Treatment course6 min read
Managing oedema and regaining range of motion
The approach to post-injury oedema management has changed in recent years. Prolonged rest and ice have given way to early controlled movement and progressive loading.
The first days
Elevation and compression are effective at reducing swelling in the first days. The limb is raised above heart level and an elastic bandage applied.
Cold reduces pain. Evidence that it speeds healing is limited; it is used briefly for pain control.
Complete rest is not advised. Movement within the pain-free range and work that engages the muscle pump support fluid clearance.
The muscle pump and movement
Ankle pumping engages the calf muscles and increases fluid drainage in the lower leg. It is the simplest and most accessible method.
Regularly bending and straightening the joint within the pain-free range prevents capsular stiffness and supports circulation of joint fluid.
Muscle activation begins early. Stimulating the inhibited muscle with isometric work minimises strength loss.
Regaining range of motion
The earlier lost range is addressed, the easier it is to regain. Restriction lasting weeks turns into capsular stiffness.
Full extension at the knee is monitored particularly closely. Established extension loss disturbs gait and loads other joints.
Range is tracked by measurement. Subjective impression can mislead; goniometer readings are the reliable indicator of progress.
Key points
- Current practice advises early movement over complete rest.
- Evidence that cold speeds healing is limited.
- Ankle pumping is the simplest accessible drainage method.
- The inhibited muscle is stimulated early with isometric work.
- Established extension loss disturbs gait.
Frequently asked questions
How long should I ice?
Fifteen to twenty minutes, a few times a day, without direct skin contact. Longer application adds no benefit and risks skin damage.
When is heat appropriate?
Not during acute swelling, as increasing circulation can worsen oedema. Once swelling recedes and muscle tension dominates, warmth is preferred.
Are compression stockings needed?
They can help with prolonged standing and lower leg oedema. Where a vascular problem is suspected, assessment is needed before use.
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This content is for information only and does not replace medical diagnosis or treatment. Response to treatment varies between individuals. Please consult a healthcare professional about your symptoms.