Banner - Hide this banner

Author Topic: Best tips for stubborn swelling?  (Read 3134 times)

0 Members and 1 Guest are viewing this topic.

Offline rsuddeth

  • Regular Poster
  • ***
  • Posts: 77
  • Liked: 0
Best tips for stubborn swelling?
« on: April 10, 2010, 06:26:55 PM »
Since returning to the office, my swelling, pain, and mobility are worse than they were 2 weeks ago (being measurably worse started ~6 weeks post op.) I expected more swelling, since I knew I'd be on my feet more, but I am surprised at how difficult it seems to be to get the swelling down again. I don't know how much the increased pain & decreased ROM are caused by the swelling, but I won't know until I get the darned swelling down!

After full days Mon & Tues, I went to bed & put feet up with ice immediately after getting home. (Really up -- my bed can crank the feet up electrically & I put a pillow on top of that, with head all the way down flat & thin pillow.) I was up (sitting, mostly & walking a little) for about an hour and then did ice & elevate on the couch (head on seat, knee on pillows, foot propped on arm rest, alternating ice between ankle and knee) for the rest of the evening, fell asleep that way, and after I woke up, put on the brace with ice tucked in & went to bed (now flat) that way (gel pack that stays cold about 3 or 4 hours.) After all of that, the swelling didn't seem much better Wed morning, and by noon Wednesday, the pain & swelling were definitely worse than they'd been in over a week (since before going back to the office.) Thursday morning I had my first session on stationary bike, and I stayed home to be off my feet more, and did more icing & elevation. Friday morning my knee ROM was worse than it had been the previous day, or for about 2 weeks.

I will list what I've been doing & what I want to try looking for feedback on how helpful it might be? And also any additional tips (what I'm doing wrong or what else I could try) would be appreciated.

What I'm doing now:

1) Every day try to ice & elevate at least 3x/day, with at least 2 sessions of 20 minutes or longer. (Unfortunately, I don't get the whole "warm" area iced at once. My ice packs only cover about half the area on the knee, and I don't have enough of them to do knee & ankle at the same time.) Do foot pumps or circles while the knee is icing.

2) Prop my foot on my computer and ice frequently while working (not really elevated because I'm sitting up) or prop on couch while sitting at home.

3) Keep the brace off while at home or inside the office (so the walking I do will involve more flexing.)

4) Heel slides at least once/day (usually 2 or 3 times.)

5) Try really hard not to stand around talking to people. (Either remember to grab a chair if it's work at someone's desk, or tell them I need to go sit or keep walking if it's somewhere else.)

Some things to try:

A) Actually started this, but not sure it it's really helpful? Wear support or compression stockings. Last night I tried one called "anti-thrombosis" (18mm/Hg compression) thigh high last night & it felt good going on, but really uncomfortable by morning. Today I'm wearing support pantyhose (8-15mm/Hg, and probably closer the lower end since I'm on the small end for the size I have.) Despite being pantyhose, these are more comfortable, and I think might be a more appropriate compression level for what I want. Anyone tried these stockings and had them help/not help?

B) At work, I have access to a stationary bike, so maybe can add that on non-PT days. At home, I don't, but maybe it would help to add in something like lying on my back & make pedaling motions in the air?

C) I definitely want to get better ice, but can't decide exactly which.
 -- I had borrowed an ice machine, and it quit working about 2 weeks ago. Its pad gives much more coverage than what I've got, but even used it looks like it will be > $50 to replace it. Plus you go through all that ice, faster than my freezer can make more, so we have to buy it. And it's not practical to take it with me to work. But it would be nice to return a machine that actually works to the person who loaned it to me.

Another option is I could get the gel packs they use at the PT place. They run about $22 each, and they feel even better than the ice machine while on (they're softer, and cover everything they touch instead of having bumps that touch the skin & troughs in between.) I doubt they stay cold as long as the gel packs I use now, though (or obviously the ice machine), and I don't want to spend for more than 2 (one at work, one at home.) My impression is these will only be good for about 1/2 hour at a time.

