The importance of looking after your legs and Lymphedema treatment for people living with a neurological condition

When living with a neurological condition such as multiple sclerosis and cerebral palsy, caring for your skin – especially on your lower limbs – can be challenging, but it’s never been more important. Neglecting it can lead to serious complications. 

At MSWA, we often see Clients with reduced mobility, which can cause swelling in the lower limbs. Why, you may ask? Well, the calf muscle is said to be our second heart. When our calf muscles contract, they pump blood up our legs back to the heart through one-way valves in the venous system that prevent backflow. 

When someone doesn’t move around as much, their calves don’t pump effectively. This, in conjunction with spending prolonged periods in a gravity dependent position (often a recliner or wheelchair) leads to pooling of blood in the veins, increasing venous pressure and forcing fluid from the blood into surrounding tissues which results in swelling. 

Swelling creates unnecessary space between the skin and its blood supply. This reduces oxygen and nutrients reaching the skin and makes it harder to clear waste products. Over time, we start to see skin changes such as thickening of the skin because chronic inflammation and poor circulation lead to fibrosis and loss of hair as hair follicles aren’t getting the nutrients they need. 

To some, smooth hairless skin might sound appealing but trust me, this is not the way you want to achieve it!  

Ever wondered why some people have dark brown marks on their lower legs? When blood pools in the veins, pressure can build up so much that it forces not just fluid but also red blood cells out into surrounding tissues. 

Red blood cells can’t survive there, so they break down. One byproduct of this process is haemosiderin (a protein that stores iron), which deposits under the skin and causes a brownish colour.  

If you’re like me and often find scratches or bruises you can’t explain, listen up – this is important. Skin has certain requirements to heal. When swelling acts as a barrier between a wound and its blood supply – and if you have diabetes or other health conditions – the risk of developing hard-to-heal or even non-healing wounds increases.  

Wounds can get quite large and can be very painful and debilitating. When you consider the fact that your skin is a living, protective barrier, a wound is like an open house party – you’ll have all sorts of no-good characters dropping in. This can lead to infection or, in severe cases, sepsis if bacteria enter the bloodstream. It’s important to keep swelling under control (and try to protect your skin). 

When living with a disability, your legs and feet often don’t get the attention they need. If you have reduced flexibility, muscle weakness, dizziness when bending, or simply lack the energy, it can be hard to maintain proper hygiene. 

Legs and feet may not get properly washed or dried (which is just as important because moisture can lead to fungal infections like tinea). Combine that with the fact that as we age, our oil glands produce less oil which is essential for retaining moisture and you’ve got a recipe for trouble. 

MSWA Lymphoedema Clinics provide specialised services to help you maintain healthy legs. This includes: 

• Prescription for compression wear 
  We assess your needs and prescribe the most appropriate compression garments to manage swelling effectively.
• Personalised care plans 
  We create an individualised care plan for you that outlines all the strategies needed to look after your legs, which covers skin care routines, swelling management, hygiene practices and mobility tips.
• Education  
  We provide comprehensive education for you, your family and support workers, that goes beyond garment application. This includes:
• Helping you understand your care plan and the rationale behind each strategy, so you know why these steps matter.
• Practical training skills, such as how to don and doff compression garments safely and effectively, and how to assist with hygiene and skin checks.
• Guidance on recognising early signs of swelling, redness, or infection to prevent complications. 

We also educate you and your support network about the importance of routine podiatry appointments every 6–8 weeks to maintain toenail health and prevent issues like fungal infections or ingrown nails. 

Our goal is to empower you with the knowledge and tools to keep your lower limbs healthy, reduce complications, and improve your quality of life. 

If you or someone you care for is living with a neurological condition, prioritising lower limb skin health is essential. Contact the MSWA Physiotherapy team to learn more about our services and how we can help you create a personalised care plan.