, but limping to 'work around' your injury can also wind up giving you over compensation pain in other areas of your body (like your opposite/healthy knee).
- Apply Effective Cold Compression
Application of cold compression immediately following surgery will help you to manage pain while getting rid of swelling, inflammation and edema in your knee. Immediate pain relief and reduced inflammation can also relieve some of the pressure that's being placed on the soft tissue in your knee and stop your injury from getting worse. Once swelling is reduced, you can then incorporate Knee T•Shellz Wrap® treatments to boost your body's own recovery process.
- Deep Tissue Regeneration Therapy (DTR Therapy) - the side effect from deep heat (via a T•Shellz Wrap®) in an increase in blood flow. This increased blood flow helps boost your body's healing process of damaged tissue, maintaining healthy blood flow to the knee. Benefits of increased blood circulation are reflected by a decrease in soft tissue recovery time, and overall - a boost to long-term healing. An increase in localized blood flow can be accomplished by treating your knee with a Knee T•Shellz Wrap® on a daily basis.
- Stretch your Knee - Stretching will maintain flexibility of your tissue and help to break up scar tissue that forms during healing. Consistent stretching of your knee during conservative treatment pre or post surgery will increase your range of motion and speed up your overall recovery.
Other Conservative Treatment Methods can be Risky
In some cases, your doctor may recommend drugs or medications like NSAIDs (non-steroidal anti-inflamatory drugs) to manage pain and inflammation. Alternative medications like cortisone injections are NOT advised for most knee soft tissue injuries to the tendon, ligament, or cartilage. This is because there is an increased risk of rupture of a tendon following a cortisone injection.
"Medical evidence shows that cortisone shots can damage the surrounding tissue, fray the tendon, and even trigger a rupture. Most side effects are temporary, but skin weakening (atrophy) and lightening of the skin (depigmentation) can be permanent." (reference: American Academy of Orthopaedic Surgeons)
For acute (new or recent) knee injuries that have the ability to heal on their own - your doctor may even suggest use of a removable knee brace. A removable knee brace can be very helpful to prepare you for physical therapy sessions and mobility exercises.
Prolonged use of a removable knee brace or long-term rest (restricted movement) without proper exercise or stretching can make your knee injury worse. If your knee remains completely immobilized and at constant rest, the edges of your soft tissue tear will begin to fill in with massive amounts of scar tissue as part of the healing process. You may also have on-going symptoms of pain, swelling, inflammation, and even poor blood flow circulation.
Lack of proper blood flow and growth of scar tissue will tighten the tissue in your knee, changing your flexibility and range of motion. Your ability to put weight on, flex, twist or pivot your knee in certain activities such as running, jumping, or going up and down stairs all become compromised. You're also at an increased risk of re-injuring your knee, if the initial injury was large and required surgery in the first place.
Why won't My Knee Injury Heal?
Have you ever asked yourself this question? Here at MendMyKnee we've had this question asked of us for years. We've created this webpage to answer this any many other related knee injury questions.
If we're born to heal our own injuries, why does our body take so long to heal?
When we have a ligament, tendon, meniscus or other soft tissue knee injury, the tissue and cells are damaged. Your body responds to this damage with healing right away. During this healing process your knee's tissue spasms and this contraction is meant to hold the tissue still to prevent any further injury. Swelling and inflammation is your body's way of sending blood to the area to start healing. Healing at this point will also expand the blood vessels in the injured tissue - they enlarge and swell causing you pain. This pain is a signal for you to lessen activity that would put anymore undue stress on your knee injury. It also acts as a reminder that you have an injury.
Why are knee injuries so hard to overcome?
In two words - scar tissue.
Tendons, ligaments, the menisci and other soft tissue in the knee are all meant to be soft and flexible, ready to work and move extreme forces in everyday activities. Damaged tissue heals with scar tissue; little tiny band-aids that overlap each other on the tissue mending the injury. With the added scar tissue the tendons/ligaments/menisci become rigid, less ready to move and unable to recieve the full force of your movements. If you're suffering with scar tissue now you may feel the effects with stiffness, tightness, weakness and tiredness in your knee.
