Knee replacement surgery, or knee arthroplasty, is a transformative procedure designed to alleviate pain and restore function in patients suffering from severe knee damage. While the surgery is a crucial step toward improved mobility, the journey doesn’t end in the operating room. The rehabilitation process is vital for ensuring a successful recovery and regaining your pre-surgery quality of life. A key component of this recovery is Manual Lymphatic Drainage (MLD) and a tailored exercise program.
Understanding Knee Replacement Surgery
Knee replacement surgery as the name says, is basically the replacement of a damaged knee joint with an artificial one. There are two type of knee replacement surgery: a total knee replacement (TKR), which replaces the entire knee joint, or a partial knee replacement, which targets only the damaged part of the joint.
Nowadays, the decision to undergo knee replacement surgery is often made when conservative treatments, such as medications and physical therapy, have failed to provide relief. This is because, we are more aware now than ever, of how surgery are complex intervention that can yes, give pain relief and benefit, and save life, but occasionally can come with complications and leave the person with other permanent damage.
The Rehabilitation Process
As in any surgery, the rehabilitation process is extremely important to ensure that the patient returns to the best of their functions. What the rehabilitation involves are physical therapy, exercises, and, where needed, even mental support.
Immediate Post-Surgery Care:
Pain Management: Right after your surgery, you will be given pain relief medications and antibiotics, which will help in managing the pain response and keep you free from infection risks.
Initial Movement:
As a few days are pass, is super important to start moving. Initially would be a matter of few mm or cm, passive and active movement, but as days goes by these movement has to be increased, in order to avoid further muscle atrophization and to increase the blood flow to the area.
Exercise:
Isometric Exercises: As per discussed in many other blogs, those exercises are the first step in the recovery process. An isometric exercise consists of muscle contraction and barely any limb movement. This allows for maintaining a connection between the muscle and the Central Nervous System (CNS), which is essential to ensure muscle engagement for more complex tasks. Initially, those exercises can be achieved with only 25% of your strength, and within 10 days post-surgery, you may start pushing at 50% of your strength or more.
Strengthening Exercises: This second step in the exercise journey can start in week three or four after surgery. The process focuses on strengthening the muscles surrounding the knee joint. These exercises are essential for supporting the new joint and improving overall stability. Strengthening exercises may look different from person to person, in terms of load, but they all aim to increase the load to which the knee joint is placed, to stimulate muscle growth, blood flow, and restore all tissue damaged along the surgery.
Plyometric Exercises: Lastly, along the rehabilitation process, there are the plyometric exercises, which consist of loading the tendon like a spring (that’s what their function is) and releasing that loading in a fast motion. For a knee joint, think of explosive squat-type exercises. These type of exercises would start around week 8 to 10 post surgery.
This is a step-by-step guide of what a rehabilitation process may look like. Each individual then may have a different journey to follow, given their clinical history, and other factors, including genetics and return to daily activities.
In addition to the exercises, physical therapy
Consistency: Adhering to a home exercise program is crucial for maintaining progress during therapy sessions.
Monitoring Progress: Regularly perform your home exercises and track your progress. If you encounter any issues or experience increased pain,get in touch with your physical therapist to discuss what you are presenting with and what can be done about it.
Monitoring and Follow-Up: Your surgeon and physical therapist will evaluate you on an ongoing basis to ensure that your recovery is progressing as expected. Any complications or concerns will be addressed promptly.
The Importance of Manual Lymphatic Drainage (MLD)
Manual Lymphatic Drainage (MLD) is a gentle, hands-on therapy designed to stimulate the lymphatic system and reduce swelling, which can be particularly beneficial following knee replacement surgery. Here’s how MLD supports recovery:
Benefits of MLD in Knee Replacement Recovery:
Reducing Swelling:
Fluid Management: Swelling or edema is a common issue after knee replacement surgery. MLD helps move excess fluid away from the surgical site and reduces overall swelling, which can enhance comfort and mobility.
Enhancing Circulation:
Improved Blood Flow: By promoting lymphatic flow, MLD also improves blood circulation, delivering essential nutrients and oxygen to the healing tissues, which supports a faster recovery.
