Deep Vein Thrombosis (DVT) Through the Ages Continued

Last week we began studying the history of DVT. The most important advances in the field of DVT therapy occurred during the first half of the 20th century. However, numerous other therapeutic options, sometimes surprising, were tried during this period and later abandoned because of insufficient efficacy.

Even though the mechanisms of venous thrombosis (blood clots) had been discovered by the middle of the 19th century, it was closer to the 1920’s that a consensus appeared regarding the three factors contributing to thrombosis: stasis, vessel wall alteration, and hypercoagulability (abnormality of blood coagulation that increases the risk of blood clots in the blood vessels).

During the late 19th century and early 20th century, there were a number of breakthroughs that have changed DVT treatment. Many of these were discovered by accident.

1884 – Hirudin first isolated anticoagulant. It was extracted from the saliva of leaches. Hirudin could not be used as a powerful anticoagulant until production by genetic engineering in 1986.

1916 – Heparin first anticoagulant that could be effectively used for the treatment of DVT. A medical student, who was doing research to find products which would promote coagulation of blood, noticed some extracts became anticoagulant after prolonged exposure to air. Four years late he discovered true heparin.

1933 – Pure crystalline heparin was produced allowing its use in humans in 1935. The use of heparin became widespread (when available) because of its efficacy. It was administered for 7-10 days and cut the mortality from Pulmonary Embolism among inpatients with symptomatic DVT from 18% to 0.4%.

1941 – Vitamin K antagonists (VKAs) allowed anticoagulant therapy to be extended. Vitamin K is required for the correct production of certain proteins necessary in the blood clotting process. They are structurally similar to vitamin K and act as competitive inhibitors. The action of this class of anticoagulants may be reversed by administering vitamin K until there is no more VKA in the body. Vitamin K antagonists include coumarins which include, but are not limited to warfarin, coumatetralyl, phenprocoumon, acenocoumarol, dicoumarol, and non-coumarin VKAs such as fluindione and phenindione. All can be reversed by administering vitamin K.

1950 – Heparin was still the choice treatment for DVT, but surgical procedures were used for severe cases of DVT. The surgical procedures did not provide substantial clinical improvement.

1958 – First intraluminal “harpgrip” filter showed promise in preventing Pulmonary Embolisms. The filter could block movement of blood clot without significantly affecting the venous system; however it required major surgery and anesthesia for placement.

HarpgripMobbinUddinGreenfieldFilters

1967-1970 – The problem of a filter requiring major surgery and anesthesia for insertion was solved with the Mobin–Uddin umbrella. It could be inserted with a simple catheter under local anesthesia. Besides the potential for migration, this filter could cause gradual obstruction of the inferior vena cava. This was partially prevented by coating the filter with heparin.

1981 – Greenfield developed the first true percutaneous filter, which did not necessitate any surgical opening of a vein. However, truly retrievable filters (without a catheter and without persisting venous access) became available for clinical use only two decades ago. Therapeutic trials are currently underway.

Blood Clot

1970 – Venography (developed in 1923) became standardized and widely used for confirmation of DVT; physicians no longer treat clinically suspected DVT. This enabled physicians to diagnose and treat DVT while clinically asymptomatic and simplified DVT treatment with anticoagulants, ended bed-rest as a treatment, and allowed home treatment.

1980 – Development of low-molecular-weight heparin (LMWH) was the most significant step in the simplification of anticoagulant therapy. In most cases, it does not require monitoring. Was introduced in Europe and in 10 years was widely used.

1996 – Was demonstrated that LMWH given at home was safe and effective as unfractionated heparin administered in the hospital.

1996 – Evidence that early ambulation with compression stockings lessened pain and counteracted swelling without an increased risk of Pulmonary Embolism. This became widespread treatment and is now recommended treatment.

1997 – The usefulness of compression bandages in preventing post-Thrombotic Syndrome (long-term complications of DVT) shown. Even though Hippocrates prescribed compression bandages to treat leg ulcers, it was not until the late 19th century, after observing that superficial vein clots disappeared rapidly after application of compression bandages, physicians started prescribing compression bandages to their patients with DVT. Compression bandages started to be more widely used when anticoagulants became available. They were usually prescribed at the end of heparin treatment, once ambulation was authorized.

