Compression, Physical Fitness and Sports

athletic3May is Physical Fitness and Sports Month. I would like to direct this news letter to our athletes. You would think young, athletic people would have no problems with their legs, but that is not correct. Sports activities which add more weight to the legs (weightlifting, skiing, backpacking) and repetitive motion sports (running, cycling, and tennis) put a lot of stress on the veins in the legs and can damage the delicate valves in the veins and exacerbate venous insufficiency in the athlete.

When athletes are exercising, their muscles require more oxygen. The arteries transport the oxygen rich blood and the active muscles help the veins return the oxygen poor blood to the heart. Once the exercise has ended, there is no calf muscle pump to help the veins return the blood. So the legs of the athlete with varicose veins may begin to ache, throb and feel heavy. If the legs are elevated, this will help the body defy gravity and return the oxygen poor blood to the heart. This is exactly how compression socks or support socks will help the athlete and may in the long run help prevent deep vein thrombosis. Performance socks use science to help professional athletes as well as the week-end warrior maximize performance as well as recovery.

A deep vein thrombosis (DVT) is the formation of a blood clot within a deep vein, usually in the legs. A pulmonary embolism (PE) is blockage caused by a blood clot in one of the pulmonary arteries in your lungs. It usually originates from a blood clot in the legs (DVT).  You would think the athlete less likely to develop blood clots than the elderly. But that is the problem. Health care  providers think the same way so when an athlete presents with Deep Vein Thrombosis (DVT) symptoms, they interpret the symptoms as “muscle tear, “Charlie horse”, “twisted ankle”, or “shin splints”.  Chest symptoms from an athlete with a Pulmonary Emboli (PE) are often interpreted as pulled muscle, inflammation of the joint between ribs and breast bone, bronchitis, asthma, or a touch of pneumonia.

Being an athlete and being apparently healthy does not guarantee they will not get blood clots. There are several risk factors that put the athlete as well as the non-athlete at increased risk for DVT and PE…

  • Traveling long distances to and from sports events. It does not matter if it is by plane, bus, or car
  •  Dehydration (during and after a sport activity)
  •  Significant trauma
  •  Immobilization (wearing a brace or cast)
  •  Bone fracture or major surgery
  •  Birth control pills and patch, pregnancy, hormone replacement therapy
  •  Family history of DVT or PE
  •  Presence of inherited or acquired clotting disorder (Factor V Leiden, prothrombin 20210 mutation, antiphospholipid antibodies, and other clotting defects or deviancies
  •  Presence of a congenital abnormal formation of the veins
  •  May-Thurner Syndrome (narrowing of the major left pelvic vein)
  •  Narrowing or absence of the inferior vena cava (the main vein in the abdomen
  •  Cervical rib causing thoracic outlet obstruction

Built to performWhen an athlete works out, the muscles of the body act as a secondary pump to help move the blood back to the heart. The athlete also has a slower heart rate than the average person. During performance that is wonderful, but at times, that can be detrimental. After a work out or when the athlete travels the heart does not move the blood through the circulatory system as quickly as when the athlete is exercising. This is when a sock of at least 15-20mmHg is extremely important. It keeps the blood from pooling in the deep veins and forming a DVT.

Call one of the SupportHosePlus.com Certified Fitters on our toll-free number, 1-844-472-8807, for assistance with the selection of performance and/or recovery socks to enhance performance or prevent DVT and PE.

Enjoy your day!

Vanda Lancour

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

Who Looks Out For The Security of Your Legs

Spring has officially arrived here in the Northern Hemisphere or has it. A couple who are friends have returned to their home on the Upper Peninsula (UP) of Michigan after a lengthy vacation traveling the nice warm southern United States and are questioning their decision to return at this time. They shared on Facebook that they woke up to snow on the deck, the bay is still frozen and it was 35 degrees. For the rest of us the spring time weather like here in Amarillo, Texas gives us the travel bug.

If you are flying, airport security will be looking out for your safe flight by checking for bombs in shoes, explosives in hats, and (oh, of course) the .357 magnum that someone “forgot” to take out of their carry on bag. But what are you doing to make sure you arrive at your destination safely and are not attacked by enemies of a differ kind, Deep Vein Thrombosis (DVT) or the even more deadly Pulmonary Embolism (PA).  Either one can ruin a wonderful vacation. It is not just flying that can create these enemies… any travel by car, bus, or train that lasts 5 hours or longer is a candidate for creating these vacation ruining enemies. 

Air travel has been put on the most wanted poster more times because you are sandwiched between two other travelers, you are sitting, and sitting, and sitting in very dry, low-pressure air with lower than normal oxygen levels. Your legs are bent in the same position for hours and the seat you are sitting in for your safety is constructed with a fairly rigid  metal frame which is cutting into the back of your legs compressing the popliteal vein and slowing down the blood returning to your heart. It is at this point that you become a great candidate for a DVT. As I said, you do not have to be on a plane for this to occur…all you have to do is travel for long distances in the same position. Sitting can be dangerous for your health!

Lets make your journey one you remember because of the wonderful time you have and not because you encountered your enemies DVT and PA. Begin by choosing support socks (knee high will usually be appropriate) that will aid in returning the blood in your lower extremity back to your heart. If you have no swelling in your legs, no predisposition for developing a DVT then a 15-20mmHg compression will probably be adequate.  

Following is a list of factors that increase the risk of developing DVT:

  • Injury to a vein, often caused by:
    • Fractures
    • Severe muscle injury
    • Major surgery (especially of the abdomen, pelvis, hip, or legs)
  • Slow blood flow, often caused by:
    • Confinement to bed (possibly due to a medical condition or after surgery)
    • Limited movement (a cast on an extremity to help heal a injured bone)
    • Sitting for a long time, especially with crossed legs
    • Paralysis
    • Sedate lifestyle
  • Increased estrogen:
    • Birth control pills
    • Hormone replacement therapy, sometimes used after menopause
    • Pregnancy, for up to 6 weeks after giving birth
  • Certain Chronic medical illnesses:
    • Heart disease
    • Lung disease
    • Cancer and its treatment
    • Inflammatory bowl disease (Crohn’s disease or ulcerative colitis)
  • Other facts that increase the risk of DVT include:
    • Previous DVT or PE
    • Family history of DVT or PE
    • Age (risk increases as age increases)
    • Obesity
    • A catheter located in a central vein
    • Inherited clotting disorders
    • Varicose veins

If you swell when you are not traveling or are predisposed to developing a DVT, you should choose a 20-30mmHg compression or discuss this with your physician. It is up to you to be proactive to make sure your legs arrive safely.

Here’s to a wonderful journey and thanks for shopping SupportHosePlus.com,

Vanda

PS: Next week things you can do when you travel that can save your life.