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You must have JavaScript enabled in your browser to utilize the functionality of this website. Ulcers occur when the skin breaks down allowing air and bacteria to get into the underlying tissue. Associated symptoms of a venous leg ulcer are caused by blood not flowing properly through your veins.
Years of research have shown that the usual causes of leg ulcers are not a problem with the skin itself, but rather with the underlying blood supply to the skin. Because blood supply to the skin is crucial, ulcers can occur as a result of poor circulation and so it is also mostly associated with disorders that affect circulation, such as diabetes, rheumatoid arthritis and hypertension.
Diagnosis is usually made based on symptoms, location and the way the surrounding skin of the ulcer looks.
Leg ulcers usually occur in the elderly more so than any other age group, due to poor circulation in aging limbs. Two conditions that add to the complications of leg ulcers in the elderly are obesity and diabetes.
Venous (Varicose) Ulcers mostly occur due to improper functioning of the valves connecting the superficial and deep veins. Arterial (Ischemic) Ulcers are caused by poor blood circulation as a result of narrowed arteries or by damage to the small blood vessels from diabetes.
Treatment for leg ulcers should include weight loss if you are overweight and regular exercise to promote good circulation. Once the causes of leg ulcers are under control, (for example the blood sugar level in diabetes) the ulcer should heal by itself.
If an underlying disease is one of the causes of leg ulcers, it's important that it is treated - for example hardening of the arteries.
Sit with your legs raised whenever you have the opportunity - above heart level if possible. If your work requires a lot of standing or sitting, try to vary your stance as much as possible. Following our article on managing acute calf tears we've had a lot of questions on swelling and risk of DVT. The most common question we receive on RunningPhysio relates to ongoing swelling following a calf tear. While people are often concerned about swelling, it is a normal part of the healing process in this and many injuries.
The nature of the injury – an injury to a large muscle like the gastrocnemius, which has a good blood supply, can lead to a considerable amount of swelling which can continue for some time as the injury heals.
Muscle injuries take around 6-8 weeks to heal so it isn't unusual to have swelling that continues throughout this period. Ice – there is some debate on whether ice does actually reduce swelling or simply improve pain.
Please note: These are just general guides, specific advice from a health professional is recommended.
A Deep Vein Thrombosis is the formation of a blood clot in a deep vein, usually in the legs. Astute readers amongst you will have noticed I'm being particularly careful with advising proper assessment from a trained health professional.
If you have any suspicion of DVT get it checked out by a qualified health professional ASAP. An assessment tool called the Well's Score can be used to determine the likelihood of a DVT and guide further investigation and management. Reproduced from Scarvelis and Wells (2006) – an excellent article on DVT diagnosis and treatment freely available online. Closing thoughts: calf swelling is a common and often totally normal part of the healing process following a calf injury and will resolve in time. Do you have consern with the use of compression calf sleeves vs socks as it relates to this post? My mother has just gone into a care home, she loves it, leaving me free after 5 years to live my own life. Two day ago I was playing basketball when I felt a pop in my calf muscle and I collapsed to the ground in extreme pain.
My wife had a calf injury, complete with popping sound, in an exercise class a couple of weeks ago.
Edema is the noticeable swelling resulting from fluid accumulation in certain body tissues. The swelling, also referred to as dependent edema, is brought about by the accumulation of excess fluid beneath the skin in the interstitial spaces or compartments within the body tissues that are outside of the blood vessels.
Occasionally pitting edema and non-pitting edema can occur without an underlying disease and it is then known as idiopathic edema. Pregnancy can cause edema in the legs as the uterus puts pressure on the vena cava, a major blood vessel that returns blood to the heart from the legs, and progesterone relaxes the walls of the blood vessels. Standing or sitting for long periods of time particularly in hot weather can cause excess fluid to accumulate in feet, ankles and lower legs. Low protein levels in the blood caused by malnutrition, kidney and liver disease can also cause edema.
Congestive heart failure is a condition in which the heart can no longer pump efficiently, and causes fluid buildup in the lungs and other parts of the body.