1938 – First Thrombectomy (blood clot removal). Twenty years later this procedure was improved and anticoagulant was added to prevent more blood clots from forming. Surgical thrombectomy is not recommended for routine treatment today. Early blood clot removal has been achieved using pharmacological thrombic agents. (Anticoagulation therapy for some patients is not a choice because of bleeding problems.)

1953 – Plasmin (also produced in the body) used to treat acute blood clots (including isolated DVTs) by dissolving them through intravascular infusion. In the same year streptokinase was also used for the same purpose. Streptokinase causes extra production of plasmin in the body.

It will be many years before the appropriate indications and contraindications are carefully defined about the use of thrombolytic agents, and the optimal approach (catheter directed vs. systemic administration) of the use of these agents to blood clots is identified, allowing the selection of the population at highest risk of Post Thrombotic Syndrome and lowest risk of bleeding. Nevertheless, it is likely that the long-term results, despite being promising, will not dramatically modify the routine management of DVT.

I hope you keep wearing your support socks and support stockings so you are less likely to have to deal with a DVT and DVT treatment!

Vanda
www.supporthoseplus.com

Deep Vein Thrombosis (DVT) Through the Ages

I have addressed Deep Vein Thrombosis (DVT), its causes, how it can be recognized, and treatments many times. I thought we might review the history of treatment of DVT.

The first documented case of DVT occurred more than 700 years ago in the middle ages. A 20 year old Norman cobbler, Raoul, developed unilateral edema in the ankle and calf which the moved up to the thigh. His physician advised him to “wait and see”. Raoul’s symptoms worsened and he developed a leg ulcer. He visited St Eloi’s shrine, without any improvement. Then he visited the tomb of King Saint Louis. He spent some time in prayer to no avail. He then decided to collect the dust he found below the stone that covered tomb. He applied the dust direct to the ulcer. The story reports he was miraculously healed and was still alive 11 years later. After this story of Raoul, there was increased mention of DVT especially in pregnant and postpartum women.

During the Renaissance physicians thought that pregnancy-related DVT (leading or only cause of DVT) was the result of “evil humors”. It was thought that postpartum DVT was caused by retention of unconsumed milk in the legs (‘milk leg’). Therefore in the late 1700’s breast-feeding was encouraged to prevent DVT.

From 1784 – 1920’s treatment was evidence based. In 1676 Wiseman suggested DVT was a consequence of alteration of blood. In 1793 Hunter hypothesized it was a occlusion of a vein by blood clots. In 1784 Hunter performed ligations (ties) above the blood clot to prevent extension of the clot. Because there was no other treatment for Pulmonary Embolism (PE) this became widely used at the end of the 19th century. This could be done at the femoral, common femoral, iliac or inferior vena cava. Used until mid 20th century along with anticoagulants after they became available.

Iron Splints

Since there was great fear of the blood clot migrating and becoming a PE, strict bed rest was prescribed and was the
cornerstone of DVT treatment from the end of the 19th century. Patient’s limbs were set in iron splints to prevent movement and special inclining beds were used to increase venous return.

Inclining Bed

During the 19th century it was thought that DVT was caused by inflammation of the vein wall, fever, postpartum and after septic surgical procedure. Treatment included anti-inflammatory medication and treatment for infection. Blood letting was popular (especially with leeches) as well as cupping, purging, applying ice or prescribed cold bath. These treatments started becoming obsolete in early 1900’s. Prior to 1930’s (before anticoagulant therapy) treatment was bed rest to fix thrombus, elevation and now application of heat with warm compresses to increase collateral circulation and reduce venous spasm. In hospitals Wright describes the preventative measures such as early ambulation, elastic compression, avoidance of dehydration and tightly applied adhesive strapping.

Next week we will continue with the last 100 years. In the meantime, keep wearing your support stockings and support socks!

