A phlebologist and a therapist explained the risks of thrombosis during sedentary work

Long hours at a desk without moving increase the risk of thrombosis, but a healthy person without risk factors does not need compression knitwear for prevention — it is enough to move regularly. On October 13, Maxim Kazansky, a cardiovascular surgeon, phlebologist, endovascular surgeon, ultrasound diagnostics doctor at the Scandinavian Health Center, and Anastasia Samoilova, a family physician, told Izvestia about how to protect veins during sedentary work.

Why sedentary work increases the risk of thrombosis

Blood rises from the legs to the heart against gravity, and the main helper here is the muscles of the shin. With each step, they compress the deep veins and push the blood upward, and the valves do not allow it to drain back. This system is called a muscular-venous pump. However, when sitting for a long time, it practically stops working.

Samoilova, in turn, noted that sedentary work is not a sentence, but it requires conscious movement, since the veins of the legs do not have their own pump and their function is taken over by the muscles of the shin, which hardly work in the office.

Slow blood flow is one of the classic three conditions for thrombosis, along with damage to the vessel wall and increased clotting. Therefore, in a healthy person, immobility alone rarely leads to a blood clot — it is dangerous when it is superimposed on other risk factors. A clot does not appear in a minute: the risk accumulates over hours of immobility, the blood clot grows gradually, and symptoms often appear several days after sitting for a long time.

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How many hours at the table is already dangerous and who needs a jersey

There is no universal norm, after which the risk turns on as if on a click — it increases gradually with every hour of immobility. A long flight or trip is a good guideline: the risk increases if you sit motionless for more than four hours, and the probability of thrombosis approximately doubles, although it remains small for a healthy person.

In the office, it's more important how long a person sits without a break. The disturbing picture looks like this: ten or more hours a day at the desk at work and at the computer at home, for two or three hours in a row without getting up. A useful habit is much easier — to get up at least once an hour and walk for a couple of minutes.

It makes sense to wear knitwear for those who already have an increased risk: if there was a thrombosis before, there was a recent operation or injury, there is an oncological disease or pregnancy. The risk is higher after childbirth, against the background of hormonal contraceptives or replacement therapy, with severe obesity and an innate tendency to blood clots. For people with varicose veins and edema, knitwear is more often selected in the evening to treat the veins themselves.

There are also contraindications: compression is dangerous when the arteries of the legs narrow, because it will worsen the already weak blood supply. Caution is needed in neuropathy, when the sensitivity of the legs is reduced, for example, in diabetes mellitus — a person may not notice chafing or pinching. Knitwear is not worn on damaged skin and open wounds. It is better to choose the first pair together with a phlebologist.

Which jersey to choose

Knee-high socks are usually enough for prevention during sedentary work: blood stagnates most strongly in the shin, so this option is recommended for long-term sitting. Stockings and tights are needed when there are dilated veins above the knee or when the doctor has decided so after examination.

Preventive knitwear or the first compression class is suitable for everyday wear — this is indicated on the package. The second class and above refers to therapeutic knitwear, it is prescribed by a phlebologist according to indications. The size is selected according to the circumference of the ankle and shin, and it is important to get into it: too tight knee socks or a sliding elastic band squeeze the leg under the knee and harm more than they help.

She also advises you to forget about stilettos and tight pumps, and wear a stable 3-4 cm heel with a wide toe so that your fingers can move, otherwise the foot's muscle pump will be blocked. The organization of the place is also important: a footrest, loose clothing without tight elastic bands, abandoning the "foot on foot" pose.

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In practice, it is enough to get up at least once an hour and walk for a couple of minutes, and stretch your shins at the table: pull your socks on and off yourself, roll from heel to toe, rotate your feet. Samoilova also advises "pump", "bike" and thigh muscle tension for 5 seconds.

If you are predisposed to thrombosis, you cannot intensively knead the calves — you can tear off the clot; only stroking and light rubbing from the bottom up are safe. The doctor does not recommend a massage gun on the calves without consultation, pneumatic massage in the form of compression boots works, and massage capes do not solve stagnation in deep veins. If you have varicose veins, previous thrombosis, or are taking hormones, you should visit a phlebologist before compression and exercise.

Changes in one leg should be alerted: swelling of the shin or the entire leg, bursting pain in the calf or thigh, hot, reddened or darkened skin. With such symptoms, you need to do an ultrasound of the veins on the same day. An ambulance is called for sudden shortness of breath, chest pain when inhaling, or coughing up blood — this may cause pulmonary embolism; you cannot drive. Heaviness in both legs and swelling of the ankles in the evening, which pass after a night's rest, is a reason to visit a phlebologist as planned.