Post-Cast Swelling: Recovery After Leg Injury

The foot remains swollen after the cast has been removed?

I'm sorry, I have read that normally there shouldn't be swelling after removing the cast.
Could it be because I removed the cast a week early? I have a crack in my femur but did not undergo surgery, and my anterior cruciate ligament is slightly strained.
I had the cast on for almost two months, but after removing it, my ankle and knee are a bit swollen, and the skin appears somewhat discolored.
Is this due to poor circulation? The swelling doesn't seem to subside much.
Would icing the swollen areas be effective? For future rehabilitation, should the angle of the knee bend be based on individual capability, bending as much as possible without pain? I'm a bit afraid of the pain.
Sorry for the trouble.

Niming, 10~19 year old female. Ask Date: 2016/08/30

Dr. Shi Guozheng reply Orthopedics

Elevating the legs can improve poor circulation, which is often more effective than applying heat followed by elevation of the affected limb.
Additionally, increasing joint mobility and engaging the muscles act like a pump, compressing blood vessels and facilitating smooth blood circulation.

Reply Date: 2016/08/30

More Info

Post-cast swelling is a common concern after the removal of a cast, especially following a leg injury such as a fracture or ligament strain. It is important to understand that some degree of swelling can be expected after the cast is removed, particularly if the cast was worn for an extended period, as it can lead to muscle atrophy and decreased circulation in the affected limb.

In your case, you mentioned that you had a fracture in your femur and some strain on your cruciate ligament, and you wore a cast for nearly two months. The swelling you are experiencing in your ankle and knee after the cast removal is not unusual. When a cast is applied, it immobilizes the limb, which can lead to fluid accumulation in the tissues once the cast is removed. This is often due to the body’s inflammatory response to the injury and the sudden return of movement and circulation to the area.

The discoloration of your skin, described as "a bit black," could be due to bruising or hematoma formation, which can occur when blood vessels are damaged during the injury or from the pressure of the cast. This can also contribute to the sensation of poor circulation. It is essential to monitor the color and temperature of your skin; if you notice significant changes or if the swelling worsens, it would be wise to consult your healthcare provider.

Ice therapy can be effective in managing swelling and discomfort. Applying ice to the swollen areas for 15-20 minutes several times a day can help reduce inflammation and provide pain relief. Make sure to wrap the ice pack in a cloth to avoid direct contact with the skin, which can cause frostbite.

Regarding rehabilitation, it is crucial to approach it gradually. The range of motion exercises should be tailored to your comfort level and pain tolerance. It is normal to experience some discomfort as you begin to move the knee and ankle again, but you should not push through severe pain. Start with gentle movements and gradually increase the range as tolerated. If you can bend your knee slightly without significant pain, that is a good sign, but listen to your body and do not force it beyond what feels manageable.

Physical therapy can be beneficial in your recovery process. A physical therapist can provide you with a structured rehabilitation program that focuses on restoring strength, flexibility, and function to your leg. They can also guide you on how to safely perform exercises that promote circulation and reduce swelling.

In summary, some swelling after cast removal is normal, especially after a prolonged period of immobilization. Ice therapy can help, and rehabilitation should be approached gradually, respecting your pain levels. If you have any concerns about your recovery or if the swelling does not improve, it is advisable to follow up with your healthcare provider for further evaluation and guidance.

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