Ice or heat after tkr?

Posted , 5 users are following.

I think everyone agrees that icing is the best treatment immediately following tkr but at what point is it recommended to use heat? I read Dr Gabe Mirkin's  "why ice delays recovery" and his statements seem controversial but make some sense.

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  • Posted

    People seem to use heat a few months after TKR.....just to reduce stiffness and help

    Muscles relax before exercising. I guess I started using it by taking warm baths which

    Must have been around five weeks. I had to be careful to not let the operated

    Leg get too warm though, or it just increased the swelling. It was good for working on the bend though!

    🛀

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  • Posted

    After reading about the benefit of heat from this group I used wet flannels, rinsed in hot water and then wrapped a big towel round to keep the heat in, and refreshed flannels so it was warm for about 10 - 15 minutes.  It seemed to relax the knee.  I only did it for one or two days when I felt more tension in the knee.  I really did noticed the difference though - it suddenly felt as though everything had been oiled!  I never iced over my scar because I reckoned (don't know if it's correct!) that it needed as much  blood supply as possible to be there for healing.  Initially I was icing right up to the time of doing the bending, which wasn't a brilliant idea, when you think about it - they say to 'warm up' and then you 'cool down' (icing) after.

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  • Posted

    I was never told anything about heat.

    Iced from day 1 and still do it if needed..

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    • Posted

      I know that ice should reduce swelling, and I guess heat should encourage blood flow to damaged tissue.  BUT - this is what I don't understand - while the ice is reducing swelling, is it reducing the blood flow so preventing healing to some extent....  And is the heat increasing swelling.....?  Does one neutralise the other???????  Is that a silly question??????

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    • Posted

      Well, I'm certainly no expert but it seems to me that ice should be used early on after injury or surgery because it slows the blood flow and swelling that causes pain. But at some point when swelling and pain is reduced, heat should be added to help the healing process. I've seen suggestions of alternating ice/heat but usually heat s not recommended early on. Tha's my input, would like to hear what everyone else thinks. 

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    • Posted

      Again, this is another interesting one!  I've not used ice at all since about 5 weeks post op and only used the heat for the short time as mentioned, so not needing either these days, but it will be interesting to hear all the views on it:-))))

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    • Posted

      I still use ice..mainly for pain relief. In evening the leg warms up by itself,

      And this seems to be the healing process coming into action as I rest, so

      I don't tend to ice it then.???????🌋🌋🌋🌋🌋🌋🌋

      Just love the little pictures!

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  • Posted

    I love this explanation. Ps, our nerves have been cut and sensation at knee isnt "normal" so be careful w both!

    How Does Ice Treatment Work?

    Ice treatment can relaly help to reduce pain and swelling after an injur

    With an injury, swelling accumulates in the affected area which causes two problems. Firstly, there are chemicals in the fluid that aggravate and irritate the nerves fibres causing pain. Secondly, the pressure from the swelling (there is limited space in each joint) causes pain and limits the amount of movement that the joint can perform e.g. how much you can bend and straighten the knee.

    Ice treatment can help in two ways. Firstly, the cold from the ice has an analgesic effect which reduces pain. Secondly, it helps to reduce the amount of bleeding into the joint and soft tissues thus reducing swelling and any associated muscle spasms.

    How to Use Ice Effectively

    Ice treatment works most effectively when used immediately after an injury or surgery (in the first 3-4 days), but can also help reduce pain and inflammation in longer term knee problems. The simplest thing to do is to wrap some ice in a damp cloth e.g. tea towel. Place a dry cloth on the affected area and then apply the ice for 10-15 minutes.

    Do not leave it on any longer as it can cause an ice burn. It can also slow blood flow so much that the good nutrients needed for healing can’t get in and the bad chemicals produced from the injury can’t get taken away. Also, if the body gets too cold it responds by causing the blood vessels to dilate (open more) allowing more blood to rush into the area which actually increases swelling. This is known as the Hunting effect.

    Remove the ice for at least 2 hours before reapplying to allow the area to return to its normal temperature. Use frequently to maximise the effectiveness.

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    • Posted

      Again, our nerves have been cut so use w care. Rice bag works too. smile

      Heat is a great natural knee joint pain treatment for longer term knee problems such as arthritis rather than after initial injuries. Heat works in two ways. Firstly, it increases the blood flow to the area which helps bring in fresh blood, oxygen and nutrients to aid healing. Secondly, the heat reduces the pain sensations and helps the muscles to relax.

      The best way to apply heat is to use either a microwaveable wheat bag, or a hot water bottle (with a cover or wrapped in a towel). Use for approximately twenty minutes at a time.

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    • Posted

      But can you see what I mean - we want blood to come to the area for healing, so why are we icing, and while we're icing, we're reducing the healing and while we're heating, we're not reducing the swelling - it's a bit of a juggling act!

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    • Posted

      Well, I'm experimenting. I'm still swollen somewhat after 13 weeks and have been icing like a wild man during that time. My progress has been slow but now my pain is completely gone so I'm switching to heat (just ordered an electric heat pad) and only icing after my stretches, bending exercises. Will see.

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    • Posted

      Let us know then:-))))  I only used heat for a day or so, and used ice up to the first five weeks, but as you know, I've really not had pain and things just flowed very well, so never really had to look for answers to problems!  But it's always good to hear what works for who, because we never know what the future holds with more ops etc. and for those struggling more now!

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