Managing Knee Pain and Stiffness After Tibia-Fibula Fracture Surgery

Knee issues

About a month after my left lower leg tibia and fibula fracture surgery, I experience tightness and pain when bending my knee.
What can I do to alleviate this sensation?

Huo Bao Da Lao Ban, 20~29 year old female. Ask Date: 2019/05/19

Dr. Ye Qingnian reply Orthopedics

After a fracture, the knee may feel tight when bending.
If bending the knee is allowed after the fracture surgery, I recommend frequently performing knee flexion exercises.
This will help increase the range of motion in the knee joint and reduce tightness.
If you avoid movement due to fear of pain, the knee will become even tighter and more painful over time, potentially leading to decreased function.

Reply Date: 2019/05/19

More Info

Managing knee pain and stiffness after tibia-fibula fracture surgery can be a challenging process, but understanding the underlying causes and implementing appropriate rehabilitation strategies can significantly improve your recovery. After surgery, it is common to experience pain and stiffness in the knee joint, especially if there has been a significant injury to the surrounding structures, such as ligaments, tendons, or cartilage.

Understanding the Pain and Stiffness
1. Post-Surgical Inflammation: After any surgical procedure, the body initiates an inflammatory response to promote healing. This inflammation can lead to swelling and stiffness in the knee joint, which may cause discomfort when attempting to bend the knee.

2. Scar Tissue Formation: Following surgery, scar tissue can develop around the knee joint, which may restrict movement and contribute to stiffness. This is particularly common if the knee was immobilized for an extended period during recovery.

3. Muscle Weakness: The muscles around the knee may weaken due to disuse during the recovery period. Weak muscles can lead to instability and discomfort when trying to move the knee.

4. Joint Mechanics: The mechanics of the knee joint can be altered after a fracture, especially if there was significant damage to the surrounding structures. This can lead to pain during movement.

Strategies for Managing Pain and Stiffness
1. Physical Therapy: Engaging in a structured physical therapy program is crucial. A physical therapist can provide you with specific exercises designed to improve range of motion, strengthen the muscles around the knee, and reduce stiffness. They may also use modalities such as ultrasound or electrical stimulation to help manage pain.

2. Gentle Range of Motion Exercises: Start with gentle range of motion exercises to gradually increase flexibility in the knee. These can include:
- Heel slides: While lying down, slide your heel towards your buttocks and then back out.

- Quadriceps sets: Tighten the muscles on the front of your thigh while keeping your leg straight, hold for a few seconds, and then relax.

3. Strengthening Exercises: Once you have regained some range of motion, incorporate strengthening exercises to support the knee joint. Focus on exercises that target the quadriceps, hamstrings, and calf muscles, such as:
- Straight leg raises
- Wall sits
- Calf raises
4. Pain Management: Over-the-counter pain relievers, such as ibuprofen or acetaminophen, can help manage pain and reduce inflammation. Always consult your physician before starting any medication.

5. Ice and Elevation: Applying ice to the knee for 15-20 minutes several times a day can help reduce swelling and numb the pain. Elevating your leg can also assist in decreasing swelling.

6. Gradual Weight Bearing: Follow your physician's recommendations regarding weight-bearing activities. Gradually increasing the weight you place on your leg can help improve strength and stability.

7. Assistive Devices: If you are experiencing significant pain or instability, using crutches or a knee brace may provide additional support while you recover.

8. Patience and Consistency: Recovery from a tibia-fibula fracture takes time. Consistency in your rehabilitation exercises and patience with your progress are essential. It is normal to experience fluctuations in pain and mobility during the recovery process.

When to Seek Further Help
If you find that your knee pain and stiffness persist despite following these strategies, or if you experience increased swelling, redness, or warmth around the knee, it is important to consult your healthcare provider. They may need to evaluate for any complications, such as infection or improper healing, that could be contributing to your symptoms.

In conclusion, managing knee pain and stiffness after tibia-fibula fracture surgery involves a combination of physical therapy, pain management, and gradual progression of activities. By actively participating in your recovery and following your healthcare provider's recommendations, you can work towards regaining full function of your knee.

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