Vanda
www.supporthoseplus.com

Possibility of a New Treatment for Venous Insuffiency

We have talked so many times about venous insufficiency…its causes and management. From one of previous newsletters “Most leg problems are caused by age, obesity, sedate lifestyle, standing or sitting for long periods of time, past surgeries, pregnancy, or heredity. You must remember the heart is a one-way pump. The heart pumps blood from the heart through the arteries to the various parts of the body. The veins have the arduous task to return the blood to the heart along with waste and metabolic residue. The movement of the blood toward the heart can be a challenge. Gravity forces the veins to work harder to return the blood to the heart. The veins have little one way valves that work with the leg muscles to pump the blood back to the heart. In a normal vein, one way valves are located ever 2 – 5 cm to aid in the proximal flow toward the heart. When calf muscles relax, the valves close to prevent blood from flowing backward into the lower part of the veins. These valves are fragile and can be easily damaged. The contraction and relaxation of the calf muscles work as a “secondary pump” to move the blood. Many things can happen that interrupts this blood flow. The valves in the veins may be injured and do not close completely and allow the blood to remain in the lower leg. “

Mini Heart

Now we have the possibility of a new treatment. Narine Sarvazyan, a professor of pharmacology and physiology and a researcher at the George Washington University has made a startling discovery that could improve the treatment for people with impaired blood flow. Stem cells (muscle cells) from the patient’s own heart are harvested and modified so they become programmable stem cells. Using a patient’s own tissue has many different advantages, the most important being the elimination of any risk of rejection. Unlike the controversial embryonic stem cell, adult stem cells can generally only form cell tissue associated with the organ that it was extracted from. In the laboratory these harvested stem cells are grown into “mini hearts”. They are one millimeter in diameter that behave “surprisingly similarly” to a real full-sized heart. These tiny hearts can be implanted to encourage blood flow in veins that have compromised valves. The “mini heart” is a rhythmically contracting “cuff” of heart muscle cells that encircle the problem vein and pumps blood as it beats. 

Research is continuing. Perhaps we can look forward to one day when we no longer suffer from venous insufficiency. In the mean time keep wearing your support socks and hose to keep your legs healthy.

Vanda
http://www.supporthoseplus.com

Venous Disease of the Legs

Varicose veins are the result of venous insufficiency. There are many things that influence the health of the veins in our legs. Among these are hereditary, obesity, sedate life styles, and of course, age. The population of the United States is getting older, the Baby Boomers are now in their 60’s, and, unfortunately many of us are over-weight (including me). The Heart is responsible for the blood flow in our bodies. The circulatory system is made up of the heart, arteries which carry blood from the heart to our legs and arms, arterioles and capillaries (where oxygen is exchanged), and veins which carry blood back to the heart. The heart is an excellent pump, but it needs assistance in getting blood flow from our legs and back to the heart. This is where the valves in our veins come in. The tiny valves in the veins open and close to allow blood to flow only one-way back to the heart. The problem occurs when the valves get damaged form age or from physical injuries to the leg and do not close properly. When the valves get damaged they cannot close properly and the blood can then back-flow and create pooling. This can cause stasis, edema, and in severe cases blood clots or even lymphedema.

Now let’s discuss a few vein diseases

Spider VeinSpider Vein

Spider veins are created by small dilations in the veins just below the skin. Yes, they are a little unsightly. They don’t seem to cause any problems other than a slightly ache, but they are giving you a warning to wear compression stockings to keep them under control so that varicose veins do not develop.


Varicose VeinsVaricose Vein

Varicose veins are created by poor circulation in the venous system. They are generally ropy looking and should be evaluated by your physician. If left untreated, they can lead to much more serious problems. With varicose veins the valves in the veins become incompetent and the function of returning blood to the heart has been compromised. This condition is called venous insufficiency and can have very serious consequences. Wearing your support hose can assist in maintaining control of the varicosities so your venous disease does not progress. There are also many physicians who can advise you of various medical treatments including oblation surgery.

Stasis Dermatitis

Stasis Dermatitis

<Stasis Dermatitis is a red looking inflammatory skin disease that is common with people with chronic venous insufficiency. If your leg looks like this, you should definitely have seen your physician about it. Again, wearing compression stockings will help maintain control of this disease, if left untreated it can lead to venous ulceration, or worse.

Venous Ulcer

Venous Ulcer

Venous ulcers are wounds that occur when the veins of the leg do not return the blood back to the heart. The blood may leak out of the vein into the tissue. This causes the tissue to break down and an ulcer to form. They are found on the sides of the lower leg above the ankle and below the calf and are slow to heal and often reoccur.

