Tubigrip

This factsheet is for people who wear compression stockings, or who would like information about them. We are not selling this product.

Compression stockings help maintain circulation in the leg veins and reduce leg swelling. They are used to treat leg ulcers and varicose veins, and to help reduce the risk of blood clots forming in the veins of the legs (deep vein thrombosis, DVT).

  • About compression stockings
  • How do compression stockings work?
  • Wearing compression stockings
  • How to put on compression stockings
  • Caring for your compression stockings

About compression stockings


Compression stockings (also called graduated compression stockings) can be used to prevent as well as treat a number of conditions that affect the circulation in your body.

  • DVT. This is a blood clot in a deep vein, usually in the leg. If the blood clot breaks loose, it can travel to your lungs and block a blood vessel there (this is known as a pulmonary embolism).
  • Varicose veins. These are swollen veins that lie under your skin (superficial veins) that look lumpy and dark blue or purple through your skin. They usually affect your legs, particularly your calf and sometimes your thigh, and are caused by damaged valves in your veins.
  • Venous leg ulcers. These are areas of skin loss (lesions) usually near your ankle. They are caused by problems with the valves in your leg veins.
  • Fluid build-up in your legs (oedema). This can be caused by problems with the veins in your legs and can also occur during pregnancy.
Tubigrip
Compression Stocking

How do compression stockings work?


Compression stockings work by putting pressure on the veins in your leg. They are called graduated compression stockings because the pressure is greatest at your ankle and reduces further up your leg. When you walk or exercise your legs, compression stockings help the natural pump mechanism of the muscles in your leg to improve your circulation.

Compression stockings are available in several sizes and lengths. They are also available with different strengths of compression; class one to three. Class one stockings apply the least amount of pressure and class three stockings apply a much higher pressure. Your GP will advise which strength is appropriate for you.

Wearing compression stockings


For them to be effective, you need to wear your stockings constantly during the day. Usually you should take them off before you go to sleep, but your doctor may advise you to wear the stockings at night. Take them off every day to wash your legs and check the condition of your skin.

When checking your skin you need to look out for:

  • sore marks at the top of your legs
  • blisters or discolouration, especially on your heels or ankle bones

If you spot any of these signs, or if you’re worried, don’t put your stockings back on and talk to your GP.

Take care to prevent your skin becoming dry by applying an emulsifying cream to your legs. Your GP can recommend creams that are appropriate for you.

How to put on compression stockings


There are different lengths of compression stockings that fit your leg differently.

  • Knee-high stockings – these should sit below your knee.
  • Thigh-high stockings – the top of the stocking rests below your buttocks.
  • Waist-high tights – the body part of the stockings rests on your waist and the seams run vertically up the front of the garment.

Compression stockings are tighter at the foot than higher up the leg. They are difficult to put on and take off so you may need someone to help you with this. You will need to:

  • insert your hand into the stocking as far as the heel pocket and turn the stocking inside out
  • carefully slip your foot into the foot portion and ease the stocking over your heel – make sure your heel is centred in the heel pocket
  • bring the rest of the stocking over your heel and up around your ankle and calf – don’t pull the stocking, instead use the palms of your hands to gently massage the stocking up your leg
  • smooth out any creases and never roll down your stockings while wearing them – this can affect how well they work and may restrict blood flow through your legs

To help blood flow in your legs, don’t sit or stand still, or lie in bed for long periods. Take regular walks around the house and do gentle foot and ankle exercises when sitting down.

Caring for your compression stockings


You may need to wear your stockings for several weeks so it’s important that you take care of them and wash them regularly. Make sure you have a spare set to wear while the others are being washed.

Always ask your GP or nurse for advice and follow the manufacturer’s instructions that come with your compression stockings.

Typical care instructions are:

  • machine or hand-washing in warm water, at a maximum of 40°C, every two to three days
  • not wringing the stockings as this may damage them
  • letting them dry naturally as the heat from a tumble dryer may damage the elastic
Platelet Separated From Own's Blood

What is PRP – Platelet Rich Plasma?


Platelet Separated From Own's Blood
Platelet Separated From Own’s Blood

The human body has a natural ability to heal itself from most injuries. A large part of this ability lies in the healing potential of the many growth factors found in our platelets, a component of human blood.