Severe chronic (long-term) lung diseases, including emphysema and chronic bronchitis, increase pressure in the blood vessels that lead from the heart to the lungs. Tiny valves inside the veins of the legs can become weakened, causing a common problem called venous insufficiency. Most incidences of edema in children and infants are related to serious health conditions, so changes in your child should be monitored to avoid complications. Children with acute or chronic upper airway obstruction are at risk for negative-pressure pulmonary edema, associated with upper airway obstruction. While quite rare, Nephrotic Syndrome (NS), a disorder of the kidneys, can cause edema in children.
Periorbital edema should be closely monitored, as it may be the result of a more serious condition, such as congestive heart failure and liver diseases. Children and infants with diabetes may also experience edema as a side effect from insulin treatment. The diagnosis of pitting and non-pitting edema are determined by the symptoms on physical examination. Edema itself is usually a symptom of an underlying condition and can be noticed as swelling or puffiness of your face, hands, feet, legs, or around your eyes. If you experience shortness of breath, chest pain, redness or heat in a swollen edematous area, or a swelling of only one limb, consult a doctor immediately.
Depending on the causes of edema and whether it is temporary or permanent, treating edema usually focuses on treating the condition that is causing it. If a blocked or damaged blood vessel is suspected as one of the causes of edema, surgery may be needed to improve the flow of blood. Treating edema should include protecting any swollen, edematous areas of the body from pressure, injury and extreme temperatures.
Hailing from Kuching Sarawak, Leona Lim is a freelance writer and blogger now stationed in the Klang Valley.
Enter your email address to subscribe to this blog and receive notifications of new posts by email. A bruise, also called a contusion, is a type of relatively minor hematoma of tissue[1] in which capillaries and sometimes venules are damaged by trauma, allowing blood to seep into the surrounding interstitial tissues. As a type of hematoma, a bruise is always caused by internal bleeding into the interstitial tissues, usually initiated by blunt trauma, which causes damage through physical compression and deceleration forces. Increased distress to tissue causes capillaries to break under the skin, allowing blood to escape and build up. During this time, larger bruises may change color due to the breakdown of hemoglobin from within escaped red blood cells in the extracellular space. Bruise shapes may correspond directly to the instrument of injury or be modified by additional factors. Condition and type of tissue: In soft tissues, a larger area is bruised than would be in firmer tissue due to ease of blood to invade tissue.

Age: elderly skin and other tissues are often thinner and less elastic and thus more prone to bruising.
Diseases: Coagulation, platelet and blood vessel diseases or deficiencies can increase bruising due to more bleeding.
The harm score is determined by the extent and severity of the fractures to the organs and tissues causing the bruising, in turn depending on multiple factors.
Low levels of damaging forces produce small bruises and generally cause the individual to feel minor pain straight away.
Damage that causes bruising can also cause bones to be broken, tendons or muscles to be strained, ligaments to be sprained, or other tissue to be damaged.
Treatment for light bruises is minimal and may include RICE (rest, ice, compression, elevation), painkillers (particularly NSAIDs) and, later in recovery, light stretching exercises. Very gentle massage of the area and application of heat may encourage blood flow and relieve pain according to the gate control theory of pain, although causing additional pain may indicate the massage is exacerbating the injury.[6] As for most injuries, these techniques should not be applied until at least three days following the initial damage to ensure all internal bleeding has stopped, because although increasing blood flow will allow more healing factors into the area and encourage drainage, if the injury is still bleeding this will allow more blood to seep out of the wound and cause the bruise to become worse.
During an autopsy, bruises accompanying abrasions indicate the abrasions occurred while the individual was alive, as opposed to damage incurred after death. Folk medicine, including ancient medicine of Egypt, Greek, Celts, Turks, Slavs, Mayans, Aztecs and Chinese, has used bruising as a method of treatment for some types of health problems. Phlebitis that is superficial is caused when a catheter (venflon) is inserted into the vein or when a person is put on intravenous catheter. Deep vein thrombosis is caused by trauma or injury to the legs or due to inactivity for long time. People who are over-weight (obese) and individuals who are inactive for prolonged period (bedridden or long journey on a plane or car without any movement) are prone to deep vein phlebitis. There would be inflammation of the vein for all people who are put on IV fluids for long time. Your doctor will look for the above symptoms and physically examine the body to ascertain the illness.
