- Hi, I'm Bob Schrupp, physical therapist.
- Brad Heineck, physical therapist.
- And together we are the most famous physical therapists
on the internet.
- In our opinion of course, Bob.
- Bob, this might be hard to believe
but we don't know everything.
- Right, but who's this guy?
- This is Aaron Cast
and Brad, he knows a lot about lymphedema.
- Yeah.
- So we brought him in today to talk about that.
You know, some of you out there may be wondering
against the swelling in your legs,
do I have lymphedema?
Do I have adema?
Do I have just plain old swelling?
- Or am I just gaining weight?
- That's right.
So let's talk a bit about that, Aaron.
You go ahead and take control of the situation here.
What are we talking about here?
- Well, first let's maybe give lymphedema a definition
or an idea of what is the cause of lymphedema, I guess?
Lymphedema can be caused by a few different things,
but ultimately it's a blockage of the lymphatic system.
The lymphatic system is a network that runs through
your body just like your veins
and arteries that pump your blood,
but the lymphatic system pumps your lymph.
It's a fluid in your body.
- L-Y-M-P-H.
- Correct.
- So it's a fluid just like you said, blood.
- Right.
- Oh.
- So if your legs are getting swollen up,
this could be fluid
and we call it lymphedema.
- That's correct.
And one, or I should say a few ways that might make
you lean towards lymphedema rather than just adema
or swelling, could be if you've recently had any type
of surgery on your leg,
your trunk on one particular side or the other.
- Well, definitely if you've had the lymph nodes replaced.
Not replaced, removed.
- Removed, yes.
- They don't replace them do they?
- So any surgery that removes lymph nodes,
that definitely puts you at risk for lymphedema.
Any surgery in general can put you at risk
also because the scar tissue can basically
close down those lymph nodes.
It will block off a highway, so to speak.
- Aaron and I just had a patient who had some surgery done
in the abdominal area
and you wouldn't think that would affect the extremities,
but that's exactly where the lymph goes.
And that surgery, the scar tissue was blocking the limb.
- Right.
- So it couldn't come out of her legs.
- Right.
This particular person had a surgery right around
their belly button which happens to be one of
the more important areas of your body
for lymph processing.
It's a very important area
and once there was that scar tissue,
the fluid just couldn't get through that scar tissue.
So gravity working against us in this case,
took that fluid that was blocked up
by your belly button here,
and pulled it down into her legs.
Down into her toes, so.
- Now just what you're talking about the belly button,
and we're talking about swelling in the legs.
They're not connected, so what's going on?
- You may not think that they're connected,
but this network of lymphatic system
covers your entire body.
And the blockage by your belly button doesn't
allow the fluid through,
so it's gotta go somewhere.
- So the fluid in your leg has to go up through your leg
if it's in your legs or ankle,
has to go up through your leg
and then it goes into there?
- It goes into this area.
Not specifically your belly button,
but it goes into this area of your body
where it gets processed by the other organs
and systems of your body
and then ultimately gets expelled.
- By urine?
- By urine.
- Okay.
- So after watching some of our previous videos,
where you're doing some exercises,
you may notice that you have to urinate more often.
Which is a good sign.
That means you're getting the fluid moving.
- Okay.
- So why don't we give some instances in which
it probably isn't lymphedema
where it may be caused by, let's say, your heart
or something along that line, Aaron.
- Right.
If you have swelling in, say, one leg,
that's generally leading you more towards lymphedema.
If you can rule out any sort of a trauma.
- Sure.
- Say, ruling out-
- You didn't sprain your ankle.
You didn't blow out your knee.
- Correct.
- Yeah.
- With general adema
and more overall swelling that's due to heart problems,
kidney problems,
you're going to notice that in both legs.
- Sure.
- So if you've got congestive heart failure,
both legs will swell up.
- Right. Right.
And generally people will notice it
most often in the ankles,
because that's a place where if you don't have swelling
you can see more of the bony structures
in that sort of thing.
- So if it's in one leg
and it hasn't been in any trauma,
it is more like likely to be lymphedema.
- Right.
- That'll be your first initial guess.
- Yep. And ultimately you'd wanna seek out your
medical doctor to have a true diagnosis,
but for maybe more of your own comfort,
or maybe some knowledge to ask questions-
- Right.
- When you do go see your doctor.
- Right.
- The more knowledge, the better.
- Right.
So if you sprain your ankle and it swells up,
is that adema?
- That's gonna be more of a general adema.
Right.
And you're gonna wanna reduce that swelling
more in a simple fashion as far as just elevating
and compressing it lightly-
- Cool packs?
- Using ice.
- Yeah.
- Yes. Like I'm sure you guys have talked about-
- Right.
- Some of your other videos.
- Right.
- P.R.I.C.E. And the P.R.I.C.E method, so.
All right, well, anything else you wanna say?
I think that's a good general explanation of it.
I think that helps.
- Yeah, so lymphedema can be in your arms?
It can be in your legs?
- Right.
- But all this fluid, no matter where it is,
has to go to this part of your body.
Kind of like the drain in a tub.
- Right. Exactly.
You think of your belly button like your tub drain,
and that's where I was saying with that scar tissue.
If you have scar tissue,
that's like a clog in your tub drain.
And the water doesn't go down very well.
That's what's blocking it,
is the clog in that tub drain.
So we either gotta find an alternate route,
somewhere else in the body,
or we've gotta clean that drain out.
- Wow.
So if you have hip surgery or a broken hip,
that could be a blockage from the fluid
from coming up to get there?
- It could be, depending upon where the scar is.
And you might have a combination of the two,
if you say you have a hip surgery,
because your body's gonna be sending extra fluid
there to help it heal-
- Sure.
- And gravity is going to pull that extra fluid down there.
- Right.
- So you might have a combination of the two-
- Sure.
- But the lymphedema likely won't be severe enough
that you would, six, eight months down the road ever
notice a real difference from it.
- Sure.
- So this could get pretty complicated.
You could-
- It is.
- Have surgery.
You could have a heart problem
causing adema in both legs.
- Right.
- Lymphedema on one leg.
Swelling from the trauma.
You really need to have-
- You need a professional to sort this out.
- Right, but maybe this could help explain-
- This was a starting point.
- Right.
- So.
- So, I don't know.
I'm gonna go home and read some more on this
so I can get a better understanding and-
- Bob, I'm glad you're getting some knowledge.
- Yeah I mean maybe I'll watch this video again
so I don't forget it.
- Put something in that empty head.
- Really, if you wanna learn more about this tech-
Bob, what?!
- What?
- Can't we just get through the video-
- That's right.
- Without these antics-
- How about those Packers by the way, though?
- The Packers are good.
They all got lymphedema somewhere.
- All right thanks a lot.