The recent advancement in separation and concentration of a patient’s blood platelets for injection into his damaged body part, is an amazingly elegant tissue regenerative technology.

Although it involves the drawing of a small tube of a patient’s blood, and the injection of the treated body part with his concentrated platelets, the ability to heal his injured muscles, tendons, and other body parts make this a very promising treatment option for many patients.

Platelet rich plasma (PRP) is derived directly from your own blood. PRP is a blood plasma with concentrated platelets. Contained within platelets are high concentrations of bioactive active proteins that aid in healing, including growth factors which are necessary to initiate connective tissue healing. With concentrated amounts of these proteins in an injured area, healing and tissue repair is accelerated. Healing can occur in various tissues including tendons, ligaments, muscle and bone. Along with tissue repair the regeneration process also stimulates new blood vessel growth which also promotes the wound healing process.

Where Does Platelet Rich Plasma – PRP Come From?


A small amount of your blood (30-60 cc) is taken from your arm. The blood is then placed in a special kit and centrifuged. The centrifuge processes the blood, extracting the PRP, leaving the excessive plasma and red blood cells in the container. The PRP is a concentration of platelets and growth factors, concentrated up to 500%.

Injuries are prevalent in sports, and athletes often have to take time off for surgery and rehab.

Platelet Rich Plasma Therapy helped Tiger Woods’ left knee.

It is available right here in Singapore Sports and Orthopaedic Clinic. It’s done right in the clinic, and you don’t have to be an athlete to benefit.

Platelets have long been known to help the blood clot, but in the last 20 years research has shown that when activated in the body, they release healing proteins called growth factors.

In addition to tennis elbow, platelet-rich plasma therapy can also be used for problems with the Achilles tendon and knee and heel pain, and is also showing promise in treating osteoarthritis.

Epidural Injection

An epidural spinal injection is a non-surgical treatment option that may provide either short- or long-term relief of radiating back pain.

When spinal nerves become irritated or inflamed due to a degenerative condition in the spine that is causing nerve compression, such as a herniated disc or spinal stenosis, the result may be severe acute or chronic back pain, as well as pain, numbness and muscle weakness that extends elsewhere into the body, such as the hips, buttocks or legs. Before your doctor considers spine surgery to relieve these symptoms, he or she will most likely recommend one or more non-surgical treatment measures. An epidural spinal injection is one of these options.

What is an Epidural Spinal Injection?


An epidural spinal injection involves delivering anti-inflammatory medication—typically a steroid combined with an anaesthetic—directly into the area around the irritated spinal nerves that are causing the pain. This area is called the epidural space, and it surrounds the sheath-like protective membrane—or dura—that covers the spinal nerves and nerve roots. Steroids reduce nerve irritation by inhibiting production of the proteins that cause inflammation; the anesthetic blocks nerve conduction in the area where it’s applied, numbing the sensation of pain.

How does an Epidural Injection work?


An epidural spinal injection may be done either for diagnostic or therapeutic reasons:

  • By injecting medication around a specific nerve root, your doctor can determine if that particular nerve root is the cause of the problem.
  • When administered for therapeutic reasons, a spinal epidural injection may provide long- or short-term relief, anywhere from a week to several months. In some instances, an epidural spinal injection may break the cycle of inflammation and provide permanent relief.

How Is An Epidural Spinal Injection Administered?


Epidural Injection
Epidural Injection

An epidural spinal injection is generally done on an outpatient basis, either at our doctor’s clinic or local hospital or medical center, and the procedure typically involves:

  • Positioning the patient to give the doctor clear access to the area of the spine to be treated.
  • Wiping the skin with an antiseptic to clean the area where the epidural needle will be inserted;
  • Injecting a local anesthetic to numb the injection site;
  • Injecting the steroid/anesthetic medication into the epidural space; and
  • Removing the needle from the epidural space, wiping the injection site with an antiseptic and covering it with a bandage.

The procedure typically takes 15-30 minutes. After the procedure, you’ll be monitored for about 30 minutes in the recovery room. You should avoid any strenuous activities for the rest of the day following your procedure.

