Leg swelling after surgery can be unsettling, especially when it feels like it’s getting worse before it gets better. Whether you’re recovering from a joint replacement, a fracture repair, or any lower extremity procedure, swelling is a normal part of healing, but it’s also something you want to keep an eye on.

Wondering why your leg is more swollen after surgery or what to do about it? You’re not alone. From normal healing to red flags to watch for, here’s what you need to know about swelling after surgery and how to manage it with confidence.

Is swelling normal after surgery?

Yes, swelling after surgery is completely normal. In fact, it is one of the body’s first responses to healing. This process, known as the inflammatory phase, begins right after surgery. Your body sends immune cells and healing proteins to the surgical site, which causes fluid to build up in the area.

When the surgery involves the lower extremities, like a knee or hip replacement, gravity adds an extra challenge. Because your legs are below the level of your heart, fluid naturally collects there. This can make the swelling more pronounced, especially in your feet and ankles.

Some swelling is expected for several weeks after surgery, and it typically fluctuates depending on how much you’ve been on your feet, how recently you iced the area, and whether you’ve been elevating your legs.

What causes swelling after surgery?

Swelling after surgery (also called edema) is caused by several factors, including:

• Inflammation: As part of the natural healing process, your immune system increases blood flow to the surgical site, which leads to fluid accumulation.
• Tissue trauma: Surgical procedures often involve cutting through tissue, which triggers fluid retention as the body works to repair itself.
• Reduced mobility: Limited movement post-surgery can slow down circulation, leading to fluid buildup.
• Gravity: When standing or sitting for long periods, fluid naturally pools in the lower parts of the body.

Why is my leg more swollen now than it was in the surgery center?

This is one of the most common concerns patients express.

While you were in the surgery center, you likely spent most of your time lying down or seated with assistance nearby. Nurses helped with mobility, and physical activity was closely monitored. Once you return home you begin transitioning back into daily life.

You start preparing meals, walking to the bathroom more frequently, and doing post-operative exercises. All of this increases the time your leg is in a dependent position (below the heart), which means more swelling. Because you’re more upright and mobile at home, swelling may appear more noticeable, especially in the evening or after periods of activity. This increase in swelling after leaving the hospital is usually temporary and not a sign of complications.

However, if the swelling is accompanied by increased pain, redness, or warmth, contact your surgical team. These could be signs of something more serious going on. 

When should I worry about swelling after surgery?

While some swelling is expected, there are times when it may signal a more serious issue. Contact your OSMS surgeon if you experience:

• Sudden or severe swelling that comes on quickly
• Redness, warmth, or pain around the swollen area
• Shortness of breath or chest pain (which could indicate a blood clot)
• Swelling that continues to worsen instead of improving over time

These symptoms could indicate complications like deep vein thrombosis (DVT), infection, or a delayed healing response.

How to reduce leg swelling after surgery

The good news? There are several safe and effective ways to reduce swelling after surgery at home:

1. Elevate Your Legs
   1. Keep your leg raised above the level of your heart when resting
   2. Use pillows to prop your leg comfortably on the couch or bed
   3. Do NOT sit in a recliner to elevate your leg as this does not properly drain the fluid from your body
2. Apply Ice Packs
   1. Ice the swollen area for 15-20 minutes every couple of hours
   2. Always wrap ice in a cloth to prevent skin damage
3. Wear Compression Stockings
   1. Your doctor may recommend compression socks to improve circulation
   2. Be sure they’re fitted properly and worn as directed
4. Move Regularly
   1. Gentle, prescribed movement helps promote blood flow
   2. Avoid standing or sitting too long without a break
5. Stay Hydrated and Eat Well
   1. Drinking water helps flush excess fluids from your system
   2. Focus on an anti-inflammatory diet to support healing

Always check with your physician before adding new treatments to your recovery routine.

Physical Therapy and Swelling: Why Movement Matters

Staying on top of your physical therapy plan is one of the most important things you can do to reduce swelling and regain function after surgery. Exercises designed by your physical therapist aren’t just about mobility, they’re carefully chosen to help reduce inflammation, promote circulation, and rebuild strength where your body needs it most. Healing doesn’t only happen during your clinic visits. What you do at home matters just as much.

Surgery is just the first step. Following your physical therapy plan and consistently performing the exercises at home can be the difference between a good outcome and a great one.

FAQs About Swelling After Surgery

Is swelling normal after knee surgery?

Yes. Knee replacement and other knee surgeries often cause noticeable swelling due to the location and tissue involved. Expect some swelling for several weeks post-op.

How long does swelling last after surgery?

Some swelling is expected for several weeks after surgery, especially with lower body procedures. It’s also normal for it to come and go throughout the day. You may notice that swelling increases in the evening, after standing or walking, or on days when you’ve been more active. That’s why elevation, icing, and rest are so important to help your body recover. While it can feel discouraging to see your leg swell up again after some progress, these ups and downs are part of the healing process. Most patients find that swelling steadily improves week by week as mobility increases, and inflammation subsides.

Are swollen feet after surgery a concern?

Not usually, especially if both feet are slightly swollen. If one foot is significantly larger or painful, talk to your surgeon.

Can I take medication for post-surgery swelling?

Over-the-counter NSAIDs like ibuprofen may help but only use them if approved by your doctor.

Is swelling a sign of infection?

Not always. Mild to moderate swelling is part of healing. But if it’s paired with fever, redness, warmth, or pus, contact your physician immediately.

Key Takeaways

• Some swelling is expected after lower-body surgery, especially in the legs, feet, and ankles.
• Swelling often increases after leaving the hospital due to increased activity and gravity.
• It should gradually improve over time. Contact your care team if it worsens or is paired with symptoms like redness or pain.
• Ice, elevation, movement, hydration, and nutrition all play a role in reducing swelling and supporting recovery.
• Following your physical therapy plan, both in and out of the clinic, is essential for long-term healing.

When to Call OSMS

If you’re ever unsure whether your swelling is normal or cause for concern, it’s always okay to contact us. At OSMS, our orthopedic teams are here to guide you through every phase of recovery. From surgery to rehab, our goal is to keep you safe, comfortable, and informed.

We understand that recovering at home can bring up new questions and concerns and sometimes, peace of mind comes from a simple conversation. You don’t have to navigate this alone. Whether you need a quick check-in, reassurance about your symptoms, or next steps in your healing plan, we’re here to help you feel confident and supported every step of the way.

Learn more about after surgery care.

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This blog was originally published in October 2018 but updated and republished in April 2025 to reflect current best practices in post-surgical care.