Let us say that you just spent 10 hours in an airplane, a car, or bedridden with a fracture of some type. About 5-10 days later you now have pain, swelling, and discoloration to your left leg. You go to the hospital or doctor not knowing what the problem is and then you are admitted to the hospital with the diagnosis of a DVT (Deep Venous Thrombosis). Knowing how to perform little exercises to promote venous blood flow can help prevent this inconvenient and potentially life-threatening condition.

A DVT is called a Deep Venous Thrombosis. It usually starts in the lower calf veins and grows upward toward the larger veins. It occurs in a deep vein, but can occur closer to the surface (superficial), most commonly to the femoral, popliteal, or iliofemoral veins. The major complication is when this thrombus breaks free and flows through general circulation (embolizes) and lodges somewhere like the lung (pulmonary embolism), heart (heart attack), or brain (stroke).

Lack of mobility, such as sitting for long periods of time in a car or airplane (also called economy class syndrome) or behind a desk are some causes. Venous blood flow is dependent upon several factors as you will see below but compression of the muscles surrounding the large veins is what promotes venous blood flow. Since blood flowing back to the heart is contained in a low pressure dependent system it requires muscle contraction to assist it against gravity. The muscle contraction pushes the blood upward and back-flow is prevented by one-way valves.

When the flow of blood slows in a particular area of the legs or arms it may begin to clot. When blood coagulates it sticks together and this is what forms the thrombus. The influential factors are based on the Virchow Triad which encompasses three main factors: alterations in normal blood flow, injuries to the lining of the vessel, and alterations in the clotting of the blood.

A simple bedside examination is not sensitive enough to confirm a diagnosis, therefore requires what is called a clinical correlation (an imaging or radiological study). The usual study is an ultrasound. Some of the signs usually include:

• Edema (swelling usually isolated to the side of the body where the blockage is occurring)
• Leg pain (not necessarily found in all patients)
• Homan’s Sign is pain elicited in the back of the calf upon flexion of the foot (toes towards the head)
• Tenderness in the calf
• Warmth over the area of the occlusion

Just because you have some of the above signs and symptoms does not mean that you have a DVT. It will be necessary to exclude other medical conditions that can mimic a DVT. Some examples are listed below.

• Achilles tendonitis
• Cellulitis
• Lymphedema
• Neurogenic pain
• Varicose veins
• Stress fracture or bony lesions

Use some of these exercises when sitting or even standing in one place for a long time. It promotes muscle contraction which helps with venous blood flow.

Exercises While Sitting

Ankle Circles: Lifting your feet off of the floor and motioning them in circles for 15 seconds and then reversing the direction.

Foot Pumping: Placing your heels flat on the floor and then lifting the front of your foot upward then placing the ball of your foot on the floor and lifting your heels for about 30 seconds each time.

Knee Lifts: Lifting your knees alternately, keeping your knees bent, up to your chest about 20-30 times per leg.

Shoulder Roll: Roll your shoulders forward, downward, backward and then upward again for 20-30 seconds.

Stretches While Seated

Knee to Chest: Lean forward slightly and alternate bringing your knee to your chest for about 10-15 seconds per leg.

Forward Lean: While sitting lean forward and attempt to touch your ankles for about 10-15 seconds each stretch.

Overhead Lean: Raise both arms above your head grabbing one wrist at a time and lean slightly to the side of the hand holding the wrist for about 10 seconds each side.

Shoulder Stretch: Place your right hand over your left shoulder. Then place your left hand on your right elbow and pull across your body alternating sides for about 10-15 seconds each stretch.

Neck Circles: Allow your chin to flex forward and then place your right ear to your right shoulder, then flex backward, then to the left, and finally to the front again, ensuring that you are stretching the muscles for 5-10 seconds in each direction.

Next time you are traveling or sitting around for long periods of time remember that you have something to do – exercise.

DVT by the Numbers

There may be no symptoms in the location of the DVT, but the classic symptoms of DVT include pain, swelling, and redness of the leg and dilation of the surface veins. In up to 25 percent of all hospitalized patients, there may be some form of DVT, which often remains clinically unapparent (unless pulmonary embolism develops). DVT occurs in about 1 per 1000 persons per year. It is estimated that approximately 350,000 to 600,000 Americans each year suffer from DVT and pulmonary embolism and at least 100,000 deaths may be directly or indirectly related to these diseases.

Source: http://www.webmd.com.