ACL Surgery - SCAR TISSUE / Arthrofibrosis

After ACL surgery, some patients may have issues with scar tissue / arthrofibrosis which may limit their range of motion. It's important to recognize signs and symptoms to address it in a timely manner in order for patients to progress.
FREE GUIDE - 8 CRITICAL KEYS TO SAFELY RETURNING TO SPORTS AFTER ACL SURGERY - wesleywangdpt.com/acl-rehab-g...
The ACL Mastermind Group Includes
-Currently OVER 450 members & 450 videos!!
-Exercise library organized by difficulty level for quads, hamstrings, glutes, calves, balance, plyos
-Exercises ranging from immediate post-op to late stage sport-specific exercises
-Exercise breakdowns - learn how to teach exercises properly, what compensations to look for and how to address them
-Treatment philosophies - I share my thoughts on various topics surrounding ACL rehab
-Case studies - I share case studies of real-life patients
-Pre-jogging exercises
-Return to sport testing
-Private forum to discuss articles, share resources and share difficult cases you may be dealing with
-Click the link below for more information!
Questions or comments? Post them below!
Intro bumper video made by Jonathan Hsu
Email: [e-mail]
IG: / jhsumedia
Join my ACL Mastermind Group: wesleywangdpt.mykajabi.com/of...
ACL Mastermind FAQ: wesleywangdpt.com/aclmastermind/
Online ACL Consultations: wesleywangdpt.com/online-pers...
My website: www.WesleyWangDPT.com
Follow me on Instagram: / wesleywang.dpt
Questions or comments? Post them below!

[@rtyuu999]

If anyone is having trouble with extension I came up with a technique that really helped break down my scar tissue. I tried placing weights in a bag and letting my knee hang with the bag while it rested on another chair but that didn't have much success with it. The biggest exercise that gave me success was standing for longer and longer periods of time while trying to force my knee into as much extension as I could. I would do this for 2-3 hours a day in 20-30min intervals of standing while either playing playstation or watching a movie to pass the time. I would also bend and put weight through my arms on the knee to better force extension. My physio was astonished when I went back to her as I had achieved past 0 degree extension and my quad activation sky rocketed. Now when I go back and see the surgeon soon I will tell him maybe we dont need to go back in for the revision surgery.

[@StoicIntellectual]

0 degrees isnt enough, you must be able to hyper extend to the same angle as your good knee

[@Silphwave]

Sadly mine is screwed. I had to wait 14 weeks for meniscus surgery after injury. And now 6 weeks after surgery, it's been 20 weeks since I last fully extended my knee and the scar tissue is extensive and deep inside the knee joint. I'll need more surgery to remove it.

[@gk2744]

I have the same issue with flexion, except the pain is in the back side of my knee on the lateral side.

[@justinmarkel1604]

Do you have the links to the two articles/studies?

[@marnikstrengthconditioning7502]

Hey Wesley I have a girl that already had 2 scar tissue removal surgeries and it seems like its getting created again as knee flexion hit a wall and there is a lot of clicking and popping going on. The leg is getting stronger but it just seems like its not really catching up to the healthy leg. It just seems like something is blocking there and like the quad is inhibited for some reason. Do you think there is other ways to fix that issue or to keep training like that as going under the knife again would absolutely crush her? Thank you

[@ReyBandz9]

I actually got an mri 9 months post op because i was experiencing locking, missing degrees of flexion and quad deficiency. Strength wasn’t lacking but explosion definitely has been. Turns out i have a cyclops lesion and hopefully I’ll be fully back afterwards. Is 11 months post op too late to regain hyper extension?

[@systema1893]

Dear Wesley, Can you refer who the Doctor / Surgeon was who successfully performed the scar tissue removal for the athletes you make mention of. I have the same issue and would like to consult with the Doctor. Please advise.

[@77knutik]

Question! Please help, my ortho won’t answer me. I’m 13 weeks post op, and my knee Este soon hits terminal and hyper extension after a lot of warming up. It’s not natural to get the extension early in the day. Is this a sign of scar tissue, or is it quite normal For 13 weeks post op?

[@ninalee8625]

I did everything to prevent scar tissue after my TKR surgery. Some sites suggested my exercises may have actually caused the scarring. Why wouldn't scar tissue simply re-form after removal surgery? What are the stats?

[@arthur38379]

How log are you out after scar tissue removal?

[@jesussuastes238]

Hello, I’m 11 weeks post acl reconstruction. I’m feeling my like the acl is tight & stretchy when walking. Doesn’t let me walk fluently. When I wear a brace it actually helps out a bit. Any idea what I can do? My therapist started to put K tape on knee. Do you think that will help or should I be concerned

[@monalisasweetheart7369]

I have the same thing! I was trying to ride a bicycle and my knee absolutely would not let me move and more. It hurt bad and felt like it was locked and at one point, almost felt like plastic. It has felt like that since I got home from surgery but I thought that was normal after surgery! This helped a lot. My doctor suggested aquatic therapy but if that doesn't improve it, I may have to get another surgery to get it removed! The physical therapist told me the doctor would literally put me out and flex my leg up and down to get rid of the scar tissue. I am nervous how it will feel after that though and if I would be back to square one like I never went to surgery!!

