Knee Swelling After Surgery – My Number 1 Tip To Reduce Swelling

Thanks to many of the readers of this website they had a few questions regarding my Pre ACL surgery Checklist. Below I have provided answers to each along with a surprise tip on the number one way to reduce knee swelling after surgery.

First Question:

Do I need to purchase the Aircast Cryo Cuff Knee System with Cooler before surgery?
My Answer:
Yes you should purchase the cryco cuff as soon as you know you will be having surgery. If you wait until days before your surgery you may have a hard time finding one in time.
In my opinion the Cryo Cuff is the MOST IMPORTANT tool for recovery after ACL surgery and the most important part of the Pre ACL surgery Checklist.

Second Common Question:

Do I need to do physio before surgery?
My Answer:
Although you dont need to do “physio” before surgery its a really good idea to build up muscle and get your leg into as good a shape as possible before the surgery. The better shape your leg is going into surgery the better off you will be after surgery!

Number 1 Tip To Reduce Knee Swelling After Surgery


If you are having a hard time reducing swelling after knee surgery I have a tip for you which involves…

  • Cryco Cuff
  • Ice Pack
  • Warm Pack

The process is simple and uses gentle heat and cooling to pull the blood out of the knee. Everyone knows that if a door seperating two rooms one warm and one cool is opened the two rooms temperature will equalize…all reasonable things being held constant. Using this principle you can use physics to suck the swelling out of your knee…here is how…

Step 1 – Warm up a Hot Pack
Step 2 – Put on your Cryo Cuff
Step 3 – Get an ice pack from the freezer
Step 4 – Elevate your knee
Step 5 – Put the warm pack on your upper thigh
Step 6 – Put at least one ice pack on your ankle
Step 7 – Hold for 15-30 minutes (watch for frostbite)

icing-knee-after-surgery

icing-knee-after-surgery

Why Does This Work?

What is happening is you are using the laws of physics, gravit,y and the laws of Thermodynamics (Second Law of Thermodynamics or Entropy for the engineers/geeks, like me, reading this) to have the cool blood flow to the warmer area and cause circulation within the knee.
This technique is especially helpful for the stubborn swelling that remains deep inside the knee which standard icing is not able to reach.
Try this out and let me know if its as helpful for you as it was for me!


The Top 5 At Home Exercises
I did that helped get me walking 4 days after surgery

Click Here to see the exercises

Comments

  1. Sunil Potnis says:

    Jon

    I hope all is well at your end and wish you a speedy recovery. I had a complete tear of my right knee ACL 2 months ago while playing racquetball and am having a surgery sometime late July. I plan to take the hamstring autograft from the same leg that has ACL tear. I have completely ruled out Patellar Tendon autograft because of future pain issues and potential weakening of the knee joint. My orthopedics doctor said there is a chance that my hamstring harvest may not have adequate length for the graft so he is saying that I should have a backup plan? Have you heard about this situation happening? I also have a concern of post surgery pain. A friend of mine suggested don’t use meds but use Ice therapy to reduce pain and swelling. I am of the opinion to have minimal pain using strong pain killers for atleast a week after the surgery. I would appreciate your advice.

    Best wishes again
    Sunil

  2. How long does does it take to get teh swelling down? I am three weeks out of a allograph acl surgery, I am 45, and feel really good about my progress but I know that allographs have an easier time of it.

  3. Hi! I just had surgery for torn ACL on June 22nd. They used a cadaver tendon to reconstruct the repair. After the 4th day, I am walking and have had very little pain either in physical therapy or out. I wish you the best with your surgery.

  4. Thanks Renee, glad to hear you’re walking. Julie, what is your “status”? I am going for surgery on the 29th, using the cadaver tendon.

  5. I have a complete ACL tear in my right knee and a lateral mensicus tear. I will have surgery in a couple of weeks with a cadaver tendon. I am 55 and am really concerned especially with my age. I also don’t tolerate pain medication but have a high tolerance for pain. Will I be able to do this with motrin or aleve and ice. Football player friends have told me to use lots of ice. I have been doing therapy for two weeks so far and except for having to be careful I am getting around pretty well.

  6. I am two months post op on my THIRD ACL reconstruction. I have had two patellar and one cadaver repair. Cadaver is definitely an easier recovery. Allison, I suffered through my first two operations, unable to tolerate the pain meds. A good friend did my third operation and took really good care of me. He wanted to make sure my pain was very well controlled, so ordered a nerve block (can’t feel your leg for 2-3 days after surgery) and a pretty new pain medicine called nucynta. He also had me take zofran around the clock for those first few days so that I would be able to tolerate the narcotic. I did it, but was able to tolerate the nucynta after that, without the zofran and sometimes with very little food in my stomach.

