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A common question in the clinic. One we address with every patient managing their ACL reconstruction during the early rehabilitation days.
If you have recently had an ACL reconstruction, or suffered an ACL injury, your knee probably feels quite puffy, swollen and almost as if it is not your knee… that you can’t control it. It is probably quite sore and after a week you probably are seeing that your quadricep muscles are almost disappearing before your eyes.
This is a very common experience in knee physiotherapy.
So, should you Ice to help this?
Simple answer: Yes. Ice your knee whenever you feel uncomfortable. Also Ice it before exercise and probably after if you can.
Long answer: It’s still yes, but here is a bit more about why.
Ice won’t be changing your swelling. But the time you are resting with the ice pack on, assuming your leg is elevated and maybe even compressed, you will notice the swelling might reduce. This occurs due to the elevation and compression.
The ice, however, is helping reduce the sensation you feel from the knee.
“Oh, I can put up with a little bit of pain.” Sure, but your quads don’t know the difference.
So, even if you think you can tough it out, what happens is before your brain even has a chance to provide input, there are messages being sent through to your spinal cord that tell any brain-muscle connection to “do less” in the name of protecting the injury. This is called Arthrogenic Muscle Inhibition (AMI).
These messages are being sent whether you like it or not. They arise from your joint sensing an increase in swelling, and also arise when there is pain. Note that these can be two independent scenarios - you might have pain without swelling!
So, it stands to reason that if we can reduce the causes of those messages being sent, which limit your ability to switch on your quadriceps, perhaps you will have better outcomes.
The research supports this as well. We see in a 2014 study that people who ice their knee before their rehab exercises saw the best improvements in quadricep muscle strength when compared with people that did not ice their knee. Same strength program!
Ice cubes, in a bag with a small amount of water, covering the majority of the front and back of your knee. Keep a tea towel on to prevent ice burns! Do this until you can’t really feel the ice anymore (often 15-20 minutes).
This piece of equipment will provide the circumferential cooling effect of option one, but it will add pneumatic compression. This is likely to help both elements of the cause of AMI and is a frequent part of post-surgery recovery.
Yes. Why? Because it adds the compression and once it is wrapped on your knee, it generally won’t fall off. You set the timer and away you go. It takes away a lot of the hassle as any set and forget system would do. But it also covers far more surface area. And you don’t have to keep filling the ice tray multiple times a day. If you set it up and use the machine throughout the day (4-5 times per day) then the machine will keep the ice fairly cool.
Yes, of course, there are other options on the market. Do they offer the same compression feature at the same quality? Perhaps, but we haven’t seen one that does everything as well as this Game-Ready system.
Well that is a case by case answer, but it is based on “when you are sore” and “before exercise.” So that could be quite a lot for some people, or only occasionally each day for others. Everyone has a different experience in their physiotherapy rehabilitation.
Is the Game-Ready for hire? Yes! RHP Physiotherapy offers the machine to hire. If you know you have surgery booked, it might be worth getting this the day before surgery, or asking someone to pick it up for you before you get home! Contact us for more information and pricing.
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