(ambient music) (wall exploding) - This is Tom Biernacki. And today, I'm going over
swollen feet and swollen ankles. I know, I'm in a great mood, but this is no laughing matter because there are nine causes. See, I almost ran out of fingers there. Nine causes of swollen
feet and swollen ankles with one that in my opinion makes up 75 plus percent of these, And I'm gonna show you how to fix it. But we're gonna go over
the more dangerous ones at the beginning, how to
know if you've got them, and how to solve them. And then, we're gonna go over
the absolute best diagnoses, when to see your podiatrist,
and when it's dangerous, home remedies, stretches, exercises, massages, creams, pills,
shoes, ankle braces, everything you could
ever need in this video. I'm gonna go rapid fire, and we're starting right
after you do me a quick favor. Guys, thank you so much
for watching this video. We appreciate your likes,
your subscribes, your comment. We really love hearing
if this stuff helps, it really makes a big
difference for us, so thank you. The number one most
common cause of swelling is probably not the
demographic that's watching, but if you have health issues. So, I'm gonna wrap this all up into one, but things that cause
swelling are heart prompts. Congestive heart failure,
previous heart attacks, COPD, (indistinct), lung issues, smoking, emphysema that
creates a backup on your heart. So, it can't cycle blood through as quick, and it settles down in your feet. If you have kidney issues. Long-term diabetes, metabolic problems. If you're severely overweight, your heart is not necessarily
bigger and stronger, but it has to cover
significantly more volume and a higher percentage
of that kinda seeps down into your feet. I'm gonna bundle that
into metabolic diseases. That's kinda beyond the
scope of this video, you need medical management,
go see your podiatrist, go see your primary care
doctor and your cardiologist. And they can help you with that because that might require diagnoses of those underlying prompts. But all that stuff will cause swelling, and if you have that stuff, that's probably the number
one priority for you. Number two is pregnant woman. I'm gonna go over this really quick, but pregnancy messes
with your fluid levels, pregnant woman, you are saints
for taking care of these kids and helping us husbands
so we don't have to do it, but you're gonna have
swollen feet, sore feet. A lot of the remedies
I talk about at the end will help with the swelling, but this baby pushes on veins, it backs up blood flow. You have to cycle more blood
than you're usually used to and your heart's still the same size, so it has a harder time
keeping up with that demand. So unfortunately, that's gonna happen, especially the further
you go on in pregnancy. Another one is lymphedema, lymph vessels. I see this a lot, this is
a pretty dangerous one. When your skin looks
like has tree bark on it, if you have scaliness, if you have thicker dry crusty skin starting to develop,
this can be lymphedema. And that thick crust is
called papillomatosis. What lymph vessels do is they
suck up the bigger proteins, the bigger molecules, and dump it back into
your blood flow system from the surrounding cells. A lot of the times this can get damaged from genetic reasons, being overweight for a
very long period of time, having skin infections. When people get cellulitis or skin infections on their feet, a lot of the times that can
kill some of the lymph vessels and damage them, so can
injuries, long-term injuries. And this can create this
thicker skin that's swollen. This differ, so lymphedema
differs from venous stasis, or venous insufficiency,
or varicose veins. Venous insufficiency or
varicose veins means, because your heart is
backed up a little bit, you swell a little bit more. And varicose veins means you have valves, so one way valves, when you take a step and
your muscles function, the valve lets the blood
flow return to your heart, but with gravity, it doesn't let it back. But see, the valve doors can break back, and then the whole vein just engorges, because it's not enough pressure that keeps moving it back up there. Right here is a great
home remedy right now, especially with a lot of
people working from home. You're sitting in chairs, you're
barely moving on the couch, a lot pumps, leg pumps. Personally I do a lot of charting, after I see patients in the office, you want the pumps to squeeze
the blood flow back up into your legs and move it up your legs and cycle it through and
make your legs feel better. That's a great one for
people who sit all day, that can help with venous stasis. That's a little bit
different than lymphedema, even though that could
help for lymphedema. For lymphedema, you want
more professional pumps and you wanna probably see your podiatrist to get a prescription for these things. An infection can really cause swelling, if you have a cut, or a scrape, or some type of skin
irritation, infection. Could be a fungal infection, or could be a bacterial
infection, call your podiatrist. Things you wanna look
out for: open wounds, any redness, tingling, irritation surrounding this cut. This is stuff you wanna
look for, if there's pain, if there's irritation, if one leg is more swollen than the other, let your podiatrist or
primary care doctor know, and you might wanna start
off on an antibiotic. A blood clot. So, blood clots, most commonly they could develop anywhere, but most commonly they
develop in the calf. This is called the deep vein thrombosis. If you squeeze your calf
and it's red, hot, swollen, that could be a venous stasis
or a deep venous thrombosis. What happens is, here you want to go to the emergency room or see your doctor and
you want a venous Doppler. A venous Doppler can show
us if there is a clot, if that happens, a lot of the times you're
starting on medication, like a blood thinner to break it up. If you have a lot of these, then what happens is you
might need to be on medication or even have some protective
materials implanted into your body, which is
called the Greenfield filter. But usually, what's a
risk for a blood clot? severe injury, if you break your ankle, if you break your leg, your hip, if you're a smoker, if
you're very overweight. The more health conditions you have, but the single biggest causes
is a history of a blood clot in your family or both in you, sometimes it's genetic as well. But squeezing your calf, a
red, hot, irritated area, that's not getting better.
