♪ Bob and Brad ♪
♪ The two most famous ♪
♪ Physical therapists ♪
♪ On the internet ♪
- Hi folks, I'm Bob Schrupp, physical therapist.
- Brad Heineck, physical therapist.
- We are the most famous physical therapists
on the internet.
(Bob clapping)
Let's get the energy going! (Brad yelling)
There we go!
Ten ways to reduce knee, calf, and ankle swelling and pain.
- Yes.
- This is, unfortunately, a part of, sometimes, aging.
Sometimes different processes can be going on
that cause swelling, - Right, right.
- And obviously, you need to check with your doctor
if, you know, this is new
and you don't know what's causing it.
- Right.
I mean, if you sprained your ankle,
these could work as well.
Depending on what phase of injury it is.
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- There you go, Bob!
Okay, ten ways to reduce the swelling and pain
that you're having.
Often times, if you have swelling, there's pain.
If there's pain, there's swelling.
They go together very, you know, more than that.
- You can also get skin breakdown.
- Oh, right.
- You can get weeping, you can get fluid buildup.
- Yup, when you've got that edema,
that's really swelling up, literally like a balloon.
- Right.
- And it can get that bad.
So, we're going to show you some techniques.
Five of them in the seated position,
and five in a standing position
depending on what you're doing
with your work or at home duties.
So, first one. Sitting down, this is really critical,
you really have to address this,
is the heighth of your chair or your feet.
We want to set it up so the edge of the chair right here
does not push in to your hamstrings
or the back of your thigh.
Because if I sit like this, and I'm going forward,
that edge is pushing in,
and that's literally restricting flow of that swelling.
The swelling has to come back up through your lymph nodes,
as well as your venous return.
And if that is limiting that,
- It's cutting it off.
- It is, it's like a tourniquet.
- It's cut off pressure.
- It's like a half a tourniquet.
So, we need to change your posture.
You can either raise the seat, or lower it.
You know, if you just get a cushion,
this is a cushion that we use, it's about two inches.
And it makes the seat more comfortable.
And that might be a,
- You can see that eliminated the cut off pressure.
- Right, exactly.
It might be, if you can't change that,
you might want to put something
under your feet to raise it up.
You should be able to get your fingers underneath here,
and then, you know, you have adequate space.
- The other thing on this,
it's kind of of on the fly here, Brad,
'cause it wasn't part of your board, but
- I'll let it go, Bob.
- You really want to have your knees not bent back
like this, this even cuts off pressure,
you know, a little bit, too.
- That's an excellent point.
- You're better off having your legs,
it's better for your knees, too, by the way.
- Sure.
- As you get older,
these are things you've gotta think about. - Exactly.
- It's actually better to have your legs
a little bit straighter than bent.
- I always tell my patients, imagine a garden hose.
When you kink it, it reduces the circulation.
Same thing with your knees.
- Good analogy.
- Okay! The next thing you can do,
once, you know, you have good circulation under the calf,
is simply ankle pumps. Up and down. Ten to 20 of them.
Make sure you pull them up good and far,
stretch those calves out.
So, what we're doing is we're working the muscles here.
That's the natural way to act as a pump
to pump that fluid up. - Sure.
- It's your own body's natural pump.
That's trying to get that fluid back into the abdomen,
where it can be processed, and you can pee it out.
- Yeah, exactly.
And the other thing is, we're going to do
long arc quads or kicks.
And this not only helps with the muscle contraction,
the fluid, but if you do have pain in your joints,
there's a very good chance the pain is
from lack of motion in the joints.
So, we not only want to increase circulation,
but get the joints moving.
About ten on each leg would be perfect.
- So like his, it's pretty difficult, Brad,
to go up further and do butt squeezes.
'cause that's what we have you do in bed.
- Right.
- If you were lying down in bed,
- Well, Bob, the title says knee, calf, and ankle.
We're not talking about the butt.
