Do My Swollen Legs Need Compression?

I recently had a patient who came into the office telling me that his feet and ankles hurt. When I asked him to describe his pain, he described it as “not really painful anywhere in particular, just uncomfortable because they are tight all over”. He also mentioned that “my legs get tired”. Well, the foot bone is connected to the leg bone, as is all the skin and what’s underneath as well!

Looking at this guy’s legs, feet and ankles, what was most obvious was the swelling! His exam showed no issues with bone, tendon or ligament. He just had some swelling!

Swelling (aka edema) is an excessive collection of fluid in the soft tissues of your body. In the legs, it can cause that dull, achy, heavy and tired feeling. This feeling gets worse towards the end of the day or after standing for a long period of time. Does this sound familiar? Though you might have gotten use to it, this is not normal and should really be treated.

There are many causes of swelling in the lower extremity. Some of these include high blood pressure, congestive heart failure, liver or kidney problems, medications and varicose veins.

It is important that you visit with your primary care physician to try and nail down the cause of your swelling. Once you have done so and are being treated for the underlying condition, your podiatrist can help you to get some of the fluid off of the legs. The best way of doing this from our end is with the use of compression socks or stockings.

Compression (the amount of pressure or tightness you will feel) of the sock/stocking is listed in the form of “mmHg”. You should see this on every compression garment you purchase. The lightest form of compression is in the 15-25 mmHg range and goes up from there. The amount of compression and the actual length (knee-high to thigh-high) is chosen depends of how bad your edema is and to where it is most evident. Your podiatrist will typically start you on a low level of compression and work up to a higher level as needed.

A few things to keep in mind:

1. If you have heaviness in the legs and have noticed that you have less hair growth on your legs, cramping, pain and/or cold feet /legs, this could be a sign of arterial disease. If you area not sure whether or not you have arterial disease because you have never been checked for this, it is important to discuss testing for this with your podiatrist prior to using compression.

2. Remember to wash your garment preferable daily or at least every two days allowing them to air dry out of the sun or a dryer, both of which can break down the fabric. Have at least two pairs of compression garment to trade them out.
3. Inform your podiatrist the minute you notice any bruising in the lower extremity or any bluish discoloration to the toes.

4. Let your podiatrist know if the garment feels loose. As the swelling improves, the garment will feel looser. Depending on the level of swelling you have at that stage and your tolerance, your podiatrist may recommend a higher level of compression.

Not Motivated to Exercise?

It is the first weekend in February and it is now that all those people who decided January 1st to start an exercise program have fizzled out and returned to the couch.  Are you one of those individuals?  Not motivated to exercise any more?  If you are, I'm sure you are wondering why that happened?

Let's look at a few reasons to why this happens and how you can turn it around:

1.  Your goal was to exercise 1 hour everyday of the week.
If you have not exercised in a while, this is really unrealistic.  And attempting it will cause you to fail 99.9% of the time.  Start with something you CAN do...20 minutes 3-4 times a week.  Progress 5 minutes each week adding another day after every 3 weeks.  This is gradual increase in exercise and will reduce your chances for heel pain and Achilles tendonitis.

2.  You decided to lose 30 lbs in the first month.
For healthy weight loss, 1-2 lbs per week is the best.  So how do you do this if you don't have a gym membership?  Easy...just walk.  All you need is a good pair of tennis shoes.  Want to know which shoe is right for your? The doctors at FAANT are experts in knowing what is best for your feet.

3.  Your reward for losing weight is a treat of your favorite food.
Don't reward yourself with food.  That will make it that much harder to lose those inches.  Better yet, how about a new pair of jeans or a night at the movies (but skip the buttered popcorn!).  Download the newest album from your favorite artist.

4. You keep cheating!
Before you start your week, write down excuses you have used in the past to cheat on your healthy eating.  Then write down responses and ways to counteract this when the urge arrives.

5.  You tried exercising everyday, but just got bored.
If you don't like walking on a treadmill, you don't have to.  If you find biking to be more boring than watching paint dry, then don't do it.  Do what you like.  Are you a dancer?  Have you tried Zoomba?  How about just turning on your stereo for 40 minutes and shaking your thang!  Are you a fish in the summertime?  Then join a local Y with an indoor pool and swim all year long.  The important thing is just to move!

Hopefully these 5 things will help in your journey for better living.  Along the way, your feet are going to hurt.  That's why FAANT is here!  If your foot or ankle is preventing you from meeting your goals for a healthier lifestyle, call us right away!