Varicose Veins and Exercise: Benefits and Considerations

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Varicose veins are twisted, enlarged veins. Any superficial vein may become varicosed, but the veins most commonly affected are those in your legs. This is because standing and walking gradually increase the pressure in the veins of your lower body. For many people, varicose and spider veins not only look unattractive, but also cause aching pain and discomfort. For others, varicose veins can be a sign of a more serious condition of venous disease. The terms “varicose” and “spider” refer to veins that have become abnormally thick, twisted and/or leaky. Spider veins are minuscule, ropy, bluish-purple veins that are close to the skin’s surface and become enlarged. They can be associated with dull discomfort as well as burning, itching, and/or throbbing sensation. Varicose vein is the larger, more serious-looking type of vein problem, although they may still be associated with only mild discomfort. They are more likely to be associated with aching pain and discomfort, fatigue, restlessness, throbbing, burning, cramping, muscle soreness, and swelling, especially after prolonged standing. Symptoms may be worse at the end of the day. If you are in the habit of making a self-diagnosis, you may think that you’ve got such things as arthritis, osteoporosis, and/or circulatory problems, when in reality it may all be stemming from an underlying vein problem. By the same token, a number of conditions can be associated with varicose and spider veins, such as swelling, night cramps, and leg sores. And while you may not like the looks of the veins, the symptoms that they cause are what you should really be paying attention to.

Benefits of Exercise for Varicose Veins

Aerobic exercise is also a very good way to improve your circulation. Step aerobics and exercises like it are particularly good because they will concentrate on the muscles in your legs. But anything that gets you moving and your legs working will be beneficial. However, avoid anything that puts too much pressure on the veins in your legs. For example, weightlifting or high-impact sports may be more damaging than beneficial.

Walks and swimming are probably the two most beneficial things you can do. Like walking, swimming is a highly beneficial exercise. Swimming will improve your general fitness and also help tone the muscles in your legs. The best thing about swimming in relation to varicose veins is that when you are in water, it takes pressure off the veins in your legs. This is beneficial because it will decrease the swelling in your legs and reduce the discomfort you get from the varicose veins.

One of the most important tasks to do for your health is to exercise. That’s true for anyone, but when you have varicose veins, the majority of exercise will benefit your veins dramatically. Exercise helps to improve circulation and strengthen the muscles in the legs, two very important things varicose vein sufferers need to do.

Improved Circulation

Any type of exercise involving contraction of the calf muscles will serve to improve the symptoms of venous disease, as it will improve the efficiency of the calf muscle pump. This could be anything from walking, to swimming, to taking exercise classes at the local gym. Often patients with varicose veins don’t like exposing their legs and so prefer to take up swimming. This is a great form of exercise for varicose veins, as the hydrostatic pressure of the water on the legs serves to reduce leg swelling during and after swimming. Another positive effect of exercise is that it often leads to weight loss. This is highly beneficial for varicose veins, as research has shown a strong correlation between obesity and worsening severity of venous disease. And we all know that exercise is a great way to keep the kilos off! On the contrary, certain higher impact sports such as running may make varicose veins symptoms worse, so it’s best to consult a doctor before changing your current exercise regime.

Since varicose veins are a manifestation of an underlying venous disease, it’s important to understand the circulatory system and the role exercise plays in affecting it. Common symptoms of chronic venous insufficiency and varicose veins are aching pain, heaviness, tiredness, and often swelling in the legs. Calf muscle cramps are also quite common. These symptoms are particularly worse after standing or sitting for long periods of time. This is simply explained by understanding that the calf muscle is the engine room for the venous system in the legs. When the calf muscle contracts, it compresses the veins and forces blood out of the legs and back to the heart. When the calf muscle relaxes, the veins close to prevent blood flowing back down the leg. This mechanism is known as the calf muscle pump. Static standing or sitting means the calf muscles are inactive and so the blood in the veins accumulates in the legs, which in turn makes the symptoms of venous disease worse.

Exercise is good for pretty much everyone, and it’s especially helpful for people with varicose veins. It may be hard to imagine failing to motivate yourself to stick to a regular exercise routine. Most of us already know why exercise is important in improving how our bodies look and feel, and when you have varicose veins, exercise can be particularly helpful in this area. When we talk about circulation, we are generally referring to the movement of blood from the heart, through the arteries, to the capillaries, back to the heart, and then through the veins to all the body’s tissues.