As you can tell venous diseases of the leg can become progressively worst. When you are experiencing leg problems always consult with your physician. They can direct you to wearing the correct compression stockings and can assist you in maintaining control of the disease.

Lets strive to keep our legs healthy,
Vanda
www.supporthoseplus.com

How To Put On Your Socks

I have customers call and tell me they would like a stocking with a zipper because they are not able to put on (don) their stockings or socks. You would think it would be a lot easier with a zipper, but it really is not. It takes 3-yes three hands to put on a zippered stocking. It takes two hands to hold the zipper together and one to zip the stocking. The zipper tends to slide down on the zippered stockings and the top of the zipper can dig into the leg causing a sore. Other customers express their desire to “step back” in compression (i.e. from a 20-30 to a 15-20 mmHg compression). This is not necessarily a good idea. You would not be following your physician’s orders and you would not be getting proper compression for your diagnosis. This should be a last-ditch choice when no other methods work.
First I suggest they follow the directions which we send with each and every order. If you have misplaced yours, here they are again:
Turn back the top of the stocking onto itself. Usually this is down to nearly the heel pocket.
Place your foot (toes pointed if possible) in the stocking until it meets resistance. With both hands grab the stocking on each side of your ankle and pull towards you body until it meets resistance.
donning3
Fold the stocking back onto itself, grab at the sides at the top of the fold and pull towards your body. Repeat the fold back and pulling procedure again until the garment is positioned correctly on your leg.
donning6
Smooth out any wrinkles and adjust the heel and ankle area for comfort.The top of knee-high stockings should be two finger widths below the crease at the back of your knee. Thigh high stockings should be two to four finger widths below you groin. With knee-high and thigh high garments, never pull on top band. This will break the threads on the band. Stockings will wrinkle and move throughout the day. Check your stockings periodically to smooth out any wrinkles. It is not unusual to need to adjust your compression socks or compression stockings at least three times a day. Don’t just pull on the top of the garment. Fold the stocking in half, place your thumbs inside the garment next to your leg and pull up. Repeat until the stocking is back in place.

 

SigvarisDonningGloves
If this method does not work, I recommend the Sigvaris Donning Gloves I call them my “Magic Green Gloves”. They give me greater strength in my fingers. The rough “nubbies” on the gloves enable you to “pinch and pull” your stockings up. You can also rub up and down your leg so the fullness of the garment is distributed even on the leg.
JobstAndMediDonners

 

Several of our manufacturers including Jobst and Medi make metal framed Donners which stretch the stocking open and enable you to “almost” just step into the stocking.

There are many other methods we use to enable you to get your support socks or support stockings on. Give us a chance to work with you and find a method which works for you so you can remain compliant with your doctor’s orders.

Remember, support socks or support stockings do you no good if they sit in your dresser drawer.

We hope we can make your life easier,

Vanda

We’re sorry…these donning devices will soon be on SupportHosePlus.com. Until they are, please call our toll-free number, 1-844-472-8807, to order.

Let’s Keep Your Legs Looking Great

EnlargedVeinAndDamagedVein

Chronic Venous Insufficiency (CVI) is one of the leading causes of swollen feet, ankles, and legs. There are several things that can cause CVI. In CVI the butterfly valves which help blood move from the lower extremity back to the heart are damaged (incompetent) and do not close properly. Ultimately long-term blood pressure in the leg veins that is higher than normal causes CVI. Prolonged sitting or standing can stretch the superficial vein walls and damage the valves. Compression stockings and compression socks help the veins to close by applying a specific amount of pressure to the leg (this is the compression which your physician recommends). The compression stockings and compression socks also work with the muscles of the lower extremity to act as a secondary heart pump to move the blood out of the lower extremity and back to the heart.

  • Ankle swelling
  • Tight feeling calves
  • Heavy, tired, restless or achy legs
  • Pain while walking or shortly after stopping

At the end of the day, someone with CVI may experience only slight swelling and their legs may be tired and heavy. Now is the time to visit your physician and get some compression socks or compression stockings to keep the CVI from becoming worse.

