The relationship of foot and ankle movements to venous return in the lower limb

Abstract

W e have studied the relationship between movements of the foot and ankle and venous blood flow from the lower limb using colourflow Duplex ultrasound to determine the optimum type of exercise for promoting venous return. Studies of both active and passive movements were carried out on 40 limbs in 20 subjects (18 men; 2 women), with a median age of 27 years (20 to 54). We assessed ankle dorsiflexion and plantar flexion, subtalar inversion and eversion, and a combination of all movements. There was no difference in venous flow when comparing opposite limbs in a single subject (p > 0.5), but active exercises produced higher peak and mean velocities of blood flow than passive ones. The active combined movement produced the highest velocities with an increase of 38% in mean and of 58% in peak flow velocities, which were significantly greater than the peak and mean flow rates produced by passive movements. The active combined exercise would therefore be the most effective in eliminating stasis and could contribute to the prevention of deep-vein thrombosis.

Physical inactivity and idiopathic pulmonary embolism in women: prospective study

“…Muscular activity in the lower extremities is required to promote venous blood return. [30][31][32] Thus, lack of such activity could result in venous stasis and thrombosis. Lower levels of circulating factors such as tissue plasminogen activator, platelets, and fibrinogen could also play a role by increasing thrombotic tendency and plasma viscosity.…”

Muscle blood flow in response to concentric muscular activity vs. passive venous compression

“…The beneficial haemodynamic effects of active movement of the foot on the venous system in the early postoperative period after a major operation on a lower limb have been reported (McNally et al. 1997, Sochart & Hardinge 1999). In addition, Gardner & Fox (1983) described a venous pump mechanism in the sole of the human foot that is capable of returning blood from the leg up into the thigh.…”

Therapeutic compression materials and wound dressings for chronic venous insufficiency: A comprehensive review

“…The highest compression is exerted distally (e.g., on the ankle), and the pressure decreases proximally up to the knee or thigh. Compression therapy can reverse venous hypertension (Van Bemmelen, Beach, Bedford, & Strandness, ), augment the skeletal muscle pump (Miller, Pegelow, Jacques, & Dempsey, ), and promote venous return (Sochart & Hardinge, ) and lymphatic drainage (Chan, Duffield, & Watsford, ). It also triggers sophisticated physiological and biochemical effects on blood vessels, soft tissue, and lymphatic systems (Lim & Davies, ).…”