Should I push through the pain in physio to loosen my stiff knee?

Why forcing can backfire

A stiff knee after surgery is often an inflamed knee. Hard, painful stretching adds more inflammation, which the body answers with more swelling and scarring. The muscles also guard against pain, tightening up and resisting movement. Patients sometimes find their range improves at the session and is worse the next day.

In some people with arthrofibrosis, a gentler, inflammation-calming approach recovers more movement than aggressive therapy.

A useful guide to discomfort

• A stretching sensation that eases within minutes of stopping is acceptable
• Pain that stays mild and settles by the next morning is usually acceptable
• Sharp pain during exercise is a sign to ease off
• Swelling and warmth that increase after sessions mean the dose is too high
• Movement that is worse the next day means the plan needs adjusting

What usually works better

Short sessions several times a day, rather than one long, painful session. Take prescribed pain relief before exercises. Use ice and elevation afterwards. Prioritise getting the knee fully straight, with simple positions such as resting the heel on a rolled towel. A stationary bike with a raised seat helps bending in a rhythmic, gentle way.

Tell your physiotherapist honestly how the knee responds the day after, so the programme can be adjusted.

When to come back to your surgeon

If movement has not improved for two weeks, or you are losing range despite sensible exercise, ask for a review. At Aman Hospital in Doha, Dr. Gelber checks for swelling, scar tissue and other causes, and decides whether medicines, an injection or a procedure are needed alongside physiotherapy.