Scar tissue can form fast to bring together the edges of a tear, but working fast doesn't mean that the job's done right. When scar tissue forms it doesn't come together as neatly as regular (healthy) tissue would. Scar tissue fibers will lay down over top of your tear in a cluttered, messy and jumbled up way.
Imagine throwing a bunch of drinking straws in the air... When those straws hit the ground they'll land in a random, unorganized way. It even seems silly to think that those straws could land perfectly straight and all in the same direction.
Using conservative treatment methods will help to soften scar tissue and bring more blood flow to allow your body to convert this scar tissue to normal, healthy tissue much more quickly. Stretching also helps to organize the scar tissue, increasing the strength of this tissue so it's more like the weave of a basket. Using conservative treatment methods and stretching regularly are both key parts of your recovery and your physical therapy after surgery.
Effective Conservative Treatment Options are Available
If your doctor has decided that your injury can be treated with conservative treatment, you can join our many customers who have had great success treating themselves with the powerful, conservative treatment products we offer through MendMyKnee.
What You Need to Treat Your Knee Injury:
- Cold Compression to reduce initial swelling and inflammation in your knee (as soon as possible).
- A Deep Tissue Therapeutic T•Shellz Wrap® to increase Deep Tissue Regeneration Therapyto the injured soft tissue (DTR Therapy).
The T•Shellz Wrap® will not only enhance blood flow in the treatment area, it will also help prevent soft tissue atrophy by increasing elasticity of the affected soft tissue (ACL, LCL, PCL, MCL, patellar tendonitis, quadriceps tendonitis, IT band syndrome, prepatellar bursitis, pes anserine bursitis, infrapatellar bursitis, chrondromalacia, hoffa's syndrome, osteoarthritis, baker's cyst, etc).
Knee injuries can happen to anyone and right now there are thousands of doctors and physical therapists delaing with patients that require a solution to treat their knee injury fast and heal it (where possible). If you want to be pro-active about properly addressing your knee injury, speak to your doctor about adding to your treatment with MendMyKnee's system utilizing DTR Therapy Therapy via the KNEE T•Shellz Wrap®.
If Surgery is Required...
The type of surgery you will have depends on the type of knee injury you're suffering from. The longer you've waited to have surgery will also be a factor that determines the type of sugery that's needed.
With acute (recent) tearing the stretch or tear in your tendon/ligament or the damage to your bursa/meniscus may be minimal. If you have an acute tear that is relatively small you may qualify for less invasive surgery (like an arthroscopic procedure). Surgeons will always choose a shorter, less invasive procedure if it's possible to do so. Most surgeons know that a less complicated procedure will have less trauma to your knee and a much quicker rate of recovery after the surgery.
If you're suffering from a chronic knee injury or tissue tear that's been going on for a while (from overuse/repetitive movement) or has been damaged due to aging of your soft tissue, then you may have less options available for surgery. A repair of soft tissue in the knee, for example, is usually only ever performed for newer (acute) tissue tears where it is possible for the tissue to heal back together. If you have a chronic knee injury there may be more fraying to your ligament or tendon tissue. If you suffer from chronic knee bursitis, it's likely that you also have another soft tissue knee injury (like tendonitis or a torn ligament) that keeps causing your bursitis to recur. In either case arthroscopic surgery may be enough to fix your knee but the amount of tissue that can be repaired will depend on how worn away/frayed (degenerative) your tissue damage is.
Your age will also be a factor. Surgery is generally used more often for younger patients requiring a repair to a tendon or ligament tear. Conservative treatment methods and physical therapy are recommended (instead of surgery) for older patients suffering from the same type of injury. (reference: 1)
Even if surgery is required to treat your knee injury, your surgeon may still recommend physical therapy before the procedure. This is sometimes recommended so you may strengthen your quadriceps and hamstring muscles. This is done to help with your post-surgery rehabilitation and speed up post-surgery healing of your knee.
Arthroscopic Knee Surgery
There are 2 main types of surgery: knee arthroscopy and open knee surgery. Arthroscopy is by far the most common procedure used when performing a knee surgery. It's a doctor or surgeon's preference to perform an arthroscopy whenever possible, because it's the least invasive surgical procedure and usually has the quickest form of rehabilitation afterward.
