This article is a transcribed edited summary of a video Bob and Brad recorded in August of 2022. For the original video go to https://www.youtube.com/watch?v=W4e251A31_8
Brad: Okay, we will give you six excellent options for improving blood flow in your feet and your legs without exercise. We’re going to explain why exercise may not be an option which is a realistic case in many cases.
Mike: Can I still exercise if I want to?
Brad: You bet, always exercise. Therapists, we always advocate exercises, but we’re going to get into that in a little bit. As therapists, we’re talking about circulation in the legs, and how to get the blood flowing better. As a therapist, we almost always recommend some form of exercise or repositioning of your body to get gravity to assist. However, there are three problems that can cause different populations and different people to now exercise. Number one, there are some people who absolutely refuse to exercise. If you’re a therapist, you know those people because it’s obvious. Sometimes they come out and tell you, "I am not going to exercise," and I say thanks for your honesty, and it helps me guide doing treatments that don’t include exercise.
Mike: Other cases are people with severe dementia or memory loss. They do not remember to do the exercises, they don’t remember they have swelling, and sometimes they don’t know who you are. They are not going to remember. These are some options you can try as well with them.
Brad: That’s right. Of course, there are certain people who may have work challenges where they’re sitting at work. It’s hard to exercise, they’re just busy people and exercise doesn’t fit into their day well, but these will and without problems.
Mike: Option number one is elevating your legs for at least 30 minutes a day. You can do it laying down, or you can do it in a recliner if it goes back far enough. I have a leg wedge and you can purchase one or you could simply use some pillows. The goal is to get your feet elevated above your heart to help with that swelling and get the circulation flowing better throughout your body.
Brad: Right. One thing, if you are in a recliner and the recliner oftentimes, the legs won’t go up high enough, so again add a couple of pillows onto the leg part, underneath the calves, so the pressure is spread out very nicely and it’ll work well. The second one, now this is a nice option, especially if you’re up and about or sitting at work for a long time, is compression socks. Mike has two different options here. Make sure they do not go above the knee, and they have more compression, like 15 millimeters of mercury around the ankle. Then 20 millimeters of mercury around the calf is a popular and common spec for these. So, wear those throughout the day and do not wear them to bed.
Brad: If you have severe swelling or typically older people use this, my mother does, I’ve worked with a lot of patients in the geriatric community, and it’s using what we call Tubigrip. The toes are cut off and that’s because it comes in a long rolled-up tube of cloth. We cut it so the length is right at the knuckles of the toes if you will, then below the knee and you slide them on. They don’t have the compressive gradient where it’s tighter in the foot than the calf, but they work well, particularly in the population I described. If they roll down it can cause a tourniquet. It usually happens at the top near the knee, but I already put on Coban tape which does not stick to your skin, but it does stick to itself. That can prevent the rolling. Usually, you don’t need to use it, but in case you do have that problem, it works nicely. So, that’s the compression garments. Wear them throughout the day, and take them off at night.
Mike: Another way to get the circulation going throughout your body and in your feet especially is just massage. You can start at the bottom of your feet and just dig in with your thumbs. Make sure to move all around, what feels good. I’m in what they call a figure four position so I can reach my feet. If you can’t reach your feet, you might have to have someone massage them for you.
Brad: The nice thing about this position, Mike, is that it’s elevated so you have gravity working the fluids and getting the blood going downhill along with massage. It’s important you start on the feet, spend about a minute or so on that, and then work to the calf, working that calf belly. We’re just getting that blood moving in any areas where it’s pocketing if you will, moving in the right direction. You’re probably going to spend 3-5 minutes and what’s going to happen that’s going to limit you is your hands are going to get tired. If you do one leg at a time, if you do both legs, you’ll figure out quickly how much time you can do this before your hands fatigue, and it becomes uncomfortable. You don’t want to get problems and "itises" in your fingers and knuckles and whatnot.
