Reducing swelling will get you moving faster after ACL surgery and will help you achieve full knee extension which is critical to the success of your recovery!

A question that if often asked by a person who has undergone a knee reconstruction is how do I reduce knee swelling after ACL surgery? Knee swelling after ACL surgery is common and it is very important that your treatment and rehabilitation includes measures to reduce swelling.

Applying the appropriate protocols and learning how to reduce knee swelling after ACL surgery will assist you with improving your knee extension and flexibility.  Restoring knee extension and flexibility is a key goal within the early stages of your ACL rehabilitation.

Several studies have shown that pain and swelling in the knee limits range of motion and causes the surrounding muscles including the quadriceps to be ineffective.

Therefore it is very important that you ice regularly and take the appropriate steps to manage knee swelling as part of your ACL prehab before surgery and also throughout your ACL recovery timeline post surgery.  Reducing excess swelling in your knee, should be a key focus in the early stages of your rehabilitation.

What happens in hospital to control swelling after ACL surgery

After the operation, once you return to the hospital ward many surgeons will have an inflatable cuff (cryo cuff) placed around your knee. This is filled with ice and water to cool the knee and control swelling. People find this very comfortable and is a good first step for controlling your knee swelling.

Depending on your surgeons preference you will have either 1 or 2 drain tubes placed in the knee to stop unwanted blood and swelling from accumulating which can inhibit recovery. The tubes are usually removed within 6 hours of surgery.

At each post operative appointment with your physiotherapist your progress will be reviewed to ensure you are on track and suggestions made regarding your recovery.

Reoccurring problems are likely to occur as a result of poor fulfilment with your ACL rehabilitation.  It is very important to commit yourself to reducing and managing swelling after ACL surgery.

Below we discuss 7 key tips on how to reduce knee swelling after ACL tear surgery.

Why is knee swelling after ACL surgery such a problem 

A common problem that people face after ACL Surgery is a highly swollen knee. This is often accompanied by pain and soreness.

Swelling is a key reason for loss of flexibility in the knee.   Swelling can inhibit your recovery, and impact other activities such as when you can walk after ACL surgery or even influence when you can drive following the operation.

Swelling effectively shuts down the muscles surrounding the knee.

How long does it take to reduce knee swelling after ACL surgery

Significant reductions in knee swelling can be achieved in the first one to two weeks after ACL surgery (read below for more information),

Swelling can continue to be present for 6 to 8 weeks after surgery and you may notice short term increases for periods of up to 48 hours after exercise. This just indicates that you have done too much too soon.

How do I reduce knee swelling after ACL surgery

There are a number of actions you can take to reduce and manage your knee swelling after ACL surgery, effectively starting from the moment that you tore your ACL prior to surgery.

The most obvious of these actions would be regular icing of your knee to help limit localised inflammation by reducing blood flow.  However there are further steps you should take to manage knee swelling as noted below.

It is just as important that you maintain consistent application of your action steps ‘each day’ to reduce knee swelling which will ultimately in conjunction with your exercises and protocols prescribed by your physician play a big role in the success of your ACL recovery.

7 key tips to reduce and manage your knee swelling after ACL tear surgery

Cooling and icing the knee can commence immediately post-surgery taking care to keep the incision and bandages dry otherwise infection can occur and set back the ACL recovery process.

Icing and other swelling reduction techniques are considered to be a key component of your ACL tear recovery and will help you extend and flex your knee after surgery.

ACL swelling protocol – Tip 1: Icing

Regular icing immediately after surgery 

Generally speaking as a rule try to ice your knee as much as possible following ACL surgery.

At a minimum this includes icing with an inflatable cuff (cryo cuff) or ice pack 15-20 minutes 4 to 5 times a day.  A more affordable option might be a cold pack of frozen vegetables.  In that case you will probably need two packs to allow sufficient time for cooling between treatments.

Continue icing for at least 4 months

As you move into the phase two of your ACL recovery timeline you will gradually extend the level of physical intensity applied to your recover exercises.

Even after the swelling subsides it is not uncommon to see short term increases of less than 48 hours. This is effectively where your knee will swell up from time to time in response to more intense training loads.  It just simply indicates that you have probably overexerted yourself and done too much too soon.

It is recommended that you continue to ice your knee for at least 4 months after ACL surgery. Plus also continue to where a compression sleeve for the first 6 to 8 weeks. To assist with sleeping you can take off the compression sleeve at night after 2 weeks.

ACL swelling protocol – Tip 2: Rest and elevation

A key part of your ACL rehabilitation in week 1 is to rest a lot especially within the first week post surgery.

This effectively means spending lots of time on a bed or couch with your knee elevated. Prop your foot on pillows whilst you are resting to elevate your knee above the level of your heart.

As a reminded, the main aim during week one is return full knee extension and icing/rest will assist with achieving this goal.

