PT Modalities - External Compression

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Effects of External Compression:

• Improved venous and lymphatic circulation
• Limits the shape and size of tissue
• Increased tissue temperature 

Adverse Effects:

• May aggravate a condition that is causing edema
• If to much pressure is used it can act as a tourniquet 

Clinical Uses for External Compression:

• Edema - due to venous insufficiency and lymphedema
• To prevent deep vein thrombosis
• Residual limb shaping after amputation 
• To control hypertrophic scarring

When NOT to Use External Compression:

• Heart failure, recent or acute deep vein thrombosis, or pulmonary embolism
• Obstructed venous return
• Severe peripheral artery disease
• Acute local skin infection
• Acute fracture or other trauma

Precautions (be careful when using)

• Impaired sensation or mentation
• Uncontrolled hypertension
• Cancer
• Stroke or significant vascular insufficiency 
• Superficial peripheral nerves

For our use in physical therapy we typically use compression wrapping (separate post), compression garments (shirts, socks, etc or custom upper and lower extremity for lymphedema patients) or intermittent compression pumps.

Advantages of Intermittent Pneumatic Compression Pumps:

• Actively moves fluids
• compression is quantifiable 
• can provide sequential compression
• requires less finger and hand dexterity to apply than compression bandages or garments
• Can be used to reverse as well as control edema

Disadvantages or Intermittent Pneumatic Compression Pumps:

• Used only for limited times during the day
• expensive to purchase unit
• extremity cannot be used during treatment
• patient cannot move during treatment
• pumping motion of device may aggravate an acute condition