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How to TREAT thigh pain at HOME after Total Knee Replacement!
Feb 7, 2022
What helps with thigh pain after knee replacement?
In this video I share one of my favorite ways to treat thigh pain after a total knee replacement. Using a simple rolling pin to perform a self massage is an easy way to reduce thigh pain, increased circulation, reduce swelling, and improve normal hip and knee function.
During a total knee replacement some surgeons use a tourniquet to reduce blood loss. The tissue damage caused by the tourniquet will result in thigh bruising and pain.
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sharp pain after knee replacement
quadriceps weakness after total knee replacement
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0:00
I want to show you two of my favorite self massage tools and how to use them
0:07
Number one, you see it all the time basic rolling pin this is a $5 wooden rolling pin from Walmart
0:15
You could use wood, you could use metal, you could use marble just about anything will work and even
0:22
if if I didn't have a rolling pin but I still wanted to get some of the benefit instead of
0:29
exposing the skin if I just have a smooth surface I could just roll I've
0:35
had patients fill up a plastic 2-liter pop bottle squeeze it to let some space
0:43
out and then freeze it I've had them use a water and rubbing alcohol solution in
0:50
there so it doesn't freeze solid but it stays extremely cold but we're gonna go
0:55
with a rolling pin. Since we've got it, it's basic, it's cheap. Typically what we're dealing with
1:02
we're dealing with a sore, painful, uncomfortable knee. This could be two, three days post-op. This
1:09
could be two, three months where it's just aching. You're out on your feet longer than usual. It's
1:15
aching now. It's uncomfortable. What do you do? So typically what I advise, I like the couch
1:21
I'm going to slip my shoe off real quick. And what I would do is I would turn sideways
1:27
So the armrest of the couch is basically going to be my backrest
1:31
I'm going to bring this over. All right, hopefully that light doesn't blind you
1:38
So I'm leaning against the couch. I've got my surgical leg up on the side of the couch
1:43
And now I'm going to use my rolling pin. So if it's pretty acute, if you just had surgery
1:50
if there's lots of swelling, if there's some circulatory issues or concerns going on
1:55
what we do is we try to start high in the hip, and we apply pressure back toward the heart, back into the system
2:03
So I might go maybe four or five inches below the hip crease, and I'm working my way up
2:09
I can go on the outside, I can go on the top, I can go on the inside. Once I've done a couple swipes down in this area, I'll go a little bit lower
2:18
depending on what your incision is like if you have staples you don't have to go
2:24
over the staples if you have a vacuum pump on there you don't have to go over
2:28
that you can avoid the incision if it's still covered with the dressing the
2:32
bandaging but if it's not you can go right on the incision and basically what
2:37
you're looking for is you're looking for any tender spots anything that's
2:41
noticeably uncomfortable sometimes what you'll find is you'll find an area in
2:45
and it might be a little bumpy. It might hurt, it might not
2:49
but that bumpiness is basically thickness in the connective tissue And so what I usually explain is maybe you were 12 years old you riding your bike you fell off your bike you hit your thigh you got a contusion in there it scarred over never bothered you for
3:08
your entire life you had no idea who is even there but now we're rehabbing the
3:13
knee and all of a sudden you're like what is this bump what is this stuff if
3:17
you start to apply pressure and kind of focus some energy and time and and work
3:23
through that most likely you're gonna be able to at least soften it I'm not
3:29
gonna claim that you're gonna break up scar tissue and you're gonna do a lot of other stuff that we used to say but you're gonna soften hard non-compliant
3:36
tissue and potentially improve the mobility of that tissue and that's what
3:43
the rolling pin is all about the other benefit to the rolling pin is that it's
3:47
pushing the fluid it's creating a vacuum effect normally when you're walking
3:53
you're probably a super active person before the surgery before the knee pain
3:57
you're walking a lot every step you take these muscles are contracting and when
4:02
they contract they squeeze the blood vessels they squeeze the lymph vessels
4:07
the veins which pushes the fluid out of the limp when you're walking less than
4:12
you had when you're walking differently because of the limb post-op things like
4:17
that you just don't get that kind of muscle contraction. The fluid isn't
4:21
getting out of the limb as well as it used to. So this gives us a little
4:25
mechanical advantage to get that fluid back up and allow the kidneys and the
4:31
rest of the body to kind of clean it up. The other part that the rolling pin or
4:36
any kind of massage does is it desensitizes the tissue. You add a
4:41
tourniquet, most likely around the upper thigh. They obviously cut the knee open
4:45
there's two incisions the superficial and the deep most likely all of this
4:51
trauma they retracted the skin lots of stuff that was going on in there so you
4:56
your body and your brain and your nervous system is sensitized to what that
5:01
might feel like and so we want to turn the sensitivity down a little bit
5:07
because the protection of the pain is over we don't need to be protected any
5:11
longer. The function of pain is done, but our body is still kind of in that
5:17
protective mode. So this helps to desensitize. And then the final thing is
5:23
where back in the day you used to stretch your muscles and I always kind of
5:27
explain if I take a rope and I tie a knot in the middle of the rope and I pull
5:31
the ends of the rope the knot doesn't go away, right? I have to go to the knot and