For treating superficial type of phlebitis you can apply warm or cold compress on the affected leg or arm. In case of deep vein phlebitis, your doctor will give medications for reducing swelling and pain. You can prevent from getting phlebitis by doing regular exercise and indulging in sports activities like cycling and swimming.
Individuals who are on IV fluids for long should change positions of catheter to prevent phlebitis. An important factor to consider is that the great saphenous vein is used for heart and leg bypasses for cardiovascular surgery.  If the vein is severely diseased and would not be a suitable conduit for future bypass surgery, eliminating the vein is not an issue.
Therefore successful prevention for leg ulcers and successful treatment for leg ulcers must be directed at correcting the underlying cause, not the ulcer itself.
A diagnosis is determined by the patient’s medical history, a thorough physical examination by a wound specialist or physician, and laboratory tests, which may include X-rays, MRIs, CT scans and noninvasive vascular studies to help develop a treatment plan.
Ulcers in the elderly affect their quality of life, especially if they are affected by them chronically.
Since many elderly individuals spend a majority of their time sitting, one of the best remedies is to keep their legs elevated, preferably above the heart.
The failure of these valves causes blood to improper flow of the veins, causing varicose veins.
Decreased circulation from diabetes is the main reason for the development of diadetic leg ulcers. Treatment may involve wound cleansing, anti-inflammatory treatment and application of dressings. Leg and foot ulcers have a tendency to recur in elderly people, and sometimes may require years of therapy. Firstly let's be clear, if you have any concerns after an injury you should consult your GP or Physio for proper assessment and treatment. Normal movement helps to clear swelling, so oedema can be aggravated by periods of inactivity.
In clinic we sometimes see swelling long beyond this initial time scale, it can become chronic and remain for several months. Regular small amounts of comfortable activity are usually helpful to reduce swelling but don't over do it! Little and often is key, recommendations vary so check with your Physio what's most appropriate for you. A concern with DVT is that this clot can be mobilised and move to a vulnerable part of the body, such as the lungs, where it restricts blood flow and causes lasting damage.
In some situations where other symptoms and risk factors are present there is the possibility of deep vein thrombosis.
It is most commonly found in the feet, ankles and legs although it may also affect the face, hands and other parts of the body and body organs. Excess fluid accumulation in the lower regions of the body, such as the ankles, feet, and legs, is referred to as peripheral edema. Pitting edema is the term used to describe edema when pressure applied to the skin of the swollen area is released and an indentation is left behind (e.g. This is most common in women who experience it in their legs and feet when they are pre-menstrual or pre-menopausal – it is then often known as cyclical edema. Fluid retention during pregnancy also can be caused by a more serious condition called pre-eclampsia.
The proteins help to hold water inside the blood vessels so fluid does not leak out into the tissues. This pressure backs up in the heart and the higher pressure causes swelling in the legs and feet. This makes it more difficult for the veins to pump blood back to the heart, and leads to varicose veins and a buildup of fluid.
This condition may also occur after head injury, seizure, or accidental chemical ingestion or inhalation.
As the main symptom of NS, edema is commonly seen around one or both of the eyes, also referred to as periorbital edema, but may be found in other parts of the body such as the legs. Other causes of periorbital edema in children and infants may include allergies or infections, such as conjunctivitis. However, children with diabetes should report this to their pediatrician, as it may be a symptom of cerebral edema (brain swelling), a rare but serious complication of diabetes. The doctor will examine the skin over the swollen area to check whether it may be stretched or shiny.
