Exercise for thrombosis. Thrombophlebitis: causes, symptoms, treatment, exercise therapy, alternative treatment

Thrombophlebitis of the lower extremities treatment gymnastics

Forecast provided that thrombophlebitis is treated correctly, it is favorable in most cases. With deep vein thrombophlebitis in patients, as a rule, postphlebitic syndrome develops. Thrombophlebitis of superficial veins can result in the resorption of a thrombus or its organization (germination by connective tissue) with obliteration of the vein, which turns into a dense cord.

Unlike deep vein damage, this does not lead to impaired venous outflow. Sometimes blood clots calcify, forming phlebolitis (vein stones). With thrombophlebitis, especially deep veins, there is always a risk of developing severe, often fatal, complications - pulmonary embolism. With purulent thrombophlebitis, there is a danger of ascending thrombosis with damage to the iliac and inferior vena cava and the development of sepsis (see). With migratory thrombophlebitis, the inflammatory process usually responds well to treatment, but after a while, thrombophlebitis develops in other veins. In parallel with this, the phenomena of endarteritis are steadily progressing, therefore, this pathological process should also be treated at the same time.

Thrombophlebitis treatment should be complex, it is different for different forms of thrombophlebitis. In acute deep vein thrombophlebitis, bed rest with an elevated position of the diseased limb is mandatory, which reduces edema, the risk of embolism, pain and improves blood flow. Considering that the compensation processes are faster at functional load extremities, as well as the fact that a blood clot from the 3-5th day is more firmly fixed to the wall of the vein, the patient is allowed to move the fingers and foot of the affected limb from the 4th-5th day of the disease, from the 6th-7th day in the absence of acute events - sit in bed, and from the 8-9th day - walk around the ward with an elastic bandage applied to the sore limb.

In acute thrombophlebitis of superficial veins, prolonged bed rest promotes the spread of thrombosis to deep veins; therefore, bed rest is not currently used in the treatment of thrombophlebitis of superficial veins. A light bandage with heparin ointment or Vishnevsky ointment is applied to the affected limb, on top of which an elastic bandage is applied in order to turn off the superficial vein system from the circulation.

The patient is allowed to walk only with an elastic bandage applied.

Thermal procedures for a diseased limb in the acute stage of thrombophlebitis are contraindicated. Cold is used in cases of persistence of pulsation in the arteries of the affected limb (cold intensifies the spasm of the arteries!).

Antibiotics are prescribed from the first day of illness. Penicillin is administered intramuscularly in combination with streptomycin in the usual dosage. Anticoagulants are used as directed by a doctor under the obligatory control of the blood coagulation system (coagulogram) and urine analysis (microhematuria!). Heparin is injected intramuscularly at 5000-15000 IU every 6-12 hours. within 3-5 days. Effectively drip introduction of heparin with novocaine and penicillin (100 ml of 0.25% solution of novocaine. 5000 U of heparin and 200,000 U of penicillin) into the paravenous tissue of the diseased limb. This mixture can also be infused intraosseously into the calcaneus or the outer ankle of the affected limb. The injections are repeated 2-3 times every 3 days.

In the acute stage of thrombophlebitis, no later than the 3rd day of the disease, good healing effect is achieved when fibrinolysin is administered simultaneously with heparin. 40,000 IU of fibrinolysin is diluted in 300 ml of isotonic sodium chloride solution and injected intravenously over 3 hours. At the same time, 10,000-15,000 IU of heparin are injected intramuscularly: fibrinolysin dissolves the formed thrombus, heparin prevents the formation of a new thrombus.

As an analgesic, anti-inflammatory and reducing blood clotting, butadion is prescribed in a dose of 0.1-0.15 g after meals 4-6 times a day, as well as dressings with Vishnevsky's ointment, which are changed every 3-4 days.

To relieve vascular spasm, especially in cases of severe arterial spasm, apply perirenal novocaine blockade according to Vishnevsky (see Novocaine blockade).

In acute thrombophlebitis, novocaine blockade according to Shkolnikov is indicated.

The blockade is made on the side of the defeat. The patient is placed on his back. After treatment with an alcoholic solution of iodine, 5 ml of a 0.25% solution of novocaine is injected into the skin of the abdominal wall 1.5 cm inward from the anterior superior spine of the ilium. Then 250,000-1,000,000 IU of streptomycin in 150-200 ml of 0.25% novocaine solution is injected there to a depth of 14 cm along the inner surface of the ilium. When involved in the pathological process of both lower limbs produce a bilateral blockade. The blockade is considered to be done correctly if in the first 10-15 minutes. the patient experiences a feeling of heaviness and pleasant warmth along the back of the thigh of the diseased limb. After the blockade, it is recommended to rest in a horizontal position for 30-40 minutes.

Hirudotherapy is also prescribed (see. Leeches), which reduces vasospasm and inflammation, reduces blood clotting.

Treatment for migratory thrombophlebitis is the same as for deep and superficial vein thrombophlebitis. Topical application of corticosteroids - hydrocortisone and prednisolone - has a good effect.

With often recurrent thrombophlebitis, intramuscular aevit is used, 1 ml daily, for a course of 15-20 injections. At the same time, Escuzan is prescribed inside, 15-20 drops 3 times a day before meals for one and a half to two months. The use of escuzan prevents new thrombosis and exacerbation of thrombophlebitis. After the end of the intake of escuzan, an alcoholic tincture from the roots of plowed steel (T-rae Ononis arvensis) is prescribed, 30-40 drops per dose 3 times a day before meals. The course of treatment is 1 - 1.5 months.

With postphlebitic syndrome in mild cases, constant wearing of an elastic bandage or elastic stockings is shown, limitation of stay on the legs, in severe cases, especially with varicose ulcers, it is shown surgery... Physiotherapy treatment (high frequency, sollux, iontophoresis with novocaine), as well as spa treatment (mud, sulfuric and other baths) is shown no earlier than 3 months later. after subsiding acute phenomena with thrombophlebitis of superficial veins and after 6 months. after deep vein thrombophlebitis. Treatment in the resort with radon and hydrogen sulphide waters is especially effective.

Surgical treatment of thrombophlebitis is used for purulent melting of the vein and the formation of abscesses: the vein is ligated above the purulently melted thrombus or the entire affected vein is excised, the abscess is opened; then treatment is carried out as in a purulent wound (see. Wounds, wounds). With thrombophlebitis of varicose veins top scores gives surgical treatment in the form of excision of the affected veins.

Prevention of thrombophlebitis- timely treatment of diseases that contribute to its occurrence (purulent processes on the limbs, varicose veins, trophic ulcers, etc.). In the prevention of venous thrombosis arising after various operations, great importance has early getting up of patients in the postoperative period, physiotherapy, combating dehydration, improving performance of cardio-vascular system.

Source: http://www.medical-enc.ru/18/thrombophlebitis-2.shtml

Therapeutic tactics

Treatment objectives

In the treatment of acute venous deep vein thrombosis of the lower extremities, surgeons must solve several problems:

1. To prevent the progression of thrombosis.

2. Prevent pulmonary embolism.

3. To prevent the progression of edema and thereby prevent the development of venous gangrene and loss of a limb.

4. Promote rapid recanalization and the achievement of compensation for venous outflow.

4. To carry out the prevention of post-thrombophlebitic syndrome.

5. Prevent retrombosis.

In solving these problems, the following are important:

1. Mode physical activity.

2. Correct and long-term elastic compression.

3. The effectiveness of pharmacotherapy.

4. Timely surgical treatment.

5. Qualified rehabilitation.

The leading method of treating deep vein thrombosis of the thigh and lower leg is conservative therapy, for which a patient with an acute thrombotic process in the venous bed should be urgently hospitalized in the department of vascular or general surgery. A patient with acute venous thrombosis should initially be considered a candidate for pulmonary embolism.