I can't decide which way to go. Either way, I probably won't have anything in place before Tuesday *sigh*

Feb 24th, 2010 TTT/LR (meniscus trim)

Offline smillie

  • SuperKNEEgeek
  • *****
  • Posts: 1438
  • Liked: 1
Re: Best tips for stubborn swelling?
« Reply #1 on: April 10, 2010, 08:37:55 PM »
Just yesterday someone told me how to make my own gel packs.  You use half water, half rubbing alcohol for the gel.  Put it in a freezer ziplock and double bag it in case of leaks.  I haven't tried it yet, but it would be an inexpensive way to get a big gel pack.  I also saw somewhere a "recipe" for making a gel pack using Dawn dish soap.  I can't find it at the moment, though.  For smaller areas, I'm using a small bag of frozen peas.  It was $.88 at the store and I can reuse it.  I've marked it not to eat and I try not to let it completely thaw before throwing it back in the freezer, but it's great for a couple of sore spots I have on my it bands.

When I was working post-op, I used to try to ice and elevate during my lunch hour.  My boss had a sofa, so I could usually go in there while he was at lunch for about half an hour.  But really, any empty room where you could lay on the floor and put your leg up on something with your ice packs would help.
patella pain began early teens
'94 TTT/LR/VMO adv.
'94 MUA
'10 tried PT again
1/11 scope/hardware removal
4/11 (Finally!) dx medial instability due to LR
5/9/11 LPFL reconstruction scheduled

Offline Snowy

  • SuperKNEEgeek
  • *****
  • *
  • *
  • *
  • Posts: 2555
  • Liked: 93
Re: Best tips for stubborn swelling?
« Reply #2 on: April 11, 2010, 07:36:02 PM »
It sounds like you're doing all the right things. Here are a couple more thoughts from my experience, although my swelling is post-injury rather than post-op (it is, however, VERY stubborn!)

* I've been using a tensor bandage on the knee at work for compression.
* I bought a couple of gel packs with a cloth cover and velcro straps, so that I can wrap it around my knee and walk around at work with it on. With two packs, you can have one chilling while you wear the other.
* Wherever you are at work, see if you can have a second chair or something else to prop the leg on. Having it down definitely caused my swelling to get worse, and I had to start commandeering a second chair in meetings. Fortunately my coworkers have been very sympathetic! I also found there was no way to have my leg propped on a second chair and work on the computer comfortably (because of the angle my desk is at) so I put a couple of boxes of photocopy paper under the desk, and can now keep my leg propped while I work away.
* If pedalling helps, get on that stationary bike whenever you can. I find it really loosens the joint up, as does my boss who had knee surgery recently - her theory is that it moves the fluid out of the joint. I try and go up to the gym for a few minutes before and after work, and spend both my coffee breaks and part of my lunch break up there. Even just 5 minutes eases the swelling and stiffness considerably.
* Ask your PT whether lymphatic massage (I think that's what it's called) would be good for your knee. My PT recommended this for my swelling and it really helps. You need a willing partner, who starts with both hands circling about half the leg below the knee. They then push all the way up to the top of your leg with steady pressure all the way. This moves the fluid out of your knee and toward the core, where it can be absorbed. We do this for a few minutes every evening and the swelling is noticeably reduced afterwards.

Good luck!
« Last Edit: April 11, 2010, 07:37:53 PM by Snowy »
Mar 11: R Biceps femoris tear (skiing)
Jul 10: ACLr (hamstring autograft)
Mar 10: L ACL rupture (skiing)
Feb 06: L partial ACL tear (kickboxing)
Dec 03: R bone edema (motorbike)
Jan 01: R patellar chip (motorbike)
May 93: R ACL sprain (hockey)
Ongoing: bilateral PFS and OA

Offline rsuddeth

  • Regular Poster
  • ***
  • Posts: 77
  • Liked: 0
Re: Best tips for stubborn swelling?
« Reply #3 on: April 12, 2010, 12:03:10 AM »
Thanks so much!

Today the swelling is much better than I expected after the stuff I did the previous two evenings, so I'm thinking the stockings are helping. Could be last night was actually less of a problem than expected, too, though. I probably shouldn't have, but I got up and danced a few times (mostly in the immobilizer, but loosened a bit so I could bend the knees more.) It might not have been the safest thing to do, but it sure did feel good, and luckily no ill effects.

On days I don't have PT, I do the home exercises at lunch time. My work day is long & home time is limited. I do ice & elevate 10 or 15 minutes after that, but that's probably about all I can manage for that. At my desk, the top of the computer works out pretty well for propping the foot on. But we're always short of chairs, so just getting one to sit on sometimes takes a bit of doing. Luckily I get priority on that these days.
Feb 24th, 2010 TTT/LR (meniscus trim)