    And finally, in regards to the hamstring, a girl in PT had hers blow during the surgery, so the doc had to use a cadaver graft. She is pretty petite, I’ve heard this is fairly common.

    Good luck to all :)

  7. ty jackson says:

    Just had my surgery on 2 jun 2011. Actually i did not have much pain at all afterwards…..i used the crutches for the 1st 3 or 4 days then i just used one to support the side of the surgery. I am a month post op and still have swelling but normally only after activity. After the 3rd week i am bike riding and driving pretty much as normal. Physical therapy has been great and i have 120 degress of flexion after just 3 and a half weeks.

  8. mohamed ali says:

    i just had the surgery on my torn acl on june 14. it was easy one. i start walking a week after the surgery. just make sure u do ur therapy and u will be fine.

  9. Kevin Kearney says:

    My ACL (left knee) was surgically repaired last Friday (7/8) by Dr. Nick Dinubile (http://www.drnick.com), arguably the best knee surgeon in the states; if you’re looking for an opinion and/or are electing to have the surgery, I can’t emphasize enough how great he really is. I chose the allograft, or cadaver ACL, for my repair after weighing out all options (this option had the fewest amount of potential problems post-op). The day after my release from Delaware County Memorial, I was pain-free, crutch-less and healthy enough to go to my own engagement party (yes, of all times to have surgery…). The next day, I was able to drive two hours by myself to visit the Doc’s office for the post-op follow up appointment. The following day, Tuesday, I began my rehab (3X a week).
    My best advice to someone who has just gone through surgery is to let pain and swelling be your guide. I’m more of the proactive/aggressive type so lying in a bed for three consecutive weeks while taking hourly narcotics was never in my plans. The repaired ACL is actually at twice the strength of its counterpart ACL following surgery so as long as you’re experiencing a minimal amount of swelling and pain, go for it – be active – strengthen up.
    To all those heading into the surgery, good luck. And thank you to, Dr. Nick.

  10. Sunil –

    I had the hamstring autograft on 6/28/11. I only needed pain meds for 2 days and was also walking without support after 2 days. I never heard that a hamstring would not have enough length. Hamstrings are very long! The Cryo-Cuff was definitely helpful! Good luck!

  11. Tammy

    Thanks so much for your reply. My surgery is scheduled on Aug 8th. I have opted for Hamstring Autograft

    Regards
    Sunil

  12. Renee

    Thanks for the wishes. Hope everything is fine at your end

    Sunil

  13. Alison

    Best wishes for your surgery. I have read that body heals quickly if we control pain so even if you have a high tolerance for pain, allow the medications to control it and let the body heal faster.

    Regards
    Sunil

  14. joey carbone says:

    I got acl reconstruction this morning an am feeling pretty sore I was just wondering why I am not aloud to walk on it for a week and some of u guys are walking two days later?

  15. billy kelly says:

    My name billy and i just had acl surgery a week ago do to this day i have been in so much pain it seems everyday the pain is gettting worse i cant sleep at night it just makes me want to cry im 18 and was on a football scholarship any help or advice for the pain would be so helpful thank you

  16. 5 Knee surgery Jeff says:

    Joey,
    It is a matter of swelling. Swelling will block the nerves from being able to move your muscles. You knee may be stable enough but if the muscles don’t all work then you will not be able to walk. Get the swelling down as fast as possible and this will allow your nervous system to control your muscles and then you will be able to walk.

  17. Billy-

    Hello there. I am currently 9 weeks post surgery and have been doing VERY well so far (i.e. no pain rx pain meds after the first week, currently -5 to -10 extension, hardly any swelling now, etc).
    Sorry to hear that you are having such a difficult time post surgery so far. If the pain is not getting better (and is getting worse), I would DEFINITELY recommend going to see your doctor and/or physical therapist soon to make sure that everything is ok. In my experience, it was normal to be in pain for about a week or two, but I gradually had less pain each day. To reduce or even eliminate pain please follow your surgeon and physical therapist’s advice. This is what helped me: ICE for sure (machine is best) often, regular use of pain meds as prescribed, good sleep, consistent prescribed physical therapy. Please keep us posted and good luck! =)

  18. Hi, I’m going to surgery tomorrow. My orthopedist is going to use a cadaver tendon. I hope everything goes well. Actually, I have no pain but I need ACL.