Patient management regimen

In case of deep vein thrombosis of the leg, thigh and iliac veins, the first 3-5 days before the removal of venous hypertension and instrumental examination for the nature of thrombosis (localization, embolism), bed rest is recommended.

In the absence of flotation and embolism, patients are allowed active image life with correct elastic compression of the entire limb up to the groin fold.

In cases where it is not possible to conduct a full examination (ultrasound scanning), patients should be kept in bed for 7-10 days against the background of anticoagulant and compression therapy. This time is enough to remove the threat of pulmonary embolism and fix the thrombus to the venous wall, and patients are allowed to get up, walk in a dosage rate, actively bend and unbend the feet and toes to accelerate blood flow, that is, patients are recommended a motor regime with limited static stay in the vertical position.

At first, physical exercises contribute to the compensation of the activity of the cardiovascular system in general and venous outflow from the extremities in particular.

Secondly, muscle contraction provides an increase in the concentration of an important antithrombotic factor - tissue plasminogen.

During bed rest, and especially with existing limb edema, the lower end of the bed should be raised to improve venous outflow.

After deep thrombosis, it is necessary to gradually expand the amount of physical exercise. Special gymnastics in a horizontal position has a beneficial effect on the rehabilitation of patients. It is necessary to exclude only those types where a static component is present or which can provoke leg injuries. In addition, all exercises should be performed with elastic compression of the lower extremities.

The build-up of the load should be gradual. For a start, a daily 1.5-hour walk with periodic rest is sufficient. If the affected limb does not respond with pain or convulsive syndrome, the duration and frequency of walks may be increased. After 2 - 3 months, physical exercise can be expanded through gymnastics aimed at improving venous outflow from the limb. These are exercises in a supine position with raised legs ("birch", "scissors", "bicycle", etc.). In the future, exercise on a stationary bike, jogging, cross-country skiing... In addition, at all stages of rehabilitation, it is advisable to go in for swimming, which is the optimal sport for patients with pathology of the venous system.

Therapeutic exercises for thrombophlebitis

With thrombophlebitis, classes in the pool, yoga, Pilates are allowed.

Are prohibited sports activities, during which sharp intense movements are made - for example, tennis lifting weights.

In the complex of therapeutic and prophylactic measures, a large role belongs to physical culture.

Therefore, dosed work, coupled with the contraction of the leg muscles, contributes to the fight against the phenomena of blood stagnation in the veins. Prolonged standing and sitting is static work, accompanied by a fixed position of the legs. The muscles of the legs in such cases squeeze the veins and do not contribute to the movement of blood through them, which leads to significant stagnation. Therefore, stationary work is more tiring than work involving movement. Weakening of the activity of the heart in various diseases of the heart can also lead to venous stasis in the legs. Pregnancy in women often causes enlargement and overflow of the veins of the lower extremities with blood, since the veins of the pelvis are compressed by the enlarging uterus with the growing fetus in it.

In the overwhelming majority of cases, the superficial veins located under the skin of the lower leg and thigh are exposed to nodular expansion of the veins. With this disease, blood circulation in the affected leg is impaired, which leads to a nutritional disorder of the skin. In some cases, varicose veins do not cause significant concern. If treatment is not carried out in a timely manner, then even benign leaking nodular veins (without any complaints) can develop and be complicated by edema, eczematous rash, ulcers of the lower half of the leg and foot.

Nodular varicose veins can be complicated by blockage and inflammation (thrombophlebitis), so it is very important to systematically carry out preventive and therapeutic measures, which should be comprehensive.

You should regularly engage in daily morning hygienic gymnastics with the inclusion of special exercises followed by water treatments like: rub-down, wash or shower. During the day, several times you need to do special exercises for 3-7 minutes. Participation in industrial gymnastics is beneficial. Regular, non-tiring walking walks at a distance of one to three kilometers (in the morning, afternoon, or before going to bed) are highly advisable.

It is unacceptable to wear round garters that tighten the legs. It is important to monitor regular bowel activity to prevent blood stagnation.

With thrombophlebitis in the subacute period, small slow movements in bed are allowed, you can sit at the table while eating. We give exemplary complex therapeutic exercises for thrombophlebitis in the subacute period.

Along with other methods of treatment, in chronic thrombophlebitis, therapeutic exercises with careful hardening and walking play an important role. However, overvoltage should be avoided.

An approximate set of special exercises for performing during the day with chronic thrombophlebitis

1. Walking with high leg raises and a large arm swing.

30-100 steps, 2 steps - inhale, 3 - exhale, or 3 steps - inhale and 4 - exhale.

2. Raising the straight leg, touch the opposite palms with socks, 4-8 times each

3. Lying on a couch or rug or sitting. Raising your legs as high as possible, do vigorous bending in the knees - "bicycle". 20-40 times. Breathing is even, with an emphasis on prolonged exhalation.

4. Alternate leg raises based on a chair. 6-12 times.

An approximate complex of therapeutic exercises for thrombophlebitis

(TM - slow pace. TS - average pace)

1. Full breathing. Slowly 3-4 times.

2. Spread your arms, pull yourself up and bring your arms together, clasping your shoulders. TM. 3-5 times.

3. Alternate flexion in knee joint with the simultaneous lifting of the pelvis. TM. 3 times.

4. Pull the bent leg to the stomach. TS. 3-5 times each.

5. Sit down with your hands. TM. 3-4 times.

6. Alternate abduction or raising of a straight leg, 3-8 times each.

7. Flexion and circular motion of the feet. TM, TS. 10-40 times.

8. Alternate flexion of the lower leg, relaxed. 3-5 times.

9. Imitation of walking. TM + TC. 20-60 steps.

10. The transition from a sitting position to a standing position. 4-20 times.

11. Raising the case. TM. 10-6 times.

Note: Start with 4 exercises and gradually add one exercise every 2 days. Finish the complex with a full breath.

Find out the symptoms, how to treat and whether it is worth playing sports at all if you have a disease such as thrombophlebitis.

The content of the article:

Thrombophlebitis is an inflammatory disease that affects the vessels of the venous system. The main cause of the development of the disease is blood clots that form in the veins. The initial stage of the disease, in which the inflammatory processes have not yet been activated or are insignificant, is called phlebothrombosis.

The disease can affect not only superficial veins, but also those that are deep. However, this disease is most often found in the superficial veins. Any damage to the veins can initiate the development of the disease. Since the vessels do not have their own muscles, the blood clots formed in them continue to develop, which leads to a violation of blood flow in a specific area of the limb.

If thrombosis develops in deep veins, then with sudden changes in blood pressure, they can break and clog small vessels. Thus, thrombophlebitis is a serious ailment that, in a certain situation, can cause death. Everyone knows that under the influence of physical exertion, blood pressure increases. In this regard, a fair question arises, is sport possible with thrombophlebitis?

The main reasons for the development of thrombophlebitis

The main reason for the development of superficial thrombophlebitis is trauma to the walls of the vessel. This can happen if the catheter is not inserted correctly or the syringe needle is inserted during the injection. The ailment in deeply located vessels is directly associated with varicose veins. Let's note the main reasons for the development of thrombophlebitis:

A sedentary lifestyle - if physical exercise are absent for a long time, the thrombus is actively increasing in size and, as a result, can cause serious disturbances in blood flow.
Damage to the walls of a blood vessel.
Genetic or acquired abnormalities of the blood coagulation system.

Among the risk factors for the development of this ailment, we note:

Forced long-term limitation of mobility.
Obesity.
Smoking and alcohol abuse.
Pregnancy period.
Various ailments of an oncological and hematological nature.
Limb injuries.

According to the available statistical information, in 2004, when women undergo hormone replacement therapy during menopause, the risks of developing thrombophlebitis significantly decreased.