Whether you'll qualify for an arthroscopy depends on the severity and type of injury that you have. In many cases, arthroscopy is also used to examine an injury for diagnosis, because this procedure is done with a thin tube containing a camera and light inserted through an incision near the knee joint. This type of surgery will provide the surgeon with a direct look into your injury and help to limit the amount of additional damage from surgery. During this surgery your doctor will only make 2 to 3 keyhole incisions (less than 1 inch in length) to insert the thin tube with the camera, an irrigation instrument and any surgical tools they will need to fix your knee. There will be minimal surface damage to your knee and in some cases; the tiny incisions won't even require stitches to heal.
If you suffer from a more severe knee injury you may need to have an open knee surgery to give the surgeon a better view of your injury and more room to move the surgical tools around if your injury is complicated to fix.
Open Knee Surgery
When researching your options for surgery you may find more information available about arthroscopic surgery. This is because arthroscopy is considered to be the gold standard for knee surgery, meaning that many surgeons prefer to perform an arthroscopy to minimize the how invasive your surgery is. Most doctors and surgeons will automatically consider you for arthroscopy whenever possible to provide you with the fastest rehabilitation and recovery option after surgery.
If, however, you have a severe injury - like a full tissue tear, an open wound from a traumatic event or an accident, bone damage, displacement or fracture, or require a full knee replacement - then you will probably have to undergo an open knee surgery.
In an open knee surgery your incision could be 6 to 10 inches in length, or longer if you already have an open wound. During the surgery, instead of making a few keyhole incisions like in the arthroscopy, your surgeon will open up your knee to see the inside joint. This means your surgeon will cut through your skin and the muscle underneath to see your injury. Open knee surgery will probably leave a scar on your knee. The possibility of a scar is yet another reason why surgeons will avoid open surgery wherever possible.
Arthroscopy is considered an outpatient surgery (most of the time you can leave the hospital the same day as your surgery), open surgery is considered an inpatient surgery (you'll have to stay overnight or maybe even longer).
Stability of your Knee after the Surgery
During the first 24 to 72 hours after surgery your knee will be tender, swollen and very painful. Your knee may be weak and unstable, and depending on your surgery, you may have to weara knee brace or use crutches for a few weeks. One of the things to keep in mind when recovering from knee surgery is the importance of resting in the beginning, but getting active and going through rehabilitation when it's needed. When you're recovering from surgery and using tools to keep weight off of your knee (like a knee brace or crutches) then your knee and the surrounding muscles aren't as active as they once were.
If you fail to deal with proper rehabilitation of your knee after surgery, muscle loss (atrophy) will occur in your leg. The soft tissue and cartilage in your knee joint may start to wear away (a process called degeneration). There is always a possibility of re-injuring your knee even after a surgical procedure has been done.
Ask any doctor and they'll tell you that the success of your surgery depends on your level of dedication to regular at home care of your knee. Most of our knee post-op clients have treated themselves succesfully through regular use of cold compression and the Knee T•Shellz Wrap®.
Using these therapies will lessen the chance and/or severity of knee joint degeneration and surrounding muscular atrophy during your rehabilitation process. In some cases our customers have prevented the onset of degeneration through regular use of these treatments. They will even combine these therapeutic treatments with the rehabilitation plan recommended by their doctor, surgeon or physical therapist.
Getting Started with Your Post-Operative Rehabilitation
If you've had surgery on your knee then your doctor will quickly get you on the path to rehabilitation. The aggressiveness of your rehabilitation efforts and your injury's ability to heal will depend on a variety of factors including (but not limited to):
- your age, overall health, and activity level
- the state of your knee injury before surgery... Severe injuries like a full tissue tear, open wound, bone damage or fracture, and partial or full knee replacement will require more intense surgery.
- the type of surgery you had
- how soon you need to return to normal activity
Know that no 2 rehabilitation plans are alike - The less invasive your surgery is, the quicker your road to recovery will be.
