Managing Swelling After ACL Surgery: The Role of Physical Therapy

Medically reviewed by Misty Seidenburg

ACL reconstruction surgery is a common procedure, with an estimated 175,000 procedures performed annually in the U.S., according to Yale Medicine. While swelling after ACL surgery is normal, it often causes painful pressure on the joint that affects muscle function. Here, we discuss the benefits of post-surgery physical therapy to manage swelling and promote healing after ACL reconstruction.

What Causes Swelling After ACL Surgery?

Swelling is a common and expected response to ACL surgery. The procedure involves cutting into the body, removing the torn tissue, and attaching replacement tissue to reconstruct the damaged ligament. While surgery is often necessary to restore knee stability and range of motion, it is still a trauma to the tissues.

This trauma triggers the body’s natural inflammatory response in which immune system cells release and send chemicals and fluid to heal inflamed tissue. This leads to swelling in and around the joint. Surgery triggers bleeding and changes blood flow near the surgery site, both of which also cause swelling after ACL surgery.

The Importance of Post-Surgery Swelling Management

While some knee swelling is anticipated after ACL reconstruction, it’s also important to be proactive about managing swelling. First, decreasing swelling eases pressure on the knee, which can help relieve pain and stiffness.

Reducing swelling also helps with mobility and allows you to perform physical therapy and other activities more comfortably and effectively. Finally, severe swelling that goes untreated can lead to serious complications, like blood clots or infection.

After surgery, monitor and manage your swelling and seek medical attention if your pain persists or worsens. Contact your surgeon for guidance if you experience excessive swelling, warmth, or redness on or near the surgical site.

Managing Post-ACL Surgery Swelling With Physical Therapy

Physical therapy for ACL recovery can be a game-changer for restoring joint strength and range of motion after surgery. It helps patients achieve a completely-straight knee so they can resume walking and return to their favorite activities, and it eases pain and stiffness in and around the surgery site.

When ACL reconstruction is scheduled, patients may consider 2-3 “prehab” sessions, which can lead to better outcomes. The benefits of physical therapy before surgery include stronger muscles and tissues, faster recovery, and lower risk of complications.

Post-surgery physical therapy also offers several treatments and modalities to bring down swelling that can slow the rehabilitation process. Effective physical therapy for ACL surgery involves a customized treatment plan that combines therapeutic movement with manual therapy.

Your post-surgery physical therapy program can include:

• Exercise and stretching: Gentle, supervised movements reduce pain and ease swelling. Targeted exercise also builds strength in nearby muscles to support and stabilize the knee during and after recovery to prevent re-injury.
• Cryotherapy: This treatment uses sub-zero temperatures to treat pain, stiffness, and swelling. Cryotherapy decreases blood flow and inflammation, which can reduce swelling.
• Manual Lymphatic Drainage: Lymph is fluid that flows through the body’s lymphatic system, transporting nutrients and proteins to cells and tissues. Lymphatic massage helps lymph move back into the circulation, dissipating swollen areas where lymph has accumulated.

Physical therapists also educate patients on how to reduce swelling after ACL reconstruction using home exercise plans (HEP) that align with their efforts in the clinic. If you are scheduled for ACL reconstruction and want to plan ahead for your recovery, request an appointment for a post-surgery evaluation at a clinic near you.

External Sources:

 ACL Injury Treatment Program > Departments > Yale Medicine (referenced but not linked.)