You want to make sure you get that evaluated with your doctor because that blood clot
could travel up to your lung and plug your lung. And sometimes, this is
called a pulmonary embolism, and this could kill people. This is a very big risk
factor after surgery, or broken bones, or broken
ankles, high risk factor. And certain medications. There's a lot of medications, you see in commercials how
many side effects they read. You wanna get that checked out, always check with the medications
what the side effects are. But what the real problem is, is tight muscles, tight
legs, tight ankles. If you wear an unsupportive
shoe like this, see how I can bend this
and move it around. Look, when you walk it bends
and moves your muscles, your joints, your tendons
have to absorb all of that. Whereas if you wear a good shoe like that, look, a lot more cushion. It has a little bit of a heel
lift compared to the front, a stiff back, it doesn't
really bend as much. And what happens is, if that
shoe still doesn't help, you wanna go to the heavy duty shoe. Look at all that cushion,
a lot of heel lift here, especially in the front, doesn't bend. Now, the principle here
is called rocker bottom, see how it rolls across, whereas a shoe like this just lands flat. There's a theory, should
you be a barefoot walker? I'd say for the majority of the people, especially if you're swollen and sore, go with the more supportive shoe. There's a lot more evidence
for the more supportive shoe, I could talk about that all day. Younger, healthy people without swelling, maybe you can train your
muscles by walking barefoot. But if you're already so
sore they can barely move, and you're so swollen
that you can barely move, get a good supportive shoe
until the swelling comes down, then you can think about exercising. And another thing is, watch this... with gravity look at how
much of this arch collapses. It stretches all the tendons
on the inside of the ankle, on the top of the ankle,
the outside of the ankle, all the joints, look at
the motion right here. That's not big thick muscles, those are little muscles that
have to carry a lot of weight. Your big muscles are your
calf muscles, your thigh, your hamstring, your butt muscles, those are your big muscles. You can squat large amounts
of weights with that, but with your toe, you
don't wanna lift, you know, 200 pounds with your toe, but that's why people's
feet and ankle gets swollen. Take a look at this
gentleman running right here, this is stiffness through the hamstrings, through the calf muscles, and the feet just kind of plunk down. They don't absorb the shock, this makes the joints and
the muscles in the feet, very sore and very swollen. The root cause of this... is this, look at my left foot here is a little bit stiffer
than my right foot. As an example here, look at how
much my right foot bends up, but the left foot, it's
like 10 degrees less. This is called dorsal flection, right there, see that? My left foot has to externally rotate, so what that does is,
now I have to compensate through my knees, through my hips, all these little foot muscles and bones don't work the way they're supposed to. See that 10 degree difference there, it makes you off balance,
that's called asymmetry. Take a look at this, this
is a healthy young athlete that's flexible, the feet
land and they're equal. They absorb, these aren't
even the best shoes. They're not the best
orthotics, but strong, flexible muscles allow you to do this. On the other hand, take
a look at this technique. The feet are buckling out,
the ankle is rolling in. This is because this person
has tight hamstrings, tight knees, tight calf muscles. They're not used to running,
they're all over the place. And the joints and muscles in the feet have to work much harder. Look at the difference right here, see how in a good orthotic
it's not collapsing. It has cushion, the foot's not collapsing, you could easily move through the ankle. You can move your big muscles, but your little toes and little tendons are not getting beat up all day. A good orthotic combined with
a good shoe is a great combo. Simply doing that will take
a lot of stress off there. The next thing you wanna do is, see your podiatrist
for biomechanical exam. Is one ankle tighter than the other? Is one knee tighter than the other? Is one hip tighter than the other? With 95% of patients that
I see with swollen legs, this is the problem, you're uneven. You're leaning, one hip
sore, one knee sore, one back muscle sore, you
wanna get this evaluated, you wanna work on
stretching and exercising. When your feet are sore, and
swollen, and you ruled out all that dangerous stuff I talked about, freeze a can, freeze a water bottle, just make sure it doesn't explode. This works on the bottom
of your foot muscles, which are gonna be very sore. You can buy one of these cryospheres, they're like 20, 30 bucks online. You freeze that metal ball there, it doesn't work great in
the bottom of the foot, but it works great on the calf. These balls are like a dollar, you can come home, you can massage. The trick is, it doesn't
