The ability to move the ankle, known as ankle motility, is im- portant to consider. The calf muscle acts as a pump to push blood in the leg— against gravity— from the leg, back up to the heart. If the ankle does not have full range of motion, it is considered an independent risk factor for venous disease. For this reason, high-heeled shoes are often associated with bad veins. When one is wearing high heels, the calf muscle cannot be fully extended, which decreases its power within the pumping mechanism.


Standing for long periods, with or without high heels, is also


a risk factor. Research has shown that the more hours one stands, the more likely it is that a vein issue will develop. Likewise, sit- ting or lying in one position for too long can cause serious vein problems. Patients in the hospital or on bed rest, for example, may experience a slowdown in blood fl ow that can lead to blood pool- ing in the extremities. One possible risk caused by prolonged im- mobility is deep vein thrombosis (DVT), which is a blood clot that forms in the deep vein system. Another risk is superfi cial thrombo- phlebitis, which is a blood clot that forms in the superfi cial system. Both types of clots can damage the valves and result in venous refl ux or insuffi ciency.


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At my practice, many patients have asked if crossing their legs


causes varicose veins. The answer is: we don’t currently know. There is no research supporting this claim, but anecdotally, I oc- casionally see a patient who crosses her right leg over the left who experience issues with their small saphenous, a vein that begins at the back of the knee and extends down the backside of the leg. Continuous pressure on this vein may damage the valves, or at least impede fl ow, which could create permanent damage.


People often assume that weight is a risk factor in venous


disease. However, weight, obesity, waist measurements, and BMI (Body Mass Index) have confl ict in research. There have been sev- eral studies that show a connection and several others that don’t. One study found a connection between BMI and superfi cial vein disease but not deep vein issues. Again, there has not yet been conclusive research about this.


In some cases, such as family history or ethnicity, it is impos- sible to eliminate risk factors for vein disease. Some risk factors, however, can be reduced. There are many treatment options today that are minimally invasive and highly successful, but education and prevention are the most important keys to good vein health.


Dr. Cindy Asbjornsen is the founder of the Vein Healthcare Center in South Portland, Maine. Certi- fi ed by the American Board of Venous and Lymphatic Medicine, she cares for all levels of venous disease, including spider veins, varicose veins and venous ulcers. She is the only vein specialist in Maine to be


named a Fellow by the American College of Phlebology. You can contact Dr. Asbjornsen at 207-221-7799 or info@veinhealthcare. com. See ad on back cover.


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