- No, but we're trying to push the fluid.
- I know, I'm just kidding.
- We're trying to push the fluid all the way up,
get it up this high, now you wanna use the butt
to push it up harder.
- Right, Bob is exactly right. The lymph goes up,
and it actually goes back into the system
- Sure - Above the belt line.
- Sure.
- So, that's helpful as well.
Now, the other thing that you can do
is get a device or something
so you can get your feet moving, whether if you're at desk
or just sitting at a table.
I'm gonna show a device that we started out with years ago.
With a lot of our patients.
It's one of these little ellipticals,
this is called the InMotion,
and you can put your feet on there,
and you just start to pedal.
You get some ankle, you get some knee range of motion,
and you get some exercise, muscle contraction,
doing everything we want as well.
- I had actually had a patient, Brad,
and we actually use this a lot in the clinic.
- Yup, very.
- Lot of our elderly patients use these.
- Sure.
- But this alone controlled his swelling.
Because he would do it every day,
and if he didn't do it, he'd get some puffiness.
- Right. - In his leg.
There's a couple disadvantages to this particular model,
the number one things is that - Weight.
- It weighs about 40 pounds.
- Oh, it's a beast.
- It is really heavy. - Yeah.
- And it's just a beast, like Bob says, to move.
(Bob groaning)
- Oh, Bob.
- Yeah, well I'm not exaggerating.
- I don't like lifting them.
So, there is another device, it's called a knee glide.
- FitGlide!
- FitGlide, I'm sorry. It's so close to the Knee Glide.
But it weighs about less that five pounds.
- Look at this, Brad I gotta do this.
- Oh, Bob's gonna do this
- I love doing this, yup.
- And you can do fingers curls with it.
- Now, you can grab it by this handle,
it's a little more awkward.
But you can also grab it by this one.
It does slam down like that,
but it works well for carrying around.
- It works best just to carry it like this.
- Sure.
- So, anyways, we're going to put this down,
and this is a really nice thing to do.
And you can use this under the desk, at home,
in a wheelchair, both of these, if you are in a wheelchair,
it works very well.
- If it's a little bit too loud for you,
because it makes a "swish, swish" sound, what you can do
is you can actually put a little silicon on it,
and she really slides then.
But this is a really great exercise device
for mom, dad, grandma, grandpa. You know what I mean?
- Right.
You know, this is one of things that,
I had a person use at his desk underneath.
- Sure.
- He had the Knee Glide, same thing, but with one knee,
and he loved it!
So, very good. Again, five to ten minutes,
you'll know 'cause you'll get tighter.
And then you do that three times a day or so
with either one of those devices.
All right, the next thing you can do,
now this is something I'm going to throw at you, but with,
- You probably want to talk to your doctor about this.
- Right.
- And you might even be measured for compression socks.
- Right. It's a compression sock.
There's a lot of different varieties,
but Bob says talk to your doctor first.
- Yeah.
- Get fitted.
It's helpful to have a little more compression
around the foot and ankle than up around by the knee.
That way it pushes the fluid upwards.
- Yeah, a good compression sock will actually
kind of have a gradient.
- Right. Yup, that's a good word for it, Bob.
- Yeah. Will actually put a little more stress
and pressure down here, and less as you go up.
- Yup. Exactly.
- That's why I don't like, really, TED stockings.
Because they don't seem to be made that way.
They actually can cut off pressure here sometimes.
- Yeah. Yeah, and so, again,
compression socks are an option, but look into first.
Sometimes a physical therapist is nice to work with.
- The other negative thing about that
is that they're very difficult to put on.
- They can be.
- You gotta learn the right way to do it.
- Now we're gonna go to standing, Bob.
- Sure.
- You got a job that you work at, or at home,
the first thing you can do, I'm gonna,
(Brad grunting)
get this out of the way.
Now, have something to hold onto.
A chair, I'm going to use a Booyah stick for balance.