Thrombophlebitis symptoms

Thrombophlebitis of superficial veins develops slowly and the main symptoms are redness of the skin at the site of damage to the walls of the blood vessel and the appearance of seals. As the disease progresses, the redness spreads further, affecting new areas. Often, the inflammatory process resembles a cobweb and more and more small blood vessels are damaged.

Even with a severe form of the development of the disease, its symptoms may be mild. At the site of inflammatory processes, the skin becomes hard and reddens. Most often, the disease affects the lower extremities, and its symptoms are pronounced hyperemia and the appearance of a venous pattern on the skin at the site of injury.

After the appearance of edema on the skin, the patient begins to feel incessant itching, and the pain becomes pulsating and burning. If you quickly change the position of the legs, then the situation is aggravated. This is possible, for example, in the morning when getting out of bed. Among other things, the patient gradually develops a feverish state, and the body temperature is in the range from 37.5 to 38 degrees.

The symptoms of deep thrombophlebitis are very similar to superficial ones:

Local increase in body temperature.
The appearance of redness on the skin, and sometimes blue discoloration.
Swelling.
As the disease develops, pain appears.

Note that in comparison with superficial thrombophlebitis, edema with a deep one is more pronounced and immediately striking.

How is thrombophlebitis treated?

When diagnosing this ailment, first of all, the question arises before you not about whether sport is possible with thrombophlebitis, but how to be cured. Note that therapy for superficial and deep thrombophlebitis is different. If the ailment was diagnosed at the initial stage of development, then most often the patient carries out the treatment on his own, but before that, you should consult with a specialist.

In the acute form of the disease, drug therapy is carried out, which includes anti-inflammatory medications, as well as ointments. They are able to relieve swelling, improve blood flow and increase vascular tone. We also recommend carrying out the following procedures:

Use a warm compress.
Drugs like ibuprofen or aspirin can help suppress inflammation, relieve pain and speed up blood clotting.
You can use non-steroidal ointments and gels.
During clinical trials, the high efficiency of using special dressings and stockings has been proven.

It should be noted that when the tone of the blood vessels is low, the use of compression garments and elastic bandages promotes squeezing of the veins and thereby prevents the separation of a blood clot from their walls. The length of the stockings depends on the height of the lesion. Using compression garments can limit the spread of edema and reduce the risk of developing deep thrombophlebitis. Most often, the thrombus resolves over several days, and in especially difficult situations, weeks. After that, all the symptoms of the disease disappear.

It only makes sense to use antibiotics if the veins are infected. V otherwise the use of medications of this group is not only unjustified, but may have negative effects... All of the above concerns the treatment of superficial thrombophlebitis.

If deep vein disease is diagnosed, then the therapy should be different. First of all, this concerns the mandatory use of drugs of the anticoagulant group and the need to keep the legs in an elevated position. In this case, it is important to prevent the development of pulmonary embolism, and for this, hospitalization of the patient is required for the entire period of treatment.

Also, in some cases, in addition to anticoagulants, thrombolytic drugs should be used. They allow you to speed up the process of resorption of blood clots. Thrombolytic medications not only speed up the healing process, but also dramatically reduce the risk of a blood clot ruptured. If all Taken measures on the treatment of the disease do not bring positive results, there is a need for surgical intervention.

We will also tell you about the most effective folk methods of dealing with the disease:

Consume one third of a glass of nettle decoction three times a day.
The leaves of the golden mustache are used locally.
Hazel leaf tea is very useful for thrombophlebitis.
Honey should be used to make a compress.
In a similar way, a cabbage leaf, previously oiled with vegetable oil, is used. To increase the effectiveness of such a compress, the cabbage leaf must first be broken.

All of these treatments can only be effective in combination with drug therapy.

Prevention of thrombophlebitis

The development of many ailments can be avoided if special preventive measures are taken. Thrombophlebitis is no exception to this rule. First of all, you must lead an active lifestyle. In addition, we recommend that you do the following:

Avoid sitting or lying down for long periods of time.
You cannot be in a horizontal position for a long time period. If you are forced to limit your activities due to injury or illness, wear compression garments.
On long flights or commutes, get up and walk around the cabin.
Drink plenty of fluids. To avoid dehydration.

Sports with thrombophlebitis: is it possible to do

If you want to know whether it is possible to play sports with thrombophlebitis, then get acquainted with the contraindications:

Active running and jumping- cardio training that involves the use of bouncing or intense running should not be carried out.
Avoid excessive stress on the leg muscles- all sports in which exercises must be performed in a standing position are banned. Exercising on a treadmill or an ellipsoid should be limited in time.
Strength training- when diagnosing thrombophlebitis from training program it is necessary to exclude squats, deadlift as well as lunges.

Many women prefer jogging when choosing a sport. This is due to the fact that many specialized resources often talk about the benefits of aerobic exercise for weight loss. In turn, many representatives of the beautiful half of humanity want to get rid of excess weight... As we have already said, varicose veins can become one of the reasons for the development of thrombophlebitis. In this regard, the question of whether it is possible to play sports with thrombophlebitis is somewhat modified.

It is generally accepted that varicose veins are mainly found in elderly women. However, according to statistics in last years this ailment has become much younger. Scientists have proven that age does not matter here. On the planet, about 60 percent of women suffer from this disease, which can cause the development of thrombophlebitis.

Blood circulates throughout the body and it is especially difficult for it to return back to the heart muscle from the lower extremities. If you are active, frequent contractions of your leg muscles can help improve blood flow. One of the main reasons for the development of varicose veins is a passive lifestyle.

As in the case of thrombophlebitis, running with varicose veins is contraindicated. It is high loads that can provoke the formation of a blood clot and its subsequent separation from the walls of blood vessels. Answering the question, is sport possible with thrombophlebitis, if it comes about jogging, then definitely not. Another thing with varicose veins, light running loads are allowed in order to stimulate the outflow of blood from the lower extremities.

However, there are some rules you should follow when doing this. First of all, remember that with varicose veins, jogging should not be long. We also recommend wearing compression garments for class. But swimming with varicose veins can only be beneficial. Since water has a much higher density, blood cannot stagnate in vessels, even when you are just lying on the surface of the water. That's all that I wanted to tell when answering the question, is it possible to play sports with thrombophlebitis.

Physical culture plays an important role in the complex of therapeutic and prophylactic measures. To assess its value, it is necessary to familiarize yourself with the features of blood circulation in the lower extremities.

The heart muscle, contracting, pushes blood into the arteries and arterioles - small arteries - capillaries that carry blood from the heart. Through the veins, the blood returns to the heart. The lymphatic system performs a role similar to that of the veins: it drains the lymph through the venous bed to the heart. The contraction of the heart occurs on average in a quarter of a second and alternates with relaxation for half a second. Blood flows through the vessels in a continuous stream. The elasticity and elasticity of the arterial walls and the presence in them of smooth muscles, which relax with contraction (systole) of the heart and contract with relaxation (diastole).

Regulation of the activity of blood vessels is carried out through nervous system... Each vessel contains nerve endings, the so-called receptors. They perceive various irritations from the inside (from metabolic products) and from the outside: cold, warmth, tremors, bruises. All these stimuli are transmitted to the central nervous system, and impulses (jolts) go from it to the vessels, which reflexively change their lumen.

The range of motion in the legs is less than in the arms, but the mass of muscles, blood vessels, nerves and other tissues in the legs is three times greater than in the arms. The legs carry out a supporting function and bear the weight of the whole body. For most of the day, the legs are in a state of constant tension, resting completely only in the supine position.