  19. I had ACL surgery hamstring option on 19 august 2011, and after the surgery there is a little numbness on the left upper thigh and the whole knee is swollen and the range is motion is negligible …its been 6 days now and im not able to move around and it hurts. any suggestions how to remove the knee swelling, im using the cryo pump but it seems of no use

  20. Thanks for this tip, I can’t wait to try it out! Having ACL reconstruction with patellar tendon on Thursday.

  21. Cory Holzer says:

    I had surgery 2 weeks yesterday. Pateller tendon. I am now walking with a cane at times but usually with a slight limp. Good Luck to everyone on the site.

  22. I had surgery on monday october 24 and i was walking on tuesday and the heating and icing tips helped thanx

  23. I had ACL reconstruction on October 18, 2011. I had the nerve block which helped a lot but didn’t completely rid the pain as well as meds. I’m still in pain with swelling in my foot. I start pt today as my leg is very still. I am getting around some with the help of crutches but it will be a long road to recovery.

  24. The graft has to be able to fuse, walking earlier can stretch and or tear your graft best to non weight bear for first week.

  25. Hello everyone..I had my ACL reconstruction surgery(Hamstring Autograft) nd meniscus repair on 12th october…got rid of crutches in a week…pain was also bearable..walking without any brace,just a knee cap..overall I am happy with my progress..I am concerned about only 1 thing which is pain in nd ard my ankle,,,nd sometimes in my calf …can any1 suggest me the reason of it??

  26. More than likely, the pain you are feeling is due to one of two factors or both. 1) The first reason may be due to swelling or pooling from the migration of fluid to your lower leg. This is well known to happen in not only the shin/calf area, but also the ankle and heel of the foot. It’s the law of gravity! Limit your activity or periods of time standing and remember to elevate your leg when reclining. 2) The second reason you may be feeling pain is from weak atrophied muscles. If this is the case, this pain should gradually decrease through therapy.

  27. Thanx a lot…I am about 2 months post surgery nd feeling very good….i go to gym everyday nd do cycling nd upper body work out…I can’t wait to start running…But don’t know when did that happen…walked a bit on treadmill today but it wasn’t that comfortable walking…might be because i was on treadmill after 4 months…Can any1 suggest me what should i do to get back to running as soon as possible plus sports….nd is it advisable to do squats nd other leg exercises????

  28. Had ACL Reconstruction using allograph on Dec. 14. I’m 50 and am not sure how hard to push beyond pain. My doctor recommended icing, elevation, pain meds, as needed, and hourly exercises (vigorous ankle flexion and extension an leg raises). By day 3, only using Ibuprofen for pain. I can only put minimal weight on my leg witout pain, so haven’t started walking with full weight, only with crutches and a little weight. The leg raises cause twinges of pain in my knee but I’m doing them anyway. Should I stop until I see my doc tomorrow or is it normal to feel pains throughout the knee on day 4? Some folks on this blog seem to have amazingly quick recoveries. I’m guessing that age and fitness/strength level prior to surgery make a difference. I’m thin and healthy, but not particulary strong.

  29. I am on day 11 of acl recovery and I do believe age is a factor (52). I still cannot get my leg extended fully and trying to walk on it unsupported is difficult. On day 9 I was doing some ankle exercises and out of the blue it locked on me. Now the pain in my ankle is greater than the pain in my knee. My hammies still are sore as well and I am feeling old after reading and watching videos on this site. Flexion is no problem (120 in machine) but the bite in front of my knee (top of tibia) is out of this world painful therefore trying to stretch my knee is no fun. Swelling was going down but now it has come back along with swelling. The pain is close to kidney stones but that bite is no fun. I was hoping to be able to walk by now and after re-evaluating I hope b/t 2 and 3 weeks post-op I will be able to walk. I see the doc tomorrow to get stitches out and will have him examine my ankle. I cannot put pressure on that ankle because it feels so weak and don’t want to do any damage to my knee. I did slip on ice 3 different times on day 2 and 4 that hurt like crazy but all I can say is ouch.
    Pain meds? I stopped taking them on day 3 and only use them at night when I wake up because of pain. I don’t even think I have used half the bottle but maybe I should just so I can straighten out my knee. Not sure where to go with my age and my stubborness. :-)

  30. on my third acl reconstruction, first was an early one and in the wrong place, 18yrs later had a patella tendon graft put alongside it. Now onto the other knee using hamstring graft. Surgery was jan 24 and have to say brilliant, one month on though I cant shift the swelling which is obviously hampering my rehab.Anyone have any ideas , have the cryo cuff, not helping.

