Elevation: Doing It the Right Way

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Administrative Staff
Jun 11, 2013
United States United States
Updated September 11, 2022 by Jamie

Proper elevation is one of the best ways to help with pain and swelling following either hip or knee surgery. Many people elevate improperly, which can dramatically lower the effectiveness. In the weeks following your surgery, make sure you elevate your legs as much as possible. Pay close attention to the images below to avoid the wrong way (red "x") and ensure the right way (green check mark) to elevate.

Should you choose to use a foam wedge for elevation, we've provided links to an information/purchase page for the scientifically designed Lounge Doctor on images below. Your purchase through this link gives you a quality product we proudly support and provides a donation to BoneSmart.

When you are relaxing and elevating your legs, it's not enough to just put your foot on a foot stool like these

foot stool 2.jpg
foot stool 1.jpg

and the leg flap on some recliners only comes up to about 30 or 40 degrees before the back rest starts to go down. Many recliners also keep the feet below seat level even with the chair reclined. You're not getting proper elevation in any of these situations.

foot stool recliner.jpg

For a KNEE REPLACEMENT, it's also not a good idea to try and elevate with your leg totally straight like this as it stresses the muscles at the back of your knee tremendously, which can cause pain instead of helping it.

elevating angles.jpg

You may hear that you should try to keep your legs straight when elevating in order to help with your leg extension. But when you have a swollen, painful leg already, this is not helpful and can be quite uncomfortable, if not torture! A slight bend at your knee is much better for both you and your new knee.

Don't EVER use a wedge that keeps your knee bent, either - like this. It really is a
as it puts pressure on the wrong places in your leg.

elevate 4.jpg

The correct way to elevate

At a minimum, your foot should be above the hip and the higher the better in order to get good drainage for the lymph and tissue fluid that is the primary cause of swelling. This also helps with the pain levels.

An often quoted is "toes above nose" gets the point across very well, although this more appropriate in cases of extreme swelling.

Here are some points to remember when elevating:

- If you are a hip patient, observe the 90 degree rule if required by your surgeon.
- If you are a knee patient, never have a bundle of pillows or a cushion firmly behind the knee or belly of the calf as shown in these six photos below. All these positions cause compression in the knee and calf which may result in a blood clot, especially in the early days post-op.

bad elevate 1-horz-vert.jpg

- Other dangers that can arise if a pad or cushion is placed under the knee include:
Compartment syndrome
- Make sure your heels are not in a position to take weight or pressure as this can lead to sore heels and in extreme cases you may even risk getting pressure sores.

Some examples of good elevation:

1. In or on the bed. BoneSmart supports the use of the Lounge Doctor foam wedge for bed elevation.
Hudson shaped wedge.JPG

2. On the couch - though preferably not with your back twisted like this lady's is. BoneSmart supports the use of the Lounge Doctor foam wedge for elevating while lying on a couch.
elevate 2.jpg

3. Sitting up on a chair. Be sure to have a high back to support the spine, neck, and head.
elevate 3.jpg

4. Using a pillow stack.
pillow stack.jpg

A pillow stack can often fall apart, so one of our BoneSmarties suggested using three inexpensive pillows and giant safety pins (available on Amazon) to create a pillow wedge. This can be a good alternative if you choose not to purchase a foam wedge.

pinned pillows.jpg
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