Reducing Pain and Discomfort:
Pain Relief: The gentle massage techniques used in MLD can help alleviate pain and discomfort associated with swelling and inflammation, contributing to a more comfortable recovery experience.
Facilitating Faster Recovery
Helping the Healing: By reducing swelling and improving circulation, MLD can lead to a more efficient recovery process, enabling more effective physical therapy and exercise.
Incorporating MLD into Your Rehab Routine
Timing: MLD can be introduced a few days to a week after surgery, depending on your surgeon’s recommendations and your individual healing progress.
How can I help?
At Melbourne Massage and Treatment, as a Clinical Myotherapist I am trained in helping people recovering from knee surgery or other major surgeries, either with Fitness Class, which can be part of a Myotherapy treatment plan, but even via treatment like Manual Lymphatic Drainage.
So if you are about to get a surgery, that is a knee replacement or any other surgery, and you are looking for someone that can assist you with your recovery, get in touch now to discussed your needs and I can give you a rund down on how I will be able to help you.
Knee replacement surgery and lymphoedema.
As mentioned earlier, we can all have different outcomes from the same type of surgery.
Given the location of the knee, and its proximity to lymph nodes (we have the lowest lymph nodes in the body, right into the popliteal fossa), a surgery as knee replacement can instigate a Lymphoedema presentation.
Nothing of this would be intentional, it is only a risk factor that has to be taken in consideration as part of the surgery outcomes.
A lymphedema, is a chronic condition caracherised by swelling in a limb where due to the lymphatic system interrupted, no liquid can be collected from the area, and the skin would keep swelling.
Melbourne Massage and Treatment in Fitzroy North is also a Lymphoedema Clinic, as I am specialised in Lymphoedema therapy, so I will be able to assist you if this were ever your case.
Frequently Asked Questions (FAQ) About Knee Replacement Surgery and Recovery
1. What is knee replacement surgery?
Knee replacement surgery involves replacing a damaged knee joint with an artificial one. It can be either a total knee replacement (TKR), where the entire knee joint is replaced, or a partial knee replacement, targeting only the damaged part.
2. When is knee replacement surgery necessary?
Surgery is usually recommended when conservative treatments (medications, physical therapy) no longer provide relief, and knee damage significantly limits daily activities or quality of life.
3. Why is rehabilitation so important after knee replacement surgery?
Rehabilitation helps restore mobility, strength, and function. It typically includes physical therapy, exercises, and sometimes mental support. A structured rehab plan is essential to ensure a smooth recovery and prevent complications.
4. How does Manual Lymphatic Drainage (MLD) aid in recovery?
MLD is a gentle therapy that promotes lymph flow, reduces swelling, alleviates pain, and enhances circulation. This helps speed up recovery, making physical therapy and exercises more effective.
5. What types of exercises will I be doing after surgery?
Post-surgery exercises begin with light movement and isometric exercises to maintain muscle connection. Around weeks 3-4, strengthening exercises are introduced. More dynamic, explosive exercises (plyometrics) start around weeks 8-10, depending on your recovery.
6. How soon can I start MLD after knee replacement surgery?
MLD can usually be introduced a few days to a week after surgery, depending on your healing progress and your surgeon’s recommendations. It’s a key therapy for managing swelling and improving circulation during recovery.
7. Can lymphoedema occur after knee replacement surgery?
Yes, due to the knee’s proximity to lymph nodes, knee replacement surgery can sometimes lead to lymphoedema, a condition where swelling occurs due to lymphatic fluid buildup. If you experience this, specialized treatment like MLD may be necessary.
Giovanni La Rocca
Giovanni moved to Melbourne, Australia, from Italy in 2008 and became a citizen in 2017. He started studying massage therapy in 2016, then completed a Bachelor of Health Science in Clinical Myotherapy in August 2024. During those years, he also specialised in Thai Massage and Manual Lymphatic Drainage for presentations like Lipedema and Lymphoedema. Nowadays, he runs his clinic in Fitzroy North, Melbourne, where he integrates movement therapy into his practice to enhance overall well-being. He also values meditation, having completed several Vipassana courses. Committed to continuous learning, he aims to share his expertise in integrated therapies to help others achieve balance and resilience.