Mike: So, this is not a good option for severe edema, that type of massage is a little different.
Brad: Particularly if you have pitting edema. If you have edema you know, where you push your thumb in and then you take it off and a dent stays in that area, that’s called pitting edema. This would not be for that situation. We’re carrying on, number four. The next option is another massage, but instead of getting sore hands and fingers, if you happen to have a massage gun, that could be a great way to get circulation moving, relax muscles, etc. Here we have a massage gun, our T2 massage gun. The head that I like to use for this is the round head. There are other heads, the bullet head, the air-filled head, not like me. Anyways, the round head I think is the best. We’ll demonstrate why now. Getting in a supine position again so gravity assists with the blood flow going down is a big advantage and it’s comfortable. This is the way I like to massage my legs, particularly lying down.
Mike: This feels nice.
Brad: Yeah. The massage should feel good. If it’s too aggressive, there are five settings to the massage gun, slow it down or speed it up.
Mike: I’m using number one on the bottom of my feet, and this is going to be less aggressive going lateral versus directly into it.
Brad: That’s the big advantage of the round head. It allows you to change the angle which then, in turn, changes the intensity of the massage. It should feel good, very relaxing. Start at the feet, and work down to the muscle belly of the calf. The blood is going with gravity and the percussion of the gun making it go down proximal to the core and into the system. How are you doing, Mike?
Mike: I’m good. When you said airhead, it reminded me of the old movie “Airheads”, you’ve probably never seen it.
Brad: Yeah, I’ve heard of it. So again, working the quadriceps, these are large muscles. There is a lot of blood involved in these muscles, so we need to get the fluid moving down and that’ll open the pathways for circulation from the feet and the calves.
Mike: Should we go on to the next option?
Brad: Absolutely. With the massage gun, your hands don’t wear out. You can spend five minutes, happily doing this and it feels good. Yet, another good option to get the blood moving in the legs and proximal, where you want it to go, is the foam roller. This does take a more able-bodied person. It’s more effort to do it. They work well, however, just a little difficult. You also want to get the foam roller that’s not so dense. You want to be able to squish it in. Some people like the black ones that are denser. That does get into the muscle and massages the muscle more aggressively. That’s your choice. Again, we’re going to start on the feet, lying supine.
Mike: If want to get a little more aggressive with this, I can lift my butt off the floor, and it will take balance and coordination to do this. Also, works your hamstrings a bit. It’s just digging in down my plantar fascia area. Massaging in and just start near the toes and roll to your heels. Then I can go up to my calves easily. You can do both legs at a time or one at a time, whichever you prefer.
Brad: I do both just because it’s quicker, but if you have a knot or it’s more tender, you’ll want to go one leg at a time.
Mike: You can also turn your toes out and turn them in. It works different areas of the calf when you do that. That’s when I feel it the most. I like an aggressive one, mine has nodules in it. That’s just me, pick what one you prefer and what works best for you.
Brad: I’m going to do the Anterior tib., the muscle which is the front part of your leg. You simply sit your legs on the roller and turn sideways. It feels great. It’s a nice massage. You’re getting that blood flow moving.
Mike: Then sit back on your butt and we’ll do the same thing to the hamstrings.
Brad: For the quads, you need to go prone stomach down. I go back and forth, side to side. Do one leg at a time for that so you get those lateral quadriceps. You’re probably going to spend about 15-30 seconds on each muscle group and they can get all the way into the glute muscles as well.
Mike: Yeah, you can do glutes. I like to sit in figure four personally and roll around in different positions.
Brad: Number six, this is probably the most desired way to get the circulation going in your legs. It is for me, at least, and that’s simply to hire a massage therapist. They’re excellent at their job. They’ll get the muscles loose, and move the blood flow in the right direction because that’s what they do and they’re experts. The big thing is, it costs money, and you must go to it. That’s why I never use them. It’s more of a treat, for me. All right, thanks!
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