have to be painful. People think it has to be painful, but it doesn't have to be painful, a gentle massage is
what you're looking for. Massage roller sticks are like $7. I'm a huge fan of these, I
use these myself personally. When I stand and walk all
day, but on your calf muscles, on your hamstrings, on
your plantar fascia, on the inside of your leg, this
stuff works extremely well. It can get a lot of pressure
off your legs, your knees, and get you walking
much more symmetrically, it can make you feel
like a teenager again. The towel exercise works really well, what you wanna do though first is, before you stretch, warmups. So massage, ride a bike for five minutes, if you have a Peloton
or something at home. If you don't just warm up, move your ankle and then start stretching. You wanna stretch your thighs, your hamstrings, your calf muscles. This towel exercise works great if you can't reach your toes. Creams are really good too,
Biofreeze is one of my favorite, but also Voltaren gel is
a little bit stronger, that's a medication. See, this is lotions, essential oils, these things can help warm up your muscles and get the swelling and soreness down. Pills, ibuprofen, Aleve can
help get the soreness down, but I would recommend only
if you have like a week or so of pain, because if
you use this long-term, it's gonna hurt your
kidneys. It has side effects and it doesn't really get to
the root cause of the problem, so don't rely on just pills
that will never solve it. The next thing too is cross training, if you're standing 60 hours a week, maybe come see your podiatrist,
get a note for a chair, get some better shoes,
get some ankle braces, get some orthotics, get evaluated to make sure
you're not off balance. That's the real key to getting
rid of that leg swelling, for 90% of people that
I see in my opinion, it's not any of this dangerous stuff, even if it's as dangerous
stuff, this also contributes. You wanna get assessed by
a biomechanical expert, like a podiatrist. I know, I'm biased, but I'm telling you it's very beneficial. An appointment or two can really make a big
difference for people. If you're in Michigan, come see us. I'd love to give you a biochemical exam and help you out with all this stuff. And there's fancier stuff too, there's lasers, there's shockwave therapy so we can help with all that
stuff as well, so come see us. Take a look at this technique again, these feet are buckling out. I can tell you right now,
a full day of walking, if this person was a teacher or a nurse, they're gonna have swollen, painful feet, and they're gonna be sore every day. They're not going to know
what it's like not to be sore because they're probably
gonna be sore for years and they're gonna just accept it. But you shouldn't accept it,
because take a look at here, look at how symmetrical
this person's running is. I can tell you right now, the thighs, the hamstrings, the glutes, the calf muscles are absorbing
this weight right here, that's why this person can
be athletic and not sore. The underlying cause is asymmetry, you want to see a podiatrist
for your biomechanical exam. And this is probably
one of the best things that we do as podiatrists,
is we analyze your feet, your ankles, your plantar
fascia, your knees. Why are you walking that way? Can orthotics help? Can stretching help? Can shock wave therapy? Can laser? Some people might need
surgery for arthritis, further imaging, but
that's really the key. And then you can design a plan, but it generally consists
of rotating your ankles, warming up, getting some massage therapy on the tight sore muscles. If it's chronic tightness, you can use stuff like shockwave therapy, you can do physical therapy, there's a lot of great doctors. If you have back pain, a physiatrist can really help
or physical medicine doctor. And then, you can incorporate
stretching, offloading. This is how you really
start getting healthy because just starving yourself or going on long runs is going
to cause more pain for you. Using gravity to stretch your hamstrings, your calf muscles, and then assessing. Are you making progress
after a week or two? Or two to three months? Is it progressing? Why is it not progressing? But it's simple stuff,
standing on a towel, stretching your calf and your hamstring. Right here I'm stretching
the inside of my thighs, my groins, I love this
ankle stretch board. Standing on this ankle stretch board can really make a big difference because you start at
15 degrees right here. And once you're making
progress in a week or two, then you move it up to 20 degrees. And if you're making progress
there for another week or two, then you move it up to 25 degrees. Right now you're already
feeling more athletic, less back pain, less hip
pain, less knee pain. You're really making a lot of progress, so you can work your way up there and you can tell how
I'm sliding back there. But you can see how much
ankle flexibility get if you have flat feet. If this helped give us a thumbs up, give us a like, click on
future videos if you want to, but help us out.
