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Recently my workout buddy was at a phlebologist who diagnosed varicose veins which have to be treated by surgery (just one large vein) the cause of this seems to be genetic and she now have to wear compression tights (at least until the surgery next winter).

We workout together for 3 or 5 times a week. The problem is that much of our workout seems to be not very good for her veins:

  • HIIT
  • Strength training (including leg work like weighted squats, lunges etc.)
  • Hill sprints (which is in particular intended to be a strength exercise for the legs especially the posterior chain)

She often uses also a mini trampoline for cardio.

Is it a good idea for her to continue doing this just wearing compression tights?

The point is that she is afraid to ruin her veins because of the HIIT, Weight-lifting and sprints, but she is also afraid to stop doing this because it is fun, and gave her great results.

I already asked google which gave me those articles:

The second article suggests particularly to avoid standing leg exercises such as weighted squats, deadlifts or lunges and choose exercises instead where the heart and the legs are on one level. I guess that doing upper body exercises like pushups, pullups or handstand pushups is no problem, but I am not sure.

However multiple discussions on this site showed that it is difficult do replace those ones (even by a chain of exercise) while getting the same results.

So it would be great if someone could give me some tips how to make her training more vein friendly while not sacrifice the results she has now (think of the goals as if she were a female figure fitness athlete, only as a hobby without competition).

Especially it would be great to see a good series of safe exercises for the lower body that can be done at home (i.e. with dumbbells, resistance bands and exercise balls) and that don't have other shortcomings (such as being bad for the knees or leading to functional muscle imbalances etc).

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She may need to get more direction from her doctor. Generally, exercises with the legs level or above the heart are preferable to those in standing or sitting. Exercises on a Pilates Reformer may allow her to keep her legs above her heart. The Mayo Clinic recommends: "Exercise. Get moving. Walking is a great way to encourage blood circulation in your legs." This will seem very basic compared to her present program. They suggest, "Your doctor can recommend an appropriate activity level for you." –  BackInShapeBuddy Jul 14 '13 at 8:18
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Physicians are not exercise experts. Usually they only recommend some low intensity things like walking, swimming or something like that. They are not experts in helping with specific questions about designing for example a strength training program... –  Sarah Jul 14 '13 at 9:56
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Yes, but physicians are experts on medical and surgical conditions and they can guide you as to what types of exercises would be contraindicated for a particular condition or diagnosis. If your friend's condition is severe enough to require surgery, it is prudent to clear any exercise, esp. resistance training with their doctor. And it is wise to err on the side of caution than to create a worse problem. –  BackInShapeBuddy Jul 14 '13 at 10:36

1 Answer 1

My son asked me to take a look at this question. I'm a second-generation phlebologist, myself the son of the man who coined the word "Sclerotherapy" (=injection treatment of varicose veins) in 1939, and who founded the organization currently called the "American College of Phlebology" (it started as the "Phlebology Society of America", which I ran for about 3-4 years, until politics reared its ugly head).

I almost never advise any patient to avoid any exercise because of varicose veins. The only exceptions to this are (1) if they've just been treated for their veins, or (2) if they have a spontaneous phlebitis. People with phlebitis know there's something wrong, and since virtually all cases of varicose vein-linked phlebitis are what's called "superficial" phlebitis, which is generally harmless but very painful, I presume such people are in sufficient pain that they don't need to be specifically told to lay off exercises until they've been attended to. Note that most varicose vein patients will NEVER get phlebitis as long as they live, so, statistically speaking, this is not a huge problem. The second category, patients who have just been treated, do not need to stop exercising in general. If, post-treatment, I've put them into a compression stocking, or ace bandages, I advise them to do their regular exercises while wearing whatever such device has been recommended. In this office, bandages/stockings are seldom prescribed for more than a week (there are innumerable bandaging/stocking protocols of varying lengths, some up to 6 weeks, but none of them, including mine, have been proven "correct" by controlled studies). I also recommend holding off on exercises in which the legs are pumping vigorously in a position higher than the heart, such as exercises where one is lying on one's back and lifting weights with their legs. I must add, however, that the risk of exercising the legs in a position higher than the heart, which is a risk of pulmonary embolus (blood clot to the lungs), is purely THEORETICAL, and I have never, in 35 years of practice, either seen or heard of any case where ANY exercise has actually caused a blood clot to migrate.

I should perhaps add that, in the vast majority of cases, there are NO BLOOD CLOTS in varicose veins, and, as I said above, in most cases none will ever develop.

In general, I'd advise any person who has varicose veins, and who is involved in an exercise program, to proceed with the program as if they had no disease at all (and I should add that it hasn't been proven that varicose veins is, in most cases, even a "disease" in the first place; it may be a normal variation of circulatory anatomy/physiology, comparable to being very short or tall). If the veins really interfered with exercise, that would presumably mean that the legs ached with prolonged standing. Even people with such varicose symptoms, however, will usually be RELIEVED by exercise. But if the case is severe, and even the exercises do not, by themselves, relieve the aching, then the next step is to wear a compression stocking to the gym. If that doesn't solve the problem, then the veins need to be taken care of. There are lots of phlebologists around these days, and they're not all incompetent (only some).

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Excellent answer, thanks so much for contributing your professional knowledge. –  Eric Kaufman Dec 7 at 16:15

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