Strengthened Leg Muscles

Engaging in an exercise routine to strengthen your leg muscles can help improve the symptoms of varicose veins. Vein strength and function are vital to the prevention of varicose veins and their recurrence. Nearby muscles and their strong leg muscles serve as a natural pump to push the blood up to the heart. The faster and more efficiently the blood flows upwards, and the less it pools in your veins, the lower the stress on your veins. The plaque and pooling of the blood are what cause most varicose veins and any activity that lessens these factors will improve your condition. This can decrease pain, discomfort, and swelling in the legs. Strong muscles will also improve your flexibility and range of motion in the legs. This will allow you to perform your daily activities with less pain and fatigue on your legs, helping you to maintain a healthier and more active lifestyle. Any moderately strenuous activity can effectively strengthen muscles. High-impact activities like running and jump rope may not be as effective in improving vein symptoms since they put too much stress on the veins and can actually make the problem worse. It is best to choose low-impact to moderate activities. But there are certain leg exercises that are more beneficial. Any exercise that works the ankles, calves, and thighs are what really pump the blood upwards. These would include walking, bicycling, and swimming. A simple exercise to do anytime or anyplace is to try to raise yourself up and down on your toes while standing for about 15 times. Any of these leg exercises done for 30 minutes at least 5 times a week should help you to see results in 8-12 weeks. If you’re already an active person, it is still wise to add in an extra 15 minutes of these targeted exercises. But be aware that varicose veins and their symptoms may get worse before getting better. If at any time you feel increased pain or skin sores with these exercises, it is wise to stop and consult your physician.

Reduced Swelling and Discomfort

Swelling and discomfort from varicose veins often occur when an individual has been in the same position for long periods. Leg veins rely on normal muscle movement and contractions to help force blood back to the heart. The healing of any previously damaged veins can often lead to an increase in discomfort due to higher pressures within the veins. Leg elevation and the use of compression stockings are traditional ways to alleviate these symptoms. However, it has been recommended that five times a day, a person should avoid the long-term standing or sitting that can accompany certain jobs and walk around for ten minutes. This may help to break the vicious cycle that can occur, in which prolonged sitting or standing increases swelling and discomfort, which in turn discourages the person from further physical activity and exacerbates the problem. It is important to note that although regular exercise is beneficial, too much high-impact exercise such as weight lifting and running may exacerbate the symptoms of varicose veins.

Considerations for Exercising with Varicose Veins

Prolonged sitting or standing should be broken up with short walks to take the weight off the legs and encourage blood flow. This is most pertinent to occupations that require long periods of sitting or standing. Studies have shown that nursing is a high-risk occupation for nurses developing varicose veins. Epidemiological studies have shown that prolonged sitting/sedentary lifestyle is an independent risk factor for cardiovascular disease and mortality. Thus, everyone, especially nurses, benefits from exercise as a preventative measure for varicose veins.

Compression stockings or support hosiery are designed to give a measured amount of pressure to the legs, thus helping to maintain good blood flow and assisting in improving symptoms caused by varicose veins. Wearing compression stockings will help to prevent the deterioration of more varicose veins and delay the development of skin changes from venous disease. They are particularly effective in easing tired legs and swollen ankles that may occur after prolonged sitting or standing. Wearing compression stockings during exercise can also help to reduce symptoms and encourage the blood to return to the heart.

For people with varicose veins, it is better to avoid high-impact exercises to minimize the stress on their affected veins. Instead, opt for low-impact activities such as swimming, cycling, or walking. These activities will still help to improve muscle strength and circulation without causing further damage to the veins. Exercise can exacerbate leg symptoms if there is associated moderate to severe chronic venous insufficiency. In these instances, medical intervention may be required before exercising as a treatment for varicose veins. This may include endovenous, surgical, or injection therapies. People who have not undertaken any previous treatment for their varicose veins can still benefit from activities like walking. It is not uncommon for an increase in muscle ache and tiredness initially, especially if the patient has been relatively sedentary. If micro-ambulatory phlebectomy, foam sclerotherapy, or endovenous ablation is the patient’s chosen method of treatment, it’s a good idea to increase walking or other low-impact exercise after the procedure to help speed recovery.

