Ep.09 Compression Done Right: Lymphedema, Venous Ulcers, and the Law of Laplace

In this episode of Woundcasters, host Dr. Felix Boecker is joined by Anna Stewart, OT and lymphedema specialist at the University of Michigan, for a deep dive into one of the most under-recognized drivers of chronic wounds: lymphedema. Anna shares how her path from massage therapist to occupational therapist shaped her hands-on understanding of tissue, and why so many clinicians and therapists still miss early-stage lymphedema until fibrosis, skin changes, and wounds are already present.Together, Felix and Anna unpack the relationship between chronic venous insufficiency and secondary lymphedema, when it makes sense to refer venous leg ulcer patients to a lymphedema specialist, and how tools like photobiomodulation (red light therapy), vibration, and negative-pressure “cupping” can support tissue normalization and fluid movement. Anna also walks through the art and physics of compression—from short-stretch vs. long-stretch bandages to toe management and the Law of Laplace—highlighting common pitfalls that turn wraps into tourniquets instead of therapy.The conversation closes with practical tips on finding qualified lymphedema therapists, addressing system and supply barriers, and why Anna is optimistic about growing awareness and research in lymphatic care. If you manage patients with edema, venous disease, or chronic wounds, this is a must-listen episode.