Well the short answer is it takes a music file, and removes all the unnecessary information that makes it sound good, and turns it into something short and hissy enough to fit onto your iPhone or Google phone, if that’s your thing. Wait, sorry, wrong blog. Let’s talk about compression in all its glory as it relates to my NYC podiatry patients, with a special shout out to David who asked the title question above and inspired this most inspired post. This is a rather large topic- engorged, one might say. The good news is, like an MP3 file I can remove all redundant and unnecessary data, and present the information in compressed format.

Compression is the act of gently squeezing a body part with various gradients of pressure either for treatment of acute or chronic swelling or to optimize function. And since I am sitting on an airplane on my way to the west coast to see Trey play with the remains of the Grateful Dead in Santa Clara (I’ll be knocking on the golden door - right Deadheads?) it would seem fitting to cover compression for acute and chronic swelling.

Inflammation is a common expression of the physiologic repair process that happens after an acute event such as after foot or ankle surgery, or an injury such as an ankle sprain or fracture. The hallmark of inflammation is swelling. And as my NYC podiatry patients know, swelling in the foot can be annoyingly slow to resolve. By applying compression in the form of a bandage, the fluid is managed and controlled, thereby allowing the body to heal. I think we all know about RICE by now - and the “C” stands for - wait for it - compression. The exact mechanism is not entirely clear, but it seems that as fluid leaks out of blood vessels as part of inflammation, the tissue becomes distended, and compression reduces the distention and pain.

Swelling can also be a chronic process such as in venous or lymphatic disease. The fluid that accumulates in the legs is heavy - imagine having a bottle of water strapped to your legs. By wearing compression stockings, the fluid is forced back toward the heart, thereby helping the veins or lymph channels, which may be incompetent or contain valves that no longer work properly. Compression can also prevent blood clots in the legs, which can occur when sitting for long periods of time in cramped spaces, or after any period of prolonged immobilization. And as many of my NYC podiatry patients know, deep vein clots of the leg can potentially break off and lodge in the lung, which can be potentially fatal. Nice to think about on the plane.

So kids, hope that helps shed some light on the topic of compression therapy. Tune in for next week’s exciting episode when we will discuss compression garments for runners - performance enhancer or socks for sissies? Now that this is over, nothing left to do but smile, smile, smile, and thank you for a real good time.

See you in the office (but not tomorrow or Tuesday, I’ll be preaching on the golden shore).

Ernest Isaacson