The body has developed mechanisms to move blood from the lower leg back to the heart against gravity. These mechanisms include 1) the calf muscle that squeezes the deep veins, pumping fluid upward, 2) valves in the veins that open to allow blood flow upward toward the heart and close to prevent reflux or blood flow downward and 3) respiratory function where deep breaths inward reduces venous pressure and promotes flow upward.
Chronic vein disease (CVD) results from a break-down or dysfunction of any one of these mechanisms. Venous valve malfunction is often discussed. However, what is often overlooked is that patients with CVD often have an inadequate calf pump.
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