Studies have shown that in a semi-sitting position, intravenous pressure in the lower extremities of a person is equal to 15 cm of water column, in a sitting position - 26 cm, while standing - 94 cm.When a person is standing, the veins of the legs swell and increase in volume. During work, especially rhythmically repeated in a standing and sitting position (walking, sawing wood, cycling, etc.), muscle contractions periodically squeeze the veins and push blood out of them towards the heart. Therefore, dosed work, coupled with the contraction of the leg muscles, contributes to the fight against the phenomena of blood stagnation in the veins. Prolonged standing and sitting is static work, accompanied by a fixed position of the legs. The muscles of the legs in such cases squeeze the veins and do not contribute to the movement of blood through them, which leads to significant stagnation. Therefore, stationary work is more tiring than work involving movement. Weakening of the activity of the heart in various diseases of the heart can also lead to venous stasis in the legs. Pregnancy in women often causes the veins of the lower extremities to expand and overflow with blood, as the veins of the pelvis are compressed

an enlarging uterus with a growing fetus in it. In the chapter “ Physiotherapy during pregnancy ”describes the method of physical exercises, which serve as a powerful means of preventing nodular (varicose) veins.

The main causes of varicose veins are; congenital or acquired insufficiency of the muscular layer of the vein wall, underdevelopment of venous valves and venous sclerosis.

You should regularly engage in daily morning hygienic gymnastics with the inclusion of special exercises followed by water procedures, such as: rubdown, washing or shower. During the day, several times you need to do special exercises for 3-7 minutes. Participation in industrial gymnastics is beneficial. Regular, non-tiring walking walks over a distance of one to three kilometers (in the morning, afternoon, or before going to bed) are highly advisable.

It is unacceptable to wear round garters that tighten the legs. It is important to monitor regular bowel activity to prevent blood stagnation.

Thrombophlebitis of the lower extremities is a disease in which there is an inflammatory process in the veins and blood clots appear (blood clots that clog the lumen of the vessel and disrupt the movement of blood through it).

The cause of thrombophlebitis is most often an infection that can cause a blood clot in the lower limb. The presence of nodular varicose veins creates a fertile ground for the occurrence of thrombophlebitis. The lower extremities are most easily exposed to thermal and mechanical influences from the outside, which can lead to prolonged expansion and narrowing of blood vessels, which, in turn, lead to stagnation of blood and create conditions for the development of the causative agent of infection and the formation of a blood clot. By the nature of the course of the disease, they are distinguished: acute, subacute, recurrent, recurrent, chronic thrombophlebitis and its residual effects. In acute thrombophlebitis, rest of the affected limb is shown (strict bed rest).

Currently, scientists have come to the conclusion that the risk of a thrombus (plug) ruptured and the appearance of an embolism (blockage) is extremely exaggerated in acute thrombophlebitis, since by the third or fourth day, the thrombus is usually well fixed in the vein. In this regard, it is advisable, already in the days of the patient's stay in bed, to provide him with some freedom of movement and apply dosed exercises in the knee and ankle joints, movements of the toes to improve blood flow in the vessels, while maintaining the elevated position of the lower extremities. As the pain subsides or soreness decreases with pressure along the affected vein, it is recommended to move the affected limb in the bed, lower it and, finally, begin to move around the ward.

With thrombophlebitis in the subacute period, small slow movements in bed are allowed, you can sit at the table while eating. We give an approximate set of therapeutic exercises for thrombophlebitis in the subacute period.

Along with other methods of treatment, in chronic thrombophlebitis, therapeutic exercises with careful hardening and walking play an important role. However, overvoltage should be avoided.

APPROXIMATE COMPLEX OF SPECIAL EXERCISES FOR PERFORMANCE DURING THE DAY FOR CHRONIC THROMBOFLEBITIS AND VARICOSIS VENOUS DISPENSES (within 3-7 min.)

1. Walking with high leg raises and a large arm swing.

30-100 steps, 2 steps - inhale, 3 - exhale, or 3 steps - inhale and 4 - exhale.

2. Raising the straight leg, touch the opposite palms with socks, 4-8 times each

3. Lying on a couch or rug or sitting. Raising your legs as high as possible, do vigorous bending at the knees - "bicycle". 20-40 times. Breathing is uniform, with an emphasis on extended exhalation.

4. Alternate leg raises based on a chair. 6-12 times.

APPROXIMATE COMPLEX OF THERAPEUTIC GYMNASTICS FOR THROMBOFLEBITIS IN SUB-ACUTE PERIOD AND WAYING THROMBOFLEBITIS

(TM - slow pace. TS - average pace)

1. Full breathing. Slowly 3-4 times.

2. Spread your arms, pull yourself up and bring your arms together, clasping your shoulders. TM. 3-5 times.

3. Alternate flexion in the knee joint with simultaneous lifting of the pelvis. TM. 3 times.

4. Pull the bent leg to the stomach. TS. 3-5 times each.

5. Sit down with your hands. TM. 3-4 times.

6. Alternate abduction or raising of a straight leg, 3-8 times each.

7. Flexion and circular motion of the feet. TM, TS. 10-40 times.

8. Alternate flexion of the lower leg, relaxed. 3-5 times.

9. Imitation of walking. TM + TC. 20-60 steps.

10. The transition from a sitting position to a standing position. 4-20 times.

11. Raising the case. TM. 10-6 times.

12. Alternate leg raises. TM. 4-8 times.

Alternate flexion of the lower leg. 4-8 times.

14. Lying on the right (left) side, raising a straight leg. TM, TS. 4-8 times.

15. Full deep breathing. 4-20 times.

Note: Start with 4 exercises and gradually add one exercise every 2 days. Finish the complex with a full breath.

Residual effects of thrombophlebitis are characterized by swelling of the lower leg and foot, discoloration of the skin, rapid fatigue when walking. The patient's body usually compensates for its condition by developing blood circulation in a roundabout way, due to the formation of new vessels connecting the veins below and above the place of blockage (thrombus). This is facilitated by systematic physical education.

Hygienic and physical therapy measures for chronic thrombophlebitis are the same as for varicose veins.

For citation: Bogachev V.Yu. Treatment and rehabilitation of patients with deep vein thrombosis of the lower extremities // BC. 1999. No. 13. S. 606

Department of Faculty Surgery, Russian State Medical University

The introduction of an effective system for the treatment and rehabilitation of patients with deep vein thrombosis (DVT) is one of the most pressing problems of modern clinical medicine. This is due to a steady increase in the incidence of DVT, which reaches 160 cases per 100,000 population per year. Such a high incidence is due to lifestyle changes modern man(physical inactivity, the nature of the diet, overweight, etc.), an increase in injuries, the increasingly frequent occurrence of hereditary and acquired disorders of the hemostasis system, the prevalence of oncological diseases, uncontrolled intake of hormonal drugs, etc. Venous thrombosis with inadequate treatment leads to severe chronic venous insufficiency(CVI) of the lower extremities and disability. In addition, a real threat to the life of many patients undergoing treatment in hospitals of various profiles is pulmonary embolism (PE), the most dangerous complication of DVT. The main directions for solving the problem of venous thromboembolic complications are: 1) creation common system prevention of DVT in high-risk groups; 2) prevention of PE in case of venous thrombosis; 3) improvement and standardization of DVT treatment;

4) the introduction into outpatient practice of a complex of rehabilitation measures, the implementation of which is shown to all patients who have undergone thrombosis.

Deep Vein Thrombosis Treatment

Suspected DVT is an absolute indication for urgent hospitalization of the patient. If conditions permit, the patient should be admitted to a specialized angiosurgical hospital. In cases where this is not possible, DVT treatment can be carried out in the surgical or, in extreme cases, in the therapeutic department.

Polymorphism of the clinical manifestations of DVT often requires differential diagnosis with diseases that occur with similar symptoms (intermuscular hematomas, myositis, muscle sprains, Achilles tendon injuries, arthrosis, arthritis, etc.). In this regard, it becomes necessary to attract additional, instrumental examination methods. The most informative are duplex ultrasound scanning of blood vessels and radiopaque phlebography. Doppler ultrasound in DVT has no independent diagnostic value, since it gives a large percentage of false negative conclusions in non-occlusive forms of thrombosis.

