Scheduling A Massage After Knee Replacement Surgery

Massage therapy is an effective treatment in post-surgical care to reduce pain, improve swelling, and help return patients to daily activities. Several studies have investigated the benefits of massage therapy as soon as 2 days after total knee replacement surgery.

Evidence supports the safety and effectiveness of scheduling a massage as soon as 48-hours after surgery. Be sure to choose a licensed massage therapist, physical therapist, or occupational therapist who is trained to provide post-surgical massage therapy treatments.

In this article, I will review three phases of recovery following a total knee replacement in which you may want to schedule a massage and what to look out for.

Phase 1 – Surgery day through day 7

A 2016 study looked at the benefits of a manual lymphatic drainage (MLD) massage performed on patients who underwent a total knee replacement. The massage was performed every day from day 2 to day 7.

The conclusion of that study suggests “MLD treatments applied immediately after TKA surgery did not reduce swelling. It reduced pain immediately after the treatment.” [1]

Another result from this study suggests that MLD improved knee flexion which may have resulted from decreased muscle guarding and fear of movement in the patients that received the massage therapy treatments.

Phase 2 – Weeks 2 through week 6

In a small pilot study, mechanical massage from post-surgical day 7 onward showed measurable improvement in range of motion, reduced pain, and reduced swelling. [2]

If you are planning to schedule a massage therapy session during this phase of recovery a couple of things to consider are:

• You may not feel comfortable laying on your stomach because of the pressure placed on the incision
• You should look for a licensed massage therapist with extra training in lymphedema management and post-surgical massage techniques.
• You might request a massage therapist familiar with cupping or instrument-assisted soft tissue mobilization to reduce swelling and pain in the surgical leg.

Person on massage therapy table.

Phase 3 – Weeks 7 through full recovery

During this phase of healing many patients will have already had any staples removed or full closure of the post-surgical incision.

Patients are more comfortable positioning in prone (laying on your stomach) and will receive great benefits from a traditional massage.

Does Medicare Pay for Massage Therapy After Knee Replacement?

Yes,  Medicare Part B coverage does pay for massage therapy treatment after total knee replacement surgery as long as the massage therapy service is provided by a licensed and Medicare contracted physical therapist or occupational therapist and is performed with other therapeutic interventions under a therapy plan of care.

Does my health insurance pay for massage therapy when provided by a licensed massage therapist?

Every insurance plan is different. Traditional Medicare Part B does not pay for a licensed massage therapist to deliver a massage therapy treatment, but other insurance carriers may.

The first step is to call your insurance plan to verify coverage. Some Blue Cross Blue Shield policies do cover the cost of receiving massage therapy services from a licensed massage therapist if the service has been prescribed by your medical doctor and has been determined to be medically necessary.

Reference:

1. Pichonnaz C, Bassin JP, Lécureux E, Christe G, Currat D, Aminian K, Jolles BM. Effect of Manual Lymphatic Drainage After Total Knee Arthroplasty: A Randomized Controlled Trial. Arch Phys Med Rehabil. 2016 May;97(5):674-82. doi: 10.1016/j.apmr.2016.01.006. Epub 2016 Jan 30. PMID: 26829760.

2. Kim SM, Kim SR, Lee YK, Kim BR, Han EY. The effect of mechanical massage on early outcome after total knee arthroplasty: a pilot study. J Phys Ther Sci. 2015;27(11):3413-3416. doi:10.1589/jpts.27.3413