- [Jingle Singer] ♪ Bob and Brad, ♪
♪ the two most famous physical therapists on the internet. ♪
- Hi folks. I'm Bob Schrupp physical therapist,
- Brad Heineck physical therapist.
- Together we're the most famous physical therapists
on the internet.
- In our opinion of course Bob.
- Today we're gonna talk about,
is it a blood clot causing the pain in your leg?
A DVT, which is a deep vein thrombosis clot.
And we're going to tell you how to tell it
and how to prevent it. - Right.
- So let's get to it Brad.
There's two common places where you may feel pain
from a blood clot in your legs.
One is your calf. - Yep.
- And one, another one
is right behind the knee or the thigh.
- Sure.
- Right in this area, I haven't seen any of those.
Have you?
- I don't think so. The calf is probably
- [Both] Really more dominant.
- Yeah so what you're looking for
some common signs of a DVT is,
or a blood clot, is you might feel cramping or throbbing in
the calf muscle or behind the knee
or thigh and it's usually just one leg.
- Yeah.
- It'd be unusual to get a blood clot
in both legs at the same time.
- Cause you can feel pain and cramping from other things.
- Right.
- So you can't, it's just one of those things that it's,
you have to be concerned about, but.
- Yeah, like what call claudication
where your arteries are narrowed up,
and when you walk you get pain in your calf from that too.
- Right, right, but my father,
- But that's both calves, yeah.
- my father had that very clearly
he could walk shorter and shorter
as he got worse and worse,
and it was as a result of the arteries being.
- Right.
And the same holds true for swelling Brad.
You're going to get it in one leg as opposed to two legs.
So there may be swelling in the calf or behind the knee.
- You mean with a DVT or the clot?
- With the DVT or the clot, right.
The skin may feel warm around the painful area.
The skin may be red or discolored. - Sure.
- Around the painful area.
I've seen this after knee replacements
where it's gotten red and discolored.
So then we're also going to show you how to do a one test
called Homan's Test.
Now Brad and I were just talking about this test.
It's by not no means, always accurate.
I mean, you make get a false positive,
but I have found several in my career
of people that had a DVT when I did a Homan's tests.
- Sure.
- And you know, basically Brad,
if you want to do it on me
- Oh, okay.
- I can just put my legs straight like this.
- Yep.
- And you're going to dorsiflex.
- Yep so if you dorsiflex or do a stretch like this
that will cause pain.
And now, do you normally dorsiflex
and squeeze at the same time?
And that's why it's kind of hard to do this
without a second person. - Right.
And then you're going to squeeze here
and it's going to be real painful.
This is one of those things where
like Bob said
even a skilled person may have a positive test,
and I always send them in and get it checked out.
A lot of times they come back, and they don't have a clot,
but you want to get it checked out.
- Right.
- Because if it is, it's important.
- I got to the point where I would, you know,
if there was swelling there pain and maybe
some redness.
Then I definitely would have (indistinct).
- Yep yep.
- Sometimes if there was just pain, I'd kind of watch it.
And I'd mention to nursing all the time.
- Right right.
- And they could decide to.
- If you're at home by yourself,
and you're watching this and you do it,
especially if it seems like it's getting worse.
- Yes.
- You need to go in and get it checked out for sure.
- Cause a DVT is dangerous. A blood clot is dangerous.
So it can break loose and travel through your bloodstream
and it gets stuck in your lungs.
- Yes.
So I always brought up as an example,
it was during the Iraqi war Brad
that one reporter.
He was in the tank for several hours.
I think like 12 hours, and he got a blood clot,
went up to his lungs, it killed him.
He was a young guy,
- Young and healthy. - right
So yeah.
So yeah. It's nothing to, to just blow off.
- Yeah. Blow off.
We'll give some examples when you're likely to get a DVT
or a blood clot. After an operation,
because you're immobile, and if you're
on bed rest, you know, right.
Again, immobile. This is the one that
for the average person may, may run into.
If they're on a long trip in a car or plane or train,
especially a plane, cause you can't move much.
- Right.
- You know, you can't get up
and walk as well as you would like to.
- Especially if you're in by the window,
it's really awkward. so you kind of stay there
unless you really gotta go.
- Yeah. Well, so greater than three hours.
If you're pregnant or recently had a baby.
- Okay.
- If you're dehydrated. So that's another one.
- And a lot of people are dehydrated
without even being aware of it.
- Realize it.
- Yeah
- So what, who is at increased odds
for developing a blood clot?
If you had a previous blood clot,
and I remember patients like that.
They've had them before.
In those cases, if I found something,
I would definitely send them in.
Because they already had a
(talking in unison) - A, a history of it. Yeah.
- If you have varicose veins, if you smoke,
if you take contraceptive pills,
if you are on hormone replacement therapy,
if you have heart failure, if you are overweight,
if you have cancer. So there's a lot of them.
- Yeah. And they're all kind of related,
And yeah.
and you'll,
it is one of those things
that it just fits a lot of people,
- Right.
- that don't have any symptoms at all
because of whatever reason.
Whether, it's lifestyle or situational.
- So how to prevent DVTs.
Like one thing,
when I'm on a plane,
I'm doing ankle pumps.
- So trying to keep things moving. Yeah.
- And if you're watching, listening to this on a podcast,
all we're doing is bringing our toes up. toes up and down.
- I know they can't see this on the podcast,
but maybe some viewers wanted a little more clear.
But you're going to do 10 to 20 those at a time. Yeah.
every 20 minutes or half hour.
- Yep.
And try not to sit for long periods of time,
even on a plane,
try to get up at least every hour
and upset your plane mates.
- Hopefully, if you get up again,
but you can request and aisle seat,
- Yeah aisle seat
when you're getting your seat would be helpful.
- And, and the ankle pumps will help too.
Drink plenty of fluids, which is not,
- Water.
- You don't like to do that on a plane,
Brad. Because then
you gotta go to the bathroom.
- Yeah.
- Do not cross your legs
that impedes blood flow - Right, sure.
and lead to it.
Do not smoke, which
- most people understand. Yeah.
- And don't drink lots of alcohol. - Right.
to add your trouble.
- Well, it's tough when you live in Wisconsin.
- Yeah, that's right.
- We're going to have Wisconsin's getting mad at me.
- Well, they know.
- (laughter) Everybody knows.
- Minnesota is not far behind.
- But you know it may be exaggerated a little.
- So treatment is, they have some type
of anticoagulant medicine.
- Sure, right. The doctor will prescribe.
- Very easy to prevent and also to stop.
- Right. If you have one,
the treatment is
typically medication. - Right
And there's maybe modifications on your activity per the
doctor's discretion for a while.
- For awhile, a short while.
Yeah. But typically,
most everyone that I've had over the last 20 years with
a blood clot has come out of it without problems.
- I've never had one that went to the lungs.
I don't believe.
- Right. You get them afterwards sometimes
- Right. I get them afterwards sometimes.
- People that didn't catch it early enough.
- All right. Thanks.
Check out the rest of our videos on knee pain,
which is @bobandbrad.com, go to the program section.
- That's right.
- Do you want to say anything else about it?
- Well, if you go to the program section,
click on the video. There will be, you know,
30 or 40 videos on the knee.
Look at the titles,
pick out the one that pertains to your question.
Watch the video on the right-hand side, there'll be a PDF.
You can click on it and get a printout with a review and a
exercises on the printout. So it's very convenient.
There's no charge, not even an email.
So we wish you well.
- Our gift to you.
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