Swelling after ACL surgery can be a major roadblock in recovery, and it can also be quite a stubborn issue. After having 3 knee surgeries, I’ve learned a few things about handling some stubborn swelling.
Yes, “RICE (rest, ice, compression, elevation) really does help with swelling, but there are a few tips that can make the process a bit more effective. Here are some of my recommendations:
Tips for More Effective Icing After Knee Surgery
Of course, icing will help with swelling. However, swelling after knee surgery is fairly extreme and can last a long time. A normal icing routine may not be enough. Here are some ways to make it more effective.
Use an Ice Machine
I cannot stress this enough, USE AN ICE MACHINE. They are a bit expensive, roughly $200 on Amazon, so if you know anyone who had surgery before see if you can rent or borrow one. Likewise, you may also be able to find a used one to buy for less. One alternative option that’s more affordable is a knee-specific ice pack or ice pack sleeve.
But overall, an ice machine makes a world of difference for trying to soothe and deflate your knee. It’s incredibly inconvenient and cumbersome to try to secure multiple ice packs around your knee, and they just don’t last very long. Then it takes a while for them to get cold enough again.
I found it much more effective to use an ice machine. This way, I was able to ice my entire knee, front and back, at the same time. It also circulates the water so it provides a more even cooling effect. The machine stayed colder much longer, even when I wasn’t using it, so we didn’t need to mess with it nearly as much as ice packs.
Icing Frequency
The other big shock is how often you have to ice after knee surgery. Icing your knee once a day will not cut it in the early parts of recovery. I was icing my knee on and off repeatedly for the entire day for over 2 months after ACL surgery. In the first weeks (or months depending on your recovery), you should follow the 20 minutes on/20 minutes off rule pretty much all day. That might sound extreme, but if you do not ice often enough you’ll be in quite a bit of pain and really struggle to reduce the swelling.
Ice AFTER Activity
As I got more active, icing after became more important and helpful. My knee would often get irritated during PT or after activity/exercise for quite some time. Icing after helped push out the swelling and keep any pain at bay.
Rest Between Activities
If you can at all adjust your schedule, I highly recommend budgeting in rest between activities.
Even during month three post-op after ACL surgery, I would struggle with swelling when I was out and about too much. The same issue happened for several weeks after my first partial meniscectomy. Basically, swelling at baseline would seem like much less, but whenever I was on my feet for a long time it would get worse. This would also cause pain and irritation.
The best solution I found was to split up my errands/activities. When I’m healthy, I’ll handle a bunch of errands at once. Head to the gym, then go straight to the grocery store, do some cleaning after, etc. After knee surgery, no.
After the gym, I’d have to sit down and rest. Elevate and ice a bit. Let my knee calm down. After some rest, THEN I could do the next active task. Then, I’d need to rest again.
Wear a Compression Sleeve
A knee compression sleeve is a must-have post-ACL surgery tool. It’s incredibly helpful for managing swelling, especially as you get more active. I found it to be very useful if I had to be on my feet for a while coaching or running errands. It helped keep my knee from getting as swollen. Once I was far enough along to do more soccer-specific workouts, I only really wore it after activity if my knee was a little bothered.
Use a Tens Unit
A tens unit can also help manage swelling and some pain. I used my Compex on a light setting to help get some swelling out. You can even use it in combination with icing, or in between. The Compex is a fairly expensive option, but there are plenty of less-expensive TENS units you can find online. I’ve linked an option below!
Avoid Doing Too Much Too Fast
ACL rehab is a tough, long process. It’s easy to get too eager and try to ramp up quicker than your body is really ready to. Be very intentional and conservative with how quickly you add intensity/volume (even of something that seems as basic as walking).
If the swelling that you previously reduced seems to ramp up, you may have done too much too fast. That can be a sign that you need to back off and build up a little slower. Listen to this warning and manage your body.
FAQs About Swelling After Knee Surgery
How long does swelling last after knee surgery?
There’s no set answer to how long your knee stays swollen after knee surgery. The type of surgery, your surgery history, your rehab, and your unique body all play a role. Here’s an estimate for how long I dealt with swelling after various knee surgery:
- ACL and medial and lateral meniscus surgery: Around 4 months
- Partial meniscectomy 1: 6-8 weeks
- Partial meniscectomy 2: 3-4 weeks
Why is swelling after knee surgery an issue?
Swelling is a normal part of recovery, but after knee surgery, the swelling is quite severe. During surgery, they push fluid into your knee to lubricate it. You have to get this excess fluid out and reduce swelling to be able to make progress with range of motion. Furthermore, swelling in the knee shuts off the quad muscle, which delays your recover/return to sport.
Does swelling go away on its own after ACL surgery?
Swelling naturally reduces after an injury, but without an active effort, it would take a very, very long time. You need to take intentional steps to address the extreme swelling after ACL surgery in many cases.