5:35
untie the knot where it is. And this basically does the same thing. So as I'm
5:40
massaging I'm finding these bumpy areas these sensitive areas I don't have to do
5:45
with my leg up I can do it with my leg down I'm just sitting here and so as I
5:51
find those sensitive areas and I rub them the immediate pain response kicks in and says hey wait wake up something going on I don like what happening I afraid I gonna damage something and you get this big pain response but then if you
6:06
continue to rub it and kind of work it the pain levels go from you know a nine
6:11
alarm to a seven alarm to a two alarm until there's no alarm and you can just
6:17
rub the tissue and you don't really feel hardly anything perfect that's exactly
6:21
what we're looking for. That's a perfect scenario in which the pain didn't serve a purpose. You know
6:28
all pain is real. All pain should serve a purpose. The purpose is to protect you, the person. If you
6:35
didn't have pain, you couldn't survive. But the idea is that sometimes that pain signal is, it's
6:41
like an alarm that's going off when there is no threat of theft. We just need to turn that alarm
6:47
down when it's not necessary that's what the rolling pin does I did so what I
6:53
usually do back here right I get my clients and we'll do a minute or two
6:57
above the thigh all the way around and then depending on their mobility their
7:02
back and hip mobility I'll usually have them start to do the calf same thing
7:08
they're working up toward the knee this time because I've created this vacuum in
7:13
the upper leg now I'm bringing the fluid up so that I can kind of go through the
7:18
body I'll work on the outside of the lower leg there's no benefit to the
7:23
inside of the lower leg that's just your shin bone it's not comfortable you're
7:27
not gonna get any benefit if you can't do it with the leg up on the couch you
7:33
can have the foot on the floor let me see if I can get you guys a better view
7:39
and so with my foot on the floor I just lean over and I'm rolling up and so you
7:45
can imagine here okay what what else is the benefit of this not only am I working
7:50
the soft tissue I'm also working my shoulders I'm also working my back my
7:55
hip my hamstring and my glute it's like doing little mini hip bridges or back
8:00
extensions I'm working my whole body sometimes I'll give my clients with a
8:05
the shoulder problem rolling pin on the calf because they're so focused on
8:10
feeling the calf muscle they forget that their shoulder hurts and they're able to
8:14
strengthen the shoulder without pain in this case we're working the calf because
8:19
that's gonna be a major shock absorber for you as you get back to normal
8:24
walking so a variation on the rolling pin is this you guys probably saw me the
8:32
other day I picked this up at the hardware store it's just a wheel it's a
8:36
caster from you know what you would see in an office chair the kind that I
8:41
usually like has a flat top not this knob and I don't care if it if it has
8:49
ball bearings or not because I don really use them I don like them but in this case basically what I gonna do is I gonna grab the the caster on the side so the wheel can spin but I don have to mess
9:03
with anything else and I'm just gonna do the same thing now this is a great
9:07
little tool for getting into those little areas a couple of you will
9:11
experience some IT band issues some lateral knee pain issues the rolling pin
9:16
is kind of hard and cumbersome it's hard to get to on the side so I get a little
9:20
wheel like this I think I paid for $4 for it and I just work through that
9:26
tissue on the side you know I can go parallel with with the fibers I can work
9:33
perpendicular which isn't usually as comfortable with the fibers and then the
9:39
idea is in terms of well how does that work with range of motion let me change
9:45
my angle one more time here so if I'm working my knee let's say my knee flexion I want to get a
9:53
little more bend in my knee what do I do so I've been my knee to end range whatever end available
10:00
ranges and then while it's there I can kind of work through and massage some of the inside of
10:08
the thigh the outside of the thigh all through the top of the quad usually that's going to create
10:14
create kind of a relaxation because the main thing that's going to prevent from a muscle standpoint
10:19
when you're trying to bend and the knee hurts this muscle is going to kick in because what this
10:26
muscle does is it kicks the leg straight so i need this guy to relax and the easiest way to do it is
10:32
just massage it love it care for it make it feel good right any way you have to do that so i'll
10:40
massage it a little bit I get a little more bend I'll massage it a little bit
10:44
more I might get a little more bend and I just kind of keep working I could be
10:48
there's a TV behind this camera I could be watching my favorite shows and just
10:53
kind of come in through here I can work down again like the inside of my calf I
10:58
can work the outside sometimes people will get kind of that swelling will give
11:04
them difficulty lifting their foot we call it foot drop and some of those
11:09
nerves on the outside of the leg will be compromised. Another really common
11:14
report is numbness. I guarantee people watching this are going to say, yes that's
11:19
me! I've got numbness on the inside of my knee or I've got numbness on the
11:23
outside of my knee. That's associated with the surgical procedure itself, damage to
11:29
the superficial and deeper nerves. But one of the best ways to kind of overcome
11:35
that sensation is with stimulation and a rolling kind of self massage like this
11:40
is one of the best ways to do it so I'm gonna wrap this up now because I hear my
11:45
boys coming in the house but if you have any questions or any advice just holler
11:49
at me let me know what I can do for you I'm happy to keep making these videos
11:54
I'll talk to you guys soon
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