Expert Icing After Joint Replacement Surgery

This article was reviewed by Dr. Nima Mehran, MD, Orthopedic Surgeon

Hate it or love it, icing will become a big part of your everyday routine in the weeks (even months) after joint replacement surgery. Like anything in life, there are decent ways to go about icing, and then there’s expert-level icing. This is like Olympic level icing versus house-league. In this article, we will cover why icing is important, the different methods of icing, and share the best of the best icing tips and tricks for those recovering from hip replacements and knee replacements.

Continue reading to get your ice ice baby on!

Don’t Fall Down a Slippery Slope: Why Icing After Joint Replacement Surgery

Icing is huge part of cutting down pain, swelling and inflammation after surgery. In other words, icing jumpstarts healing and helps to keep you more comfortable as you recover. Icing should be incorporated into your daily recovery routine alongside elevating your surgical leg, taking prescribed pain medications, completing physical therapy, and running through your assigned PeerWell ReHab app checklist.

Different physical therapists and doctors come with varying recommendations for how many times a day you should ice for and how long. Some care providers put a maximum cap on icing, while others suggest you ice as many times a day as you see fit.

In saying this, a good rule of thumb is to ice a minimum of 3-4 times a day for 15-20 minutes at a time. It’s especially important that you ice after therapy and activities or exercises that challenge your range of motion, endurance and so forth. This could even be a longer walk, after an hour of errands and so forth. Know when you’re pushing yourself and be ready for an ice treatment afterwards.

Caution: Fresh ice directly on a limb can burn the skin and reduce blood circulation. This is very painful and bad for healing. For this reason, it’s safest to ice in 20 minute time blocks, with fabric (like a tea towel) protecting your skin from touching ice directly.

How to Ice Properly After Joint Surgery

The best ways to ice are slightly different for those who’ve had a knee replacement (regardless of if it’s a partial or a full replacement) and a hip replacement (again, regardless of replacement type like anterior hip replacement, minimally invasive hip replacement and so forth).

Those Who’ve Had a Knee Replacement

With a knee replacement, you will want to be sure to elevate your leg while icing. This helps cut down swelling and inflammation, which speeds up healing. While icing, lay on your back and prop your surgical leg with 3 or more pillows. DO NOT put pillows directly under your knee as this cause stiffness (the exact opposite of what you want in the first weeks of recovery). Pillows should prop your heel. When icing, keep your knee as straight as possible. Your surgical leg must be elevated higher than your heart.

Once elevated, ice you 15-20 minutes at a time.

Wrap ice in a tea towel, t-shirt, or thin cloth. DO NOT apply directly to skin (you may get burned, literally).

Repeat icing at least 3-4 times a day. If you think you would benefit from icing more frequently, ask your doctor if this is a good idea.

How long to ice a knee after knee replacement surgery? It's important to keep icing daily in the first 90 days of surgery and beyond. As long as you have pain and swelling, icing is a great tool to overcome these recovery setbacks.

Those Who’ve Had a Hip Replacement

For hip replacement recipients, you will want to elevate your leg slightly (with 1-2 pillows) and lay with your surgery side up to ice. This reduces swelling and will likely be a more comfortable position.

Once elevated, ice you 15-20 minutes at a time.

Wrap ice in a tea towel, t-shirt, or thin cloth. DO NOT apply directly to skin.

Repeat icing at least 3-4 times a day. If you think you would benefit from icing more frequently, ask your doctor if this is a good idea.

Tip: Remember, icing to reduce pain and speed up recovery is apart of a “triple approach” (in show biz, they call this a triple threat): pain medication, elevation and icing. Doing all 3 will keep pain down and allow you to recover safely, with a lessened chance of complications due to excessive swelling, bruising or inflammation.

Best Icing Methods After Surgery

Crushed Ice in a Bag

An easy-to-make go-to is to take about 1-2 cups of crushed, shaved ice or ice cubes and put it into a ziplock bag. You can add saran wrap to around the bag to keep the ice block more dense, therefore making it last longer.

This method of icing works perfectly well for 20 minutes on but the ice will melt faster.

Foam Cups/ Pucks

Rather than filling up an endless supply of ice cube trays and whipping through them, we suggest making larger, cups with ice. These will last much longer and have a larger surface area to ice your joint.

To make, simply buy foam drinking cups from your local grocer, dollar store, or order online. All sizes work, but we recommend going with the 10-12 oz size.

Instant Ice Packs

Instant ice packs are great for on-the-go when you’re further along in your recovery and more mobile. If you’re heading to appointments, out to run errands, or are in the car for a prolonged period, dry instant ice packs are perfect. Instant ice packs do not have to be frozen or refrigerated. Simply, squeeze the center of the pack and it will instantly get ice cold. These packs last a couple of hours.

Find these instant cold packs at your pharmacy or order online.

Ice Therapy Machine

Ice therapy machines (also called cold therapy machines) can be costly but some pharmacies, hospitals and therapy offices rent them out. Finding an ice machine for knee surgery rental or after hip surgery may be easier than you think, so ask around locally. Some ice therapy machines with a cuff are better designed for the knee joint, so if you’ve had a hip replacement, make sure the attachment will work for you. Like ice, these machines provide pain relief, and reduce swelling and tissue damage.

Ice therapy machines can be motorized or nonmotorized and offer direct cold treatments to specific areas of the body. The machines circulate cold water and air through a wrap that you put on your joint. Since they do not get as cold as ice, they can be left on longer. Usually, the recommendation is to leave them on for two hours at at time. However, some replacement candidates report leaving them on throughout the night and swear by them for a faster recovery. If you do leave it on during the night, ask your doctor and always remember to keep your skin completely covered to avoid burns.

Here are some ice therapy machines online available for purchase.

Gel or Ice Packs

Gel packs (or ice packs) are kind of like the superior frozen bag of peas or even homemade ice puck. Like a pouch alcoholic drink you put in your freezer during summer vacation, gel packs never freeze completely. They remain kind of slushy, which is great for shaping around your entire joint area. Like ice cubes or pucks, gel packs should be wrapped in thin cloth while fresh. They can be put directly on the skin once they have warmed up a bit.

Gel packs can be purchased at your local pharmacy, department stores, or in bulk online. Better yet, read on and we will show you how to make your own. It’s cheap and easy!

DIY Gel Pack Recipe

What you will need:

1 large bottle of rubbing alcohol (at least 34 ounces or 1 litre)

Gallon sized freezer bags

Tap water

What to do:

Take a large freezer bag and measure about 8 cups of tap water. Dump water into bag. Measure out 2 cups of rubbing alcohol. Add this into the bag with water. Squeeze out air in freezer bag and seal. To avoid any leaks, place sealed bag into a second freezer bag and seal this one too. Stick your homemade ice pack in the freezer for about 8 hours.

Tip: Make at least 2-3 gel packs so that you always have “fresh”, cold ones ready to cycle out. Once the gel pack has thawed, place back in the freezer and reuse.

There you have it. Now you’ve heard everything you need to know (and then some) about icing after joint replacement surgery. Actively staying on top of what your doctor and physical therapist recommends, as well as following an at-home ReHab program (like PeerWell) will get you recovered faster. Although there will be some ups and downs, the more dedicated you are to your recovery, the better it will go.

Are you having joint replacement surgery? Have you just had a hip replacement or knee replacement? If so, sign-up for PeerWell. Our PreHab and ReHab app is designed to deliver better surgery outcomes for joint replacement candidates and guides recipients through a faster and safer recovery.