Patients with venous leg ulcers (VLU) often have swollen ankles. They also tend to have a restriction of movement of their ankles. This is very important for patients with leg ulcers.

To recover from a venous leg ulcer, the calf pump needs to work and this means the ankle needs to be as mobile as possible.

The more the ankle moves, the more the calf pumps blood out of the lower leg. This helps reduce swelling at the ankle and helps heal a venous leg ulcer.

Reducing ankle swelling decreases pain and increases range of ankle movements in Venous Leg Ulcers

Reducing ankle swelling decreases pain and increases range of ankle movements in Venous Leg Ulcers

The movement at the ankle is called the Ankle Range of Movement (AROM). This is measured with a simple device called a Goniometer.

A study looking at AROM and how this relates to leg pain and leg swelling in patients with venous leg ulcers has recently been published.

The study was admittedly very small, only involving 10 patients and over four weeks treatment for each. However, it did show some significant results.

This study showed that as ankle swelling reduced with compression bandaging, the range of movement at the ankle improved (AROM) and the leg pain reduced.

This increased mobility of the ankle will, if the patient walks and exercises, increase the calf pump. This will further reduce the ankle swelling and should help to heal the ulcer.

Unfortunately, because this study was only four weeks in duration, it did not show an improvement in ulcer healing.

However, longer studies will almost certainly show that benefit.

What this means for patients with venous leg ulcers:

This study shows that if patients with venous leg ulcers have swollen ankles, compression bandages or compression stockings that reduce the swelling will improve movement at the ankle. This should help increase mobility and more importantly get the vein pump working more normally again. An additional benefit was that leg pain also reduced making the leg more comfortable.

This suggests that getting the swelling out of the ankle in such patients should help leg ulcer healing. Further research is needed to prove this but this helps show that compression is an important part of the leg ulcer treatments, even with the new surgical treatments that are becoming available.

The Leg Ulcer Charity is committed to monitoring research and to help patients identify the best treatments to get their leg ulcers cured.

Reference: Fox JD, Baquerizo-Nole KL, Freedman JB, Liu S, Van Driessche F, Yim E, Kirsner RS. Ankle Range of Motion, Leg Pain, and Leg Edema Improvement in Patients With Venous Leg Ulcers. JAMA Dermatol. 2016;152(4):472-474. doi:10.1001/jamadermatol.2015.5637.

See: https://archderm.jamanetwork.com/article.aspx?articleid=2484643