The goal of a rehabilitation plan is to manage pain and swelling while improving function, strength, and range of motion. Ultimately at the end of your recovery you'll regain strength and return to full activity. In order to achieve this you'll most likely spend a lot of time with a physical therapist after your surgery, but as your healing progresses, emphasis will be placed on your conservative treatments at home.
The success of your rehabilitation will depend on your dedication to working with your physical therapist while also managing your recovery on a daily basis at home.
No matter what type of surgery you've had (or even if you don't need surgery at all) you home therapy routine can be improved by controlling initial and on-going pain/swelling, increasing blood flow to heal your knee injury, and incorporating daily stretches to increase range of motion so that you can achieve long-term, positive results.
All of this can easily be done by incorporating a Knee T•Shellz Wrap® into your rehabilitation routine. Regular treatment with a T•Shellz Wrap® will decrease your time spent in recovery.
Your Post-op Recovery Time can be Reduced...
With the use cold compression and a Knee T•Shellz Wrap® following surgery.
After the incision site has healed (if there is one), speak with your doctor about using our Knee T•Shellz Wrap® to get Deep Tissue Regeneration Therapy. Using our Knee T•Shellz Wrap® as soon as you can following your surgery will minimize scar tissue growth in your knee that will form as you heal. Treating scar tissue is the most important step following surgery, especially in a joint to improve its range of motion.
Leaving the scar tissue untreated can lead to stiffness, chronic pain, osteoarthritis or other chronic conditions. You're more likely to end up with another knee injury if you choose not to treat the scar tissue that develops in your knee. DTR Therapy encourages more oxygen and nutrients to flow to the area to speed healing and improve the strength of the soft tissue in your joint.
As you maintain healthy blood flow circulation in your knee it's also important to keep moving. If you stop moving your joint will stiffen up and surrounding muscle and soft tissue will begin to atrophy (waste away). Once the swelling is down, try to maintain a routine of gentle passive stretching after a treatment with the Knee T•Shellz Wrap® .
Only MendMyKnee offers a surgery recovery process that includes T•Shellz Wrap® treatments that help get you on your feet faster by speeding up healing with long-lasting, sustainable results.
Post-OP Phase 1 - Protect your Knee & Start Moving
Rehabilitation and physical therapy after an arthroscopic or open knee surgery will first focus on protecting your knee and initiating simple movement. Directly after your surgery has been completed, your knee will go through Step 1 of the healing process by stopping the bleeding that has started because of the incisions and work done inside of your knee. Depending on the type of procedure you have just had, your tissue may be sutured together, reconstructed or removed to fix your underlying condition. In any case, as with any injury to your tissue, the tissue in your knee will be bleeding again. Depending on the type of injury you have, your surgeon may even stimulate bleeding during your surgery to trigger the healing process.
Typically your body will have begun to stop the bleeding as soon as your surgeon has completed your surgery. This means that the veins carrying your blood will close off, and your blood will coagulate (condense to seal the bleeding off) in order to reduce the amount of blood loss in your body. Your body knows to do this automatically because blood is so vital to the healing process. Blood is basically the vehicle for oxygen, nutrients, white blood cells and anti-bodies that travel directly to the injury in your knee - where these things are needed most.
If you have undergone an arthroscopic surgery, you may have less blood loss and your doctor or surgeon will check before you leave to make sure your bleeding at the incisions has stopped. If you have undergone an open knee surgery, your doctor and/or surgeon will check your incisions periodically over the next few days of your hospital-stay to ensure that your body has stopped the bleeding on its own and also make sure that your incisions are starting to heal.
After your incisions and repaired/removed tissue has stopped bleeding; your knee will become tender, swollen, red and hot to the touch. These are all symptoms of inflammation (Step 2 of the healing process). At this point you will be home if you have had arthroscopic surgery, or you may still be in the hospital if you have had open knee surgery. In order to reduce pain, swelling and inflammation your doctor will prescribe an anti-inflammatory drug to be taken during the first week or 2 after your surgery. Your surgeon will also recommend a cooling therapy, like R.C.C.E. (Rest, Cold, Compression, Elevation). You can use Cold often (as prescribed), several times a day, to control your inflammation and reduce your pain.