  31. Thank you for the posts. I’m having ACL surgery next Tuesday march 20. I opted for the hamstring. Thanks for the tips on reducing the swelling.

  32. Anyone know the major differences between the hamstring graft and using a cadaver? Im 25, F, pretty active. Pros and Cons to each?? thanks!

  33. I had ACL surgery using hamstring graft on my left knee, as well as surgery to repair both meniscus on Thursday Mar. 15th. I started PT the following Wednesday. On day 1 of PT my extension was 0 which is the goal in the 1st 2 weeks. My flexion was about 30 degrees. My therapy consists of quad flexes, leg raises, and use of a pilates ball to bend the knee. I am using aleve and hydrocodone and even still today if I dont take the hydrocodone for more than 4 hours I have quite a bit of pain. After 10 days I was told to start putting 50% weight on ledt leg but only with brace on and only with crutches. My timeline is this. Crutches for 6 weeks, then still have to have brace for up to 3-4 months. Will not be able to return to full activity for 6 months. My surgeon does only knees, and works with most all the local colleges to reconstruct their athletes knees, and is regarded as one of the best. I am finding some of these posts claiming that they are not using crutches and walking etc as soon as a week afterwards hard to believe. I am thinking maybe those people had no damage other than the ACL, or they are setting themselves up for problems possibly. The key is to find a GOOD PT and see them at least 3 times a week for the 1st 4 weeks, then 2 times a week for at least 3-4 weeks then once a week until you are 100%. With a meniscus tear it is not safe to put weight on knee in a BENT position for at least 6 weeks. Good luck to you all. Oh, i am 35 and have been an athlete all my life. Injured mine playing volleyball.

  34. I am 32 year old, and went through ACL reconstruction and meniscus repair on Monday. I find your website really helpful. I started following your website before the surgery, and it gave me a lot of confidence.
    Its been 4 days now, I still see some swelling around knee, and pain upon slight knee bent. I would like to know if you could advice me on getting through this pain and swelling.

  35. j2willia says:

    Hi Trideep, hope your recovery is going well. I’m having ACL reconstruction (using hamstring) next week (4/18/2012) and will probably need my meniscus repaired (it’s folded under my knee cap). I’m guessing the recovery from ACL surgery is more difficult if it includes meniscus repair.

    If you are monitoring this site, can you post your progress? Would be curious to know if you are weight-bearing and if you are able to move around with/without crutches.

    Also, were you required to wear a locked brace? If so, for how long?

  36. Just wanna say to all who have had recent acl surgery looking for some type of comfort, to take some of these posts as suspect. IMO I think anyone saying there walking with no support after two days is full BS. I’ve had two acl repairs on seperate knees, both times filled with excruciating pain for the first week. PT is crucial and so are taking the pain Meds especially right after surgery.

  37. Kate-I agree 100% I am 4 weeks post op and had both meniscus repaired along with acl reconstruct using hamstring tendon. I am doing PT 3 days a week and can still only bend to 90% and that is tough. I am putting 50% weight on op leg WITH crutches only. a week from this monday I see ther DR again and PT says most likely he will unlock brace to about 30 degrees. I will also slowly start to ween myself off the crutches and probably, hopefully within 2 weeks of that time walk without crutches. When the meniscus is repaired rather than removed the recovery time is much slower. I havent had any pain meds for almost 2 weeks now, however I am taking 2 aleve twice a day, and 1000mg of tylenol 3 times a day and have little to no pain other than during therapy session. My PT says that once I get to the point I am walking crutchless, and can start actually lifting and squatting the recovery will go much better. It will take a lot of patience and a lot of boring monotonous therapy, i.e leg lifts, quad sets, etc but TAKE IT SLOW. It will all be worth it in the end.

  38. Did you have the cyro cuff on all the time? Stupid question – did you have in on over or under brace?- Did not get a clear answer from the store I was looking to buy it in. Having surgery on 4-20 – thanks advance

  39. Randy-I would remove the brace the first few days and run the cryo as much as possible-of course put brace back on before moving.

  40. Update. At 5.5 weeks Dr took both crutches, and brace away. It was tough and a little scary walking for about 7-10 days after that. I am now at 7.5 weeks post surgery and have 126 degrees flexion, and walk about 90% normally. I am still in therapy 3 days a week and am riding bike, doing lunges, wall squats, balancing exercises, leg presses, and have little to no selling at all. It really is amazing once you start pushing yourself how fast the recovery takes off. Keep your spirits up and push yourself, it will get better!

