Knee Healing Explained
If you have knee pain, chances are it is due to an issue with the soft tissue or cartilage in your knee. Soft tissue and cartilage heal differently due to their different properties.
Read on to learn more about what to expect during the healing process and how to speed up your recovery.
Soft Tissue Healing
Soft tissue healing is the replacement of destroyed tissue by living tissue in the body. This process consists of four phases: bleeding, inflammation, proliferation and remodelling. There are no clear boundaries between stages as the wound healing response “transitions” into the next stage of healing.
Phase 1: Bleeding
This is a short phase that occurs immediately after injury. It lasts about 6-8 hours, or up to 24 hours after a crush injury.
During this phase, rest to allow bleeding to stop.
Phase 2: Inflammation
The goal of the inflammation phase is to stop the bleeding phase. This phase starts rapidly within 6-8 hours after the initial injury, reaches the maximal reaction between 1-3 days, and gradually resolves in a few weeks. Swelling and heat may be observed around the injury.
During the inflammation phase, the injured area undergoes vasoconstriction, the retraction of injured blood vessels, fibrin deposition and clotting. Blood supply to the area increases in this phase, causing oedema (build up of fluid causing swelling at the injury) and redness.
During this phase, use the R.I.C.E. (rest, ice, compress, elevate) method to relieve inflammation and pain.
Phase 3: Proliferation
This phase starts between 24-48 hours after injury, lasts up to 2-3 weeks, and stops after around 4-6 months. Scar tissue is formed to repair the injury.
During this phase, you should gradually exercise the area without pushing through pain. This helps to build strength and flexibility without overloading the new scar tissue.
Phase 4: Remodelling
This phase starts around the peak of the proliferation phase. The result of this phase is an organised, quality and functional scar similar to the tissue it is busy repairing.
New scar tissue is not good quality or very functional. It therefore has to be taught to behave like the structure it has repaired. When the proliferation is at its busiest (around 2-3 weeks after injury), your body begins to remodel the new scar tissue to get it as close as possible to the function of the original tissue. This process can last up to 2 years.
It is very important to continue to build strength, flexibility and function throughout this stage of healing.
Cartilage Restoration & Rehabilitation
Some cartilage injuries heal on their own with rest and time, but others require surgery to repair. Because cartilage is avascular (it has no blood vessels and does not directly receive blood flow), it does not heal itself well compared to other parts of your body.
Cartilage Restoration Surgery
Doctors have developed surgical techniques to stimulate the growth of new cartilage. Restoring articular cartilage can relieve pain and allow better function. Most important, it can delay or prevent the onset of arthritis.
The goal of cartilage restoration procedures is to stimulate new cartilage growth or implant new cartilage in the damaged area.
Many procedures to restore articular cartilage are done arthroscopically. During arthroscopy, your surgeon makes two or three small, puncture incisions around your joint using an arthroscope.
Some procedures require the surgeon to have more direct access to the affected area. Longer, open incisions are required. Sometimes it is necessary to address other problems in the joint, such as meniscal or ligament tears, when cartilage surgery is done.
In general, recovery from an arthroscopic procedure is quicker and less painful than a traditional, open surgery. Your doctor will discuss the options with you to determine what kind of procedure is right for you.
The most common procedures for cartilage restoration are:
Matrix-induced autologous chondrocyte implantation
Osteochondral autograft transplantation
Osteochondral allograft transplantation
After surgery, the joint surface must be protected while the cartilage heals. If the procedure was done on your knee or ankle, you may not be able to put weight on the affected leg. You will need to use crutches to move around for the first few weeks after surgery, or possibly longer depending on the type of procedure and location of the lesion.
Your doctor may prescribe physical therapy. This will help restore mobility to the affected joint. During the first weeks after surgery, you may begin continuous passive motion therapy. A continuous passive motion machine constantly moves the joint through a controlled range of motion.
As healing progresses, your therapy will focus on strengthening the joint and the muscles that support it. It may be several months before you can safely return to sports or other strenuous activities.
How HeatPulse & Thermosleeve Can Help
Heat & Massage
For stiffness, tightness, and range of motion
For older injuries
Ice & Compression
For pain, swelling, and inflammation
First 72h after acute injury / flare-up of old injury
The Thermosleeve and HeatPulse are great hot and cold therapy tools to help you treat your soft tissue and cartilage injuries.
Thermosleeve uses cold compression to relieve pain and inflammation
HeatPulse provides a heated massage to boost blood flow to your knee, encouraging healing and improving range of motion
You can use Thermosleeve to bring down initial pain and swelling in your knee. Once pain and swelling have calmed, or after the first 72 hours post-injury or post-surgery, switch to the HeatPulse to improve flexibility and range of motion, as well as encourage healing.
You can also use the HeatPulse to warm up and loosen your muscles before doing strengthening and stretching exercises. When you have completed the exercises, use the Thermosleeve to calm flare ups of pain and swelling.