Last month, I spent a good portion of my time researching the pros and cons of leg amputation. No joke. My revised (left) knee was killing me with daily pain starting back in November 2019 when I was becoming more actively engaged in work, social times, and those occasional shopping moments required to feel good about limping. Granted, I have a wounded knee, scarred by many operations (Blog #9). Between visiting websites on the pros and cons of amputation, I convinced myself that perhaps it was time to just live with pain.
But, this kind of pain attached to simple movements like standing, walking and getting up, cast a shadow on my mood and on my view about my rehabilitation over the last year and a half. I wanted out of this cycle and I wanted out quickly and finally– fed by a stalwart refusal to consider any more surgical or metal interventions into this knee already bionic and webbed with internal scar tissue and various external scars to prove it. I was truly in a state of despair.
I did my research on amputation, recovery and prosthetics. It is not an easy subject to consider since it is not an easy procedure to heal from. I knew I was courting extremes but living with chronic pain can lead to extremes. I prepared my list of issues to review with my orthopedic with this topic as the final discussion point. When I hobbled in, he ‘leaned in’ to listen but when I ended on the topic of amputation his audible gasp at the word stunned even me. He shook his head as he quietly declared that he would not broach the subject of amputation because I am far from needing it: only if my joint was bulging from infectious bacteria or shattered would he consider amputation as an option. But he fully agreed that x rays were required to review the status of the joint implant.
The x-rays proved that the joint was well embedded and in alignment. He surmised that scar tissue was inflaming the joint and that perhaps a few nerves were pinched in the process. He recommended that I see the pain specialist about a nerve block and possibly some narcotics to ease the pain. It just so happened, the specialist was just down the hall. I plodded over and waited. While waiting turned into an encampment period, my mind floated back to when I regularly worked with my PT who periodically massaged the joint and leg to move trapped lymphatic fluid, soften the scar tissue and ease the muscles. She then applied kinesiology tape. K-tape! Of course! I jumped up as only my knee would allow, cancelled my appointment with the pain specialist and went home to do what I should have done from the start. I massaged my own leg and then taped the joint. I then put the leg up while chastising myself for forgetting this simple step in pain management.
How did I forget this simple self-care step? I thought I knew what I was doing, proven by having ‘graduated’ from needing regular visits with my PT. Most importantly, the level of pain I was feeling led me to believe that it had to with the metal structure itself. Instead, my chronic pain led to ‘drastic thinking’ (opting for an amputation meets the criteria for drastic thinking) rather than calmly reviewing methodical, step-by-step strategies for pain management including periodic PT visits, rest, massage, anti-inflammatories and K-tape. With the help of K-tape, I was able to walk to the pool later that day and carefully complete my workout. Later, I was able to make dinner, virtually pain free. My husband and I celebrated with a gooey, wonderful mango sticky rice dessert.
Some simple pain management strategies can be hard to remember when your nerves are pinched, and your brain is spasmodically on high alert. I now find K-Tape extremely useful and on an infrequent basis to manage scar tissue pain and the lymphatic build-up caused by the stiffening of collagen fibers.
WHAT IS K-TAPE?
It is a roll of stretchy spandex material that sticks as gently as painter’s tape but is almost as strong as duct tape. It is flexible, moving where and how you move, and it can last up to about 5 days in and out of water depending on how well curved you trim the tape edges ( for avoiding tugs), how vigorously you swim or how hot is the water.
K-tape is not to be confused with Athletic tape, which serves a different purpose and is a different product – and subject- altogether.
HOW CAN K-TAPE HELP REVISED KNEES?
In short, the PT and orthopedic communities agree that K-tape helps to:
- Create balance in the neural circuitry in muscles, tendons, joints, and skin
- Reduce pain, decrease swelling by improving circulation of lymphatic material
- Improve muscle performance and function.
It is ironic that something so easy as tape can manage something so complicated as pain production. Pain sensations start with the aggravation of nociceptors found in our muscles, skin, and joint structures. This pain is then transmitted to our brain where our best and worst feelings, images, rationalizations, alert signals and decisions are generated. Importantly, decreasing nociceptor messages to the brain is believed to normalize muscular spasms, improve muscle tone, and thus minimize pain. K-tape minimizes aggravation of the nociceptors – enabling us to think clearly and calmly about next step pain interventions, if needed.
Scar tissue management: Interior fibrous tissue, or collagen, binding to your skin and underlying fascia is inevitable after a revision procedure. It is called scar tissue and most of our readers are intimately familiar with this difficult material. The previous incision used to implant the original knee replacement is the same incision typically used to enter the joint to revise the implant. Build up of scar tissue is inevitable for our lot and can, sometimes severally, limit normal mobility and range of motion. Kinesiology tape consistently and gently pulls on scar tissue, providing a low intensity and lengthy stretch to the tight collagen that makes up scar tissue, allowing for more flexibility.
Swelling management: K-Tape may help decrease swelling by decreasing pressure between the skin and underlying tissues. This provides a pathway for excess lymphatic fluids (accumulated through surgery or excessive exercise) to better circulate and, through osmosis, to disappear.
Facilitation: K-Tape is used to help improve muscular firing and contraction patterns, especially immediately after knee surgery. This can lead to normalized muscular tone and improved overall performance. Facilitation use is often relied on in the early stages of incision healing. But for those of us with excessive scar tissue, use of K-tape can be extensive. I have a dedicated drawer…though it is important to note that:
K-Tape is not intended to be used more than a few days at a time, and then infrequently. If your pain persists after using K-tape, please consult your medical team.
HOW TO TAPE YOUR KNEE
While a serious session on the subject with your PT is strongly recommended, instruction books are available and various video tapes offer clear visual tutorials. Here are just a few:
https://www.youtube.com/watch?v=v2xYUxXrjxk I like their comprehensive description.
https://www.youtube.com/watch?v=R1m1WGUlZ8A This shows the use of tape by physical therapists, immediately after a TKR. The ‘Fan’ style could still have relevancy for you as it does for me. Consider fast forwarding to 2:21 onward.
www.verywellhealth.com/different-types-of-kinesiology-tape-2696483. This provides examples of different cutting patterns to use for different issues.
Caveat: Please consult with your PT first to determine suitable taping methods for your particular knee structure and for the type of pain you are experiencing. Some of you may have a partial knee replacement, or a torquing metal knee structure, and/or scars from previous procedures and/or various, sundry screws that may need to be considered when determining effective taping procedures.
The primary goals of revision knee replacement surgery it to correct the existing TKR joint itself, adjust for any alignment issues, reduce pain, manage infection and improve mobility. But as we heal, pain revisits and, like a tax audit, causes us to review all that may have contributed to it. If pain is severe or chronic enough, we may also and again tumble down the rabbit hole of despair and worry, taking our activities, our social life, our optimism and our clear-headedness with us. Once untreated pain becomes chronic, we may come to believe that we need yet more invasive procedures to treat it including nerve blocks, opioids and possibly an amputation, besides eternal use of over-the counter anti-inflammatories such as Tylenol.
Use of K-tape can detour, postpone or eliminate falling down the rabbit-hole of despair and distance us from reliance on more extreme pain management measures. As a treatment modality, its use is supported by medical research, while also being accessible, easy to apply and almost immediate in offering relief. But, like tape itself, please always adhere to a suitable PT routine, stick to your medical team overall, and rest when needed so you can roll with the punches of life with more clarity.