Rest at this point is vital to your rehabilitation plan depending on the surgery you have undergone. If you have had arthroscopic surgery with minimal work from your surgeon, you may be encouraged to start movement early or as soon as possible. Walking with the aid of crutches and a knee brace will be required in most cases after the surgery. If you have had an invasive open surgery, then you may be encouraged to rest longer at first before starting movement with you knee brace and crutches.
Your doctor or surgeon will advance you to the next Phase of rehabilitation when there is no evidence of inflammation or swelling in your knee. If you have had arthroscopic surgery, your doctor may expect that you are able to walk around pain free (with the aid of crutches or a knee brace if needed) before moving onto the next Phase of rehabilitation.
Post-OP Phase 2 - Gain Back Range-of-Motion (ROM) and Stability
After the initial healing of your knee injury (when Step 1 and 2 of the healing process is done), temporary tissue will start to grow to replace any veins, nerves and tissue that were damaged during your injury or the surgery (Step 3: Temporary Tissue Growth). This temporary tissue will also pull together the two sides of your tissue tear, and strengthen any area where you will have sutures. This tissue will lay the foundation for stronger, healthier tissue to come, but it will be soft and not as strong as regular healthy tissue. This is why you really need to be on "re-injury watch" and make the most of your home therapies for the rest of your rehabilitation. After all, it would be devastating for you if over-doing it at any point during the next few weeks or months of rehabilitation will send you right back into the operating room.
Once your new tissue has begun to grow you will be encouraged to gain back some of your range of motion (ROM) and increase the stability of your knee. Your doctor or surgeon may also introduce regular physical therapy appointments. You may still be expected to wear your knee brace to reduce the amount of stress you are placing on your knee during movement (reducing your risk of re-injury).
You will start gradual movement of your knee in a free (non-forced) way with very low impact exercises. Your knee may be stiff at first, and you should expect simple and easy movement to be a bit more difficult for you to master and painful. Exercise of any kind is a method of increasing blood-flow in your knee to increase the amount of oxygen, nutrients, white blood cells and anti-bodies that travel to your injured tissue. You can increase your blood flow before exercise to warm up your tissue and increase your ease of movement. Use of the Knee T•Shellz Wrap® for approximately 15 to 20 minutes (finishing 15 minutes before exercise) will warm up your knee, relax your muscles and encourage tissue elasticity.
Some of the basic exercises you will start with may include controlled flexing (bending) of your knee by sliding your heel away from your body then back toward your body. Other exercise and strengthening may focus on the use of a stationary bicycle, or stretching of the leg muscles surrounding your knee (quadriceps, hamstrings, thighs and calves) to increase the overall stability of your knee joint.
Controlling post-exercise swelling and inflammation is crucial during this Phase. Any sign of swelling or inflammation after exercise may be an indication of minor re-injury to your knee or to the surrounding tissues and muscles. Controlling your inflammation immediately after exercise for at least 15 to 20 minutes with cold compression or an icepack may help reduce risk of re-injury to the knee. If you are not careful to treat your swelling or inflammation immediately after exercise you can experience a set-back in your recovery.
Your doctor, surgeon or physical therapist will advance you to the next Phase of rehabilitation when you show measured improvement of range of motion (ROM), strength, stability and flexibility of your knee. The level of improvement will depend on the severity of your injury and the type of surgery you have had. For example, if you have had a relatively simple arthroscopic repair of tissue, you may be expected to walk normally (no limping) before moving to Phase 3 of your rehabilitation.
Post-OP Phase 3 - Gain Back Full Capability of Your Knee
After temporary tissue has grown in Step 3 of the healing process, this temporary tissue will go through different stages of conversion into healthy, normal, flexible tissue during Step 4 (Complete Tissue Re-Growth). Before converting into healthy tissue, temporary tissue will often become tough, dense, fibrous scar tissue. Scar tissue has a weak and unorganized tissue structure, which makes it brittle. Scar tissue will provide your injury with more long term fusing together, but will also stick to surrounding healthy tissue in your knee. The growth of this scar tissue is what stiffens your knee, restricting movement and flexibility.