  • Family history of varicose veins
  • Being overweight
  • Not exercising enough
  • Being pregnant
  • Smoking
  • Sitting or standing for long periods of time

If you have a parent who has had varicose veins, if you are overweight, or if you sit or stand for long periods of time, again now is the time to visit your physician and get some compression socks or compression stockings to keep the CVI from becoming worse.

CVI can be diagnosed by your physician by reviewing your patient history and a physical exam. The physician may also measure the blood pressure in your legs and examine any varicose veins you may have. To confirm a diagnosis of CVI, the physician will usually order a duplex ultrasound or a venogram. A duplex ultrasound uses sound waves to measure the speed of blood flow and visualizes the structure of the leg veins. A venogram is an x-ray that uses a dye (contrast) which enables the physician to see the veins.

Chronic venous insufficiency is usually not considered a health risk; your physician will try to decrease your pain and disability. In mild cases of CVI, compression stockings or compression socks may alleviate the discomfort and swelling. Physicians usually use a 20-30mmHg compression stocking or a 20-30mmHg compression sock for this. The stockings will not make the varicosities go away, but is the least invasive treatment.

Chronic Venous Insufficiency

More serious cases of Chronic Venous Insufficiency require sclerotherapy, ablation, or surgical intervention such as stripping to correct the problematic vein. This is usually done by a vascular specialist or vascular surgeon. During sclerotherapy a chemical is injected in the affected vein or veins and a scar will form from the inside of the vein. During ablation a thin, flexible tube (catheter) with an electrode at the tip will heat the vein walls at the appropriate location to seal the vein. When a vein stripping is done one of the saphenous veins is removed. The physician will make a small incision in the groin area and usually another in the calf below the knee. The veins associated with the saphenous vein will be disconnected and tied off and the vein removed. There are other surgical procedures which are done to improve your leg health. After one of the above procedures 20-30mmHg compression stockings are usually put on and you are told to wear them for a certain length of time. Some physicians will tell their patients on their follow-up visit that it is no longer necessary to wear the compression garments. For me, this is where I have some concerns. If the real underlining cause of CVI (such as family history of varicose veins, being overweight, not exercising enough, smoking or sitting or standing for long periods of time) has not been corrected why would you not continue to wear compression stockings to keep from developing CVI again.

Compression stockings and socks have come a long way in the last few years. They no longer look like the garments our grandparents wore. They look like ordinary stockings and socks and can improve the quality of life. The stigma of wearing compression garments is in the past.

Let’s wear our compression stockings and socks to keep our legs looking great!

Vanda

http://www.supporthoseplus.com

Defy Gravity

The condition of men’s legs are not something that they are concerned with; they don’t sit around and talk about varicose veins while drinking a beer and watching a game for the FIFA World Cup or their favorite sports program. Perhaps the condition of their legs is at least something they should think about and talk to their physician. About 10-15% of younger men have varicose veins whereas about 20-25%of the young women experience the problem. As I wrote about last week, it’s the women who will seek a physician’s advice about varicose veins and not the men. Most men think varicose veins are no big deal…a woman’s problem. Think again. By the time men are in their sixties between 50 and 60% have varicose veins.

Exercise regularly...It's important to involve your calves. It is the calves that act as a secondary pump to return the blood to the heart.

When sitting or standing for prolonged periods of time, blood pools in the lower extremity expanding the vein walls. Over time the veins loose their elasticity and do not return to their taut state. Some people (both men and women) have a genetic preponderance to varicose veins. If one of your parents has vein disease (venous insufficiency), you have about a 33% chance of developing it. If both of your parents have venous insufficiency, your chance jumps up to 90%.

  • Exercise regularly…It’s important to involve your calves. It is the calves that act as a secondary pump to return the blood to the heart.
  • Wear compression hose… Some physicians recommend everyone wear knee-length compression stockings—even if they don’t have signs of varicose veins. The compression of the stockings assists the calf muscle in pumping the blood from the ankle back to the heart. Usually a 15-20mmHg or 20-30mmHg compression is adequate.
  • Watch your diet… Foods high in sodium may cause your body to retain more fluids and swell.