ACL swelling protocol – Tip 3: Avoid activities that cause pain

Avoid exercises and activities that cause knee pain or inflammation.

Pull back on any exercise where you notice pain or an increase in bloating or swelling of the knee

As your recovery progresses beyond weeks 1 and 2 post surgery, steadily increase the intensity in your activities as you feel comfortable and be guided by the level of pain.

ACL swelling protocol – Tip 4: Painkillers and anti-inflammatory medication

Immediately after ACL surgery anti-inflammatory medication is often prescribed by your anaesthetist. It is important that you disclose any medical conditions such as history with stomach ulcers as the medication may not be appropriate.

Your surgeon will advise you to take painkillers such as two paracetamol every 6 hours which is usually adequate to help control your pain. Reduce your intake as the pain subsides.

ACL swelling protocol – Tip 5: Use crutches to walk after surgery

The use of crutches to assist with walking after ACL surgery in the first 1 to 2 weeks is important to assist with managing your pain. Crutches will help with walking and moving around the house without incurring pain in your knee. Crutches are normally required for about 1 to 2 weeks post surgery depending on the preference of your surgeon.

ACL swelling protocol – Tip 6: Pre ACL surgery injury management

If ACL surgery is to be performed preparing the knee is really important.  The key goal pre-surgery is to restore full knee extension of which reducing knee swelling is a key component.

Application of ice for 15 to 30 minutes at least 4 to 5 times a day after an ACL injury can assist with reducing swelling and preparing the knee for surgery.

Icing your knee will assist with the restoring full knee extension which as noted above is the key goal prior to surgery.

If you have injured your ACL you may be advised to wear a brace and or use crutches depending on the severity of the injury.  Some studies suggest that 80% of ACL injuries result in significant bone bruising which necessitates minimal weight bearing in the first instance.

Walking with a torn ACL without the assistance of crutches is certainly very realistic for most people and walking is encouraged by most surgeons prior to surgery. Be careful to avoid any sudden twisting or pivoting movements which without an ACL can cause you further damage to the knee such as to the cartilage.

ACL swelling protocol – Tip 7: Wear a compression bandage

Wearing a compression bandage or sleeve is another key factor to controlling your knee swelling after ACL surgery.  Compression is applied to limit the amount of oozing of fluid from the damaged capillaries which helps to control the amount of inflammation in the injured area.

At two weeks post surgery you can take the bandage off at night however continue to wear it for at least the first 8 weeks to help you with your recovery.

How do I accelerate a reduction in my knee swelling after ACL surgery

• Begin with the consistent application of the above 7 tips both before and after ACL surgery
• Use a cryo cuff to ice your knee after surgery. A cryo cuff is an excellent way to cool your knee and decrease inflammation as it covers a large amount of surface area surrounding your knee plus there are additional benefits from the compression. A standard ice pack is not normally as effective as a cryo cuff. Consider purchasing a cryo cuff for your own personnel use or ask your surgeon or therapist if one can be loaned/hired (as a more affordable option).

Summary

Knee swelling after ACL surgery is common and it is key that your treatment post surgery includes measures to reduce swelling which is an important objective of your ACL surgery recovery.

You should regularly ice your knee for 15 to 20 minutes, 4 to 5 times a day in the first few weeks and continue to ice before and after exercise especially where swelling is evident.

Taking action to reduce knee swelling is in addition to your weekly ACL knee exercises as discussed with your physician!

Swelling reduction tip 1:

Regular Icing before and after surgery

Generally speaking, as a rule try to ice your knee as much as possible following ACL surgery. At a minimum ice 4 to 5 times a day for 15 to 20 minutes each time

Swelling reduction tip 2:

Rest and elevation

In the first week after ACL surgery, it is recommended to keep your knee elevated on a couch or bed during rest periods.

Swelling reduction tip 3:

Avoid activities that cause pain

This might mean pulling back on an exercise where you have gone a bit too hard too quick.

Swelling reduction tip 4:

Anti-inflammatory medication

Discuss with your surgeon taking painkillers and anti-inflammatory medication.  Anti-inflammatory medication prescribed by your surgeon can help reduce swelling.

Swelling reduction tip 5:

Walk on crutches after surgery

Use crutches up to 1 to 2 weeks post surgery.  This will help protect the knee from painful movements and jolts.

Swelling reduction tip 6:

Pre surgery icing of your knee

If ACL surgery is to be performed preparing the knee is really important. Restoring full knee extension is the key goal and icing 4 to 5 times a day leading up to surgery will help.

Swelling reduction tip 7:

Wear a compression bandage or sleeve

Wearing a compression bandage over your operated knee will help reduce inflammation in particularly in the early stages both after the injury and surgery.

Good Luck With Your ACL Surgery Rehabilitation!

Click the link below for a copy of your Free ACL Recovery Checklist:

www.ACLinjuryrecovery.com/checklist

Video – 7 Key Methods to Reduce Knee Swelling After ACL Surgery