Pedi-Care

11/04/2025

Edema series #2: Available Treatments

Regardless of the cause of lower extremity edema, the basic treatment is the same.

Compression: Stockings or wraps. Elevation: Sitting or laying with one's feet raised, preferably higher than the level of the heart, several times per day. Exercise: Walking and leg exercises to keep muscles strong and to move fluid back up and out of the legs. Sodium Reduction: Maintaining a low sodium diet. Medication: The use of diuretic medication to remove water from the body.

When these simple interventions do not do the job, Complete Decongestive Therapy (CDT) is the gold standard for treating edema. This treatment is performed by a trained physical, occupational, or massage therapist or nurse. This type of treatment includes both a treatment phase and ongoing self care. The treatment phase takes several weeks and involves manual lymph drainage massage, compression bandaging, and education on skin care and exercise training.

Another treatment used is Intermittent Pneumatic Compression Therapy (IPC). IPC involves a pneumatic sleeve being applied to the leg which inflates and deflates sequentially applying pressure to encourage fluid absorption. IPC can be used in both treatment and self-care phases. Selection and use of IPC should be done in consultation with a trained CDT therapist.

Jennifer Ryan, RN, CFCN

09/08/2025

Edema Series #1 Why are my feet swollen?

I am often asked by clients “Why are my feet swollen?" This is not a simple question.

The first step in dealing with edema is to identify the cause. It is best to consult with a medical provider and if the cause can not be simply eliminated, referral for edema therapy for management is appropriate.

Lower extremity edema refers to swelling in the legs, ankles, or feet due to the accumulation of excess fluid in the tissues. This condition can result from a variety of causes, ranging from benign to serious underlying health issues.

One of the most common causes is venous insufficiency, where the veins in the legs struggle to return blood to the heart efficiently. This leads to fluid leaking into surrounding tissues. Prolonged standing or sitting, especially in hot weather, can also cause temporary edema due to gravity and blood pooling. Injury or surgery involving the leg, ankle, or foot can also cause swelling.
Heart failure is a more serious cause, particularly when the right side of the heart is affected, leading to fluid backup in the lower body. Similarly, kidney disease can result in the body retaining excess sodium and fluid, contributing to swelling. Liver disease, such as cirrhosis, may reduce the production of proteins like albumin, which help keep fluid in the blood vessels. Other contributors include medications, infections, blood clots, and lymphatic obstruction.

Treatment and management are necessary to prevent secondary conditions such as sores and infections. Once the reason for edema has been found, treatment can begin.
Jennifer Ryan, RN, CFCN, CFCS

https://medlineplus.gov/ency/article/003104.htm
https://www.med.umich.edu/1libr/Homecare/MVN/LEEdema.pdf
https://www.mayoclinic.org/diseases-conditions/edema/diagnosis-treatment/drc-20366532

Learn about symptoms, causes and treatment of swelling caused by too much fluid in body tissues.

05/22/2025

Kick Off Your Shoes!

Kicking off your shoes is not just relaxing; it may be good for you. Going barefoot helps to strengthen the muscles in your feet, encourages better posture, and stimulates nerve endings, all things important for balance. Balance is a complex process that involves the brain, muscles, peripheral nerves, specialized sensors in tendons, equilibrium sensors in the inner ear, and the visual system. Constant messaging between these systems allows continuous adjustment of body position to maintain balance. If the nerves of the foot are never given stimulation they may grow “lazy” and may not pass on information well.

Walking barefoot on natural surfaces like grass, known as "grounding," it can reduce stress, improve circulation, and enhance your connection to nature. Many people find it calming and mentally refreshing.

While all this sounds great, I am not suggesting that you throw away your shoes and orthotics and go for it! If you are never barefoot the transition to barefooting must be slow and best done with the guidance of a medical professional. But how about adding some safe barefoot time? When seated in a chair there is no reason not to touch the floor or the ground with bare feet. It is important to take a moment and involve your brain, think how the surface feels, rough or smooth, warm or cold, damp or dry? Encourage your brain to pay attention to what your feet are telling it. If this goes well, you can progress to doing this while weight bearing.

While it’s not always practical everywhere, adding some barefoot time into your daily routine—especially outdoors—can offer health and wellness benefits. Jennifer Ryan RN, CFCN

01/28/2025

Sometimes, it’s the soap.

Most days that I work at least one person will ask me what moisturizer is best to put on their feet. Although this seems a simple question, it is not. Skin differs, and what works well to moisturize for some, does not for others. In general, feet like a product that is more heavy or “greasy”. Aquaphor Healing Ointment is a glycerol-based emollient that I see a high success rate with.

An important factor of dry skin prevention that is often overlooked is what soap is used. Many soaps are harsh on the skin and remove natural oils. If the natural oils are not stripped away skin will remain healthier. It is important to avoid soap with artificial fragrance and color. Antibacterial soap may be fine for handwashing but is not needed for bathing. Brands to avoid are Dial and Irish Spring.

The original Dove bar soap contains no parabens or sulfate cleansers. It is also pH-balanced to help skin retain natural moisture and has a moisturizer in it. Many liquid soaps are a better choice than bar soap as they most often have moisturizers and a balanced pH. Remember, all types of soap, whether liquid or bar, are composed of the same essential ingredients- alkali salts, fatty acids and detergent. When selecting a body soap, check the label for such words as Ph balanced, emollient and moisturizing. Soap should be used sparingly. Running water will remove most debris and germs from your skin. You need not lather up from head to toe.
Jennifer Ryan, RN, CFCN