Some people experience no symptoms with varicose veins, for others, the varicose veins hurt (throbbing, aching or burning). Other people experience itching or the vein feels hot, and many experience swelling in their legs. Symptoms are usually less severe in the early morning and worse at the end of the day (after standing or sitting for prolonged periods of time). The cause of the pain may be nerve irritation. As varicose veins dilate, they can begin to press against adjacent nerves.

Some athletes relate that their legs feel fine when training, but a short time later the legs that have varicose veins begin to ache, throb and feel heavy. If they lie down and elevate their legs, they feel better. While an athlete is exercising, their muscles required more oxygen. So the oxygen rich blood is transported through the arteries and the muscles helped the veins return the oxygen poor blood to the heart. When the exercise is completed, there is no calf pump action to help the veins return blood to the heart resulting in pooling of blood in the lower extremity. Elevating the leg helps the body defy gravity and return the blood to the heart (just as compression stockings and socks do).

Sports which add more weight to the legs such as weightlifting, skiing, backpacking and repetitive motion sports such as running, cycling and tennis put a lot of stress on the veins in the legs. These activities can damage the delicate valves of the venous system and exacerbate the venous insufficiency. There are positive and negative reasons to exercise or not, but they cancel each other out. So stay active and defy gravity by wearing compression socks!

Visit your primary care physician so he can make arrangements to have them checked out and defy gravity by wearing compression socks.

If your legs ache and swell, it could be a bigger problem than simply overdoing it at last week’s soccer game. And even if your legs aren’t in pain, if you’re seeing weird vein patterns, chances are there could be something wrong. Visit your primary care physician so he can make arrangements to have them checked out and defy gravity by wearing compression socks.

Vanda

June Is Men’s Health Awareness Month

Father’s Day is past, but we are not forgetting the special men in our lives. What better way to show them how much we care, than by celebrating their health and encouraging them to seek regular medical check ups? This is the 20th anniversary of Men’s Health Awareness Month which is dedicated to enhance awareness of preventable health problems in men. According to the Department of Health and Human Services Men face unique health challenges, and one of the most dangerous is their reluctance to seek health care. In fact, according to Agency for Healthcare Research and Quality (AHRQ), men are 24 percent less likely than women to have seen a doctor in the past year.

A look at men’s health issues shows they experience different, but no less serious, health problems than women. A secret weapon of millions of women for decades has been wearing support hosiery to keep the veins and valves inside the veins from weakening or becoming defective. Men are beginning to recognize the energizing effects a pair of support knee high, thigh high or even a waist high compression garment can provide to improve daily living. The length of the support hose or socks may be determined by the amount and location of the swelling you are experiencing.

There are many reasons men should choose to wear support socks or support stockings. Here are a few:

  • Tired achy legs at night
  • Heavy legs at night
  • Swollen legs
  • Leg pain from prolonged sitting or standing
  • Dull, aching pain in leg
  • Tingling, numbness burning or cramping in the legs and feet
  • Legs “fall asleep” often
  • Spider veins
  • Reddish Discoloration of the skin
  • Hardened skin on the lower leg
  • Patches of dry skin on the lower leg
  • Open sores on the lower leg that do not heal (see your doctor immediately)
  • Family history of venous disease
  • Travel (to prevent Deep Vein Thrombosis)
  • Surgery (to prevent Deep Vein Thrombosis)
  • Orthostatic Hypotension (A form of low blood pressure that happens when you stand up from sitting or lying down…head rush or dizzy spell)
  • Injury

There seems to be a stigma of people being able to recognize that a man is wearing a compression garment, but many young men are becoming staunch supporters of compression garments.

Professional Athlete

Think of the professional athlete…

  • As he travels long distances to compete, he wears compression socks. He definitely does not want to arrive at an event for which he has been training to be knocked out of competition by a blood clot (deep vein thrombosis).
  • During his competition he wants to be at his best. Sigvaris High-Tech Knee High (formerly known as Sigvaris Performance) increase arterial flow, reduce muscle strain, decreases exertion, and reduces skin temperature.
  • After he has completed his competition he wants a speedy recovery, so he wears his recovery socks to help get the lactic acid out of the muscle so there is less muscle soreness.
Happy Man Wearing His Compression Socks

The “week-end warrior” can also appreciate what support socks can do for their sporting activities as well as their everyday living. Why should the non-athlete not have the same advantages as the athlete? By taking action to wear an appropriate compression garment, our special men could prevent more serious problems which ultimately could affect his quality of life as well as his family.

