Medical statistics say: every third patient, after removing the cast from his leg, discovers swelling and edema, but does not always know what to do and begins to panic. The doctors reassure us that there is no need to worry. The phenomenon is of a natural nature and does not persist for too long. However, the process should not be left to chance either. The best decision: take a responsible approach to rehabilitation therapy and adhere to the recommendations of a specialist in a white coat.
About lymphedema
Lymphedema is a swelling condition that can develop in the legs after lymph nodes are removed or injured. Lymph nodes are small, bean-shaped structures that are located throughout the body. They drain fluid away from different areas of your body. The inability to drain fluid leads to tissue swelling.
During surgery, lymph nodes in your pelvis were removed to get rid of any remaining cancer cells. This increases the risk of developing leg lymphedema. The risk will be higher if you have had radiation therapy or had lymph nodes removed in your groin. If you only have lymph nodes in your pelvis removed, you may be less likely to develop leg lymphedema.
Lymphedema may develop immediately after surgery or years later.
to come back to the beginning
Relieve swelling using traditional medicine
After a fracture, there is a need to remove swelling from the arm as quickly as possible. In a cast, the limb is immobilized for one and a half months. This leads not only to swelling, but also to weakening of muscles and ligaments. In a displaced fracture, the swelling of the radius lasts much longer, since the surrounding tissues were more traumatized. However, it also goes away over time. With proper treatment and rehabilitation, the hand fully restores its functions.
To eliminate swelling, special ointments and gels are used, physiotherapeutic procedures and physical therapy courses are carried out.
Anti-edema medications
If the swelling lasts too long, the doctor may prescribe a number of medications that speed up the process of blood circulation and healing of tissue injury. They are used after removing the plaster cast. Medicines to relieve swelling can have two types of effects:
- cooling,
- warming.
To relieve swelling from the hand, most often, cooling ointments are used, for example, heparin ointment, Lyoton or Troxevasin. They must be applied 2-3 times a day to the damaged area of the hand. The ointment helps relieve pain and cool tissues, which promotes speedy recovery.
Massage
Therapeutic massage is included in the rehabilitation course after a fracture. It allows you to quickly eliminate the consequences of the injury and return to normal activities. This is one of the most effective methods.
How to remove severe swelling from the arm after a fracture using massage? A professional massage therapist conducts a comprehensive course that helps normalize blood circulation, especially in the atrophied area, stimulates the work of nerve endings, as well as regenerative processes in the tissues of the hand. Then you can continue the massage at home.
Physiotherapy
When there is damage near the joint of the humerus or radius, as well as in the area of the fingers, a callus is formed, the muscles lose activity, and a number of processes in the tissues are disrupted. To avoid consequences, a number of physiotherapeutic procedures are carried out aimed at normalizing the functioning of the hand:
- electrophoresis,
- ultraviolet irradiation,
- applications from medicinal mud, etc.
Physiotherapy
After the plaster cast is removed from the arm, the person must perform a series of exercises. They have a versatile effect:
- restore blood flow,
- increase muscle strength and elasticity,
- remove swelling.
The arm must be loaded gradually, slowly increasing the duration of exercise and the range of movement. Exercises must be performed every day, strictly following the instructions of the traumatologist.
Risk factors for developing leg lymphedema
Risk factors for developing leg lymphedema include:
- weight gain or excess weight;
- infection of the affected leg;
- radiotherapy of the pelvic area;
- reappearance of cancer.
There are other factors that are thought to increase this risk. These include:
- Sedentary lifestyle.
- Flying on an airplane.
- Compression of the leg. It occurs when there is a tight ring of pressure in one area of the leg and is often caused by wearing certain clothing.
- Exposure to extreme temperatures.
to come back to the beginning
How to reduce your risk of developing lymphedema
It is impossible to predict which patients will develop lymphedema, but there are preventive measures to reduce the risk of its occurrence.
Protect your skin
One of the measures to reduce the risk of developing lymphedema is to protect the skin as much as possible from injury or infection. This is because the affected area begins to receive cells that fight the infection, which in turn causes swelling. Your legs may simply not be able to handle the removal of this extra fluid.
Treat cuts and scrapes
- Wash the area with soap and water.
- Apply first aid ointment to it.
- Place a clean, dry gauze pad or Band-Aid® over the top.
Treat burns
- Wrap an ice pack in a towel and apply to the burn for 15 minutes. You can also wash the burn with cold water.
- Wash the area with soap and water.
- Apply first aid ointment to it.
- Place a clean, dry gauze pad or bandage on top.
Watch for symptoms of infection, which include:
- redness;
- edema;
- heating of surrounding tissues;
- sensitivity.
Call your doctor or nurse if you have these symptoms.
Don't wear tight clothes
Avoid wearing tight clothing that leaves deep marks on your legs, such as socks or sweatpants with elastic cuffs. Wear loose-fitting clothing that does not leave marks on your legs.
Compression garments, which prevent severe swelling from occurring, work differently. It ensures uniform pressure on the leg and proper fluid flow through it. You can learn more about compression stockings in the Compression Stockings section of this resource.
Avoid exposure to extreme temperatures
Extreme heat and cold can cause fluid to accumulate in the leg and cause swelling. Avoid or reduce time in hot baths or saunas.
