Massage for TKR & THR

I have been thru Left HRT myself in 2016 and might be getting a TKR in the next few years. In 2016 healing up the left THR I had 2 PT appointments every week for 8 months. 1 massage appointment every week for 8 months. Plus, 1 chiropractor appointment weekly for 8 months. In addition, I softball rolled daily stretched, and went to the gym. My hip has been fine since the surgery but my main issue now is the nerve and muscle damage I got in 2005 falling off a rooftop. I have a lot of empathy for injured athletes and do my best to get them back to what sport they love.



Why massage therapy?

For many people, the answer is massage therapy. This is an all-natural and proven method of pain management that more and more knee surgery patients are seeking. And when you see the benefits, it’s no wonder why.

Let’s look closer at why knee pain happens and how massage therapy can aid your recovery and help you get back on your knees, er, feet, and do your normal activities again.

So what about massage therapy for your knees?

Most people are able to resume typical activities 3-6 weeks after their knee surgery. However, recovery can be painful, and physical therapy can be a lot of work. That’s why many patients turn to massage therapy for pain management and improved knee function, along with the medication and physical therapy prescribed by their doctor.

You probably already know that a massage feels good. Even when it’s just for fun, massage loosens your muscles, leaving your body feeling calm and relaxed. This is exactly what your body needs after undergoing invasive surgery.

Knee surgery requires cutting into the muscles and tendons around your knee joint. This kind of trauma causes painful inflammation and muscle spasms. A deep tissue massage focusing on the quadriceps and hamstring muscles in your thigh, however, can relieve the tension that causes spasms and reduce inflammation. Ahhh…

Sound good? Well, it is.

Massage in postoperative care is good for you and has benefits beyond just pain relief. A 2015 study published in the Journal of Physical Therapy Science about the effects of massage therapy on pain, swelling, and range of motion after total knee replacement surgery found massage to be a comparable alternative to physical therapy in post-operative recovery.

Immediately following any operation, your tissues are basically freaking out and it is common to have swelling and inflammation. Massage has long been recognized as an effective treatment for swelling, as it provides counterpressure that forces the body’s fluids back into the blood vessels where it belongs.

For long-term recovery, a massage therapist can help improve alignment and train all the parts of your knee to work together effectively after surgery and prevent future pain. This is especially important in reconstructive or knee replacement surgeries. Physical therapy will help you learn to use and control your newly repaired knee, but no amount of strengthening exercises will help if things are out of alignment. A massage therapist can make sure everything stays in their places as you recover and that each is practiced in its own small movements. This will prevent long-term pain and improve your range of motion and overall function so you can go back to regular life.

Massage is also used in scar tissue therapy. After surgery, scar tissue forms at the incision, including in the cut muscles and tendons around the knee. However, this scar tissue can be more rigid than the mobile tissues around it, so it needs to be “remodeled” or worked over and moved around to train it to tolerate the stress and forces endured by the body. A massage therapist has the training to do this for you, further improving knee function after surgery.

It’s not just about pain relief

Don’t get us wrong, pain relief is a great reason in and of itself to receive post-operative massage therapy, but it’s also proven to improve your entire recovery experience. No surgery recovery will be complete unless you can regain a reasonable, if not full, amount of prior mobility and function of your knee. Massage therapy after your knee surgery can help you get just that by reducing the side effects of surgery and preparing your knee to be a fully working part of your body again so you can go back to chasing your dog, dancing with friends, or kicking your feet up and relaxing with no discomfort.

If knee pain is getting you down, talk to your doctor soon about treatment. And if surgery is the prescribed treatment, ask about implementing the magic of massage therapy into your post-operative plan so you can make the most out of recovery and quickly go back to making the most out of life.

Massage can play a critical role in the recovery process after joint-replacement surgery. Hip- and knee-replacement surgery offers a path to pain-free mobility for people whose joint function has diminished due to age, illness, activity, or injury.
Massaging your scars is important. It keeps the tissue around the incision loose so it doesn’t “stick” to the tissue underneath. Wait until after your skin has healed before you start massaging your scar. Your skin will be healed when the edges of the scar are well closed with no gaps and have no drainage.

What is considered a functional ROM from the PT’s view?

In order to complete your normal activities of daily living (ADLs) with ease, your knee has to be able to move freely. After a total knee replacement, at the very least 100-110° of knee flexion is needed to perform basic ADLs such as sitting, walking, and stair climbing. However, some activities may require even more knee flexion for optimal performance and comfort.

  • Walk on level surfaces: 60-75°
  • Go up and down stairs: 80-90°
  • Sit and stand from a regular chair: 90-95°
  • Sit and stand from a low chair: 90-115°
  • Squat: 110-165°
  • Sit in a bathtub: 135°

What are important ROM milestones during the recovery process?

While everyone’s recovery process will look very different based on their overall health status, age, and other personal factors, there are some key milestones your physical therapist will look for as indicators of ROM progress. End of week 1: the goal is to reach at least 90° of knee flexion and be working towards full knee extension. Weeks 2-3: the goal is to achieve at least 100° knee flexion and full knee extension. Weeks 4-6: you should be approaching or have already achieved 110-120° of full knee flexion. Weeks 6+: the goal is to focus on strengthening the lower extremity muscles with a functional range of motion at the knee joint.

Imagine displaying the knee in flexion and extension

I feel pain when performing ROM exercises. Is it normal?

While total knee replacements are routine surgeries with great outcomes, there’s no denying that movement during the recovery process is likely to be painful. Be patient with yourself – your knee just underwent a surgical procedure and the surrounding tissues are healing. Contrary to what you might think, early movement is essential for recovery and will decrease pain and stiffness in the long run. Your physical therapist will guide you through exercises that are safe for you to perform in order to increase ROM, even if you feel some soreness. Don’t worry, just breathe, take it one step at a time, and know you are on your way to getting better.

Why is early ROM important after a total knee replacement?

After surgery, you will likely experience some degree of pain and swelling surrounding the knee joint. In addition, scar tissue formation as part of the healing process can cause the knee joint to become stiff or “stuck” in a position that negatively impacts a range of motion. Performing ROM exercises early on can help reduce swelling around the joint and decrease the formation of scar tissue, both of which will help the knee to move with greater comfort and allow for an increased range of motion so that you can get back to doing the things you love sooner.

What steps can I take to improve my knee ROM post-surgery?

The best way to ensure you have a holistic recovery program after a total knee replacement that will help you regain full ROM and strength is to regularly check in with a physical therapist and assess your progress.


Therapeutic Deep Tissue, Swedish Massage, Sports Injury Massage Therapy in Santa Barbara, Goleta, Ca.

*Disclaimer: This information is not intended to be a substitute for professional medical advice. You should not use this information to diagnose or treat a health problem or disease without consulting with a qualified healthcare provider. Please consult your healthcare provider with any questions or concerns you may have regarding your condition. The information provided is for educational purposes only and is not intended as a diagnosis, treatment, or prescription of any kind. The decision to use, or not to use, any information is the sole responsibility of the reader. These statements are not expressions of legal opinion relative to the scope of practice, medical diagnosis, or medical advice, nor do they represent an endorsement of any product, company, or specific massage therapy technique, modality, or approach. All trademarks, registered trademarks, brand names, registered brand names, logos, and company logos referenced in this post are the property of their owners.