Amongst others edema can indicate disease of the heart, liver, thyroid, lymphatic system or kidneys (causing salt retention). A low dose of a diuretic (water pill) may be prescribed to reduce the swelling and help you expel the excess fluid, but it is important to remember this just treats the symptom and is not necessarily addressing the cause. I know medically, you’re not supposed to pop the blister as the water or serum beneath the pillow like blister is there to protect the wound and not cause infection. Gosh, hopefully there won’t be an obvious scar on my arm, I have enough scars already. Bruises can involve capillaries at the level of skin, subcutaneous tissue, muscle, or bone. Trauma sufficient to cause bruising can occur from a wide variety of situations including accidents, falls, and surgeries. Sometimes bruises can be serious, leading to other more life-threatening forms of hematoma, such as when associated with serious injuries, including fractures and more severe internal bleeding. As time progresses, blood seeps into the surrounding tissues, causing the bruise to darken and spread.
The striking colors of a bruise are caused by the phagocytosis and sequential degradation of hemoglobin to biliverdin to bilirubin to hemosiderin, with hemoglobin itself producing a red-blue color, biliverdin producing a green color, bilirubin producing a yellow color, and hemosiderin producing a golden-brown color.[3] As these products are cleared from the area, the bruise disappears.
Bruises often become more prominent as time lapses, resulting in additional size and swelling. For example, a contracted muscle will bruise more severely, as will tissues crushed against underlying bone. Further bleeding and excess fluid may accumulate causing a hard, fluctuating lump or swelling hematoma. The symptoms and signs of these injuries may initially appear to be those of simple bruising. Particularly, immediate application of ice while elevating the area may reduce or completely prevent swelling by restricting blood flow to the area and preventing internal bleeding.

Unexplained bruising may be a warning sign of child abuse, domestic abuse, or serious medical problems such as leukemia or meningoccocal infection.
This happens when a person is destined to bed due to some disease which would arrest the movement of his legs and arms. Women who are pregnant are also under the risk of getting blood clot in their veins since the enlarged size of the uterus would compress the veins of the pelvic region. Similarly people who smoke frequently and those using contraceptive pills are also under the risk.
Slowly there will be inflammation of the leg or arm indicating the swelling of superficial veins.
The surrounding area of the skin may look swollen and warm due to the inflammation of the vein. For diagnosing deep vein thrombosis blood clot testing (D-dimer) may be done or ultrasound scan is done.
For treating inflammation and pain you can take medications like Ibuprofen and other anti-inflammatory drugs.
In case you are traveling for long hours, you should get up and walk for few minutes before continuing the journey. Many elderly individuals are inactive, making it very hard to treat ulcers in a traditional manner. Treatment for leg ulcers greatly depends on the factors that cause the ulcer or have prevented healing. So long as there is no arterial disease, venous leg and foot ulcers will benefit from elevation and compression dressings. When you've injured the calf itself working the muscle is often painful and so this normal pumping action is reduced, meaning swelling remains in the calf, foot and ankle. With calf tears there is a risk of DVT, which, although small, means I don't want to take any chances by giving out unsafe advice. Pregnant women and older adults are often affected with this condition, but it can happen to anyone.
If a blood protein, called albumin, gets too low, fluid leaks out the blood vessels and edema occurs, especially in the feet, ankles and lower legs.
Because edema can be a symptom of a serious underlying disorder, and can cause serious consequences itself, it is always important to seek medical advice. Cuts, scrapes and burns in areas that have edema take much longer to heal and are open to infection.
