How To Massage The Knee (and Scar) After TKR Surgery

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Massaging your knee at the proper time after total knee replacement can aid in your recovery.

A general full body massage can help relieve tension, stress and anxiety. It also can increase circulation to the soft tissues that include muscles and tendons.

For your surgically repaired knee, massage can increase the blood supply to the area and promote healing. It can also help reduce swelling, relieve pain and just give you a general soothing feeling when your knee is aching.

Once my doctor gave me the okay to massage the area around my knee and the scar itself, I used my hands and later an electronic massaging device on a regular basis.

My wife was also kind enough to help out with these massages too. It is much easier for a caregiver to reach the back of the leg and knee area.

Massage also helped me before many of my physical therapy sessions to loosen up the knee so I could do the required exercises. In this article I will share my experience with massage post TKR.

Why Your Knee Will Be Sore and Uncomfortable After TKR

TKR causes some serious trauma to your knee joint.

Your surgeon will make a large incision directly over the top of your knee. Once the surgeon has you opened up, the bone is either cut or shaved.

Small holes are drilled in your bones. Your muscles and supporting structures probably have atrophied before surgery.

In my case my knee had bowed and the surgeon physically straightened it. During the process, my ligaments and tendons were stretched in ways they hadn’t been in decades.

Often times, surgeons remove your ACL too. My ACL was missing from previous injuries and my surgeon jokingly thanked me for not having to remove it during my TKR.

After surgery you have to deal with the wound (incision), also with the drainage (blood), swelling and the stiffness that results. The physical therapy starts hours after surgery; the hospital physical therapist had me up next to my bed and doing my initial range of motion exercises.

At this point, I was medicated and still had the drainage tube attached to my knee.

How Massage Helps With These Issues After Knee Replacement Surgery

After the home therapist’s first visit, she gave me the okay to begin massaging the area around and behind my knee.

She explained that massage helps to stimulate blood circulation around the muscles, which increases the flow of oxygen and nutrients to them.  She emphasized that massage may also aid in improving range of motion and flexibility.

My first massaging by my caregiver and myself was all by hand. I began massaging away from the incision area which is extremely tender and far from healing.

My early massages were centered on the back of my knee and above my knee (thigh) where the tourniquet was placed during surgery.  These areas were still tender too and I started with very slight pressure, more of a rub.

Later I began massaging the sides of my knee still not anywhere near the incision. As time went on and the swelling went down, I was able to increase the pressure little by little.

Massaging helped increase the circulation by increasing the blood supply to the knee, which is critical for healing. Along with frequent icings, massage also helped reduce the swelling.

I had to wait until my staples were removed and all the scabs had fallen off before I could begin to massage the scar itself. Massaging the scar helps to decrease scar tissue build up and may help to make your scar less noticeable.

How I Massaged My Knee During Physical Therapy

After warming up on the stationary bike, my offsite therapist massaged my knee with Free-Up massage cream for 10 minutes before I did any of the more demanding exercises.

The massage not only felt good but it seemed to loosen up the muscles as well. My therapist encouraged me to massage my knee at home too, especially before I did my exercise routine.

He recommended the product Free-Up (it is advertised as “a lubricant for soft tissue mobilization and massage”) I liked it because it worked well, was not greasy and could be wiped off easily.

Massage at Home:

My first massages were all by hand, either by myself or by my caregiver. Preparation for the massage was relatively simple.

I used a towel and a jar of Free-Up. I sat up on my bed, and put a towel under my knee. I had the Free-Up nearby.

Small amounts of Free-up are all that is needed. A little goes a long way and helps your hands glide along the massage area.

As I mentioned above I started out with minimal pressure but as time went by I increased the pressure. My therapist encouraged me to push away from the wound.

At first, I really worked the area behind my knee and my upper thigh the most. The towel keeps any Free-Up off your bedding and then it is right there to wipe off any excess cream after you complete your massage.

I would massage my knee for about 10 minutes prior to a workout. Before going to sleep, my caregiver or I would massage my leg for about 20 minutes.

Every now and then I would massage my knee while sitting in my recliner watching television. I feel like I got better results sitting up in bed because I could reach my knee better.

Massaging in bed also allowed me to turn over on my stomach if the caregiver was giving the massage.

Once the scab fell off my incision I began to massage the scar area 3 times a day with either Free-Up or Carmex hydrating lotion. I often put the Carmex lotion on the incision 8 to 10 times a day to keep it moist.

