♪ 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 are the most famous physical therapists
on the internet. - In our opinion.
Of course, Bob.
- Today, we're gonna talk about eight common causes
of swollen ankles.
Is a doctor visit needed?
- Right Bob, swollen ankles are relatively common.
Sometimes it could lead to something serious,
other times, not so much,
but we're gonna go through eight different things.
Listen up to 'em and you'll figure it out.
Maybe for you, maybe a family member,
older friend or mother or father.
- I just had a friend this weekend.
He's turned 60, he joined the club,
and he actually is complaining of that one leg swells up.
And I'm like, you gotta see the doctor.
- Yeah, right. - 'Cause he's diabetic
and he's got a lot of things going on.
- Yep, right, exactly.
Should we start out right away, Bob?
- Let's start off, yes.
- Now the first one, you and I and other men
are really not that familiar with.
It's pregnancy, but we know that pregnant women,
that is one of the problems that can occur is retention,
water retention.
- You know what I found about pregnancy?
- Oh my God. - This is true.
- Okay.
- Now, there's a book What to Expect When You're Expecting,
and it's a really well received book.
- People who are gonna be pregnant or they are-
- Or are pregnant, they can follow along at every stage.
- Yep, yep.
- And you get everything.
I mean, seriously everything.
- Did you read it? - I read it.
- Oh good.
- Yeah, I was there with my wife.
- What's the name of it again?
- What to Expect When You're Expecting.
- Oh.
- It's been out in publication probably for 30 years.
- Sure.
And I really think, typically there's a doctor involved
when someone's pregnant- - Right, right.
You can go in and say.
- Yeah, you should have a doctor involved
if you have swollen ankles when you're pregnant.
It's probably not a big problem,
but it needs to be addressed.
- Well, you wanna make sure
you're not getting getting a blood clot
or something like that. - Right, some other thing.
- Yeah.
- The next thing, common, what is it,
80, 90% of the people sprain their ankle
throughout their lifetime?
It's very high.
And you are- - I've done it.
- Yep, you're probably gonna experience swelling
with an ankle sprain.
It's common.
You don't need to see a doctor for it.
Although you could if you wanna see if there's a fracture.
There may be a hairline fracture, something like that.
- If you're not able to take weight on it,
that's starting to think that, as you just said,
see a doctor. - Right.
That's a good time to see a doctor, get some x-rays.
But other than that,
you can put a cold pack on it, elevate it.
- You can wait a little bit to see the doctor.
- Exactly.
My daughter sprained her ankle pretty bad in basketball.
Her mother is a registered nurse, I'm a physical therapist.
We did not go see the doctor
'cause we knew even if it was broke,
they were gonna say, go home, ice it, wrap it,
blah, blah, blah.
We waited 'til the swelling-
- Put it in a boot.
- Yeah, well we waited 'til the swelling came down.
She didn't actually need a boot.
She went to crutches and- - She was fine.
- Yeah, it started, she was 16, they heal fast at that age.
- That's right, that's true.
(laughter)
- Anyways, that's the trauma section.
Number three, lymphedema.
Now this swelling is completely different.
You do not have to have any trauma.
The leg just, or ankle, starts to swell up.
It has to do with the lymph return,
which is fluid in your body,
it's not part of your blood system, not your venous return,
but it's fluid that's extra cellular
and it comes back up through your lymph system,
gets filtered through your lymph nodes
in the femoral crease, and then back into your system.
- Now, your lymph nodes could be blocked somehow.
- Yes, right.
- It could be a blockage in your groin.
- Exactly.
- Or behind your knee.
- You're getting the swelling without any trauma.
And you're kind of wondering,
like your friend, he's getting the swelling.
You should see a doctor then, find out what's going on.
- You wanna go at least the first time
to make sure to rule out any problems.
- It is typical with obesity. - For sure.
- There's no real direct problem,
but it's part of the whole being obese
and the way the body functions with that.
- Scenario, yeah.
- It's typical with cancer treatments,
if you have a null lymph node removed.
- Yeah, if you remove the,
the nodes help act as a filter.
- Right, exactly. - For the lymphedema,
and if you remove the nodes, it can get caught in that area.
- Yeah, yeah. - It's all fluid.
- It interrupts the flow.
Obviously, those people are involved with a doctor
and being treated.
The next one, venous insufficiency.
