Post-operative swelling is an annoying complication to deal with. It can limit mobility, increase your perception of pain and even limit your strength.
When tissues are damaged inflammation is triggered. Blood vessels dilate to increase blood flow to the affected area. Vessel wall permeability increases as well, allowing fluid to make its way into the tissue space and create swelling.
This inflammatory phase lasts about 48-72 hours, but the fluid build-up left behind can last for much, much longer.
Now that we know what post-operative swelling is and why it’s there, let’s work on getting rid of it!
Here are the 3 key strategies I’ve found beneficial when trying to control post-operative swelling:
Gravity is both our friend and foe here. You’ve likely noticed by now that the more time you spend with gravity pushing down on you, called a dependent position, (i.e. standing/ sitting) the more post-operative swelling you’ll see.
Our goal is to send fluid back into the direction of the heart so that it can re-enter the system and get flushed out of the surgical site. When you’re in a dependent position, gravity works to do the exact opposite.
However, we have the power to manipulate gravity and use it to our advantage!
Elevate your post-surgical limb so the downward force of gravity is driving the post-operative swelling back to the heart.
Having the limb above your heart is ideal. Since I know that is not always realistic (yes, most workplaces frown upon feet on tables) getting your limb at least a little elevated can make a big difference (i.e. foot up on a chair equally level to yours as shown below).
When you contract your muscles they act as a pump that helps to drive your post-operative swelling away from the surgical site.
Combining movement with elevation (like in the videos below) can be very effective in decreasing fluid accumulation.
If gravity is becoming more of your enemy and less of a friend, this is where compression can come into play.
Applying compression to the area of post-operative swelling can significantly decrease the amount of pooling that occurs throughout the day.
Ace wraps, compression sleeves and stockings are all great choices.
Make sure that the end furthest away from your torso is tighter than the end that is closest to your torso to help guide the fluid back toward your heart.
Never use compression that is so tight that it limits your circulation (watch for blue fingers/ toes!).
What About Ice?
Ice can be beneficial when trying to calm the inflammation that is present in the first few days after surgery. However, once that inflammatory phase is over you’re left with fluid build-up at your
If ice feels good, absolutely use it! Ice after the inflammatory phase is mostly for pain control and is
But, is it going to make a huge difference in the amount of fluid built up at your surgical site? P
But, it won’t hurt!
So, if you enjoy icing, by all means, continue. As for decreasing fluid build-up? Gravity, movement, and compression are going to be your biggest allies.
Post-operative swelling is to be expected, but this doesn’t make it any less unpleasant! Using the 3 keys above can help you to manage your swelling throughout your recovery.
In need of a physical therapist to help you through your post-op rehab? Come work with me!
Song M, Sun X, Tian X, et al. Compressive cryotherapy versus cryotherapy alone in patients undergoing knee surgery: a meta-analysis. Springerplus. 2016;5(1).
Comparison of three treatment procedures for minimizing ankle sprain swelling. – PubMed – NCBI. https://www.ncbi.nlm.nih.gov/pubmed/3133668. Accessed December 4, 2019.
How Is Inflammation Involved in Swelling? | Britannica. https://www.britannica.com/story/how-is-inflammation-involved-in-swelling. Accessed December 4, 2019.