Category Archives: total knee replacement

What’s the difference beween massage and physio?

Differences between physiotherapy and massage I often get asked the difference between physio and massage. Massage is the manipulation of superficial layers of muscle and connective tissue to enhance the function and promote relaxation and well-being (wikipedia)

Physio is more about restoring abnormal movement patterns, improving posture, mobilisation of joints as well as muscles and many other forms of treatment such as electrotherapy, taping, exercise therapy, education ergonomics etc.

Massage combines very well with physiotherapy though and we are taught to do some ourselves in our course, although nowhere near as much as most trained massage therapists (when I first met my wife a trained massage therapist who had done years of study I realised how little I knew!) We also have a lot of other things we need to do in a physio session so I tell my clients if you enjoy the small massage component in my physio session to have regular massage in addition to the physio.  I do caution though great though massage is it won’t help get your strength back -you still need to do exercise, but massage can help to make the exercises easier to do)

Total Knee Replacement



Massage after total knee replacement is one of the most effective treatments I have found to speed the recovery from what is more often than not a VERY painful experience (am not trying to scare you off here a lot of people don’t have any choice with OA knees, and just about everyone comes good eventually, it can just be very trying in the first 6 weeks particularly). Massage helps to move the fluid and get the scar tissue moving, helps decrease pain levels, and restore sensation and normal movement (particularly knee bend which we physios and doctors are so obsessed with -the magic 90 degrees you will need before leaving hospital)

CAUTION A couple of big things about massage though – 1/ In my opinion it should not cause pain. You can get an area to loosen up without pain (a little discomfort occurs sometimes but this is a lot different from pain) Listen to your body, frequent light massage works better I find than really hard massage done occassionally. This can often just cause more tightness and swelling (defeating the whole purpose of massaging!)

2/ Make sure you are medically safe to do so, and that there isn’t wound ooze or risk of infection -check with your health professional if unsure)

Besides these two things massage is generally safe TKR particularly once the wound has healed over and scar tissue (like a scab) has formed. Most of the problem getting movement and strength I find comes from the fluid and the scar tissue. This is a result of the surgery trauma -I often say to people post knee you have a good brand new knee in there its just that you are recovering from the operation! My first two patients I treated I watched their TKR being done -it was absolutely horrendous to watch and I said to them afterwards if you saw what was done to your knee you would know why you are so sore!)

It always amazes me though the number of clients I see who went through their entire hospital stay without having a massage or even being told that a massage will help the pain, swelling and scar mobility! Massage (and exercise in water, you can even do both massage and exercise in water) really helps to get things moving post knee replacement, and makes it easier to do the physio exercises to regain knee strength that are also REALLY important. I find though that those clients who have massage really seem to tolerate their exercises better, and with less pain, than those who just do exercises alone. Its common practice for people who have undergone cardiac or breast surgery to be encouraged to massage, I hope one day everyone who has a total knee replacement is given the same advice. I’ve yet to see good research on massage post TKR but I can tell you firsthand after treating many hundreds of people that it really does work!

And you don’t have to have had a knee replacement to benefit from massage. Its a great form of preventative health care and not just for those in pain.