Now, that's where the blood coming back through the vein,
the artery supplies the blood, then the vein comes back
with a de-oxygenated blood
and it doesn't have everything it needs
or it needs for the proteins and all those things.
- Right, so the veins- - That's coming back.
- Are not working like they should.
They might be collapsing on you
or they're just not in good shape.
- Right.
And if you're having swelling from that,
that should be a doctor visit, as well.
Boy, a lot of these things
are requiring a doctor visit, Bob.
- That's why sometimes you wear compression stockings
to help aid the veins on the way back,
the venous I was gonna say, veins.
- And again, a lot of these, it'll require a doctor visit,
but then you're gonna treat it on your own oftentimes.
It may be a medication,
it may be the compression wear and whatnot.
Now this one, if there's infection from trauma or a wound,
if you get some redness, some swelling,
the line going up the leg if you have a wound,
these are all big problems or potentially big problems.
- This is the time to see the doctor now, not wait.
- You're not gonna wait and call
and wait two weeks for when they have an opening,
you're gonna go to urgent care probably,
but get in there and make sure it's not a problem.
- Yeah, infection can get out of control
and really weak havoc on your system.
- Again, it's redness, things are getting warm,
that does not happen-
- And the swelling along with it, and-
- That kind of stuff doesn't happen with lymphedema
or venous insufficiency, there's something going on,
your body's talking to you, so you gotta listen
and get to the appropriate care.
- DVT? - Ah, yes.
A deep vein thrombosis or blood clot.
And in this situation, it's probably gonna be in the calf,
maybe behind the knee- - Knee.
Right behind the thigh sometimes.
- And with that, you'll get the swelling in the ankle
and in the calf, if you grab and squeeze it,
it's gonna be tender, painful.
There's something called a homan sign,
although it's not real accurate,
to help determine if there's a DVT.
To find out if there's a DVT,
you have to go get a scan, a Doppler scan,
and then confirm it.
- This too can be life threatening.
- Yeah, it can.
But again, you get, see it early,
and that's easily treatable with some medication.
- You're also probably wondering why is it life threatening?
Because a clot can let loose,
it can find its way up into the lung,
and suddenly compromise your breathing.
- Right, yeah, and then-
- People have died from these. - Sure.
Or it could break loose
and eventually get to the brain and cause a stroke.
- Right, exactly.
Not to mess with. - Yeah.
And that's an easy one, you go in,
they'll check it out and find out pretty easily.
The next, heart, liver, or kidney disease.
These are the types of things that come on slowly,
you don't have swelling, but over a period of months,
you notice your legs start to swell up a little bit here,
and it's typically both legs.
- For example, if your heart is not pumping well,
it's not handling the fluid that's coming back to it.
- Right, and then it builds up.
I know my father had that, but, and again, doctor visit.
- Yeah.
- They're gonna deal with that as probably some-
- Pretty much everything has to go into a doctor visit.
(laughter)
Well maybe the ankle sprain, you can hold off a bit,
and if you're pregnant, you can hold off a bit,
but when you're pregnant, we always like to be cautious too.
- Sure, exactly.
Side effects from medications is the last one.
Already you're seeing a doctor, and they should tell you,
or the pharmacist will let you know,
you may get some swelling in your ankles
from this medication.
And so, it's something you're forewarned on typically.
- And sometimes they put you on medication
to help with the swelling.
- Yeah, right, it may be a second medication
to offset the side effect of the first medication,
which that scenario does happen.
- Yep.
- Yeah. - That is the eight, Brad.
- Yeah.
Eight of 'em, and typically, for an ankle sprain,
ankle swelling, you don't need to see a doctor
on a regular basis, but just to get the red flags
and big problems out of the way.
- Right, make sure that you're okay.
- Absolutely.
- Remember, Brad and I can fix just about anything.
- What about a giveaway?
- [Both] It's a future.
- Just go to bobandbrad.com, go to the giveaway section-
- Oh yeah.
- And you'll find out what we're giving away,
or go to Facebook. - Yeah.
- Join us on Facebook
and it'll be pined to the top of the page.
Every week, we give something away, nice stuff.
- And what I'm gonna say prior to your this was,
you said we could fix about anything?
- Except for? - A broken heart.
- Right. - Right.
- A broken heart could cause increased fluid.
(laughter)
Crying. - Yeah, yeah.
- If you have a broken heart, you cry.
- I don't think that's going anywhere, Bob.
- All right, thanks for watching.
(laughter)