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Post-operative care · South Berkeley
I have had one of these myself, fairly recently.
I had a knee replacement not long ago, which reopened a scar I have carried since 1984. So when I say that the swelling is the thing that limits your physical therapy, and that the scar matters more than anyone mentions, I am not saying it from a textbook.
- Common start
- Once your surgeon clears you
- Also covers
- Knee, hip, shoulder, revision
- Works alongside
- Your physical therapy
- First step
- A free phone call with me
Why swelling matters here
A swollen joint will not bend.
After joint replacement the limiting factor in the first weeks is usually not pain and not strength. It is fluid. A knee full of swelling has a mechanical ceiling on how far it will flex, and no amount of determination in physical therapy gets past it.
Reducing that fluid gives your physical therapist more to work with. This is not an alternative to PT and I would never suggest it was. It is the thing that lets PT do its job.
The other half is the scar. A joint replacement incision is long, and the fascia underneath it can bind in ways that quietly limit range of motion months later, long after everyone has stopped thinking about it.
What this helps with
Alongside your surgical team and your physical therapist.
Timing is set by your surgeon. Most people are cleared earlier than they expect.
Swelling around the joint
The main event, and the thing most directly limiting your range of motion early on.
Range of motion
Less fluid means more movement available, which means physical therapy makes faster progress.
Bruising
Often extensive after joint surgery and clears faster with lymphatic help.
Comfort and sleep
Heaviness and throbbing at night are common, and easing fluid often eases both.
The scar, later
Once fully closed. Long incisions can bind, and the fascia beneath them restricts more than the skin does.
Taping between visits
For newer scars and swollen joints, kinesiology tape works on skin, fascia, lymphatics and joint together.
Timing
What I know from both sides of it.
Your surgeon decides. Many people are cleared for gentle drainage away from the incision earlier than they expect, sometimes within the first couple of weeks.
Direct work on the scar waits until it is fully closed: steri-strips off, any scabs fallen away naturally, skin intact. For me that was a matter of weeks, and the wait is not optional.
While you are waiting, there is still useful work. Drainage away from the joint, and calming a nervous system that has been through a significant operation.
Worth saying plainly
Where my part ends.
I am not your physical therapist
This work supports PT. It does not replace it, and I will always tell you to keep going.
Anything sudden goes to your surgeon
New or rapidly increasing swelling, redness, warmth, fever, or calf pain. That last one urgently.
I do not do wound care
Anything open or not yet closed belongs with them.
I cannot promise your range of motion
I can help remove one of the things standing in its way.
Before you call
Questions I get asked.
How soon after a knee replacement can I have lymphatic drainage?
Your surgeon decides, but many people are cleared for gentle work away from the incision earlier than they expect. Ask them and tell me what they said.
Will this help my physical therapy?
That is the main argument for it. Less fluid in the joint means more available movement, which means your physical therapist has more to work with.
When can you work on the scar?
Once it is fully closed and your surgeon is satisfied. Usually several weeks. It is well worth coming back for, because a bound scar limits movement long after everything else has settled.
Does it hurt?
It should not. The work is very light and stays away from the surgical site until it is ready.
Does this apply to hip and shoulder replacement too?
Yes, and to revision surgery. The principle is the same: fluid limits movement, and a long incision can bind.
What about kinesiology tape?
It is useful for newer scars and swollen joints between sessions, working on skin, fascia, lymphatics and joint at once. I used it on my own knee.
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Related to this.
The next step
Tell me which joint and when.
Fifteen free minutes on the phone with me. Tell me the procedure, the date, and what your surgeon has said, and I will tell you when to start, what to expect, and when the scar will be ready.