Why is This Swelling Worse During the Summer?

by Amelia Mitchell, LMT

EDEMA AND FLUID RETENTION CAUSES AND TREATMENT

Summer, especially when it is very hot and humid can be challenging for all of us, and yes, edema does develop more easily when we are hot.

You may have noticed your hands or feet feeling a bit tight or swollen when taking an evening walk on a summer day. What is happening is that the body is circulating more blood out to the limbs to cool itself down.

Unfortunately, sometimes this natural process of cooling can leave some extra fluid behind for a bit. For many the swelling will resolve itself quickly as soon as they cool off. In general, if this only happens occasionally, and clears overnight or sooner, there is not too much to worry about.

For those with a compromised lymphatic or venous system, or some other health challenges, the body is less able to clear the fluid and a more lasting swelling/edema can result. If you regularly have swelling of the feet, ankles, calves, or legs then looking into causes and treatments is a smart choice for the long term health of the effected area.

Swelling isn’t only uncomfortable, if an area stays swollen, or gets increasingly swollen, the health of the tissue can be challenged. The interstitial spaces can get stretched out, the body is less able to respond to infections or injury, and there is risk of a more serious condition called lymphedema developing.

If you regularly experience heavy, swollen, puffy, or tight feet or legs it is time to consult with a specialist. There are a couple of reasons that this may be happening and finding a cause is a smart first step, although even if a cause cannot be found, reliable treatment methods are available. 

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​CAUSES OF SWELLING - EDEMA

​VARICOSITIES – VENOUS INSUFFICIENCY
For most people experiencing swelling, this is a cause or a contributing factor. Gravity is the biggest challenge to circulation in the legs. Varicose veins (varicosities) can develop both at the surface and deeper in the leg; and while many find them unsightly, the real issue is a gradual failure of the valves and walls of these large veins. When this happens, venous blood does not move out of the legs as easily. With a reduced level of circulation, fluid is not removed from the interstitial (between the cell) spaces as efficiently. This leads to swelling, known medically as edema. The lymphatic system provides a boost and generally moves 10-15% of interstitial fluid, however as varicosities worsen, the load increases and can overwhelm the lymphatics. Treatment of varicosities is required for relief and long-term health of the legs in this case. For most people experiencing swelling of their legs, diagnostic sonograms of their legs is an important first step in treatment.
 
SURGERIES – INJURIES - LYMPH NODE REMOVAL
Edema and Lymphedema can develop at any time when a person has lost lymph node(s) due to surgery, illness, or disease. Once lymph nodes are gone, they do not re-grow and the lymphatic system must re-route the lymphatic fluid through different pathways. This is often a delicate balance and one extra stressor can bring on swelling/edema. Surgery or injuries on the legs can also damage the local lymphatics and do cause long term swelling for many. Often it is more localized, like an ankle that was once broken is more prone to swelling after a long day.
 
CHRONIC OR SEVERE ILLNESS
Heart conditions are a primary concern, in general one is aware of heart issues before swelling occurs due to an inability to fully move blood from the legs. Many medications can cause edema, and this side effect always needs to be balanced against the other benefits. Edema can also develop in severe illness if the body is depleted in proteins or other nutrients. In all these circumstances, medical intervention is the first step, with support to manage the condition to follow.
 
PRIMARY LYMPHEDEMA
A small number of people were born with a lymphatic system that doesn’t work properly. Often they will reach their teens or adulthood with no outward symptoms, and will one day develop edema often moving quickly to lymphedema. While relatively rare, primary lymphedema is a diagnosis that is given when no other reasons can be found. Care and treatment is the same.
 
Often for any cause, there is a genetic factor. If you are aware of other family members having issues with swelling, that is probably the case for you as well.

TREATMENT AND TIPS

• Have a plan to keep cool on very hot and humid days
• Treat underlying conditions such as varicosities or other challenges
• Hands on Therapy – Lymph Drainage Therapy or Manual Lymph Drainage with trained therapist
• Compression hose and in some cases,  bandaging is an important treatment. Discuss with a specialist
• If you wear compression, the heat of the summer is a time to be even more careful about wearing them daily
• A therapist may also apply Kineseotape to assist your body in moving fluid
• Elevate your legs - up on a footstool, legs up the wall from yoga, lay down, or rest in a recliner
• Pools are great places to cool off
• Participating in movement that you enjoy is important when you are able
  • Walking, yoga, Pilates, light aerobics, dance, water aerobics, swimming, ballet, and cycling are all recommended. If you are doing weight training build up slowly
  • If you are working with a trainer, be sure they have proper training and fully understand your situation.
  • A trainer focused on pushing for performance, weight loss, diet, or extreme fitness is probably not a good fit.
• ​Always keep an extra watch on areas that are swollen. Infection can spread more quickly, keep the areas clean and seek medical attention if anything becomes red, hot, or more swollen.

​This is simply an introduction to the topic of edema and swelling. If you are experiencing challenges, please make an appointment to see your doctor or a specialist. At Alchemy, Amelia Mitchell, LMT, LLCC, BCTMB is a certified Lymphedema/Lymph Drainage Therapy specialist and can consult on your situation and provide treatment. Amelia will also make referrals to other medical professionals as appropriate.