Treatment program for DVT: The treatment program for DVT includes: 1) Cessation of the growth and spread of the thrombus. 2) Prevention of PE. 3) Restoration of the patency of the lumen of the vein.

Stopping the growth and spread of a thrombus can be achieved thanks to anticoagulant therapy, which implies consistent application direct (heparin) and indirect (phenylin, acenocoumarol, etc.) anticoagulants.

In the absence of contraindications, conventional (unfractionated) heparin is prescribed in a daily dose of 450 IU per 1 kg of the patient's body weight. Depending on the route of administration, a single dose is calculated by dividing the daily dose by the number of injections (8 injections for intravenous, fractional administration with an interval of 3 hours; 3 for subcutaneous administration with a frequency of 8 hours). To achieve the fastest anticoagulant effect, it is advisable to initially intravenously administer 5000 U of heparin in a stream, and then the rest of the daily dose using an infusion pump.

The duration of heparin therapy is individual and averages 7-10 days. In this case, the dose of heparin should be corrected taking into account the temporal indicators of blood coagulation. (optimally their lengthening is 1.5 - 2 times from the norm), which are assessed daily before the next administration of the drug.

Currently, DVT is widely used for anticoagulant therapy. low molecular weight heparins (NMH). Their selective predominantly anti-Xa action prolongs the antithrombotic effect and reduces the incidence of hemorrhagic complications. In international practice, the most widespread is enoxaparin... Enoxaparin is prescribed at a dose of 1 mg / kg 2 times a day under the skin of the abdomen. It should be emphasized that when using LMWH, daily laboratory monitoring of the hemostasis system is not necessary, which creates favorable prerequisites for outpatient treatment of embolone-dangerous DVTs.

3 - 4 days before the expected cancellation of heparin, it is necessary to appoint indirect anticoagulants... Their effective daily dose is controlled by the level of the prothrombin index, the value of which should be stabilized within 45-60%.

In recent years, for the standardized monitoring of the effectiveness of anticoagulant therapy, international index INR , representing the relationship between patient's prothrombin time (PTp) and prothrombin time control (PTcontr.). The anticoagulant effect is considered to be achieved if the INR is more than 1.5 ... The duration of taking indirect anticoagulants is usually 3-6 months, since it is during these periods that DVT recurrences are most often observed. In thrombophilic conditions, therapy with indirect anticoagulants should be longer.

Along with anticoagulants in the therapy of DVT, it is advisable to use hemorheologically active drugs (rheopolyglucin, derivatives of pentoxifylline and nicotinic acid) and nonspecific anti-inflammatory drugs (NSAIDs) parenterally or rectally (in suppositories). The need to use NSAIDs (preferably diclofenac and ketoprofen derivatives) is due to the presence inflammatory reaction on the part of the venous wall, as well as pain syndrome that makes it difficult to activate the patient ... Subsequently, for 4-6 weeks, drugs with the predominant anti-inflammatory effect on the venous wall (rutoside, troxerutin).

As for antibiotics, their use for uncomplicated DVT is meaningless, just like with varicothrombophlebitis. An exception can be made in the case of pustular skin lesions or the presence of an “entrance gate” for infection (open fractures, surgical wounds, etc.), as well as for patients with a high risk of septic complications (diabetes mellitus, HIV, etc.).

For the prevention of pulmonary embolism, in addition to anticoagulant therapy, which to a certain extent prevents it by preventing the progression of thrombosis, various surgical methods are used for embolism (floating) thrombi: thrombectomy, implantation of a cava filter, or plication of the inferior vena cava with a mechanical suture.

It is sometimes possible to completely restore the patency of the vein in cases of early diagnosed (3 - 5 days old) segmental DVT with the help of direct surgical intervention (thrombectomy) or thrombolytic therapy.

The period of active thrombus formation lasts on average about 3 weeks. It is shortened with adequate therapy, or it can be delayed if the treatment is not carried out correctly. The result of DVT in the overwhelming majority of cases is post-thrombophlebitic changes in the venous system of the lower extremities.

Depending on the path of evolution of the thrombus, vein recanalization or his persistent obliteration. In some cases, recanalized vein segments alternate with occluded ones.

Deep Vein Thrombosis Rehabilitation

After DVT, the patient passes into a qualitatively different pathological condition called post-thrombophlebitic disease (PTFB)... It is characterized by the development of chronic venous insufficiency syndrome and the rapid progression of trophic skin disorders, which necessitates a comprehensive rehabilitation program for DVT. Comprehensive rehabilitation program for DVT: 1) Reliable prevention of disease recurrence. 2) Compensation of venous outflow and prevention of PTFE progression. 3) Social adaptation of the patient while maintaining his usual level of quality of life.

Prevention of relapse of the disease

The basis for the prevention of DVT relapses is the leveling of the factors provoking thrombosis, which were summarized by Robert Virkhov in the middle of the last century: damage to the vascular wall, slowing blood flow and violation of the physicochemical properties of blood.

Damage to the vein wall may result from a variety of injuries, surgical interventions and endovasal procedures ... In accordance with this, preventive measures are also planned. A number of pharmaceuticals (anavenol, rutoside, diosmin, troxerutin, etc.) have phleboprotective action. To accelerate the flow of blood, periodic contractions of the muscles of the lower extremities are required. That is, patients are recommended an active motor regime with limited static stay in an upright position. Rational dynamic loading is necessary for all patients with DVT.

Firstly, physical exercise helps to compensate for the activity of the cardiovascular system in general and venous outflow from the extremities in particular.

Secondly, muscle contraction provides an increase in the concentration of an important antithrombotic factor - tissue plasminogen.

Third, weight control without rational exercise appears to be problematic.

It is often believed among doctors and patients that any exercise after DVT is contraindicated. This position is wrong. Special gymnastics in a horizontal position has a beneficial effect on the rehabilitation of patients. It is necessary to exclude only those types where a static component is present or which can provoke leg injuries. In addition, all exercises should be performed with elastic compression of the lower extremities.

The build-up of the load should be gradual. For a start, a daily 1.5-hour walk with periodic rest is sufficient. If the affected limb does not respond with pain or convulsive syndrome, the duration and frequency of walks may be increased. After 2 - 3 months, physical exercise can be expanded through gymnastics aimed at improving venous outflow from the limb. These are exercises in a supine position with raised legs ("birch", "scissors", "bicycle", etc.). In the future, exercise on a stationary bike, jogging, cross-country skiing can be connected. In addition, at all stages of rehabilitation, it is advisable to go in for swimming, which is the optimal sport for patients with pathology of the venous system.

An important factor improving phlebohemodynamic parameters is adequate, constant elastic compression... In particular, the 2-fold decrease in the diameter of the vein achieved with its help leads to a 5-fold increase in the blood flow velocity.

Compression treatment is prescribed for a long, and in some cases even life-long term for all patients who have had DVT. In this case, special elastic bandages of a limited degree of extensibility or medical compression hosiery can be used.

Elastic bandages, suitable for long-term wear, must be made of dense fabric with a cotton content of at least 50%. Their distinguishing feature is the extensibility in only one direction - along the length. The width must remain constant. The technique of applying a compression bandage should be trained in every patient. The bandaging of the limb should be carried out in a horizontal position (before getting out of bed) from the toes, with the obligatory grip of the heel in the form of a hammock, and each subsequent round of bandage should cover the previous one by 2/3. The upper border of the elastic band should, if possible, overlap the proximal border of the affected venous segment by 10-15 cm.

