Does Walking Reduce Swelling After Knee Replacement? (PT’Tips)

If your knee is swollen after knee replacement surgery, you might wonder if walking more can help reduce it.

As a physical therapist, I’ll provide you with my best tips on walking with a knee replacement and its impact on swelling!

Feel free to leave any comments or questions below!

Happy reading 🙂!

Take-Home Message: Both not walking enough and overdoing it can increase knee swelling after knee replacement surgery. Finding the right balance and gradually increasing walking frequency is essential.

Why does the knee swell after surgery?

In the days, weeks, or months following knee replacement surgery, there may be a difference of several centimeters between the operated knee and the healthy knee. This difference can be 2-3 cm, 5-6 cm, or even more.

This is a normal phenomenon. However, the swelling can be more significant in some people, due to various factors, including genetic predisposition.

The swelling is caused by an accumulation of fluids in the various layers of tissue in the knee. It is related to the inflammation of the different tissues.

Inflammation triggering the swelling is a very healthy and therapeutic response! It is an automatic reaction of our immune system, inherited from our ancestors.

This inflammation helps to repair damaged tissues.

Swelling after TKR or PKR is normal and usual, and it means that your body is doing everything it can to ensure proper healing and recovery!

TKR = Total Knee Replacement

PKR = Partial Knee Replacement = unicompartmental knee replacement 

When should I be concerned about knee swelling?

It’s quite common for your knee to be about 2 to 2.4 inches larger in circumference than your non-operated knee in the days and weeks following your knee replacement.

Even if the swelling appears to be more pronounced, this isolated sign is not indicative of a problem or complication in itself. It’s other signs that should prompt you to seek medical attention, such as those indicating an infection:

1. Redness and warmth around the surgical site
2. Fever or chills
3. Drainage or discharge from the incision site, especially if it’s cloudy, yellow, or foul-smelling
4. Increased stiffness in the knee joint
5. Difficulty or inability to bear weight on the operated leg
6. Fatigue or overall feeling of unwellness

The fact that swelling persists for several months, and sometimes even years, is not necessarily a sign of a more serious problem in itself. While it can be bothersome and a cause for concern, it doesn’t necessarily indicate a severe issue.

Now, if this isolated swelling concerns you and it hinders your ability to perform simple tasks, you may also consider seeking the advice of your doctor or physical therapist / physiotherapist.

💡 See also: How Long Does Swelling Last After Knee Replacement?

How does walking affect knee swelling post-surgery?

Walking can have a dual effect on post-surgery knee swelling, impacting it in both ways, either exacerbating or reducing it.

Reducing Swelling

Controlled and gentle walking can encourage circulation and lymphatic flow, aiding in the removal of excess fluid and reducing swelling.

The contraction of calf muscles during walking acts as a natural pump, assisting in fluid movement from the lower extremities back towards the heart.

Weight-bearing and knee flexion during walking can prevent joint stiffness, improving overall joint health and reducing swelling caused by immobility.

Exacerbating Swelling

If you overexert yourself or walk excessively, it can lead to increased inflammation.

Excessive weight-bearing can strain the surgical site, causing more tissue damage and potentially more swelling.

The mechanical action of walking can also trigger a local inflammatory response as the body attempts to repair any microtrauma that may occur during movement.

Find the right balance!

The key lies in finding the right balance. Gentle, controlled walking, as recommended by your healthcare provider, can be beneficial in reducing post-surgery knee swelling.

However, overexertion and excessive walking can have the opposite effect, leading to increased inflammation and discomfort.

As a physical therapist, our role is precisely to assist our patients in finding that delicate equilibrium.

In my career, I’ve seen just as many patients do too little as those who overdo it.

Some people, out of fear of exacerbating their pain, remain largely sedentary, spending most of the day on their couch and only getting up to go to the restroom.

These patients should aim to walk gently for at least 2 or 3 minutes a few times during the day, even with the support of crutches.

Conversely, some people are overly ambitious. They engage in intense rehabilitation immediately after their knee replacement surgery, often right after leaving the hospital.

They do numerous exercises and even walk outside daily, sometimes covering more than 1 or 2 miles from the very beginning. Typically, their knees protest loudly. The pain, especially at night, becomes quite severe.

As a result, they adjust their approach and find a better balance in their walking routine to reduce knee swelling.

How should I walk to reduce knee swelling once I have my replacement?

To walk in a way that helps reduce knee swelling after a knee replacement surgery, you can follow these guidelines 🙂:

1. Start Slowly: Initially, take short and gentle walks. Begin with a few minutes several times a day, gradually increasing the duration as you become more comfortable.
2. Use Assistive Devices: You may use crutches, a walker, or a cane for support during the early stages of walking. These devices help reduce the load on your new knee.
3. Take Short Steps: Keep your stride short initially to avoid overextending your knee joint. As you progress, you can gradually increase the length of your steps.
4. Avoid Overexertion: Don’t push yourself too hard. Pay attention to your body’s signals. If you experience increased pain or swelling, reduce your walking time or frequency.
5. Use Proper Technique: Make sure your physical therapist or healthcare provider has taught you the correct walking technique, including how to transfer weight and move your operated leg.

Below, I’ll show you the different ways to walk with crutches after a fracture or replacement, gradually helping you to transition away from them!

What can I do to help reduce knee swelling?

I’ve already written a more comprehensive article dedicated to the duration and reduction of knee swelling after knee replacement surgery.

In summary, here are 3 additional things you can implement to minimize your knee swelling.

1. Wear compression stockings or compression socks with a class II rating (see on Amazon). Although compression stockings can reduce swelling in healthy individuals, they don’t appear to reduce swelling in people who have had knee replacement surgery (Liu 2020).
2. Elevate your leg (with your legs and feet above your hip and heart level).
3. Limiting the time spent in static positions, such as standing (while doing household chores) or sitting (during meals or computer work). It’s important to alternate between walking and elevating your leg.

✅ The following tips may provide short-term relief for edema, but once they’re no longer applied, the swelling is likely to return!

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