Can PT Help With Chronic Venous Insufficency?

We investigate the relationship between diagnoses and how physical therapy can help in our recent blog series. Today, we are talking about an impairment that affects much of the population in America, chronic venous insufficiency. Chronic venous insufficiency is defined as an inadequate venous return over a long amount of time. However, what does this mean? To simplify, blood is pumped from the heart through the body to send nutrients to our tissues. Blood rushes to our head, feet and fingers and allows us to perform movements. The blood then returns through the veins and goes back to heart to start the process again. However, with chronic venous insufficiency, the blood from the feet is not able to return to the heart. This is due to defective veins or venous obstruction. Pooling or collecting of blood in the legs can cause high tension in veins, swelling, skin changes and can eventually lead to venous leg ulcers.

Prevalence

About 40% of the adult population in the US suffer from chronic venous insufficiency.

1-2% of the adult population progress to the severe stage venous ulceration.

Causes

  • Sedentary lifestyle
  • Smoking
  • DVT
  • Prolonged venous hypertension
  • Vein obstruction

Risk Factors

  • Age
  • Sex
  • Family history of varicose veins
  • Obesity
  • Previous leg injury
  • Prolonged standing or prolonged sitting

Treatments

Despite the urgent need, evidence on effective preventive strategies is limited mainly to two interventions:

  • The use of daily compression therapy for life- compress helps push the blood up from the foot and back to the heart
  • Venous surgery

Unfortunately, many patients with venous insufficiency are not suitable or willing to undergo surgery, because of age and multiple co-morbidities. Additionally, many patients are unwilling to wear compression or report of difficulties with application, comfort, appearance and cost.

Can PT Help?

A study looked at the relationship between exercise and venous insufficiency. The study consisted of a supervised leg and core strengthening program 2x/week for ~1 hour. The sessions included stretching, strengthening and uphill treadmill walking. Subjects exercised for 3 months. The result showed significant improvement in lower extremity strength and venous return to the heart. Strengthening the muscles of the leg help to push the blood up to the heart when they contract, such as walking or going up stairs. The stronger the muscles of the legs, the better the blood moves back to the heart. The best news was that the participants sustain the results for at least 3 months after termination of the exercise program!

Contact us!

If you have venous insufficiency and would like to learn more about exercise for PVD, stop by or call us today! Direct Access in NJ allows you to come in without having to see your Doctor, probably quicker than you could get that appointment, while also saving you both time and money!  

Please, call us to schedule your student’s evaluation at one of BeneFIT’s locations, Bridgewater (908.203.5200) or Chester (908.879.5700)  with one of our highly trained Doctors of Physical Therapy!

Sources:

Eberhardt, R. T., & Raffetto, J. D. (2014). Chronic venous insufficiency. Circulation130(4), 333–346.

Finlayson, K., Edwards, H., & Courtney, M. (2011). Relationships between preventive activities, psychosocial factors and recurrence of venous leg ulcers: a prospective study. Journal of Advanced Nursing, 67(10), 2180–2190.

Padberg, F. T., Jr, Johnston, M. V., & Sisto, S. A. (2004). Structured exercise improves calf muscle pump function in chronic venous insufficiency: a randomized trial. Journal of Vascular Surgery39(1), 79–87.