I’m not looking for medical advice, but simply an explanation of this phenomenon. Toward the end of July, I fractured one of the fifth metacarpal bones of my right foot. I’ve been in a cast or splint for 7 weeks now (it comes off in 4 days, yay! ).
When the injury was new, and while the surgery site was healing, of course there was inflammation and swelling. However, the healing process seems to have gone very well, and x-rays look good.
Nevertheless, when I “stand” with the crutches for a long period (without putting weight on the injured foot), my toes and foot still swell. How come? This doesn’t happen to my uninjured foot – but the foot in the cast is, by this time, also basically uninjured, so I don’t think the swelling can be a response to the trauma any more.
My best guess is it’s because the foot and ankle are still immobilized, so the circulation is poor in that foot. If that’s a correct guess, will the swelling probably cease once I can move the foot and ankle normally again? And why would poor circulation result in temporary swelling?
Absent active measures, blood & lymph will pool in your lower extremities due to gravity. Your body has what amount to small check valves and mechanical pumps embedded in your plumbing down there. As you move, they act roughly like an old-fashioned hand-operated well pump to lift fluid upwards.
Even flexing & relaxing the muscles in your foot & leg will have a pumping effect. Not so great as standing, walking, or running, but some effect.
You just letting the immobile foot hang there is a very different situation than the other foot that’s supporting you while that foot’s muscles are continuously actively adjusting to keep you upright. If you chose to hang by your arms from a chin-up bar for an hour the two feet would swell similarly. At least after you adjusted for the head start your injured foot already has.
Folks trapped in restrictive airline economy seating for very long flights experience considerable temporary edema unless they take active measures to exercise their legs & feet. Your situation is similar except instead of 12 hours it’s been 7 weeks.
If your doc says it’s ok, you can start flexing muscles inside your cast (wiggling your toes, tightening then relaxing foot, calf and ankle). I was in a cast for several months last year (broken ankle) and I was encouraged to do this. It might help with the swelling.
Yes, it does – you just don’t notice it because that foot is not constrained by a cast. (Also, putting weight on the good foot, and using the muscles in it to walk will improve the circulation, and move the blood along somewhat.)
Most people have feet with (slightly) different sizes, anyway. On new shoes, one foot is usually tighter than the other*. Doesn’t really matter, since leather & other shoe material stretches a bit anyway. It’s more noticeable in boots. Some people have differences in foot size of a half-size or more – they may need to have custom boots made.
*In my experience, it’s opposite the hand – right-handed people have a slightly larger left foot.
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