Standing still - flex your calf muscles

The best thing you can do to delay varicose veins is to keep the blood circulating in your legs.

Think of your calf muscles as the "heart" of your venous circulation. If you point and flex your foot enough to strongly contract the calf muscle, you will move one cup of blood out of the leg. You can also squeeze your feet together in your shoes, or go up and down on your toes. Shaking your leg is not very effective. You need to make your muscles work.

Avoid binding clothing, on a day to day basis

Girdles or knee-high nylons or socks can block the movement of blood up the leg. The vein wall has to expand to get around this barrier. As a result, the valves lose their tight fit and can start to fail, allowing blood to pool - the beginning of varicose veins.

Wear graduated support hose

Many pharmacies carry special knee-high socks, nylons, pantyhose, and tights that are good for your legs and come in a variety of very fashionable colours. These stockings apply a gentle, graduated pressure to the leg, from the foot upward, which helps to decrease the expansion of the vein wall. The pressure is the greatest at the ankle and gradually lessens until it reaches the knee area. You do not need a prescription for these stockings.

We recommend that patients wear a 15 mm Hg to 20 mm Hg pressure hose every day. With larger varicose veins your physician may prescribe up to 30 mm Hg to 40 mm Hg pressure.

Control your weight

Most, though not all, studies report obesity as a factor in the development of varicose and spider veins. Weight loss should be considered if overweight. Weight loss results from reduced calories and an exercise program.

Fluctuating hormones during the menstrual cycle can affect veins

Changing hormone levels, both pre-menstrual and mid-cycle (at ovulation), allow the vein wall to relax. In this relaxed state, the vein holds more blood, which puts pressure on the valves. So if you think that sometimes your veins look worse than other times, they do. For some patients, being on the pill or taking estrogen replacement hormone will have this same effect on their veins. In these situations, support hose, exercise, and weight control can all help in keeping the vein walls fit.

Pregnancy can expand veins

Pregnancy also causes an elevation of many hormones. Estrogen relaxes the smooth muscle and collagen fibres in general, which may contribute to the vein wall expanding. In addition, the amount of blood in the systems increases by up to 40%. When patients report the sudden development of varicose or spider veins, one of the first questions is, "Are you pregnant?" Veins can change rapidly when a woman is only 5 weeks pregnant and is still unaware of her pregnancy.

About 70% of women who become pregnant and who have inherited a family gene for varicose and spider veins will develop these veins. The good news is many of these veins will disappear 4 to 6 weeks after finishing breast-feeding. For many women, it is usually the third pregnancy when these varicose and or spider veins remain and require treatment. Again, support hose, exercise, and weight control are helpful.

Avoid wearing high-heeled shoes every day

High heels are not fashionable for your veins. If you wear a heel that is more than 1.5 inches high every day, your calf muscle will not be effectively pumping blood out of the leg. You can try this at home. Feel how the calf contracts when you walk in lower heels and then switch to high heels. The foot simply moves forward in high heels, and you won't feel your calf contracting as you walk.

Exercise with care

A well-toned leg muscle will pump out much more blood than a weak muscle as you walk or move - and the more venous blood you move out of the leg, the less chance the vein has to expand and cause valve damage.

You should be careful with strenuous exercise, however. Abdominal pressure can block the flow of blood back to the heart. For example, when lifting heavy weights, make sure that you blow out. Otherwise, you increase your abdominal pressure and the veins have to expand to get around this block.

Roxanne Hallgren, RN 
in association with the MediResource Clinical Team