By Professor Elizabeth Dean
Professor Dean is head of the Post Polio Clinic at the University
of British Columbia
Swelling in the legs is a common complaint of polio
survivors. Muscles act like a pump. When they contract, blood returns
to the heart after being pulled downwards by gravity. Legs with
muscle weakness or paralysis have less capacity to perform this
pumping action, either when you are walking or when you contract
these muscles in the sitting position. Swelling in the legs can
be a serious problem for several reasons. First, engorgement of
tissue with fluid can be uncomfortable, making clothing fit difficult;
it can become chronic and it is important to bring it to your doctors
attention. Here are some things to try to reduce leg swelling after
your doctor has ruled out other causes.
If you are able, move your ankles up and down when
you are sitting, and bring your knee up towards your chest. These
movements will be helpful.
If you are unable to actively move your leg, a family
member or friend can passively move the leg for you, so your hip
and knee bends; this is best down when you are lying down so the
fluid can move towards your chest cavity more easily. The leg should
be moved in a rhythmic fashion.
Put your feet up whenever you are sitting down.
Dont be proud just ask for a stool or another chair.
Before long, people will be anticipating your request and have one
waiting for you when you sit down. When you lie down for a rest
or sleep, put pillows under the leg so that it is higher then your
Have a family member massage your leg so the fluid
moved up towards your heart. Again, this is best done when you are
in a lying position so the fluid can move towards your chest. This
massage should not be vigorous, as tight swollen skin is more at
risk of abrasion, breaking down, inflammation and cellulitis. The
leg should not be massaged if skin breakdown or redness is present.
Avoid restrictive clothing, including corsets, tight
underwear, tight socks and shoes. Consider support stockings (for
both men and women) that extend up over your knee. If you have extensive
swelling, the stocking will have to go up to your groin; otherwise
ballooning of the fluid will occur where the stocking
ends. These stockings must be properly fitted by a physiotherapist
to ensure that they are an appropriate fit, that they are not too
loose or too tight, and to teach you how to apply it so it does
its job properly, when to wear it and how to take care of it. It
is important that you wear it for a period of time, then take it
off for a period of time and then reapply it.
Passive mobilizers of the legs are available as
well as what is called an intermittent pneumatic stocking. These,
however, are not typically available to the public, but may be used
by a therapist if your swelling is extensive or does not resolve
the problem with suggestions above.
If you are a diabetic or have glucose intolerance,
your skin is even more at risk of breakdown and infection. Your
doctor should be following your closely. Both your doctor and physiotherapist
should make recommendations regarding foot care.