Any number of orthopedic injuries or degenerative changes to the body may reach a point where physical therapy alone will not resolve the problems. 

As a physical therapist myself, I have had a non-insignificant number of cases where I have talked with my patient about contacting an orthopedic surgeon to fully resolve an issue in their body, be it their hip, shoulder, or any other major joint. 

Each procedure will have their own unique recovery process, but there is one universal factor that will be there regardless of what you have done: you will be swollen.

Swelling is a normal and expected part of your body’s response to trauma, even a medically necessary trauma like an orthopedic surgery.  In order to heal itself, your body needs to transport its nutrients and other resources to the surgical site and it accomplishes this by sending a lot of blood and plasma. 

The amount of blood flow to a surgical site is more than that region would normally receive and the body’s normal vessels need time to regenerate after being cut by a surgical incision.  This makes it so fluid that is brought to a recovering area cannot leave the area as easily as it normally could. 

Typically post operative swelling is at its worst within the first week after a surgery and then tapers off gradually over time (although this may vary depending on the type of surgery performed, your age, and other related factors).  Your body knows how to heal itself and it’s important to trust your body’s healing processes when you feel swollen.

Although swelling is a normal part of recovery, it can also cause a few issues when it is present.  A swollen body part may feel achy as the skin expands and the increased girth of a joint may reduce the amount of mobility you have (for example, it is hard to bend your knee fully if the joint has significant swelling). 

Thankfully, there are things you can do to help alleviate these issues in the short term while your body implements its long term methods to reduce the swelling.

 

• • A physical therapist can work with you to reduce swelling through a combination of purposeful positioning (usually using the force of gravity to promote fluid reduction from a joint space) and gentle massage techniques to help guide excess fluid towards your body’s lymph nodes, where it can be reintegrated into the body’s blood stream

• • Remember RICE to help reduce the symptoms when you are at home
    

     

    • • R: Rest the limb
    • • I: Ice the limb (usually 10-20 minutes)
    • • C: Compression to “squeeze” fluid out of the leg
    • • E: Elevate the limb to allow gravity to help the fluid drain out

• • Drink water and be mindful of your intake of salt

Post operative swelling can seem intimidating immediately after a big surgery.  You may have experienced it in the past, or you may be apprehensive about it regarding an upcoming procedure, or you may be dealing with it right now as you’re reading this. 

Either way, it is important to remember that swelling is an inevitable by-product of your body’s healing and it will resolve over time.  Contact with your surgeon or therapist following a major surgery is helpful if any questions arise, but regardless, it is important to remember and appreciate your body’s natural resilience.

Dr. Richard C. Irace, PT, DPT