Transition to an Electronic Massage

I began using a handheld electronic massage tool about a month after surgery. I did not use any massage cream with the tool.

I used it primarily on the sides of my knee, behind my knee, my thigh and my calf. I avoided the wound site and any place like the patella (knee-cap) where the massager would hit a bone.

The electronic tool works well in the meaty areas. I can massage those spots longer without wearing out my fingers (I like this Oregon Scientific massager on Amazon). In order to work close to the incision, I always use my hands. Sometimes I start with the electronic tool further away from the incision, then finish with my hands.

Transition to a Professional Massage

Before TKR, I would get a full body massage twice a month. I did not have a full body massage until 6 months after my surgery.

I could have gone earlier but I wasn’t too keen on someone else working on my knee yet and I preferred to massage myself or let my caregiver massage the knee.

When I did get my first professional massage post-surgery (with a masseuse that I had never had), I did not tell her about my TKR and she worked both legs and knees the same and it felt great.

I have since gone back to my twice a month massage routine.

Tips To Remember:

  • Find a comfortable place to massage your knee.
  • Avoid the wound area initially.
  • Start off with gentle massage and increase the pressure as time goes by.
  • Use a cream to facilitate the massage.
  • Keep a towel handy for easy cleanup.
  • Use your hands around the incision area and on the scar.
  • When using an electronic massager, focus on the meaty areas and avoid the incision area and any bony areas.
  • Hand massage and electric massage work surprisingly well on the back of the knee in the initial days.

Conclusion

Massage was and still is an important part of my recovery process from TKR.  I hope the information and the tips I have provided will help you in your TKR recovery as well.

29 thoughts on “How To Massage The Knee (and Scar) After TKR Surgery”

  1. Thank you for advice I just had TKR in March for 2019 . I’m a month post surgery. I didn’t get a home caregiver after I left the hospital. I have been having a hard time with my range if motion. I would like for me advice on how can get good range of motion.Thank you Dawn Louisiana.

    • Thanks for the comment. I know the first month can be a tough one. I can’t provide advice, only my experience. Hopefully, you can speak with your doctor or a physical therapist to find a recovery plan that’s best for you. Best wishes!

  2. Thanks for sharing your experience. I am five weeks post TKR and still experiencing a great deal of pain especially with PT and massage. I realize the benefits of massage therapy and I’m praying my knee will start to tolerate it more as time passes. I pray continued healing for both of us.

    • Thanks for visiting and for the kind words. 5 weeks is still early, so even though it’s tough, stay positive. I started to get my best improvements in months 2 and 3!

  3. I’m going to order that cream immediately! Sounds like a great idea!
    I had my surgery 19 days ago and it’s been a dream! Pain and swelling is minimal. I’m very lucky! I’ve used a compression stocking which has helped enormously. I do find I have soreness the day after physio and I think the massage will help. Thank you for your tips.

    • 19 days is still a challenging time. Soreness should be expected, especially after a physio session. You have many months of improvements yet to come. Glad to hear you’re off to a good start!

  4. I had surgery three weeks ago today. I walked one day with a walker and never after that. My recommendation to anyone is to practice your exercises before surgery. Learn how to get into and out of bed, In and out of the car, on and off the toilet and any stairs you have.
    Work hard at PT and listen to what they say. After surgery, I messaged my knee behind and all over except the incision. Everyday I did that several times. I also tapped around the incision to reduce sensitivity. Now I’m massaging the incision with vitamin E oil several times a day and doing my
    exercises faithfully.

  5. Thank you for sharing. I was given minimal instruction on massage. Almost as a side comment. I knew it had to be more to it so began researching.

    I am 5 weeks post surgery. Despite fast recovery to most aspects, I am stalled at a point where I have a click with each step. With that, pain.

    I believe massage will help this. I was doing light short term massage. Now, I will increase time and pressure and hope it isn’t too late.

  6. I had my TKR on August 22nd and find the pain horrific. Am doing the physio faithfully. Had the left knee (TKR ) done in 2013 and do not remember the pain being this bad. Tomorrow I get the staples out. What kind of medication for pain did they give you and when did you stop taking it?

  7. Hello! I have two questions I hope you can advise on. I am 10 weeks out from left TKR.

    1) is it normal that on some days my knee is much tighter than on other days? I was at 115 deg flexion last PT visit, today I can barely flex my knee is so tight.

