Leg Swelling and Circulation Issues After Injury and Long Sitting

Swelling in the calf with a sensation of poor blood circulation?

Hello, doctor.
In the past year, I have had to sit for long periods due to my studies.
The year before, I worked part-time, which required me to stand for at least two days a week for 6 to 8 hours.
After a long-haul flight (about 10 hours) back home at the beginning of this year, I noticed that my calves were prone to swelling.
In mid-August, I accidentally fell down about three steps and injured both of my knees, but I did not get any examinations because, although I directly hit my knees, they only appeared to have abrasions and swelling.
Since then, when sitting, I have experienced numbness and a slight burning sensation in the muscles above my knees (mostly on the inner side), and my calves feel a bit swollen.
Sometimes, after standing or walking for too long, I also feel a burning sensation near my knees.
However, the numbness and swelling while sitting improve slightly after massaging the area above my knees and my calves.
Recently, I feel that the symptoms have worsened, and I have a sensation of poor blood circulation (it feels more severe in my right calf).
Specifically, I feel that the blood flow in the soles of my feet is restricted, which usually occurs whenever I sit.
This sensation typically starts in the afternoon and continues until I go to bed, but the symptoms are less noticeable when I wake up in the morning.
However, by noon, I again experience the feeling of blood being obstructed.
Could you please tell me what might be causing this? Could it be deep vein thrombosis, or is it related to my knee injury?

Ning Ning, 20~29 year old female. Ask Date: 2016/11/02

Dr. Li Han reply Cardiology

Hello, based on your description of swelling in the calves, a burning or tingling sensation in the muscles above the knees, and a feeling of poor blood circulation in the lower limbs, I believe that if these subjective symptoms have been bothering you for some time, it would be advisable to consult a hospital for medical advice.
The condition may not be as serious as you suspect, and a simple physical examination or diagnostic assessment could alleviate your concerns.
The Changhua Hospital of the Ministry of Health and Welfare cares about your well-being.

Reply Date: 2016/11/02

More Info

It sounds like you are experiencing a range of symptoms related to your legs, particularly after a history of prolonged sitting, standing, and a knee injury. Your concerns about swelling, numbness, and a sensation of poor circulation are valid and warrant a thorough understanding of the underlying mechanisms.

Firstly, prolonged sitting or standing can lead to venous stasis, where blood flow in the veins slows down, potentially causing swelling in the lower extremities. This is especially true if you are not moving around frequently, as muscle contractions help pump blood back to the heart. In your case, the long hours of sitting for schoolwork and standing for work could contribute to this issue.
Additionally, your recent long-haul flight may have exacerbated the situation. Air travel is known to increase the risk of deep vein thrombosis (DVT), a condition where blood clots form in the deep veins of the legs due to prolonged immobility. Symptoms of DVT can include swelling, pain, and a feeling of heaviness in the affected leg. The fact that you have experienced swelling and a sensation of poor circulation, particularly in your right calf, raises the possibility of DVT, especially since you mentioned a history of trauma to your knees.

Your knee injury from falling down the stairs could also be a contributing factor. Even if there are no visible signs of severe injury, trauma to the knee can lead to inflammation and swelling in the surrounding tissues. This inflammation can compress nearby nerves and blood vessels, leading to symptoms such as numbness, tingling, or a burning sensation in the legs. The fact that you feel some relief from massage suggests that there may be a muscular or soft tissue component to your symptoms.

Given your symptoms and history, it is essential to consider a few key points:
1. Deep Vein Thrombosis (DVT): While your symptoms could be related to venous stasis or inflammation from your knee injury, DVT is a serious condition that requires immediate medical attention. If you experience sudden swelling, pain, or discoloration in your leg, especially if it is accompanied by shortness of breath or chest pain, seek emergency care.

2. Knee Injury Evaluation: Since you mentioned that you did not seek medical attention after your fall, it may be beneficial to have your knee evaluated. An assessment can help determine if there is any underlying damage, such as ligament injuries or meniscus tears, which could be contributing to your symptoms.

3. Circulation and Nerve Compression: The sensations of numbness and burning could indicate nerve compression, possibly due to swelling or tight muscles around the knee and calf. Physical therapy may help address these issues by improving circulation and reducing inflammation.

4. Lifestyle Modifications: To alleviate some of your symptoms, consider incorporating regular movement into your daily routine. Simple exercises, stretching, and walking can help improve circulation and reduce swelling. Additionally, elevating your legs when sitting or using compression stockings may help manage swelling.

In conclusion, while your symptoms could be related to a combination of factors including prolonged sitting, a knee injury, and possibly DVT, it is crucial to consult a healthcare professional for a thorough evaluation. They may recommend imaging studies or blood tests to rule out DVT and assess your knee injury. Early intervention can help prevent complications and improve your overall leg health.

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