Some say that frozen shoulder will resolve itself with or without treatment in 12-18 months. Does that hold true for Arthrofibrosis in the knee? (definitely not true in my case) Is there any study that says leaving it alone (no PT or stretching or CPM) will improve it? I’m thinking it will only get worse.
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Thank you Kayley. Always my “go to” source. You are doing an amazing thing. 😊
Hi,
That's a good question. Unfortunately, it's something of a myth that shoulder arthrofibrosis will resolve on its own. Our blog on the topic says " It’s a common assumption that shoulder arthrofibrosis completely resolves over time, but recent studies indicate that this is not accurate [6] and around 40 % of people still have symptoms after 4 years [5]". Arthrofibrosis in knees is less researched than in shoulders, so we don't have solid statistics on outcomes with different treatments. Knees also "hammered" from full body weight during standing and walking, with structures like the Hoffa's fat pad getting pinched and further inflamed.
But each knee is different in terms of severity and location of scar tissue - which structures are scared - and this has a large impact on how effective CPM is. Some knees require ongoing daily CPM to maintain bend, while another knee (even on the same person) won't need CPM at all, despite having internal scar tissue.
So, we can't make blanket statements, but from the treatment of scar tissue in general the best evidence is in favour of regular (daily) pain-free passive stretching. CPM is one form of passive stretching and it seems that if your knee lacks bend (as opposed to extension) and is painful after activity then it's more likely that pain-free CPM will be of benefit.
Exercising the affected limb is much more controversial and can lead to worsening symptoms.
In the end, you're the expert on the topic of your knee, and your experience with how it reacts to various things is the best guide.
I hope that helps,
Kayley