Do You Have Swollen Ankles & Feet? [What Causes It, Dangers?]

This is Dr. Tom Biernacki Actually, today I'm talking about foot and ankle swelling, the real causes and the real solutions, not the generic stuff. And we're starting now. So this is something that I see thousands of times. And when I look at these guides online and these videos, they give the generic answers like obesity, kidney issues, that kind of stuff. Yes, we already know that this is common sense. But what do you do on a practical level? You as the viewer, you probably want to know, hey, how can I get this better? Is there a risk for me as a podiatrist? This is what I see people for. I actually use an exact algorithm to work people up until they get this problem solved. Because the vast majority of time you can get quick, easy, practical solutions. This can be such a big problem. Look at the rates of heart issues. These are the more severe issues. But what comes first? Swelling vein issues that put pressure on the heart. In my opinion, this is one of the early things you can catch and see in a foot and ankle specialist is the key. We can start working on these things so that your heart doesn't have to work as hard. Now look at these statistics. This is from a study that was performed in Poland looking at the population. When you look at the age. Sure, when you're in 20, 30, 4050s, the percentage is not that high. But once you get into your sixties, you're 70 is your eighties. It starts to get to 50% of people that have extra pressure on their heart, making them more fatigued. Making them more tired. Decreasing the quality of their life. The good news is I am very optimistic that there's a lot of things you can do to make it better. I am so optimistic that you can get your foot and ankle swelling better because I see it in the vast majority of my patients that do these things. But let's start with the causes swelling in the ankles and feet can have a lot of different causes. Some are dangerous. Some are not very dangerous. Almost all of them can be improved if not fixed. And I'm going to do a top ten countdown of ones that I see. Swelling is dangerous because at the beginning it's not a huge problem. You're a little bit heavier. You maybe have £5 of fluid weight and eventually what happens is your valves start to break down. And when these valves break down, your swelling almost becomes permanent and then the fluid leaks out of your veins. You develop thick, scaly skin. This is something that happens over years or decades. One day is not a big problem, but this is not something you want to keep going on. Get comfortable with. The beauty is a lot of these problems can be prevented and improved before they get significant. And as always, I appreciate you guys so much if there's anything I'm missing or if there's anything I can do to make this video better, let me know in the comments. It really helps the channel sharing and getting this info out there. But remember, always check with the doctor if you're having a pretty severe significant issue. Number ten trauma, such as a bone fracture, stress fracture in ankle sprain. This can be internal bleeding. So essentially, I go over my ankle sprain injuries, my stress fracture injuries. Whenever people get an injury like this, they always underestimate how long it takes. Even if you break your ankle or sprain your ankle in a significant way or get a stress fracture on your foot from standing all day. On average, it takes six weeks for 50% of the swelling to go down. It takes three months for about 75% of that swelling to go down. And it takes six months for 90% of that swelling go on and sometimes one year. So after like a surgery or a broken bone, especially a year later, you could still be sworn. Now, the trick is with these types of injuries, most people are not doing the correct things to heal these ligaments, these bones in the first place. So I'm going to go over that towards the end. Number nine, pregnancy. I'm having my fourth kid right now and we just got an ultrasound. So this baby's going to be born any day. So I'm very excited. But this is something I deal with a lot with my wife. Any type of movement, you get more swelling, soreness, there's more pressure applied to the inferior vena cava, which is the vein going up to the heart. And this is going to make your ankles your feet swollen, but not just that your body releases something called the relaxin, which is a hormone that makes your ligaments flexible. So the muscles just get so much more sore, your lower back, your thighs, your calves, your feet. There is a lot of stuff you can do. Good shoes, good inserts, good support, compression socks and this prevent permanent varicose veins. Highly, highly recommended. I have a swollen foot guide video below. Make sure to watch that if you're pregnant. Number eight, certain medications, including steroids, anti-inflammatories, antidepressants. If you start a new medication and you're swelling up like a balloon. Talk with your primary care doctor about this. Sometimes switching up medications has made an easy change. But I'll tell you, for me, very rarely do we need to rely on specific medications with patients. Sometimes there's a lot easier solutions unless it's a very advanced case. Number seven infections. I have a ton of video about venous theses ulcers, diabetic ulcers, wounds people don't realize, even scrapes. Dry cracked skin is a wound. This can be a low grade infection. I deal with infections a lot. That's probably the number one thing we deal with as foot doctors, This is an area podiatrists can really help out with, but initially you can have some dry, thick skin with some bacterial colonization. It's not enough to cause an infection, but this is where preventative measures help. But at a certain point this is where the bacteria can get on the foot. It gets red, it gets itchy, it gets hot, potentially cracks or blisters wounds can develop. And then as that density of that bacteria increases, you can get systemic infection, blood infection. It can get into your body and you can get hospitalized. And that bacteria on your wound stimulates an inflammatory response that causes chronic, consistent swelling. This can give you fatigue, weakness and long term swollen legs. people don't realize you don't need to be vomiting and throwing up like having the flu to actually have an infection. It could just be a chronic non-healing patch of dry skin. It could be an irritated cut that's just taking forever to heal. And sometimes people live for months or years with these injuries and it's just so common. So consider these skin problems. I have a lot of great videos on all these skin problems, conditions. If you get these healed, then your body can take care of the swelling because all swelling is is your body telling you that something's wrong with your foot and your ankles? Number six, venous insufficiency and blood clots can lead to foot and ankle swelling, venous insufficiency. I think about it like this. This is like water weight in your feet. This is different from a condition like lymphedema that we're going to talk about. But venous swelling, essentially, the heavier you are, the more overworked