Reduce foot swelling: Foot above ankle or heart?

Factual Questions
1

(Note: I don’t think this is really medical advice, but if it belongs in IMHO, I won’t argue)

I recently had ankle surgery to put in a plate. I’ve been instructed to keep my foot elevated in order to reduce swelling. However, I’ve been given conflicting information. The surgeon said to keep my foot above my heart, and others have said I only need to keep it above my hip.

Keeping it above my heart requires me to be lying down, making it difficult to get anything done. However, keeping it above my hip is much easier.

SD Doctors: Which one is correct?

2

After both my Achilles rupture repairs, they told me above the heart. Or “toes above the nose”.

3

Do these ‘others’ have medical qualifications? If not, go with what the medically-qualified surgeon told you to do.

When I had problems with my lower legs, I was told to keep them elevated above the heart if possible, but at least above the hip.

4

I’m not sure whether the person who mentioned just above the hips was a nurse, PA, or something else. She was someone in the surgeon’s office.

Looks like you got some conflicting information, too.

5

What conflicting information did Quartz get?

6

I guess it wasn’t technically conflicting, but he was told to keep it above the heart, or at least above the hip. Does it have to be above the heart? Keeping it above the hip is way, way more convenient.

This thread is going very strangely for a GQ thread. I’m hoping to get a factual answer here, if possible.

7

There’s little if any pressure in the veins. Venous return from the legs is done by the contraction of leg muscle when you stand, walk or run.

Raising an immobilized leg allows blood to drain by gravity. The higher the better.
Guessing here: the rate/balance between draining and being pumped in(by the heart) is less than optimal if the limb is not above the heart.

8

It’s about the gravity as Running Coach notes, but I wouldn’t be surprised if there wasn’t much science supporting any particular height.

9

It’s about the gravity as Running Coach notes, but I wouldn’t be surprised if there wasn’t much science supporting any particular height.

ETA in fact, I’d be more surprised if there was.

10

IANAD and I can only give my experience. When I groke my ankle 11 years ago and they had to wait for the swelling to subside before operating to insert a plate, they put a partial cast (it went only hanf way around, they put ice on (changing it regularly) and elevated it above the knee. After four days like this, they operated.

11

Thanks, everyone. Sounds like above the hip would be sufficient but above the heart would be better or faster.

12

Why would you think this was **not ** medical advice?

13

A request for medical advice might be, “Doctors, is it important for me to keep my foot above my heart or only above my hip if I have to reduce swelling.” Or, “My surgeon says I have to keep my foot above my heart. Docs on the SDMB, do I need to listen to them?”

On a different topic, it might be, “I have high cholesterol. Should I start taking aspirin daily?”

I tried to keep my question fact-based: Would someone recovering from ankle surgery have to keep his foot above his heart in order to reduce swelling, or is it sufficient to keep it above his hip?

Basically, I’m looking for the GQ factual answer on keeping swelling down. I’m not asking for anyone to tell me what to do or advise me.

I agree it’s a close call, though.

14

I searched Pubmed and found this:

Send to:
Taiwan Yi Xue Hui Za Zhi. 1989 Jun;88(6):630-4, 628.
[The effects of leg elevation to reduce leg edema resulting from prolonged standing].
[Article in Chinese]
Liaw MY, Wong MK.
Abstract
In order to find the most comfortable and effective posture to reduce lower leg edema, 31 young women working in Chang Gung Memorial Hospital, ages ranging from 20 to 40, were studied by the volumetric displacement method with leg placed in a specially designed container. The effects of five different angles of leg elevation on reduction of leg edema were separately evaluated in 5 days. For each evaluation, two measurements of volumetric displacement of lower leg edema were performed after prolong sitting or standing of more than 4 hours, and at the end of 15 minutes of supine lying (angle of leg elevation = 0 degrees), or after the leg was elevated in an angle of 30 degrees, 45 degrees, 60 degrees, or 90 degrees respectively. A good correlation was found between the displaced volume and increasing angle of leg elevation (regression line Y = 99.109-0.016X, r = -0.96). There was a significant difference between leg elevation of 90 degrees and supine lying (t = 3.01, p less than 0.01). The degree of comfort in leg elevation was in the order of 30 degrees, 45 degrees, 60 degrees, 0 degrees, 90 degrees. Many subjects complained of numbness and throbbing pain over the lower legs or pain at the buttocks in the upright leg elevation to 90 degrees posture, but felt rather comfortable in the 30 degrees posture. Seventeen of these subjects were further studied for the degree of comfort in leg elevation at 30 degrees for 30 minutes as compared with those of 30 degrees, 15 minutes and 90 degrees, 15 minutes.(ABSTRACT TRUNCATED AT 250 WORDS)
PMID: 2794965 [PubMed - indexed for MEDLINE]
Share on FacebookShare on TwitterShare on Google+

15

My personal anecdote from a recent leg injury that has caused circulation problems: higher is better. Anything that gets the foot off the floor is better than nothing. Above the hip is better than that. Above the heart is better still.

16

Makes sense. Thanks everyone!