Today I went to physical therapy with my mother-in-law. It was her first outpatient physical therapy session since her total knee replacement on March 31st. I have worked with her when I arrived on Monday. I focused on getting her swelling under control, thus giving her more flexion/extension and muscle fiber recruitment. I can’t emphasize the importance with all rehab and post rehab clients of minimizing swelling. As a post rehab professional you are limited in your approach to managing swelling but advising the client to use ice liberally is certainly within your scope of practice. Another option for management of swelling is aquatic training. The water temperature as well as hydrostatic pressure are major aquatic factors in decreasing swelling. Remember, if swelling is decreased ROM increases, pain decreases, muscle recruitment and strength increase and overall functional capacity improves. Swelling is a byproduct of inflammation that we must respect. NEVER WORK THROUGH SWELLING!!