By Michael Hall
“Post-operative swelling is the bane of my life” said one orthopaedic surgeon recently. He was complaining that whilst modern medicine has made great advancements with shoulder replacements, hip replacements, knee replacements, ankle replacements and in fact replacements for almost any part of the body, swelling, or the accumulation of fluid following surgery continues to hamper healing, impede recovery and limit the outcomes achieved.
The cause of swelling
Swelling (oedema) following surgery or injury is associated with the healing response of the body. This healing response can be divided into 4 stages – a bleeding stage, inflammatory stage, re-growth/proliferation stage and the re-modeling/maturation stage. Swelling is primarily associated with the bleeding and inflammatory stages. In these stages, the capillaries (smallest blood vessels) become more permeable to allow white blood cells out into the spaces between the cells to defend the body against infection as well as to clear the area of damaged tissue so that new tissue can be laid down on a clean area. As white blood cells pass through the capillaries, so too does fluid (plasma), causing the area to expand (swell).
The problem of swelling
The problem with swelling is that as that it can:
- Increase the pressure (hydrostatic) in the area so much that it shuts down the circulation and hinders the supply of oxygen and nutrients so essential for healing;
- Create an acidic environment, leading to the breakdown of protein and impede the laying down of new tissue.
The inflammatory stage however, is also essential to healing as the complex chemical interactions associated with it help to protect and clear the area of damaged tissue whilst also stimulating the re-growth/proliferative phase, the next stage of healing.
Is reducing inflammation the answer?
Inflammation can be reduced by a number of strategies. These include:
- Corticosteroid and steroid medication;
- NSAIDS or non-steroidal anti-inflammatory medication;
- Creams including corticosteroid, non-steroidal anti-inflammatory and natural (arnica) creams;
- Cold therapy including ice packs, ice massage and ice baths. Whilst these strategies attempt to dampen the activity of the immune cells and enzymes that breakdown tissue, they also slow down the healing rate. Steroids and NSAID’s for example have an inhibitory effect whilst cold packs slow the rate of metabolism.
Is there a better way?
Dealing effectively with swelling falls into two categories:
- Preventing the build-up of swelling in the first place, and;
- Mobilising or moving the fluid so that it doesnt accumulate;
One way to prevent fluid from building up is to physically compress an area with a bandage, compression stocking (e.g. TED stocking) or other compression garment (Jobst garment). By swelling, compression aids in circulation and thereby hastens healing, improves the repair and accelerates recovery. Another way of preventing swelling is to ensure that the channels that carry the fluid (lymphatic vessels) remain open and viable. This fluid can then be encouraged by the use of precise massage techniques called lymphodema massage. This involves gentle stroking and milking of the fluid in certain directions to encourage optimal flow, better circulation and maximum exchange of nutrients and waste products. Whilst lymphodema massage is very effective for reducing swelling in itself, its effect is enhanced further when it is combined with specific bandaging and specialized pressure garments (Jobst garments). The combined techniques of lymphodema massage and compression bandaging is called Lymphatic Drainage and it has been proven to massively improve the repair and post- surgery and post injury outcomes.
Bodyflow therapy, the ultimate answer?
Probably the only down side of lymphodema massage and Lymphatic Drainage is the reliance that it creates on a therapist to perform the techniques. New technology has gotten around this down side by enabling people themselves to be able to move fluid, improve circulation and therefore healing with Bodyflow. Through electrical stimulation, Bodyflow causes the contraction and relaxation of the smooth muscles in arteries, veins and lymphatic vessels, making them squeeze and release. This pulsing, forces fluid along the vessels, thereby eliminating swelling, improving circulation and optimizing metabolite exchange. Like lymphodema massage, it creates the best possible environment for repair and like Lymphatic Drainage, it can be combined with compression bandaging, stockings and garments. The advantage of Bodyflow is that it can be performed in the convenience of your own home (or any location), at any time you want and as many times as you want. For best results, twice a day for 20 minutes is recommended. Already, Bodyflow has been proven to recovery following intense training as well as reduce the stay in hospital by two days following knee replacement surgery. In fact, so good are the results of Bodyflow Therapy that four weeks of Bodyflow Therapy post-surgery is now being mandated by many orthopaedic surgeons across Melbourne. Bodyflow Therapy is also used by elite sporting clubs such as Collingwood and Carlton and even by the Great Britain Olympic Team to speed up recovery following intense physical exertion thereby enhancing physical adaptation and physical performance outcomes. It is therefore likely that it could help you to achieve a better, faster recovery from your injury, surgery or sporting event. Bodywise Health is one of a select groups of health-care facilities in Bayside Melbourne to provide Bodyflow Therapy to people in the Bayside suburbs of Hampton, Brighton, Elwood, Elsternwick, Sandringham, Highett, Cheltenham, Black Rock and Beaumaris and more generally Melbourne. Bodywise Health may also be found by googling Bodyflow Melbourne, Bodyflow Bayside, Bodyflow Hampton, Bodyflow Brighton, Bodyflow Highett, Bodyflow Sandringham and Bodyflow Cheltenham. Whether you are an athlete striving for personal bests or a patient concerned about achieving the best health outcome following injury or surgery, Bodyflow Therapy has the proven research evidence to show that it can help take your health to the next level and give you a physical performance edge.
Whatever your health circumstances, if you want the best possible physical health results, give Bodyflow Therapy a trial. You will be glad that you did.
For more information or for a trial of Bodyflow Therapy, please call Bodywise Health on 1 300 263 994.
- Rebates are available through your private insurance extras cover;
- For complex or chronic conditions, you may qualify for the EPC (Enhanced Primary Care Program) allowing you to receive 5 allied health services each calendar year with a referral from your GP. For more information, please call Bodywise Health now on 1 300 263 994.