After your injection, you may experience some numbness in your arms or legs. This is a temporary side effect associated with the anesthetic component of the injection, and it typically subsides within 1 to 8 hours. Your pain also may increase over the following 24-48 hours; it generally takes 24-72 hours for the pain-relieving benefits of a spinal epidural injection to take effect.

Is Epidural Injection Safe?


It can be used to provide pain relief during childbirth, what’s more to say.

Call +65 64712674 for an appointment for Epidural Injection. Same day appointment.

Orthopaedic Surgeon Dr. Kevin Yip

What is arthroscopic knee surgery (keyhole surgery)?

It is usually a day case surgical procedure in which the inside of the knee is examined with a camera inserted through small cuts in the skin (usually one cut on each side of the knee cap). In most cases, performing the corrective surgery at the same time can solve the problem. In some cases further operation may be required.

Orthopaedic Surgeon Dr. Kevin Yip
Orthopaedic Surgeon Dr. Kevin Yip

When should I have an arthroscopy?

In the majority of cases, surgery for torn ACL (Anterior Cruciate Ligament), torn meniscus, removal of a loose piece of bone, biopsy and articular cartilage lesions can be performed using special instruments. The advantage of arthroscopic surgery over conventional surgery is less pain and usually quicker recovery.

Investigation required before surgery

At times, clinical examination would be sufficient to identify the problem. However, sometimes we may need to do some investigation to ascertain the root cause.

  • a magnetic scan (MRI) to ascertain the problem affecting the knee.
  • an x-ray of the knee joint may be needed.
  • in some cases a simple blood test and ECG (tracing of heart) may be required.
Back Pain During Pregnancy

The majority of musculoskeletal problems that arise during pregnancy can be prevented and treated with physiotherapy. Individualised physical therapy programs have been found to be more effective than group sessions for the reduction of pain and sick leave caused by back pain in pregnancy. Individualised session’s should include exercise therapy, postural training/advice, and ergonomics recommended once weekly over a 5 week period.

The 2003 joint statement of the Society of Obstetrician and and Gynaecologists (SOGC) and the Canadian Society of Exercise Physiology (CSEP) regarding exercise during pregnancy recommended resistance exercise in addition to aerobic exercise for pregnant women. “Women and their care providers should consider the risks of not participating in exercise activities during pregnancy, including loss of muscular and cardiovascular fitness, excessive maternal weight gain, higher risk of gestational diabetes or pregnancy-induced hypertension, development of varicose veins and deep vein thrombosis, a higher incidence of physical complaints such as dyspnea or low back pain and poor psychological adjustment to the physical changes of pregnancy.” (Wolfe et al 2003).

Back Pain During Pregnancy
Back Pain During Pregnancy

Pregnancy related problems that benefit with physiotherapy & exercises

The most common are musculoskeletal problems like back & pelvic girdle pain (approx. 50% prevalence in pregnancy [Britt et al 2004], thoracic pain and nerve compression syndromes (e.g. carpal tunnel, ulnar nerve neuritis, de Quervain’s tenosynovitis).

Pelvic girdle pain and back pain

According to Artal et al (2008) most of the musculoskeletal problems that pregnant women experience are related to the altered postures. Whilst it may not be possible to stop this process from occuring, it is possible to minimise these maladaptive postures. With posture advice and strengthening of the core muscles, the weakened structural integrity can be somewhat restored. This helps reduce or eliminate many of the common discomforts associated with pregnancy and improve postpartum recovery, particularly those associated with back problems (Artat et al 2008, Hammer et al 2000).

Nerve pathologies

Exercises to mobilise the nerves within nervous system can also be advised for women with nerve compression.

How does the doctor assess whether physiotherapy suits me?

Our doctor who specialise in back pain issues associated with pregnancy can recommend exercises for pregnant and post-partum women after an assessment which generally consists of an analysis of the following:

  • Joint mobility and symmetry
  • Muscle imbalances and strengths
  • Neurological evaluation
  • Evaluation of functional limitations
Physiotherapy treatment techniques in addition to exercise commonly include:
  • Pain management
  • Techniques to aid joint and soft tissue flexibility
  • Recommendations for sleeping and resting postitions
  • Posture correction and ergonomic advice
  • Postpartum rehabilitation

Call +65 64712674 for an appointment today to solve your back pain and enjoy pregnancy!