My knee is stiff, and I want to know why. Rather, I want to know how. The reason, I’m sure, is that I broke it rather badly eight weeks ago. The knee was surgically repaired seven weeks ago, with a variety of plates, pins, and screws. The leg was in a cast for a few weeks, but for the past two weeks or so, it’s just been in a sort of splint. (Actually, it’s the back half of the cast after the front half was cut off, and it’s been holding my leg more or less in place by being bandaged to the leg.)
Now I’m told to unsplint the leg a couple of times a day, and bend it. The knee will bend about 15 degrees, I think, before it starts to hurt. It starts to feel really tight inside, like if I force it to bend any further it might pop. If I push it a little, it hurts a lot.
My question is this: What makes it hard to bend? I mean, the femur and tibia haven’t fused together, I hope. It isn’t as though the skin that encases the joint is too stiff to bend. The knee is a bit swollen, but as far as I know, the joint contains no erectile tissue that might make it stiff. I have a basic biology class understanding of how the knee works, but I can’t figure out what it is that should be flexible that has become inflexible. Ligaments? Menisci?
My doctor seems like a nice guy, and his English is a bit better than my Korean. Still, our communication is limited and a little difficult, so I haven’t burdened him with this question. Can anyone here explain, in simple English, what physically makes a stiff joint stiff?
Been there, done that, except a) much worse (nearly a year on crutches, and 6+ months with no weight bearing at all) and b) to my ankle, not my knee.
2 weeks is not very long, but I’m surprised your doc is only telling you to stretch it a couple of times a day. Have you asked him about physical therapy after surgery like that?
Well, you broke your knee, and then somebody had to go in there a-cutting to repair it. You’ve got scar tissue that’s formed, as well as probably some remaining inflammation, and neither of those things are conducive to elasticity and flexibility. Not only that, but the joint has been immobilized time for a long, and that would lead to temporary loss of flexibility for virtually anyone. Slowly you’ll heal up and be able to strech out those damaged tissues so that you can regain most or all of the flexibility you used to have.
Well, thanks for the replies. Of course I realize that 2 weeks isn’t long, and that I have some months to go. I’m still not perfectly clear on where this scar tissue is–there isn’t that much skin or muscle involved, and I don’t think the bony parts are especially inclined to form scar tissue. I could be wrong, of course.
I’ll also admit that I have only a foggy idea of what exactly “inflammation” is. It seems to involve swelling, turning red, and hurting. But I’m not sure what makes that happen–an inflow of blood? What is there in a knee to get inflamed? Can bones get inflamed?
But I realize that I’m not going to get a medical degree here online. Just trying to understand the phenomenon a little better. My blender is pretty lightweight, but maybe I’ll give it a try. Thanks again!
If a healthy knee were allowed to flex only a couple of times a day, it would be stiff and painful. Your knee, on the other hand, has been bashed hard and drastically repaired. It’s only natural that it hurts and won’t bend much. Your knee, MrO, will teach you patience…whether you like it or not. I agree with Eva Luna that flexing it more than once a day would be good, but take it easy! When you flex it, don’t put any weight on it. Lie on your back, stick it up, and bend it. Don’t do that macho A.J. Foyt thing, and remove the cast early. A.J. limps. :smack:
“Doctor, I keep getting stiff in the joints.”
“Well, then, stay out of those joints.”
Thanks, AskNott. I didn’t explain that bending thing very well. I meant that the doctor told me to unwrap the leg 2 or 3 times a day, flex it several hundred times, and then wrap it back up. So it’s at least a thousand or so flexes a day. I probably do more than that, since there isn’t much else I can do these days.
Despite my username, IANAD. I am, however, married to a physical therapist. Loopydude is right on target identifying one of the culprits. Scar tissue, which is much less elastic than “normal” tissue, has formed in and around the joint. Eventually, your physician will prescribe physical therapy as part of your rehab. One of the first things the therapist will do is to begin breaking down that scar tissue. In some cases, that means forcing the knee to bend until the scar tissue tears away.
Your knee most likely will “pop” during PT, probably quite audibly. From what I’ve seen and heard it’s not a very pleasent process in the short term (they don’'t call them “physical terrorists” for nothing) but it’s necessary to regain full mobility.
Biomechanics is a very complex field, and people (like me) spend years studying it (well, in my case, it really only amounts to like 2 years, that’s why most in the field have at least a master’s degree.) I will try as best I can to sum up some of what’s happening in one post:
When your knee was broke, several things happened, one of the most noticible was inflammation (you got three out of four of the symptoms. Rubor et tumor cum calore et dolore (redness and swelling with heat and pain.))
Inflammation is your body’s attempt to heal yourself. The area sweals with fluid. In the fluid are many little cells. White blood cells try to destroy bacteria and other invaders, while other cell go abut the process of trying to reconstruct the knee you injured. The surgey itself was basically another injury. The cells trying to heal the injuries will eventually make scar tissue, which as said, is not as felxible as normal tissue. Plus, all that fluid adds to the inflexibility as well. Here’s an example:
Imagine a metal hinge. You can bend it just finem right? Well, now imagine it’s underwater. The resistance of the water is going to make it harder to open. In addition, water might get into the inner pat of the hinge, reducing the effectiveness of any grease that might be there to help prevent chaffing and friction. Similar thing happens in your knee. Fluids that aren’t normally there now are. They have a greater resistance, and they don’t proivide as low amount of friction as what is normally there.
But make sure to keep doing the exercises. The more the knee is (gradually) worked, the quicker it will get back to its old self again. If you never gave the knee any stress or strain during the healing process, then when it was finally all healed, it would be much weaker. By forcing yourself through the pain now, you’ll be better off in the long run.
Great, I’ll be looking forward to that. Thanks for the good wishes!
No argument there. Not that I’m not grateful, of course. And thanks for the explanation. It’s starting to make sense, I suppose. I do realize that I don’t have much choice except to do the exercises and wait, but it’s easier when I have some understanding of what’s going on in there.
I have a bad knee too… only i have no idea what is actually wrong with it. I injured it during a cross-country road race… but i have no idea how… anyway… x-rays, an MRI, and a scope operation later… i STILL have no idea what is wrong with it… other than I was told, unless I want full surgery, then live with it.
However, it’s constantly painful, though fully functional. But to the point of this post/reply… when it get’s cold, it get’s REALLY stiff…
so my Q to add to the OP’s is: Why duz my knee get stiff when it’s cold out?
btw… popping my knee actually feels quite ‘exhilarating’… and actually helps with the pain and stiffness. Though, I usually need my chiropractor to do it, as I can’t put enough force on it, to get it to pop.
