Chronic venous insufficiency may cause calf muscle soreness and weakness; the picture shows the situation. (picture taken from freepik)
[Health Channel/Comprehensive Report]Do you often feel weak leg muscles? Physiotherapist Wang Wenyu posted on her Facebook page “Physiotherapist Wang Wenyu‧ Amber physiotherapist“Share, chronic venous insufficiency (Chronic Venous Insufficiency, CVI) refers to the damage of venous valves, resulting in the inability of blood to return to the heart efficiently. Its characteristics are: edema, skin changes, ulcers.
Wang Wenyu explained that chronic venous insufficiency will greatly affect daily life. In addition to feeling heaviness, soreness, fatigue, and even pain, functions will also be affected, such as difficulty in walking, poor balance, reduced ankle mobility, and muscle weakness. wait.
Wang Wenyu said that these diseases are all related to neuropathy caused by venous problems or weakness of calf muscles. According to the classification of clinical etiology, anatomy and pathophysiology (CEAP), the stages and clinical features of chronic venous insufficiency are sorted out. Patients with chronic venous insufficiency can be divided into the following stages:
● Issue 0: Vein-related problems that cannot be observed
● Phase 1: “Varcose veins (capillary or reticular vein dilatation), venous thrombosis, venous valve damage”; feel heavy, edema around the ankle, edema will disappear when elevated
● Phase 2: “Varcose veins, venous thrombosis, venous valve damage”; feel heavy, edema around the ankle, edema will disappear when elevated
● Phase 3: “Calf and ankle edema appears, skin changes”; there is pitting edema (it will not disappear when raised), and the tissue hardens
● Phase 4: “Calf and ankle edema appears, skin changes”; there is pitting edema (elevation will not disappear), skin discoloration, tissue hardening
● Phase 5: “Calf and ankle edema appears, skin changes”; there is pitting edema (elevation will not disappear), skin discoloration, tissue hardening, ulcer healing
● Phase 6: “Calf and ankle edema appears, skin changes”; there is pitting edema (it will not go away when raised), skin discoloration, tissue hardening, and new ulcers appear
As for the cause of chronic venous insufficiency, Wang Wenyu said that excessive expansion of veins leads to increased venous microvascular pressure, which in turn increases the load of the lymphatic system, and in the case of lymphatic vessel compensation, it causes changes in the lymphatic vessel wall until the lymphatic vessel loses its compensatory function. Finally, edema occurs when the lymphatic system is overwhelmed.
manual lymphatic drainage therapy
Wang Wenyu also shared the manual lymphatic drainage (MLD) often used by therapists. According to the randomized controlled test literature in 2014, 10 treatments were performed within two months for cases with edema. The study found that there were improvements in the severity of chronic venous insufficiency, fatigue, heaviness, and pain; but there was no difference in muscle strength and life activities.
However, Wang Wenyu also explained that it is currently known that chronic venous insufficiency, strength, mobility, and life functions can be improved through muscle strength intervention and exercise, but there is no way to prove whether manual lymphatic drainage therapy can directly improve muscle strength, mobility, and walking. The function of life is yet to be discussed more academically.
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