But, I want you to do, it's similar to ankle pumps,
but you're going to go up on your toes,
and then lift your toes up. So rocking back and forth.
Make sure you have good balance, again,
grab something solid, a countertop if you need to.
This, again, works circulation, works strength,
it's even good for your balance.
The next thing is you want to stretch out your calf muscles.
You can lean up against the wall,
and see how I'm stretching here.
Don't let your toe point out.
Straight ahead. And stretch.
You're gonna hold it for five to 15 seconds,
you can hold longer if you like.
Make sure you do both feet.
Feels good, typically.
Don't get too aggressive
if you have not done these in the past.
Hold for five seconds, and I don't want you to get sore
the next morning.
- By the way I wanna mention, too,
on those toe ups and heel ups,
what's nice about those is you can do them all day long.
- Sure.
- I had a teacher, - well, not consistently.
You gotta take a break.
- Well, duh, but she used to do it while she was teaching.
I still remember this so clearly,
she was my fifth grade teacher.
But she'd be doing these
while she's just standing there and teaching,
and she goes: "my doctor told me
that I was supposed to do this".
That was like, 700 years ago.
- Sure. (laughs)
Absolutely.
The other thing, if you are standing,
and you have the opportunity to have a chair,
you can just simply do some sit to stands.
- Yeah.
- You know, do about five of these.
Ten if you feel comfortable. - Again, that's,
again, acting like a pump. It's moving the fluid up.
It's moving the fluid into the area
where it can be processed.
- Exactly, Bob.
Now, if you happen to be working at a countertop,
or if your workplace where you're standing
while you're working, if you can manage it,
a stool about this heighth,
you're working for about 20 minutes,
your leg pain is starting, you know,
you can feel the swelling, just to sit like this.
And you can work some ankle pumps.
Sit for five minutes, and stand,
and just working that as you can.
It can be really helpful, particularly in the joints.
If your joints are painful. - Would you agree, Brad,
that you probably wouldn't recommend prolonged standing
if you have an ankle swelling?
- Well, I'm saying if a person is working.
- Yeah, if they're doing a job
where they're forced to stand.
'Cause unfortunately, standing is probably
going to put increased stress on your venous system.
- Yup. Yup.
- And a lot of people, that's where they get swelling,
is because they prolonged stand.
- Right.
- And so, you're right, that's a great option.
If your job entails standing,
try to see if your boss will let you use a stool
to at least sit down once in a while and get your feet up.
- Right. Yup.
- A little bit.
- The other thing you can do at the same situation,
is you can just shift your weight right to left,
or if you have a short stool,
this is probably a little high,
if you can put your foot up, and continue working,
and just shift like this.
This is about eight inches high,
I'd recommend maybe four, maybe six inches,
a little bit lower.
We always say, people if they're washing dishes
at the sink, open up the cupboard below,
and you can use that little four inch step in there
for that same concept.
- Out of these ten ideas,
you hopefully will find some that work for you.
- Right.
- And you want to see the proof is in the pudding,
as they say.
You look down and you see,
is this helping decrease my swelling?
- Right.
- That's the ones you want to keep doing.
- And all of them probably are not going to eliminate
or decrease the swelling in one day.
You've got to work at this for a number of days
to see the progress.
Oh, Bob, we did say ten.
We only did nine.
But, for standing, this is the tenth one,
it's kind of a double dipper.
But you can also do compression garments
- While we're standing.
- Yup.
- I thought you did, oh. I see, you didn't do that.
- Well, it goes on to sitting,
and to standing. - I gotcha.
I gotcha, all right.
- I know the viewers are pretty sure about that.
They count. - Yeah, they're gonna count.
- And they will say:
"you did nine! What happened to the tenth one?"
- Here's number ten.
(Brad chuckling)
Remember Brad, that I can fix just about everything?
- Except for,
- A broken heart.
- But, we're working on that as well.
- All right, thanks for watching.