Venous pump of the calf: A study of venous and muscular pressures

Abstract

Little data are available concerning the relation between the muscular pumping mechanism and the variation of superficial and deep venous pressure during normal action of the calf pump; therefore we undertook this study to determine the pressure values in three compartments of the calf and in the deep and the superficial venous system and to establish correlation between muscular and venous pressure.Methods: Nine healthy young women with a mean age of 23 years (range 19 to 28 years) were examined. In the same calf, a muscular catheter was placed in the deep posterior compartment (DPC), in the superficial posterior compartment (SPC), and in the anterior tibial compartment (ATC), and a vascular catheter was placed in the popliteal vein and in the greater saphenous vein (GSV). The five lines of pressure were simultaneously recorded in the following situations: at rest, during Valsalva maneuver, foot flexion, and foot extension. The situation was studied with the patient in the following positions: decubitus, sitting, standing, and squatting. A final continuous recording was carried out after the patient had been walking for 5 minutes.Results: Mean values with standard errors of muscular and venous pressure were established in each situation. At rest and during Valsalva maneuver, the muscular pressures did not vary, whereas venous pressures increased significantly when the patient was sitting and standing. On the other hand, squatting was associated with a rise in the muscular and vein pressures. Foot flexion entailed a significant increase in the ATC pressure and a rise in the GSV pressure, whereas foot extension caused the DPC pressure to rise without venous pressure modifications. Walking was associated with an alternating increase in the DPC, SPC, GSV and popliteal vein pressures when the foot was compressed to floor followed by a significant decrease when the foot pressure was released. Conclusions:The variations in the deep and superficial venous pressures when the patient is sitting and standing both at rest and during Valsalva maneuver are not associated with an increase in the muscular pressure. On the contrary, during foot movements, the ATC and the DPC are responsible for superficial vein pressure variations without modifications of the SPC pressure.

Squatting test: a dynamic postural manoeuvre to study baroreflex sensitivity

“…However, several differences may be pointed out between the active squatting to standing transition and the passive head-up tilt table manoeuvre, among which are the absence of kinking of the arteries and the almost absence of active muscular contraction during the tilt test. In contrast, the squatting test is accompanied by a strong muscular contraction leading to increased venous pumping during active stand up [23]. Furthermore, squatting may be described as a fast way of standing, contrasting with tilt that is a slow way of standing.…”

Squatting maneuver - an easy and efficient method to evaluate postural effect on human arterial blood pressure regulation

“…Further by Rossberg and Penaz and Krediet and Wieling added that on standing and loss of compression of the legs, there would be an immediate reduction in leg vascular resistance due to already existing locally mediated vasodilatation. [26][27][28][29] Moreover, also supported by studies by Tschakovsky and Sheriff as the muscular effort involved in standing up from a squat position is considerable, it has been demonstrated that rapid vasodilatory mechanisms act in proportion to contraction intensity. [30] This would be expected to cause further vasodilatation.…”

“…The leg and buttock muscles are active and there is a restriction of blood flow due to elevated intramuscular pressure compression of the vasculature during squatting. [26,27] This combination of compression of blood vessels, leading to relative ischemia and active muscle contraction, is likely to result in local vasodilatation of the leg and buttock muscle vasculature. Further by Rossberg and Penaz and Krediet and Wieling added that on standing and loss of compression of the legs, there would be an immediate reduction in leg vascular resistance due to already existing locally mediated vasodilatation.…”

Manual Lymphatic Drainage in the Treatment of Chronic Venous Disease

“…The calf muscle pump is in sequence with the foot pump is the most important muscle pump in the human circulatory system [27,87]. The calf muscle pump is associated with the strong triceps surae muscle and can be separated in two units: a first unit that includes the soleus muscle (leg pump) and its veins, and a second unit situated in the upper leg region and composed by the gastrocnemius muscle and respective veins (popliteal pump) [88].…”