This Phase of your rehabilitation will focus on an increase in activity level in order to regain full range of motion (ROM) and muscle strength in your leg. Continued exercise and activity will break up and soften scar tissue. Your doctor of physical therapist will increase your activity by introducing regular use of a stationary bicycle (or other cardiovascular exercise), and additional stretching exercises (lunges, hamstring curls, quadriceps stretching and movement of your hip and lower leg). A continued stretching regimen will minimize the growth of scar tissue and also increase the elasticity and strength of your knee joint. After a consistent stretching regimen (as prescribed by your PT), your knee joint will be better prepared to handle higher and higher loads.
You will probably be able to stop using your crutches at this point as long as you focus on walking slowly and normally. Limping during rehabilitation should be avoided at all costs, because abnormal walking could result in re-injury of your knee, or even injury to your opposite leg, feet, hip or your back. If you have been limping to speed up your recovery, you will probably start to notice compensation pain in your opposite leg, hip or back. You can easily treat compensation pain with your doctor of physical therapist during your regular appointments, and can even further reduce this pain at home with an T•Shellz Wrap®. T•Shellz Wraps will relax your muscles, effectively getting rid of any stiffness and aching caused by compensation pain.
Continued use of cold compression after exercise and activity may still be recommended by your doctor. Like we mentioned before, controlling your pain and inflammation will go a long way to reduce your risk of re-injury. If you are noticing any recurring inflammation, you can continue applying ice packs 2 to 3 times per day for 15 to 20 minutes at a time, or as recommended by your doctor.
Your doctor or physical therapist will advance you to the next Phase of rehabilitation when they feel that you have regained full ROM (range of motion) without pain in your knee. You may also have to pass clinical exams or tests of your muscle strength, balance, stability and flexibility in order to be cleared for Phase 4.
Post-OP Phase 4 - Return to Regular Use & Activity
When your overall condition and range of motion has improved your doctor or physical therapist may clear you for a return to work or athletic activity. In many cases, they may recommend that you continue muscle strengthening and stretching instructed during your rehabilitation in order to maintain healthy ROM of your knee. Additional cardiovascular exercise will also be encouraged. If you are an athlete or have a job that requires extensive physical capability, your doctor or physical therapist will likely advise a very gradual return to previous activity.
Scar tissue may plague you for weeks, months and maybe even years after your surgery depending on your level of activity and the amount of conservative therapy you have undergone during your rehabilitation. Scar tissue will be a major problem, especially when it comes to re-injury of your knee. Even if you have been cleared to get back to activity you still must be careful with the activity you take on. You need to keep in mind that your knee won't be back to 100% for some time (if at all) and so continued stretching and treatment with Knee T•Shellz Wrap® will maintain good health of the knee and significantly reduce your risk of re-injury during recovery.
The Next Step Is Up To You!
Living with pain is never easy as it affects your entire lifestyle. Living with pain during or after an intensive surgery and lengthy rehabilitation period can be even harder! Nothing is more important than making the proper decision when it comes to treating your knee pain after your surgery. Rehabilitation at-home while attending regular physical therapy or doctor appointments is vital for your overall recovery. Consistent exercise and conservative treatment on a daily basis during your rehabilitation while working with your doctor, surgeon or physical therapist is key!
MendMyKnee stands out in this regard as our goal is to help you heal for the longer-term during your post-operative rehabilitation and beyond.
The bottom line is, you are welcome to try our products for a 60 day period after your surgery, during your rehabilitation. Discuss our products with your doctor or physical therapist, and ask your medical professionals if integrating these therapies into your daily life is right for you! If you do not receive the benefits that countless of our other customers have experienced, simply return your purchase back to us and we will issue a prompt & full refund. There will be no hassle and no hard feelings.
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If you are still uncertain which route to go or if you would like to discuss issues affecting your knee, meniscus, acl, mcl pcl, chondromalacia, hyper-extension, bursitis or other soft tissue injuries, then do not hesitate to contact a MendMyKnee Advisor immediately by phone or email.
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