Outstanding Recovery: turning around a stiff knee post-arthroscopy
ID was referred to AquaPhysio by her consultant after struggling to regain range of motion in her knee following a knee arthroscopy. Despite concurrent land-based physiotherapy, her progress was slow, and her consultant had given her just two weeks to improve before considering a manipulation under anesthesia (MUA).
Why Does Knee Stiffness Happen After Surgery?
Post-operative stiffness is a common challenge after knee procedures such as ACL reconstruction, total knee replacement, and arthroscopy. It can be caused by:
- Scar Tissue Formation (Arthrofibrosis): Excess collagen buildup restricts movement.
- Persistent Swelling & Inflammation: Fluid retention in the joint can lead to adhesions.
- Pain-Related Guarding: Avoiding movement due to discomfort reinforces stiffness.
- Limited Early Mobilization: Delayed rehab can result in soft tissue tightening and joint contracture.
In ID’s case, while she had full knee extension, her flexion was restricted to just 85 degrees, far below functional levels. Without improvement, MUA was the next step. However, manipulation carries risks such as pain, swelling, micro-fractures, and re-stiffening if not followed by intensive rehabilitation.
Hydrotherapy: A Game-Changer for Recovery
Given the urgency, ID committed to an intensive hydrotherapy program, attending six sessions over two weeks. The water’s buoyancy allowed for:
- Aggressive stretching with minimal pain
- Increased resistance to activate surrounding muscles
- Joint decompression to reduce stiffness
ID worked hard at each session, showing steady progress in her range of motion. More importantly, she was able to maintain her gains between sessions, which is key to long-term success.
The Result? A Manipulation-Free Recovery!
At the end of the two-week period, ID’s flexion had improved dramatically from 85 degrees to 136 degrees, completely avoiding the need for manipulation.
This case highlights the power of hydrotherapy as an effective intervention for post-op knee stiffness. By combining early mobilisation, resistance training, and manual techniques in water, patients can restore function faster and more comfortably than land-based therapy alone.