Postthrombotic lesion of the iliac and inferior vena cava determines the need for the use of special medical tights II and III compression class stockings, ensuring the creation of a therapeutic pressure in the range from 40 to 50 mm Hg. and more.

Patients often ask the question: is elastic compression necessary only for the affected leg, or is it necessary to bandage both? The spread of a thrombus to the inferior vena cava, conditions after implantation of a cava filter or cava plication, causing phlebohypertension in both limbs, are an absolute indication for a bilateral elastic bandage. In addition, during the rehabilitation period, when the patient subconsciously spares the affected leg, elastic compression support of the healthy leg is advisable.

Prospective use of systems variable pneumomassage of limbs... By creating a "traveling air wave" effect under the control of a computer, these devices ensure effective emptying of veins and lymphatic collectors. The compression bandage applied after this procedure consolidates the therapeutic result. The course of treatment usually includes 20-30 sessions.

Physicochemical disorders of the hemostatic system are the result of various congenital (genetic deficiency of antithrombin III, proteins C and S, erythremia, etc.) and acquired (liver failure, hypoproteinemia, hypovolemia, etc.) pathological conditions. Thrombotic readiness of the hemostasis system and DVT is provoked by various oncological diseases.

Postponed DVT is an absolute contraindication to hormonal contraception, and the issue of hormone therapy for medical reasons should be resolved strictly individually.

DVT, regardless of its cause, creates hemodynamic prerequisites for relapse. Its risk increases many times over in the event of injury, surgery, severe infectious or somatic illness. In all these situations, there are indications for preventive heparin therapy, with the preferred use of LMWH (enoxaparin, fraxiparin, etc.).

The problem of the consequences of DVT and pregnancy deserves a separate discussion. Among doctors and patients, there is an opinion that phlebothrombosis categorically excludes pregnancy and childbirth. Indeed, from a medical point of view, pregnancy is undesirable in the first year after DVT. Subsequently, the decision about it should be made by a woman after consultation with an obstetrician-gynecologist and angiosurgeon. If DVT was not triggered by severe disorders of the hemostatic system, was not accompanied by massive pulmonary embolism, did not entail severe hemodynamic disturbances (for example, due to IVC occlusion), then there are no fundamental contraindications to pregnancy, although the risk of thromboembolic complications during it increases.

Due to this the entire pregnancy of the patient should be under the close supervision of an obstetrician-gynecologist and phlebologist. From the first half of pregnancy, a therapeutic and protective regimen and a permanent elastic bandage are prescribed (best of all, special elastic tights of the II compression class). As the gestational age increases, starting from the 2nd trimester, and depending on the severity of venous insufficiency, the question of drug therapy can be resolved. The optimal are polyvalent phlebotonizing drugs, such as diosmin and troxerutin, in combination with antiplatelet agents (trental, aspirin-cardio, etc.). Pregnant women with a high risk of thromboembolic complications should be admitted to the hospital several weeks before delivery. The question of the method of delivery (naturally or through a cesarean section) is decided individually during a consultation with the vascular surgeon. In the immediate postoperative period, it may be necessary to prescribe anticoagulants preventively.

Venous outflow compensation

The basic pharmacotherapy of acute venous thrombosis is based on a course of heparin therapy in a hospital setting, followed by the selection of an adequate dose of indirect anticoagulants. After that, the patients are discharged under the supervision of a polyclinic surgeon. At the outpatient stage, the dose of indirect anticoagulants should be adjusted. The fact is that changes in the nature of nutrition and living conditions can affect various components of the coagulation cascade. In this regard, the continuation of therapy with indirect anticoagulants should be carried out subject to at least weekly monitoring of the prothrombin index and general urine analysis. The duration of taking indirect anticoagulants, as already mentioned, should not be less than 3 months.

Currently, there is no consensus on the advisability of a combination of indirect anticoagulants with hemorheologically active drugs and phleboprotectors on an outpatient basis. Patients with DVT usually receive a wide variety of different medications while in hospital. Therefore, for the prevention of various gastrointestinal and allergic reactions after discharge, it is advisable to take a 2 - 3-month break, during which the patient takes only indirect anticoagulants.

A gross mistake, often made by doctors of the clinic and patients, is the early cancellation of indirect anticoagulants and their reappointment in short courses from 3-5 days to 2-3 weeks. At the same time, an increase in the prothrombin index up to 90-100% without any clinical symptoms is considered as a manifestation of thrombosis. It must be clearly understood that high level prothrombin by itself does not indicate phlebothrombosis, but is only a marker of the protein-synthetic function of the liver. In a clinical setting, this indicator can vary widely. Prescribing indirect anticoagulants in short courses with their quick cancellation "shakes" the hemostasis system and creates the preconditions for "rebound" thrombosis.

After completing the intake of indirect anticoagulants, a program is planned drug treatment, aimed at improving hemorheology, microcirculation and lymphatic outflow, as well as relieving the symptoms of venous insufficiency, which reduce the quality of life. The physician planning treatment should clearly understand that DVT leads to irreversible changes in the venous bed. Therefore, pharmacotherapy for the vast majority of patients must be carried out for a long time, for several years, and sometimes for life. The patient should also be informed about this.

Drug treatment should be a course, with an average duration of 2.5 - 3 months, provide for a combination of drugs that are different in the mechanism of action. Depending on the severity of the disease, courses of treatment should be carried out at least 2 - 3 times a year, while for the prevention of complications from gastrointestinal tract some of the drugs are advisable to be administered by the parenteral route or in the form of suppositories.

Pharmacotherapy is most often carried out on an outpatient basis. Meanwhile, patients with severe forms of the disease who have undergone massive pulmonary embolism or thrombosis of the inferior vena cava should be hospitalized annually in a therapeutic or cardiological department for a period of 2 to 3 weeks for infusion hemorheological and cardiotonic therapy.

For conservative therapy in patients who have undergone DVT, in addition to traditional derivatives of pentoxifylline, rutoside and horse chestnut extract, modern phlebotonic drugs should be widely used. These are diosmin, troxerutin, diovenor, cyclo-3 fort, endothelon. Their complex action allows the appointment in the form of monotherapy, which reduces the drug load on the patient's body and the associated risk of various allergic and gastroenterological disorders. For example, a high degree of purification and a special micronization technology made it possible to take Detralex for a long time (up to 6 months or more), which had a beneficial effect on the quality of rehabilitation of patients with DVT.

When planning a conservative treatment program, you must remember about the seasonality of the course of the disease. The overwhelming majority of patients notice a deterioration in the summer, when the heat and the associated violation of the compression regime lead to decompensation of the venous outflow. To some extent, the course of drug therapy allows to neutralize the consequences.

Social adaptation of patients

Physiotherapy and spa treatment in the rehabilitation of patients with the consequences of DVT are of secondary importance. Of the physiotherapeutic procedures, the most effective is the effect of a magnetic field. For what they use stationary installations of the "Pole" type or special plates - magnetophores, attached to the lower leg or used in the form of insoles. In addition, Bernard's or d'Arsonval's currents can be used. It is advisable to carry out physiotherapy procedures between courses of drug treatment at least 2 times a year.

Sanatorium treatment is planned to consolidate the results of pharmacotherapy. For patients who have had DVT, hospitals with radon (Pyatigorsk) and hydrogen sulfide (Kislovodsk, Pyatigorsk, Sochi, Sergievskiy Mineralnye Vody) thermal waters are optimal.

Healing naftalan and silt mud relieve persistent pain and edema syndrome in most patients with the consequences of DVT.

General recommendations include balanced diet - an important factor that allows you to control body weight, the excess of which aggravates venous insufficiency. Patients who have had DVT and are obese are advised to take measures, including medication, to lose weight. Spicy, fatty and salty foods should be excluded from the general diet, and flour and sweet foods should be limited. It is advisable to diversify the menu with low-fat varieties of fish and meat, a large number of vegetables and fruits, use mainly vegetable oil.

