Go with the flow

Adequate blood flow, venous return and lymphatic clearance are essential to the health of your legs. Arterial blood flow provides the oxygen-rich blood and nutrients essential for cellular respiration and repair processes. Adequate venous return prevents engorgement of the veins, excess filtration of fluid into the interstitial space (causing swelling), sluggish blood flow and possible clots. Good lymphatic flow promotes the skin's immune function, the clearing away of metabolic byproducts and other debris, and efficient wound healing.

When it comes to good arterial flow, gravity works in your favorite when standing upright. Pain and paleness when feet are elevated could be a sign of a problem. Plaques can form in the arteries leading to the legs and feet just as they can form in the arteries of your neck, brain and heart. Improving overall metabolic health can help prevent this. If you have cardiovascular disease be sure to follow your doctors' recommendations and if you don't, get regularly checked for symptoms of CV disease like hyperlipidemia, hypertension, high cholesterol and inflammatory markers.

Venous flow is a little trickier because blood has to flow against gravity. One way valves in the venous system help, as does foot pump and the musculature of the calves and thighs. Perversely, the more active you are with work or sport, the more strain your peripheral venous system is under! Leading to conditions like Chronic Venous Insufficiency. If you spend long periods of time on your feet and have a family history of CVI, preventative wearing of sport-grade compression garments during prolonged periods of standing or walking could be beneficial. If you have a personal history of CVI, medical-grade compression garments prescribed by your doctor will be key to managing your condition. Custom fitted garments that work for you and your lifestyle may be the best. HINT: They only work if you wear them!

Compression garments have been in use much longer than you might expect...some historians believe the stiff leather shin-guards worn by Roman soldiers were for more than just protection in battle. During prolonged marches, soldiers' feet and ankles would have likely swollen when wearing naught more than sandals. A stiff circumferential garment around the calves would promote venous return, by compressing the veins against the musculature of the legs. 

In resource poor settings, calf-high boots also serve the purpose of controlling lower leg swelling and promoting venous return.

Please see the next blog for more information on the lymphatic system.