    2). I massage my knee and scar at least 3 times a day, using my hands, and a tissue oil, which helps. Recently, after my evening bath, I’ve twice used a massage device around the knee, and on the back of the knee (not over the incision or patella) , and both times I’ve noticed that the following morning my knee is extremely stiff and sore. Is this your experience too? I’m not sure if I should continue with the device or if I should stop.

    • Hi Colleen, I’m not a doctor so I don’t feel comfortable giving advice. I only share my own experience. 1) Early on the joint and ligaments are stretching and getting used to the new knee. At 10 weeks I had tightness after workouts as well (mainly due to swelling/fluid). 2) I also massaged the back of my knee and it felt beneficial. I always expected swelling/fluid to be around the knee during the healing process and this caused me a lot of stiffness morning after workouts. That’s why I elevated then knee and iced a lot. When in doubt, ask your physical therapist or doctor. Thanks for reading and I wish you continued improvements!

  8. Thanks for sharing your experience. One month ago today I left the hospital after knee replacement surgery. The back of my knee is very tight and sore. My foot and swollen ankle hurt during exercises.
    At my second outpatient PT, they tried to get me on the bike. I wasn’t able to do rotations because my knee was tight. As commented, there’s a lot of stiffness when getting up in the morning.
    I’m faithful to the exercises and stretches but I can see this is a slow process.
    PT recommended a cream and oils for the incision so I’ll try Free Up and Carmex.
    Elevating and icing help but the knee still tightens up quickly. Doing massages behind the knee and around the incision. Gentle healing blessings to you and all who shared their stories. Marie

    • Definitely a slow process and I understand it’s easy to get frustrated. I took my pain pill before workouts so I could do more and the next day I was stiff and sore…but I kept moving, kept icing. The hard work pays off! Thanks for the comment!

  9. I had my Tkr 3 months ago. I went to pt 2 times a week the did wonders. I walked in with a 45° degree angle walked out with a 128° angle. I have been dealing what’s a lot of swelling just got my knee drained for the second time. I can move a lot better unfortunately I am working and not much time to elevate and ice. And nobody ever really told me about the importance of the massage except for my surgeon’s PA and that was about a month ago. Getting my left knee done now next week. Now I know a lot more what I should do and what I should not do definitely I will do a lot more massage right from the get-go. Thank you for all your advice.

    • Seems like you’ve made a lot of progress. 3 months in and you should see more improvements in the months to come, though at a slower pace. 128 degrees is great! Thanks for reading and for the comment!

  11. Your blog and book have been very good. An excellent way to get the best summary experiences in one spot. I have read it many times in the last two weeks. I am 10 days post op. Could you be more specific about how you are doing the non machine massage? (Circular motion, thumbs only etc.?) Thanks

    • Thanks for the feedback! You’re right in the middle of the most challenging and important time. At that point I was massaging mostly with pressure to the sides of my knee (ligaments). I used index finger and thumbs. I massaged gently because I didn’t want to affect the wound as it healed. Be optimistic and take the physical therapy seriously…the hard work will pay off in a month when you begin to feel the improvement.

  12. Hi Ken,
    I am 3 weeks post op TKR today. The stiffness is incredible…feel like a tight band is around my entire knee all the time. In doing some research, I came across what some referred to as tight band syndrome after total knee. Think I may have it. Ever hear of it?

    Thanks,
    Sandy

    • Haven’t heard of it but I felt my ligaments were very tight after my surgery. 3 weeks is still very early. In a few months I hope you are feeling great!

  13. I am 10 days post op. From my 2nd knee replacement. The first TKR was done exactly 6 months before the second one. I feel fortunate to report amazing results. Reading your blogs has helped me try new things that I hadn’t heard of, like massage. I am 67 and wish I had consented to TKR a long time ago when my doctor first advised it. I would like to ask how long should I expect my knee to give resistance and some pain to bending ?

    • Good to hear you’re doing well and making progress. Not sure about your individual bend. I focused on stretching as well!

  14. Ken,
    Thank you so much for writing this article or blog. I started reading before the surgery and I’m day 3 after surgery at home. I woke this morning feeling so amazingly good ( yes, I’m still on meds) I cried tears of joy, finally realizing that my life is going to really change. Realizing how blessed I am to have had the surgery. You gave me hope and I thank you so much for all that you are doing.

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