  41. E. Jones says:

    I had acl cadaver and meniscus cleaned out on 21MAY2012. I had no pain and I’m maxing out on the cpm. Only problem is swelling…I cant wait til this is gone.

  42. Thanks Jon, just tried it it works great keep any knew info coming. Your a life saver big time my friend many thanks. The knee is looking good and i see the PT this coming Mon. at 11am. I’ll post back at you later. :)

  43. How offen should you do this ice – ice – heat? Thanks

  44. Well, the last few weeks I have lost a lot of the muscle and strength I had gained back. I was doing great-walking up steps 90% normally, and down them about 80& normally. I was about to be released to start jogging and light jumping when all of a sudden my kneecap started hurting while going up/down steps, and walking. It has slowly gotten worse. PT thinks it is due to IT band on outside being really tight and pulling kneecap out of alignment during flexion. We have tried everything under the sun to correct it to no avail. Going to see surgeon tomorrow to see if anything is wrong. Very frustrating especially since I have done everything I was told to down to the letter. Hopefully can figure things out soon.

  45. Doc says 1 of 2 things. Either meniscus didn’t heal properly, or got some bleeding and dried under kneecap forming a hard tissue and is irritating the knee. Can try pushing through the pain for a few weeks to see if will break up on it’s own, if not have to scope it and clean it out, resulting in 2-3 days of crutches and a month of recovery before resuming strength training. I am relieved that acl is not the issue but sad to be set back. Hopefully it will fix itself and no scope but either way I know now that I am on the right path.

  46. Jon Haver says:

    Thanks Jamie, I am glad this worked for you! Good luck with the rest of your recovery!

  47. Jon Haver says:

    @Renee – If you are to do this once-twice a day at the start and then as-required later. Once your swelling is down there will likely be times when your knee will flare up(walking more than normal etc etc), try this technique to get those flare ups under control…seems to work well.

  48. Nann Landry says:

    I had the acl allograft on march 19th. My doctor suggested the iceman, but it wasn’t covered by my insurance. If I was to pay for it it would have been $225.00. Luckily I had a friend at work that let me borrow hers. This machine circulates cold icy water around the operative area. You need to bring it in to your surgery because they will ace wrap it in position. I still had some pain but I’m SO glad I had this machine. Looking back I would have bought one because it was a big part of my recovery. Hope this helps .

  49. Nann Landry says:

    I am a 48 y/o female. I had the acl allograft on march 19th. My doctor suggested the iceman, but it wasn’t covered by my insurance. If I was to pay for it it would have been $225.00. Luckily I had a friend at work that let me borrow hers. This machine circulates cold icy water around the operative area. You need to bring it in to your surgery because they will ace wrap it in position. I still had some pain but I’m SO glad I had this machine. Looking back I would have bought one because it was a big part of my recovery. Hope this helps .

  50. My 15 year old son got hurt during a high school basketball game and ended up in the ER and just recently had ACL reconstructive surgery using the hamstring graft. He was also asked to have a back up plan if his hamstring was strong enough (we chose the hybrid allograph option rather than the patella tendon graph option). I think the doctors ask just in case, but my son’s was fine. His surgery went well and he is currently 3 weeks post op and recovering and doing physical therapy. He still has some swelling but his range of motion and muscular strength is good. I thank God and am hoping for the best possible outcome.

  51. Santhosh Laa says:

    I sustained an ACL rupture and grade 2 MCL tear on the 12th of Apr while playing badminton as I landed from a jump awkwardly on my left leg. I had my ACL reconstructed (Hamstring graft) on the 17th of Apr and the recovery has been fine till date except for the below problem; I was asked not to weight bear till week 4 post op because of the MCL tear.
    After my second post op checkup @ week 4 I was cleared to weight bear; soon after I started to weight bear the swelling around the knee started to drain to the shin area and I find fluid around the knee cap and in the knee joint. I reached out to my surgeon and explained that I have this swelling which is never reducing and he told that it is normal and the fluid will eventually get absorbed by the body give it some more time.
    Now its end of week 8 and the upper part Knee still remains swollen as how it was from Week 3; just that if I keep it elevated, extended and iced the swelling around the shin area comes down but the fluid around the knee cap still remains and pressurizes the knee when I flex it or walk on it. I do not have any swelling or pain in the knee joint.
    I have been given an appointment on the 16th of June for an Aspiration to drain the fluid from the Knee.
    My question is this normal that surgeons wait till this long to aspirate the knee and drain fluid or he should have drained it 1 week post op checkup when I complained about the swelling, stiffness while flexing?
    Also while the swelling settle down soon after the aspiration procedure is complete?

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