Be careful when flying by plane
If you are at risk for lymphedema, air travel is associated with certain negative factors, including:
- Cabin pressure. The pressure in the cabin of an airplane is usually slightly less than the pressure on the ground. This causes the skin to stretch and fluid to accumulate in the legs.
- Sitting motionless for long periods of time. If you don't move for a long period of time, fluid can accumulate in your legs.
- Lifting and carrying luggage can cause muscle strain.
- Dehydration (when your body does not get the amount of water it needs).
Here are some tips to help reduce your risk of developing lymphedema:
- Buy a seat with sufficient legroom, such as a seat at the front of the cabin.
- Ask for help to carry, lift or remove luggage that is too heavy for you.
- Stand up and walk up and down the airplane aisle if possible.
- While sitting, do simple exercises with your feet and ankles. Exercise throughout the flight will help restore circulation and movement of lymphatic fluid. You can try the following exercises: Point your toes towards the ceiling and then lower them towards the floor.
- Make circular movements with your feet in one direction and then in the other.
Other ways to reduce risk
- Do not give injections (shots) or acupuncture into your affected leg(s).
- Do not use sharp pedicure tools. Use cuticle remover cream and file your nails instead of trimming them.
- Moisturize your skin frequently to avoid flaking and cracking.
- Keep the area between your toes clean and dry to prevent infections.
- Don't go barefoot.
- Make sure your shoes fit your feet to avoid blisters.
- Make sure your toe rings or ankle bracelets fit loosely.
- Try to sit cross-legged as little as possible.
- Choose a sunscreen with an SPF of at least 30 to protect your skin from sunburn.
- Try not to gain weight, as excess weight is one of the risk factors for developing lymphedema. If you are overweight, try to lose weight.
- Limit your salt intake. Its use can lead to swelling, which will put excess strain on the lymphatic system.
to come back to the beginning
Causes of edema
Any swelling after the cast is removed is the accumulation of excess fluid in the subcutaneous tissues. In case of injury, this phenomenon often occurs due to the fact that the leg remains in a static position for a long time, there is no load on it at all, and as a result the muscle partially atrophies.
There are several reasons for the appearance of edema:
- In an injured and diseased limb, blood flow is impaired, and therefore swelling occurs either immediately after injury or after a short period of time.
- Ligaments or muscles have lost their integrity, which affects the limitation of motor activity - the person stops walking or does it only by force.
- A broken leg is unable to cope with the increased load on it. Ideally, a fracture of a limb requires complete rest, but this is not always possible and not for everyone. If the injured person ignores medical recommendations, the injured tissues cannot recover intensively. The body signals this by the appearance of a tumor.
- Incorrectly applied plaster.
Important! In addition to the listed cases, swelling of the leg may occur after the plaster cast is removed. Doctors call it lymphatic because it is associated with impaired lymph circulation. As soon as the plaster is removed, the restoration processes start in accelerated mode, which entails an influx of fluid.
How to recognize the first signs of lymphedema
After surgery, swelling occurs at the incision site (surgical suture) in all patients. This is normal and will subside a few weeks after surgery.
Swelling caused by lymphedema usually occurs in the lower leg(s). If left untreated, it can spread throughout the leg and all the way to the torso. At first, this swelling may appear and disappear. It may decrease as you lift your leg higher than your chest.
Other early symptoms may include a feeling of heaviness in your leg(s) or a feeling that clothes, socks or shoes are pressing in on you.
to come back to the beginning
How to relieve swelling after a fracture
To remove swelling and recover quickly, it is necessary to normalize blood circulation in the damaged area. There are various methods for eliminating swelling, but consultation with a doctor is recommended to determine the most effective means individually for each case.
Physiotherapy and medications
As a rule, in case of swelling after removal of the cast, comprehensive rehabilitation is necessary. The procedures are applied sequentially over a short period of time, for example, massage is combined with electrical stimulation or paraffin with ultrasound or electrophoresis. Ultraviolet radiation and mud therapy are also used.
Other Lymphedema Treatments
There are other treatments for lymphedema. Talk to your doctor or lymphedema therapist about which ones are right for you.
Other treatments for lymphedema include:
- Treatment of scars. Scarring from surgery can make it difficult for your body to eliminate fluid. Scar treatments help soften the area around the scar and make it less tight. It will help drain fluid from your legs.
- Improved posture.
- Using kinesiology tape for athletes.
to come back to the beginning
Make an appointment
To make an appointment with a lymphedema therapist, contact your healthcare provider. They will decide together which lymphedema therapy is right for you. Once your doctor has made a referral, you will be contacted to schedule an appointment. If you have any questions, call Rehabilitation Service at 212-639-7833.
Lymphedema therapy is provided at several Memorial Sloan Kettering locations. For more information, visit www.mskcc.org/cancer-care/diagnosis-treatment/symptom-management/rehabilitation/medicine-therapy.
To find a lymphedema therapist in your area, you can visit the following websites:
Klose Training
www.klosetraining.com
Norton School of Lymphatic Therapy
www.nortonschool.com
Academy of Lymphatic Studies
www.acols.com
Lymphatic Association of North America
www.clt-lana.org
to come back to the beginning