Low-Impact Exercises

A wide variety of low-impact exercises have the potential to help those who suffer from varicose veins to reduce their discomfort and improve the appearance of their bulging veins. Low-impact exercises are those where the feet stay in contact with the ground at all times, and are therefore less jarring to the legs. This in turn means they are less likely to cause damage to the veins, and are a particularly important form of exercise for those who are looking to prevent varicose veins or stop them from getting worse. Walking is the simplest form of low-impact exercise and, in spite of the low amount of effort it requires, can be very beneficial. It strengthens the calf muscles which act as a second heart in propelling blood up from the legs. If done for around half an hour each day, walking can be an effective form of exercise. However, those who live a very sedentary lifestyle may find this difficult to start. Cycling is another excellent form of exercise for those with varicose veins, as the pedaling action works the calf muscles without causing excess pressure. This may be done using a normal bicycle or a stationary exercise bike. Swimming is widely recognized as the most beneficial exercise for those with varicose veins, as the water provides a natural form of compression on the legs which helps to encourage blood flow. Swimming works the whole body and is often recommended for those who are suffering from an obesity-related condition, as the body weight is supported by the water and places less stress on the joints. Other water-based activities such as aqua aerobics may have a similar effect.

Compression Garments

The information from the PREVAIT study on the subject of exercise as a treatment for varicose veins has been covered in the previous section. On the subject of compression, Dr. Alan Harwood wrote a chapter with his colleagues in “Chronic Venous Insufficiency”, in which he introduces, with evidence, the effect of ankle compression on muscular pump function. He puts forward his venous-muscle pump paradigm, which hypothesizes that all interventions for the treatment of venous disease act on the venous muscle pump or the fascia that supports it, stating that they aim to reverse, or at least prevent, deterioration of function. The superficial, mid-facial compartment that supports the muscle pump is likely to have a slightly higher pressure threshold for distension, meaning that it could distend at an early stage of venous disease before the development of overt or skin changes. Fibrosis in the loose connective tissues in the mid-facial compartment or inflammation that impairs lymphatic and capillary function can lead to venous muscle pump failure. The PREVAIT study had patients wear class II 30-40mmHg graduated compression socks, often considered by the general population to be the most unsightly or fashionable form of compression. At the stage of their presentation, it is quite likely that they would be enrolled in future endothermal ablation or traditional surgery and would have better relief of their symptoms if they could be convinced that this management technique could alleviate their varicose vein symptoms enough to appease their concerns over their appearance. Compression hosiery was acceptable to both patients and was shown to not worsen quality of life or limitations of daily activity. The primary endpoint was change in pain, and recruitment used the McGill Pain Questionnaire, several visual analogue pain scales, and SF-36 health questionnaires.

Avoiding Prolonged Sitting or Standing

Regular exercise and weight control will also help to reduce the pressure on the leg veins and decrease the risk of future varicose veins.

Elevation is best accomplished by lying down and placing the legs on three or four pillows so that the legs are higher than the level of the heart. This should be done three or four times a day for 15 minutes. This rest time should be considered an important daily activity and should be incorporated into a patient’s daily routine.

Excessive prolonged sitting and/or standing results in a gravitational force downward on leg veins, which can result in increased pressure on the veins. This can lead to more serious vein disorders in patients who have a genetic predisposition for varicose veins. To help prevent these symptoms from occurring, frequent rest periods should be taken to elevate the legs and help decrease the pooling of blood in the leg veins. This will greatly reduce the likelihood of developing future varicose veins, as well as decrease symptoms for patients who already suffer from varicose veins.

Consulting a Healthcare Professional

The information in this document is not a substitute for professional medical care or advice. The exercises presented are suitable for most people, and in many cases, these exercises have been helpful for those with varicose veins. However, since individuals with varicose veins may also have other medical problems, it is essential that a qualified health professional supervises the selection of exercises. This may mean eliminating some exercises and modifying others. For example, an individual with vascular disease may need to omit a specific leg exercise that is contraindicated. Others may need to perform an exercise in a recumbent position initially and gradually progress to a standing position. Still, others may do best if they wear medical support hosiery and/or apply bandages to the leg prior to exercising. Any assistance from these devices or changes in exercise positions should be performed under the supervision of a qualified healthcare professional. Note that the term “qualified health professional” can be a physical therapist, occupational therapist, nurse, or physician.

Before beginning any exercise program, individuals should consult their doctors or other qualified health professional, especially if they know or suspect that they have varicose veins. Professional medical advice should be sought if there is blood around the veins, swelling of the leg or foot, ulcers in the ankle area, pain in the legs at night, or edema. If any of these symptoms are present, a referral to a vascular specialist would be advisable.

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