Some features of the diet should be taken into account when treating with indirect anticoagulants (phenylin, acenocoumarol, etc.). Foods rich in vitamin K (cabbage, spinach, sorrel, liver, coffee, etc.) should be excluded from the diet.

Fluctuations of intra-abdominal pressure during the act of defecation negatively affect the vein wall. That is why foods that have a laxative effect (vegetable oil, beets, prunes, figs, bananas, etc.) are an important part of the diet.

Certain requirements must be met for personal hygiene. Persistent phlebohypertension leads to disruption of the blood supply to the skin and overload of the lymphatic system. Under these conditions, the tolerance of the skin to various damaging factors, including microbial ones, is significantly reduced.

Clothing should be spacious enough and comfortable. In underwear, you should not use tight pants in the form of "swimming trunks", squeezing the collateral pathways of the venous outflow at the level of the inguinal fold. For the same reasons, tight-fitting coarse trousers are not recommended. Shoes should be comfortable, with low, stable heels.

A hygienic shower must be taken daily. In this case, it is advisable to pour over each leg with a tight stream of warm and cool water alternately for 10 - 15 minutes.

Permanent elastic bandage, as a rule, leads to increased dryness of the skin, accompanied by its peeling and the formation of microcracks, which are "gates" for infection. For the prevention of hyperkeratosis, nourishing creams and lotions should be used. In addition, it is necessary to prevent the formation of corns. Prevention and timely treatment of mycotic lesions of the skin of the feet and nails is important.

It is necessary to limit the use of those types of epilation, which are accompanied by heating of the limb (paraffin), significant violation of the integrity of the skin (mechanical) or exposure to damaging physical factors (laser, electrical).

All patients who underwent DVT require medical examination and examination for VTEK. Ideally, they should be attached to specialized phlebology or angiology centers. During the first year after DVT, the patient must see a doctor at least 3 times. Subsequently, in the absence of complaints - once a year. During control examinations, the doctor assesses the course of the disease, conducts a control ultrasound examination, corrects treatment program and gives recommendations for certification at VTEK.

VTEK plays an important role in the rehabilitation of patients. When carrying out it, it is necessary to take into account the fact that patients who have undergone DVT are contraindicated in work associated with heavy physical activity, prolonged stay in static position(standing or sitting), exposure to adverse factors (hot shops, different kinds radiation, sudden changes in temperature, etc.), a high risk of limb injury. That is, the overwhelming majority of patients in the first years after uncomplicated DVT need to be examined by VTEK on the basis of persistent disability with assignment of II working or III disability group. Depending on the course of the disease and the patient's compliance with the rehabilitation program, work activity may be expanded, and the disability group removed.

In conclusion, it should be emphasized that rational treatment and rehabilitation programs, selected individually, in each specific case of DVT, can effectively influence the thrombotic process, prevent the recurrence of the disease, and contribute to the patient's recovery of social and everyday activity.

Troxerutin: TROXERUTIN TREATMENT (Lechiva)

For medicinal purposes and after the course of treatment is indicated. It helps to avoid stagnation of blood, normalizes tissue nutrition and strengthens the heart system. Physical exercises for patients with this ailment are developed by doctors and initial stage performed under their supervision. Regular exercise will help prevent new blood clots and increased blood pressure in the legs, which will have a positive effect on the entire body as a whole.

When is gymnastics necessary?

Thrombophlebitis occurs against the background of varicose veins. Improper functioning of the valves leads to disruption of blood flow, as a result of which its pressure drops, it stagnates in the lower extremities and has difficulty moving through the veins. As a result, a blood clot forms - a small blood clot that can block blood vessels. Among the factors due to which thrombosis occurs, there are the following:

heredity;
varicose veins;
trauma to the veins;
stroke;
excess weight;
pregnancy;
infectious ailments;
malignant formations;
inactive lifestyle;
circulatory problems.

There is thrombophlebitis of deep and superficial veins. The first may be asymptomatic. The second can be recognized by the following symptoms:

The formation of nodules in them can be a sign of damage to the superficial vessels.

the appearance of nodules in the veins (they are visible and felt on palpation);
discoloration of the epidermis;
the appearance of purple bruising under the skin;
the emergence of a vascular network;
soreness when moving;
edema;
burning sensation in the lower leg;
increase in local temperature.

With a tendency to the appearance of an illness, the presence of adverse factors in the history, or with sedentary work, prevention of the disease is necessary. To prevent pathology, the use of medicines, local preparations and physical exercises to normalize blood circulation is shown. Exercise therapy will be effective for deep and superficial vein thrombophlebitis. After surgical interventions and during the course of therapy, exercise is part of the treatment and recovery process.

Exercises can only be performed with a mild course of the disease.

The benefits of gymnastics for thrombophlebitis of the lower extremities

Exercising with thrombophlebitis reduces the risk of new blood clots and helps to achieve the following results:

Gymnastics should be done every morning, and during the day, doctors recommend setting aside time for a leisurely 30-40 minute walk on fresh air, which will have a beneficial effect on the condition of the muscles of the legs and blood circulation. The surface on which the patient will walk must be flat and firm. In order for exercises for thrombophlebitis of the lower extremities to be beneficial, the following recommendations must be followed:

During classes, wear loose clothing that does not squeeze the body.
Before starting the lesson, it is necessary to fix the veins elastic bandages or wear compression stockings.
After gymnastics, it is recommended to take a contrast shower and douche the legs.

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Load options

There is a basic medical complex with thrombophlebitis and separately exercises for the legs. They must be performed every day. First, the basic allowed loads are done to warm up all joints, and then special attention is paid to the lower extremities in order to activate blood circulation in them. A greater effect will be observed if you engage in physical education at least 2 times a day. Gymnastics does not take much time - for full complex it takes no more than 15 minutes.

Base complex

Physiotherapy should begin with a warm-up. Warm up the neck and upper limbs within 5 minutes. At an average pace, it is recommended to make several hand swings, tilt to the left, right and bottom, stretch in a circular motion hands and shoulder joints. Movements should not be jerky or fast. While doing them, it is important to breathe deeply.

Lower limb load

It is necessary to start classes with 1-3 exercises, adding one element to them every 2 days. Gymnastics for deep vein thrombosis of the lower extremities should be performed at a slow pace and include the following exercises:

Prohibited exercises

Although gymnastic exercises positively affect the condition of the patient's entire body and on his limbs, there are manipulations that are prohibited. Charging excludes such physical activities:

jumping;
the use of weighting materials;
exercises with dumbbells, barbells, weights;
squats;
a sharp lowering of the limbs down;
some yoga asanas;
exercises with the ball.

If you suspect a disease or the manifestation of its first symptoms, you do not need to wait for the progress of the disease - you should immediately consult a doctor. A qualified specialist will select an individual set of exercises for the patient and show how to perform them correctly. Subject to all the rules of rehabilitation and treatment, you can get rid of the disease forever. You should never self-medicate as it can harm your health.

Gymnastics for thrombophlebitis of the lower extremities

Thrombophlebitis is a disease that affects both young and older people. Veins lose elasticity, are damaged, blood clots form, which lead to vascular blockage and other sad consequences.

One of the causes of thrombophlebitis is lack of physical activity and a sedentary lifestyle.

In the period after the treatment, whether operative or conservative, it is important to remain calm.

However, after recovery, you must perform special complex exercises aimed at increasing muscle and vascular tone and preventing possible complications.

Exercises for thrombophlebitis

Correctly selected exercises for thrombophlebitis of the lower extremities, associated with the contraction of the muscles of the legs, contribute to the fight against stagnation of venous blood.

With a sedentary lifestyle, the muscles of the legs squeeze the vessels, the blood circulates poorly. That's why sedentary work more tiring and harmful to the body than those associated with physical activity.