Please have that special man, visit with his physician about compression and then call one of our Certified Fitters at 1-800-515-4271. Our Certified Fitters can assist him with the selection of a garment (dress sock, casual sock, athletic sock, thigh sock or waist high garment) appropriate for his life style as well as his legs.

Lets encourage the special men in our life to see their physician regularly and wear their support socks,

Vanda

National Garden Exercise Day

June 6 is National Gardening Exercise Day…Well, I guess I missed that date, but while researching information on the internet I ran across the following. It was written by Jeffrey Restuccio. He is a nationally recognized author and speaker on the subject of gardening and exercise. (Just up my alley!)
Jeffrey has written books such as “Get Fit Through Gardening” and “Fitness the Dynamic Gardening Way”.

Now don’t feel that you have to “go for the burn” or exercise in the garden aerobically every time. Modify the program to meet your individual needs. At the very least, using these techniques will help reduce back strain and muscle soreness so often associated with gardening.

1) Warm up your muscles before you garden for five to ten minutes.

2) Stretch for five to ten minutes. Yes, stretch before you garden! Stretching will help relieve back strain and muscle soreness and avoid injury.

3) Garden using a variety of motions at a steady pace. Plan out your gardening exercise session to include a variety of movements such as raking, mowing, weeding, pruning and digging and alternate between them often, every fifteen minutes, for example.

lunge and weed side view2

Here are six different motions or techniques to rake, hoe and weed:

Don’t bend from the back as you rake or hoe. If you make just one change, this should be it. Bend from the knees and use your legs, shoulders and arms in a rocking motion. Also alternate your stance between right-handed and left-handed. Alternating stance balances the muscles used. These techniques require time and practice but after a period of seasons it will become a natural part of your gardening routine.

Get Fit Through Gardening is comparable to working out at the spa and before you leave, you’re handed a basket full of fresh strawberries, power-walking to the supermarket and receiving a ninety percent discount on fresh tomatoes, or cycling twelve miles and coming home each time to a fresh garden salad. It’s the ultimate cross-training activity!

4) Ideally, you should stretch again after you have thoroughly warmed up your muscles with fifteen to twenty minutes of steady raking, hoeing, weeding, planting or mowing.

5) Cool down after your gardening exercise session by walking, picking flowers or vegetables or just enjoying the fruits of your “exercise.”

Just remember these key points:

keep back streight
  1. Follow the Aerobic Model as often as possible.
  2. Avoid all-day marathon gardening sessions on weekends (space it out)
  3. Always bend from the knees and not your back.
  4. Alternate your stance and motion as often as possible.
  5. Use long-handled tools for raking or hoeing and kneel or sit while using hand tools.

For more information contact your Local or State Garden Club Chapter. Of course before you begin you should make sure you have your compression stocking or compression socks on. When you finish your “yard exercise”, you want to be happy that you choose to begin this endeavor.

Happy gardening,

Vanda

http://www.supporthoseplus.com

Add Some Jazz To Your Step

Add Some Jazz To Your Step

We have some wonderful Juzo® products that we have not talked about for awhile. Some of you may not be familiar with these products. So I thought I would review their attributes. Juzo® offers high quality products for both men and women who suffer from venous disease or lymphedema. Julius Zorn founded the company in 1912 and dealt with personal medical problems similar to Juzo’s clients today. It was his belief that the medical garments should not hinder a person’s ability to enjoy life that led him to create compression products and to their motto “Juzo Freedom in Motion”.

JuzoSilverSoleCrew

Juzo Silver Sole Socks – Made with X-STATIC® Silver Fibers (Anti-microbial)

  • 12-16 mmHG unisex fit by shoe size
  • Available in – anklet, crew length, and knee high
  • Pillowed Sole adds cushion to reduce blisters and callous buildup
  • Mid-foot compression to prevent sock bunching
  • Athletic Sock, Diabetic Sock, or Trucker Sock (someone with no indications of swelling.

Why not add some jazz to your step or to the step of a special someone.

Vanda
http://www.supporthoseplus.com