your heart is, the more your veins are collapsed, like varicose veins. If you've had prior blood clots, this can essentially create damage that backs up the highways, which are your veins, and it moves out into the tissue. I think about it like this. When your veins are shut down, it creates a traffic jam and those cars go off the road to try and get to the places they want to go because they're too backed up. Number five, lymphedema. Lymphedema is a debilitating condition where lymph fluid accumulates in the legs due to damage linked to vessels. This is often caused by infection, cancer treatments, cellulitis, but it could just be due to genetic conditions as well. So lymphedema, the way I differentiate lymphedema between venous insufficiency is in venous insufficiency. Your skin looks normal, but in lymphedema you almost develop tree bark like skin, thick, scaly skin. That means proteins are developing in your skin. That's called papilloma ptosis. This is something I deal with a lot. I have a specific video on lymphedema, how to take care of that, but very common condition. This is a little bit of a tougher one to take care of, but it can be improved significantly. Lymphedema is the demolition of the lymph vessels. They can't reabsorb big proteins and thus they develop in the skin, whereas venous insufficiency is swelling in the skin, the proteins can still be reabsorbed. Number four, congestive heart failure. This is a tougher one. But if you're having heart issues, a lot of the times your heart just can't create enough pressure to get your blood flow back. A lot of the times, your heart can be helped by your cardiologist. There are some medications. Things like weight loss can significantly take pressure off your heart. There's a lot of ways to approach it, and there's a lot of things you can do. Congestive heart failure is obviously a more significant disorder. If you're having heart issues, chest pain, check with your cardiologist. That's a major cause as well. Number three, kidney failure. Even though I'm a doctor, I have some videos about kidney disease because I work with a lot of great nephrologists. And this is something that I see the signs of quite a bit at the beginning. There is a lot of foot changes, a lot of peripheral neuropathy, nerve changes associated with kidney failure. There are five grades of chronic kidney disease, but essentially the more kidney disease you have, the more swelling you are going to have in your foot. In a lot of cases, the early stages are reversible or improvable, and you want to address this before it gets worse. This is almost like a silent disease, except for the swelling in your feet. So me as a podiatrist, it's very important to me. This is caused by diabetes, high blood pressure and about ten different other major causes. I go over that in a video below. Number two liver failure and malnutrition. There is something made in your liver called albumin. This can impact fluid balance and can cause fluid to leak from blood vessels into the tissue. So essentially you need nutrient. You essentially need salts and molecules in your blood vessels to track the water to it. And if you don't have that, it leaks out into your cells. So that could be a sign that something's going on with your liver. In a healthy liver. It produces enough albumin to be inside your blood vessels that attracts blood flow back into your vessels and out of the tissues. But what happens is if your albumin leaks into the tissue or if you're not making enough of it, the fluid is free to go into the tissues. Now, what gets worse is if your lymph vessels are not working because you have lymphedema, a lot of that fluid just stays in your tissues. It's not pulled back in. There are some therapies like to replace IV albumin, so if your liver can't make it, there are some IV albumin that can soak up that fluid. So there's hospital treatments. But that's a sign potentially that you need to go see your doctor and get checked out. And then, number one, blood clots. I just did a video about blood clots and they are on the rise in society. There is something that you can do called the Holman's test. So a lot of the times you can squeeze your calf where there's a blood clot, it's more swollen, it's more painful. So if you have more pain in that area, It's not always this easy, but usually it is for me when somebody comes in after an injury, a surgery with high risk factors, one leg is much more swollen than the other and what happens is you can bend that foot up and as that moves that calf, it's painful. I mean, really painful. You could squeeze that calf, you could push with your fingers on that clot area. And it's really painful. Not that that's 100%, but that's what makes you want to get a venous ultrasound test at that point. And you can go to any E.R.. They will squeeze you. And immediately, because this is considered something a little bit more urgent. Or you could go to a vein clinic. They will do this for you as well. And it just looks just like this. you might want to get a test called the venous doppler done. There is no perfect way to diagnosis at home. But if you have signs of pain irritation in your calf muscle, your foot, your arch, you might want to see your foot doctor or go get a venous Doppler with a vein specialist. The average lifespan in America is decreasing. That's why I'm so passionate about addressing these preventable disorders. This is so important to me, and that's why I appreciate you guys so much. These videos have more comments than some of these medical studies. That's why it's so important. Tell me if I'm missing anything. If there's something I can explain better and share these and like these as much as possible so that we can get the word out. But don't worry, I'm going to go over a secret. It's not just go see your doctor. I'm going to go over the most practical, big secret. But the reality is, if you have heart, liver, blood clot issues, you do have to see a health care provider. Here's the number one big secret. And almost every single person with swelling has this issue. And this is a very correctable issue. This is biomechanical overload. Almost everybody I see with foot swelling, their feet flatten out, their ligaments stretch through their ankle, their thighs, their knees, their hips. And when I actually do, I use an ultrasound in the office to measure the muscles and the ligaments in the bottom of your foot, your ankle, your Achilles tendon, your anterior group muscles, your calf muscles. And I actually know what those measurements and thicknesses should be. Almost everybody with swollen feet has a very sore, inflamed beat up muscles, and that signals your body to release inflammatory markers and sending more fluid to these areas. You have more pain, you have a hard time walking. It can make your nerves more numb. This is something I see all the time. This is a condition called biomechanical overload that happens with flat feet people, high arched people. The muscles are just not symmetrical and they're almost too weak and overwhelmed for your body. I have a video about foot and ankle swelling. How to take care of it? Click on that video for the treatments. Hope to see you there.