A bruise may be named by the length of its diameter as an petechia (less than 3 mm), purpura (3 mm to 1 cm) or ecchymosis (1 to 3 cm), although these terms can also refer to internal bleeding not caused by trauma. Disease states such as insufficient or malfunctioning platelets, other coagulation deficiencies, or vascular disorders, such as venous blockage associated with severe allergies[2] can lead to the formation of bruises in situations in which they would not normally occur and with only minimal trauma. The likelihood and severity of bruising depends on many factors, including type and healthiness of affected tissues. Nerve endings within the affected tissue detect the increased pressure, which, depending on severity and location, may be perceived as pain or pressure or be asymptomatic. Bruising present in a different location than the site of impact is called ectopic bruising and occurs when the tissue at the site of injury is loose, allowing blood to travel under the skin to another location due to gravity or other forces, such as in a black eye. Capillaries vary in strength, stiffness and toughness, which can also vary by age and medical conditions. Normally, light bruises heal nearly completely within two weeks, although duration is affected by variation in severity and individual healing processes;[5] generally, more severe or deeper bruises take somewhat longer. This has the potential to cause compartment syndrome as the swelling cuts off blood flow to the tissues. Abdominal bruising or severe injuries that cause difficulty in moving a limb or the feeling of liquid under the skin may indicate life-threatening injury and require the attention of a physician. Phlebitis is very painful and the inflammation may occur either in the superficial veins or in the deep veins. For getting temporary relief you can also wear leg stockings for improving the blood flow and reducing the vein inflammation.
For severe form of deep vein thrombosis, anticoagulation is done for thinning the blood content.
For bed ridden people it is advised to change position and wear stockings to prevent vein inflammation.
Use your thumb to exert a gentle consistent pressure for around 10 seconds then release, with pitting oedema you will usually see a small indentation left in the swelling. Please, if you have any concerns don't scour the internet for answers, see a health professional! Calf swelling with no redness, or pain, without any risk factors makes DVT considerably less likely especially if the Well's Score is below 2. For the next two days I felt crampy pains in my knee, my thigh, the front of my calf and then the back of it. Minor bruises may be easily recognized in people with light skin color by characteristic blue or purple appearance (idiomatically described as "black and blue") in the days following the injury. The damaged capillary endothelium releases endothelin, a hormone that causes narrowing of the blood vessel to minimize bleeding. The trauma that induced the bruise may also have caused other severe and potentially fatal harm to internal organs. Scraping, (Gua Sha), uses a small hand device with a rounded edge to gently scrape the scalp or the skin. Superficial phlebitis is the condition in which the upper layer of the veins gets inflamed and it can be easily treated by topical ointments that reduce inflammation.
In case of life threatening conditions like pulmonary embolism, the patient will have to be hospitalized and given lovenox injection along with coumadrin and the situation is monitored continuously. A DVT only effects around 1 in 1000 people per year but can have serious consequences, most notably pulmonary embolism, which can be life threatening. As the endothelium is destroyed, the underlying von Willebrand factor is exposed and initiates coagulation, which creates a temporary clot to plug the wound and eventually leads to restoration of normal tissue. For example, impacts to the head can cause traumatic brain injury: bleeding, bruising and massive swelling of the brain with the potential to cause concussion, coma and death. Bruising present around the navel (belly button) with severe abdominal pain suggests acute pancreatitis. Slapping, (Pai-Da Therapy), is performed using two to five fingers or the whole hand mostly against joints such as shoulders, elbows, knees, wrists and ankles. But phlebitis that occurs in the deep veins is called deep vein thrombosis that affects the veins found deep inside the legs and arms. Now two more days on, the back of my calf really hurts, in fact it hurts more and more, but the trigger for the pain seems to be when I bend it.
Treatment for brain bruising may involve emergency surgery to relieve the pressure on the brain.
For healthy people these procedures applied to a healthy part of the skin should cause redness which disappears in minutes or hours.
In rare cases, the blood clots that develop on the veins may move towards the lungs causing dangerous situation like pulmonary embolism.
For patients with pain, soreness or stiffness, the same procedure will typically cause bruising or blood blisters that lasts days. I see no cause for worry on Wells Scale you gave us (my diagnosis), I will to to GP asap, but in the meantime, what on earth is going on???? She’s been worried about walking around on it, but I found this article this morning and it made both of us feel a lot better.
Each of these methods of treatment is repeated by the health practitioner or the patient himself over a number of days or weeks.
This hurts more and more, and I find it very painful indeed now to get up off the floor, as an example. There are some language issues with GP, his French is better than mine, and I just want to know I don’t have DVT and how to get better.

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