Inactivity is a major contributing factor to the development of both arterial and venous problems that lead to poor leg circulation. Even when these conditions are caused by other factors, being sedentary will accelerate the progression of the condition, exacerbate the symptoms and possibly lead to complications that could have been avoided with proper exercise.
The main cause of arterial insufficiency is due to peripheral arterial disease with atherosclerosis and emboli being the most common causes of a blockage in the leg arteries. With venous insufficiency, varicose veins and thrombus formation (DVT) affect the superficial and deep leg veins respectively.
Ways to Improve Blood Circulation in the Leg
There are a number of methods to improve the blood circulation in the leg. This can vary from conservative management (diet, exercise or compression stockings) to medication or surgery where necessary.
- Medical and surgical management should only be considered after careful evaluation by a medical doctor with the relevant diagnostic investigation. The medical management of hypertension, hypercholesterolemia and diabetes mellitus is essential in the treatment of blood circulation problems of the leg.
- Diet may be useful in reducing the blood cholesterol levels which is the main contributing factor in atherosclerosis and can therefore be useful in peripheral arterial disease (P.A.D.). Refer to Cholesterol Diet. Weight loss with a calorie-restricted low GI (glycemic index) diet in overweight or obese patients is advisable in both arterial and venous insufficiency.
- Compression stockings is helpful in varicose veins but may aggravate leg pain and other symptoms in peripheral arterial disease. The three E’s for chronic venous insufficiency is known as elevate, exercise and elastic compression. This is essential for the management of the condition.
- Stopping cigarette smoking is crucial and nicotine replacement products may be helpful in overcoming the addiction in the short term.
Elevating the Legs
Elevating the legs as often as possible is useful in patients with venous insufficiency. When elevated, gravity assists with returning blood to the heart. Ideally the elevation should be above the level of heart although this must be done with caution in patients with heart failure.
Even a moderate elevation, like resting the feet on a foot stool, while sitting will be beneficial compared to resting the legs on the floor in the usual position. Leg pain after standing, sitting or walking for long periods of time may only ease upon elevating the legs.
Elevating the legs in peripheral arterial disease may aggravate the symptoms like pain, numbness and tingling of the feet and legs. Patients with arterial ulcers will often experience pain only upon lying flat, where the feet are at the same level as the heart or when elevated.
Since the flow of oxygenated blood to the lower leg and foot is impaired, elevating the legs increases the the resistance to blood flow due to the effect of gravity. Patients may report an improvement upon standing upright or dangling the lower leg and foot over the side of the bed as gravity assists with the direction of blood flow.
Exercise for Legs and Feet
While exercise is advisable, in both arterial and venous insufficiency, walking or jogging may result in leg pain (claudication – Leg Pain While Walking). Furthermore, with a busy lifestyle, many patients may not exercise regularly thereby losing on the potential benefits of mild to moderate exercise. Ideally a person should get a minimum of 30 minutes of exercise involving the feet and legs in a day (pedal).
- Foot circles involve raising the feet a short distance off the ground and making as many “air circles” as possible till the count of three. This should be done with one foot at a time if it is difficult to hold both feet off the ground simultaneously. Try clockwise circles followed by counter clockwise circles on consecutive reps. Do at least 20 repetitions (reps) per workout. Rest the feet back on the ground till the count of three after every rep if you are unable to keep it off the ground.
- Foot curls involves raising the feet a short distance off the ground and curling the feet into a tight ball. This should be held till the count of three and then relaxed. Both feet can be exercised together. Do at least 20 repetitions (reps) per workout. Rest the feet back on the ground till the count of three after every rep if you are unable to keep it off the ground.
- Walking on the spot for at least 10 minutes in every hour may be helpful for a person who is desk bound and does not have sufficient space to walk around the office. When walking on the spot, raise the legs and thighs higher than one would during regular walking.
- Stepping, at least using a single step, for 10 minutes in every hour is another option. However, it should be done with caution if using makeshift stepping equipment or without the proper footwear as it could lead to an ankle sprain.
In venous insufficiency, exercise helps to push blood back to the heart due to the action of the musculovenous leg pump.Walking, jogging or running are all beneficial in venous insufficiency. The action of the leg and foot muscles as well as the impact of stepping all helps with pushing blood through the veins. By firming the area (calf and feet) with regular exercise and weight bearing training of the legs, there is greater support around the veins. This helps to draw the venous valves closer together in dilated and tortuous veins. For deep vein thrombosis (DVT), exercise reduces venous stasis which can contribute to larger clots.
Venous insufficiency is common in people who sit or stand for long periods of time and is often related to a person’s occupation. If regular exercise during the day is not possible then the following exercises may be beneficial.
- When sitting, do foot circles and curls at least every 30 minutes to an hour or more frequently if possible.
- Try walking on the spot or stepping for 10 to 30 minutes every 1 to 2 hours.
- Taking the stairs instead of the elevator, walking a short distance to collect items that would otherwise be delivered to you (like when ordering lunch) and parking your car a distance from the entrance of a building are small measures that are helpful.
In peripheral arterial disease, exercise increases the blood flow to the legs, decreases the chances of blood clot formation and helps reduce the formation of atheromas which is the most common cause of arterial insufficiency. While all of the measures mentioned above for venous insufficiency is helpful as well, the focus in peripheral arterial disease should be on daily cardiovascular exercise.
This can include walking, jogging, stepping, aerobics or swimming for at least 30 minutes per day. If daily exercise is not possible, working out at least 3 times a week is essential. Exercising less than 3 times a week could strain the heart and the beneficial effects for arterial insufficiency will be minimal.
Stop exercising if the there is severe leg or chest pain. Always consult with a doctor before starting an exercise program. It is advisable to commence your program under the guidance of a registered and reputable fitness trainer or related professional.
Article reviewed by Dr. Greg. Last updated on December 4, 2011