[@AL-vi8nz]

I going through the same right now not sure what I should do either… if you find a resolution before I do please let me know

[@monalisasweetheart7369]

@@AL-vi8nz I did end up with getting a knee manipulation done which helped some. So at my best it has done 113 knee flexion. My doctor was able to get it up to 145. I just started Hyaluronic Acid Knee Injections. Today was my first of 3 series over 3 weeks! I am hopeful it helps some with the pain and stiffness. It may take a few weeks so I may not know until the end of May. And I still do physical therapy! I am also going to be getting a rollator at the pharmacy and walking more on my own. Those really help with weight placement but I will also be able to walk! If this doesn't work, I don't know what will but I do bend my knee better! The doctor said you just have to be consistent and do something every day! I have been doing just that! I hope you find something that works for you as well! Good luck and I hope we both heal!! 🥰💗

[@rookiemvp2008]

@@monalisasweetheart7369 Did the injections help at all? Looking for solutions for my wife

[@Redaye77]

How are you now? Did the 2nd surgery help you and did you have more progress over time?

[@monalisasweetheart7369]

@BuxBunneh I am doing considerably better now! Yes, the 2nd surgery most definitely helped but I also had one prp injection and a 3 series steroid injection! I also ride a bike and do crunches and have stopped wearing my brace at night! I am now in a smaller brace for during the day and it helps me to bend it better and I take many different supplements for muscle strength and helping my ability to bend it! One thing is collagen and I'm gonna be upping my protein as well and taking one specific for bone and muscle growth! Been seeing great reviews on how it helps improve muscle density and I lost about an inch or something in muscle! My leg has so much more definition than before! I looked so small the doctor said! I'm happy to be improving even without physical therapy just on my own activity! I feel better walking around for sure! Before I felt so unstable and could barely bend to 80. I'm now at 121 comfortably in my bending and my goal is 140-145. It definitely has been a gradual increase! I use an electrode machine which I believe also helps my knee to get more dense!! I'm happy to see improvement and it should definitely make others feel better to know that even though doctors say that after a certain amount of months if you haven't improved much in your bending most likely you will stay at that place its not true! I'm proof of that! It's been almost 10 months since my surgery and about 6 months since the knee manipulation which was my 2nd surgery! And since then, I have improved 100 fold. I'm happy sometimes things you hear are wrong because I wouldn't have a chance to get any better in that mentality but I am doing amazingly well! I was very depressed though for a while! I thought I wouldn't get there for a long time because my legs felt like plastic to me! It felt like they weren't real legs! My physical therapist told me that some people get that because of the lack of feeling and movement you have and the disconnect you get when bed ridden! If their was one thing I wish I had done differently it's get to moving sooner so that didn't happen but I'm happy it's doing better and I do still get pain especially at night because my muscles are still lacking a bit but I look forward to gaining muscle when I start getting more protein and soon it will be totally back to normal! I do still use my rollator and a brace to get around but I can walk around the place without either! I hope you're doing good and if you haven't already and are considering it, just do it!! Trust me, things will get better but each person's walk might be a little different but that's okay! It's the journey where it is important and now I actually understand it! I'm okay with whatever comes next!! Good luck and may you Be Blessed!! 🙂😇😍😉

[@Redaye77]

Thank you for your videos! Unfortunately arthrofibrosis hit me hard. I had acl and lateral meniscus surgery 5 months ago. After just a few weeks of intense rehab I didn‘t have any progress with extension or flexion (15 degree ext deficite and 75 degrees of flexion). That‘s when I had 2nd surgery for scar tissue removal. It‘s been 6 weeks since 2nd surgery and I‘m stuck again with progressing my extension (still around 5 degree deficit) and flexion is stuck at around 120 degrees. Every time I try to stand with my leg extended it‘s very hard to keep it in that position and also painful in the medial area of the tibia. Whenever I go from forced extension into flexion again while standing on that leg I feel some type of cracking/popping. I don‘t know if it‘s my patellar, my patellar tendon, my acl?! Do you have thoughts on it? Oh, and stiffness is also still very present..

[@Alimarie910]

I’m in the same boat. I had ACLR 7 months ago. Manipulation at 8 weeks post. And I just had a adhesiolysis, manipulation and debridement. Missing 5-10 degrees extension and can’t get past 110 yet. It’s been a terrible 7 months and my other knee has compensated so much I have pain in it too. I would get a second opinion or see another surgeon. Someone who’s dealt with arthrofibrosis before.

