- 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.
- Brad, we already did a video on top three exercises
for lower extremity swelling or lymphedema.
- No, we did it on the upper.
- Oh, upper extremity
now we're on solid ground. - That's okay,
yeah that's okay.
- Now we're gonna do one on lower extremity.
We're gonna bring in again, our guest lecture.
America's top model, Aaron Kast.
- Oh yes. Here he is.
- Kast? Is that German by the way.
- It is. Yes.
- All right. We got the three Germans.
- Excellent Kast, Schrupp
and Heineck. - Heineck. Yeah.
- So, all right, let's let him get started here.
So someone's got-
- So I think we'll have Brad be our demo, again.
These exercises can also be done,
like in the previous video, in multiple settings.
The ideal setting is gonna be lying down on your back.
So Brad I'll have you lie down on your back
with your head on the pillow.
- Would you explain this real quick, Aaron again
where the fluid needs to go?
When you have a lot of fluid here,
again, it's not gonna go out the toes.
So it's gotta-
- Right, the average person, when you have swelling,
you know gravity, when you're sitting down
gravity's gonna pull the fluid
from everywhere in your body down to your toes,
because they're the lowest point
that gravity's gonna pull to.
So you're gonna see swollen ankles. You'll see swollen toes.
And what we want to do, is we want to help facilitate
that fluid, to go back up the leg into the trunk,
where it can be processed
and ultimately expelled from your body.
So I'm gonna show you a few exercises today
that will help get that fluid from your toes and your legs.
Back up to the trunk where it needs to be.
These exercises, it'll be helpful if we elevate your legs.
So that's why lying down will help.
You'll take gravity out of it a little bit.
We're gonna bring a box in
and get his feet up in the air a little bit.
And we'll start off with a real easy exercise.
I call this one "Ankle Pumps."
So basically, Brad, what I'm gonna have you do
is bring your toes up towards your nose
and then down to the ground,
like you're stepping on a gas pedal.
Easy as that, going back and forth like you have flippers.
And usually I have people do about 30 of these,
three times a day, at least.
But you can do 'em whenever you think of it.
Whenever you get bored.
If you're watching TV, you see a commercial break,
wiggle your feet up and down a little bit.
Also- - [Bob] Would it be helpful
to do these, Aaron, even in a standing position, or not?
- It will be helpful. - [Bob] Like this.
- It'll be better than nothing.
But it won't be as effective as this.
- [Bob] As laying down, okay.
- But if you're talking someone that's still working,
you know you're working in a factory,
you're on your feet all day.
You notice late at night when you get home
your feet are swollen.
Throughout the day, if you can, maybe tap your toe
like you're tapping into a tune, (foot tapping)
that'll help.
You can also go up on your tippy toes.
So you can go up on your tippy toes, back on your heels.
That'll be helpful in a standing position as well.
(bob singing)
♪ Camptown races, sing that song ♪
- That's what I was thinking if you've got music going.
(all laughing)
- There you go. Yup, that's perfect.
So that's that one I would have people do 'bout 30 times
at least three times a day, morning, noon, after night.
That sort of thing.
- [Bob] All right. - What's number two?
- The next one is gonna be what's called glute squeezes
or your buttock muscles.
I'm gonna have you tighten those up.
I know I've seen,
a few of your videos have isometrics in them.
This is a muscle that's great for helping you stand up,
but we're gonna squeeze 'em
to help move the fluid outta your legs.
So what Brad's doing here is tightening his buttock muscles.
- [Bob] Can we see on me or not?
I'm gonna try it.
(Aaron laughing)
- Oh, if we got female listeners, we're gonna get
some pretty big response.
- [Bob] All right, that's the best I could do.
- I had a patient once tell me, I was having her do this,
She says, "Oh so just imagine like,
"there's a quarter between my butt cheeks?"
- [Bob] There we go.
- That's exactly right.
Now, one thing that will help,
because sometimes people get going too fast with it
and they lose a little bit of effect, is slow down.
Try and hold it for about a three to five count with it.
That'll make sure that muscle gets nice and tight
and it has time to contract and relax.
- [Bob] Brad should be breathing with this, right?
- Right.
- [Bob] Not holding his breath.
(Brad breathing deeply)
- And we have the previous video,
maybe Bob can link up to it.
It explains breathing and how you should breathe.
- [Bob] Diaphragmatic breathing.
- Yep, so you could kinda
kill two birds with one stone here
or you could do 'em separately,
would be a little bit more effective even.
So once again, what Brad's doing here
is he's squeezing his buttock muscles.
That's helping to kind of, what I call milk the the vessels
that this fluid is going in.
We're trying to get that fluid out of the legs
and bring it into the trunk where it can be processed.
- Again, 10 of these three times a day,
at least? - That's right.
Yup. Yup and you can do this one, seated,
standing if you want, supine.
This one isn't gonna have as big of a deal.
As far as lying down would be better.
Whatever position you happen to be in at the time.
- And number three?
- Number three, is what I call "Single Knee to Chest."
And basically what I'm gonna have you do, Brad
is probably your right knee, so the camera can see,
is bring it up towards your chest.
- Should I grab it and pull it a little bit?
- If you want to, if that makes you feel better.
Sometimes people like that feeling on their low back
but just the important thing
is getting your muscles right here in the front of your hip.
We want to get those working.
There's a lot of vessels right there
that we want to milk and get the fluid out of there.
One alternative that I might have you show.
Instead of having your feet elevated this time, Brad,
I'm gonna have you bend this knee
put your foot right on the mat.
Sometimes that's more comfortable for people's low back.
- Sure, now as far as the order of doing these,
does it matter if you're laying down
do you start at your feet, start at the butt?
- Doesn't matter. You can do 'em in any order.
Just as long as you're doing them
and doing them consistently will help.
You might see that you have an increase
in the amount that you need to use the restroom to urinate,
because we're facilitating fluid
coming from your legs to your trunk.
And it's all ultimately gonna be expelled in your urine.
So you may notice
that you need to use the restroom more often
- And this should be approved by your doctor or physician,
because we don't wanna overload your system, right?
- Right. Right.
- In case you have cardiac problems.
- Especially if you have heart, kidney problems,
make sure that you have 'em approved by your doctor
so that you don't make your fluid better in your legs
but make other systems in your body worse.
- Sounds good. All right.
- So if you wanna to learn more about edema, lymphedema,
swelling, we're gonna do another of the video.
Aaron's gonna explain that.
And Bob, can you put a link up there somewhere?
- Yeah, a magic link.
- So yeah click on that and it'll go.
I gotta get going. I gotta go to the bathroom.
(all laughing)
- All right. See ya later.