Exercise also has a beneficial effect on the heart, which promotes normal blood flow.

Gymnastics for thrombophlebitis of the lower extremities is performed in a mode that is sparing for the patient. In this case, massage is categorically contraindicated.

With a mild degree of the disease, it is capable of damaging blood vessels and causing accelerated thrombus formation, and even more so when it is neglected.

Any mechanical impact helps the blood clot to break off and travel through the vein, which leads to sad consequences.

How exercise can be done for thrombosis

Consider the answer to the question of what exercises for thrombosis can be performed without harm to the body.

Even in the postoperative period, while in bed, the patient can perform the simplest movements. Fixing a limb in one position is not only unhelpful, but also leads to postoperative complications.

A good method of physical activity in the first days of the postoperative period is to move the toes, which are slightly raised.

As the pain decreases, the movements become more difficult and gradually involve the entire foot.

There are many sets of exercises, the doctor selects the most suitable one.

Basic exercises

Permitted exercises

There are a number of exercises that are conditionally allowed for thrombophlebitis. However, they need to be performed only under the supervision of the attending physician.

Squats. Spread your legs shoulder-width apart and squat, slowly bending them at the knees, as low as possible, but so that it is comfortable. You can perform movements holding the back of a chair.
Swing your legs... They are performed very carefully, without sudden movements. Five to six times in one direction, smoothly and slowly.
Rotational movements of the feet. Holding on to the support, you need to raise the leg and smoothly rotate the foot around its axis several times in one direction and the other. Change legs.
Rolls from toe to heel. This is a simple but very useful exercise. It makes calf muscles strain and normalize blood flow in the extremities.

Such therapeutic exercises for thrombophlebitis of the lower extremities tones the vessels and improves their condition.

Prohibited exercises for thrombophlebitis

It should also not be forgotten that some physical activity with thrombophlebitis is simply contraindicated.

These include:

Please note that for any exercise, you need to choose comfortable clothing that does not squeeze the body. This is especially true for leggings that pull over injured legs, interfering with normal blood flow.

Exercises for deep vein thrombophlebitis of the lower extremities are performed under conditions of careful fixation and elastic compression with special bandages and bandages. In this case, the edema of the limb is removed and the vascular wall is restored.

Also, leisurely walking, as the most natural form of physical activity, has a good effect. It does not unnecessarily strain the body and has a beneficial effect on the muscles of the legs.

First, you need to walk on a flat surface for short distances. As you fully recover, walking should be included in the mandatory set of preventive exercises used for thrombophlebitis.

Exercise stimulates the outflow of venous blood from the affected limb and has a beneficial effect on the activity of the cardiovascular system as a whole.

Along with gymnastics, it is necessary to introduce contrasting douches of the legs, alternating between warm and cool water. It also tones the blood vessels and helps them train.

Sports for thrombophlebitis: exercises to help cope with the disease

A patient who was assigned physical activity, exercises for thrombophlebitis, usually thinks that they should be directed only to the legs. But in fact, exercises for thrombophlebitis of the lower extremities are mainly aimed at strengthening the venous system and improving blood circulation. Elastic and strong veins are essential for the good health of the entire circulatory system. However, over time, they tend to wear out and lose their elasticity, which leads to various problems. Other factors that contribute to the development of inflammation and blood clots:

sedentary lifestyle;
fatty food;
bad habits (alcohol and drug use, smoking);
lack of vitamins and minerals;
super heavy physical activity.

Is it possible to play sports with thrombophlebitis?

Since the entire weight of the body presses on the lower limbs, an increased load also falls on the veins in the legs. Therefore, if the valves and venous walls are weakened, then circulatory problems begin. Due to stagnation in the lower part of the body, at the time of an unsuccessful surgical intervention, thrombophlebitis may occur, physical activity in which is recommended by phlebologists and vascular surgeons. Gymnastics for thrombophlebitis of the lower extremities should primarily be aimed at strengthening muscles and oxygenating the blood. After all, if the inflamed part of the vein (even after a complete cure) does not have enough oxygen, then the surrounding tissues will begin to suffer from the accumulation of toxins, which in the long term can lead to an ulcer. Therefore, when diagnosed with thrombophlebitis, the recommendations of physiotherapists are to perform simple exercises.

What to do with thrombophlebitis?

Even simple walking with thrombophlebitis is considered one of the very effective ways of prevention. Any other exercise that requires constant movement of all limbs is also allowed. Yoga, Pilates, gymnastics for thrombophlebitis will help not only improve blood circulation, but also strengthen the muscles of the limbs. And here treadmill, a stepper and an exercise bike for thrombophlebitis will not be the best helpers for exercise. After all, excessive stress on the legs can significantly worsen general state veins. If there is no money for special equipment, but you still need to do exercises for thrombophlebitis, then you can use ordinary dumbbells or even bottles filled with sand. The lightest and effective exercise with thrombophlebitis of the legs: walking in fast pace, as well as rolling from heels to toes (best with dumbbells in hand). Daily charging with thrombophlebitis, it can consist of a set of simple exercises, the purpose of which is to strengthen the muscles of the legs without overloading.

Varicose veins are a terrible "plague of the XXI century". 57% of patients die within 10 years of.

Sports with thrombophlebitis should not harm, so any exercise should be started with a warm-up. Starting position: sit on the floor with legs extended forward, fold both arms behind your back. Then gently bend right leg and put under the thigh. As a result, the left leg should be straight and the right leg bent. The heel of the bent leg should point straight up, and the big toes should point to the floor. Without bending your back, you must try to raise your left leg. If the starting position is accepted correctly, then it will not work to raise the foot very high. Repeat the lifts 10-15 times, then change the working leg. After finishing the warm-up, it is logical to think about whether it is possible to pump the press with thrombophlebitis? In general, doctors do not allow abs work even with minor varicose veins, not to mention chronic thrombophlebitis. But no one specifies that only long breath holdings and compression of the femoral veins are undesirable (as happens when performing the exercise from a prone position). Professional physiotherapists, who believe that with thrombophlebitis, you can play sports, suggest raising your legs from a prone position. This will help to strengthen the abdominal muscles and at the same time improve venous outflow.

The following exercise is forbidden to perform with lesions of the veins in the legs. But if thrombophlebitis has struck the hands, then you can safely do several repetitions a day. Before starting the exercise, you need to stand up straight, spread your legs 30 cm apart, and turn your socks out. Stretch the hands straight in front of you. When performing the exercise, it is better to look straight ahead. Next, you need to bend your knees, keeping your back strictly straight. There is no need to squat down, just sit down slightly and hold this position for at least a minute. Also slowly return to the starting position. Repeat squats 10-15 times. As muscle memory develops, the number of squats should be increased.

As already became clear, physical education and thrombophlebitis are quite compatible concepts. The most important thing is to avoid overloading and blocking blood flow. The next few exercises help to strengthen the muscles of the lower extremities, but at the same time are categorically contraindicated in the acute stage of the disease. Starting position: lying on the left side, the head is lowered onto the arm bent at the elbow. Left leg straightened, and the right one is bent at the knee. Need to capture right hand lower part of the foot bent leg and slowly pull back. Repeat the movement 10-15 times. Over time, you can change the pace. For execution next exercise you need a sturdy chair. As starting position, you just need to sit on a chair with your legs wide apart. Then rest your hands on the edge of the chair and lower the pelvis (but not below the level of the knees). Sit back on the chair. Repeat 15-20 times. These squats work well in the calf muscles and improve blood circulation.

These absolutely simple exercises will improve health, and thrombophlebitis, as a result, will recede. If the stage and nature of the disease does not allow you to go in for sports, then at least you need to give up a sedentary lifestyle. Long-term immobility leads to a deterioration in venous blood flow.

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