[@jordanpostle8641]

My first ACL I had trouble and pain with flexion and extension for months. Surgeon said it was probably just scar tissue and went back in again. For a little over a year there was no change at all. Went to a new surgeon who did MRI and told me I wasn't given proper graft placement and had a cyclops lesion. Told me best results would be to do a ACL revision or he could just go in and clean up the lesion. I didnt want to go through all the pain of another ACL surgery. I was young and stupid and should've just had the revision but i just opted to have the knee debrided and cleaned up. 12 years later i am currently 6 weeks post op dealing with issues in flexion and extension again. Have about 5° extension and 85° flexion. I know people progress at different speeds but I feel like I should have more extension and flexion. Have my 6 week check up in a few days and going to have them order me a MRI just to be ahead of the game.

[@MrMagicR]

Hectic! Good luck

[@wesleywangptdpt1068]

sorry to hear about what you've been through. I couldn't imagine the mental fortitude it takes to go through it again. I actually have a patient right now who just had a ACL revision because her initial graft was too vertical and she had no rotational stability.

[@TopBoi93]

How long after your first ACL surgery did u have the cyclops lesion removal surgery

[@Marshmallowandpetey]

I’m 6 weeks post op now and at 10 extension and 80 flexion. I had pretty much full range of motion prior to surgery. I didn’t start pt until 4 weeks after due to pain though. Surgeon wants to do the scope for scar tissue removal in a few weeks, but I’m very tempted to decline it.

[@VD-tj6me]

hi, mind sharing why you opted for another ACL revision in the end?

[@seba187]

Hi doctor I’m 23 days post op and only have 65-70 degrees flexion I also have pain in the back of my knee when doing my bending exercises. I used a quad tendon graft, could this be why my progress hasn’t been as fast? And is pain in the back of the knee normal 23 days out.

[@cheetothefish4435]

i had the same exact thing and experience the same pain. how are you doing now ?

[@Istaypositive]

Guys, I have the same exact thing I had a quad graft I’m currently 5 weeks post op. My flexion is stuck at around 75-85 with force and extension at around 2-3. I feel like bending is just not improving at all and I come to a point where I feel like something is just blocking the knee from bending. I’m very concerned and I’ve been so stressed about it. Have you guys made any progress?

[@seba187]

@@Istaypositive just grab a scarf or something to put on the bottom Of your foot and slide your heel to as much as you can and when you can’t no more on your own use the scarf or whatever u have to pull on it more and hold for 5-10s it’s uncomfortable but it helped me break through the scar tissue

[@m.m.alfaihani8263]

This is exactly the same story as mine, i had 3 surgery on my ledt knee

[@Etc155]

did you do scar tissue removal? Im facing the same issue but my ortho told me he doesnt suggest i do anything with it as the scar tissue will grow back and cause more stiffness

[@MrMagicR]

Hi Wesley, any advice for a 18 months post acl repair stiff knee. I have 130 degree range of motion, but im stuck somewhere between 130 and 140. Left side of the knee still feels stiff and not like my other now. No pain. Thanks for your time.

[@jordanpostle8641]

Was it just an ACL reconstruction or did they do any meniscus repair or menisectomy?

[@MrMagicR]

@@jordanpostle8641 Hi.. Thanks for question. Just acl

[@binny9820]

Hi did u get it sorted? What did u do? I have the same issue post acl​@@MrMagicR

[@MrMagicR]

@@binny9820 Hi.... I'm doing better now, but I have learned that it can take anything from 2 years to 5 years for the stiffness to go away if you keep on working on your knee with stretching and excerises. I still have about I think 5 deg to go but it did improve slightly. I can do everything, so I think it's not the end of the world but I will keep pushing

[@russellbryant2273]

My knee feels like it has hit the wall of flexation. I am post op 9 weeks Acl (allograph, donor) and Meniscus surgery and the first 6 weeks i was told to be immobile. I had to wait another 2 weeks to get my PT on top of that! I have done 4 session so far. Is this a sign of arthrofibrosis in such an short period of time?

[@darnellejosephs6034]

Hi there, how are you doing now? I'm bucket handle meniscus and quad graft. 6 weeks non weight bearing and I can only reach 75 degrees flexation with alot of front knee pain, won't go any further.

[@Istaypositive]

@@darnellejosephs6034 hey same here I had a quad graft 5 weeks ago and can barley get to 75-80 flexion. I’ve been really stressed about this and don’t know what to do anymore.

[@tshegofatsomotebele4677]

I had ACL and meniscus repair,my knee bends up 77cm my flex is not so bad.I am 5 months in and I am super depressed. I am in pain,can sit for more than 30 minutes without the knee locking in

[@Ree-rn1tg]

My doctor won't do the manipulation they are very negative to me some doctor are not doctors