A diagram of a leg with varicose veins

Exercise Programme Following Varicose Veins Surgery

Exercise safely after your varicose vein surgery with advice from an experienced physiotherapist. Jodie Krantz from Perth in Western Australia went through this surgery herself and writes with 30 years experience in her profession.

This article is a step by step guide that takes you through the days and weeks immediately following your surgery. It will give you the confidence to help yourself recover as quickly as possible.

Please note: the following is a general guid only guide only and may not apply to everybody. Always take the advice of your surgeon and other medical personnel. Read our disclaimer

 

Day 1

As soon as you wake up after the surgery begin the following bed exercises at least once an hour:

Ankle exercises

Move your feet and toes and down rhythmically. Circle them 10 times in each direction. The purpose of this help maintain your circulation and prevent the rare but serious complication of a deep vein thrombosis.

Knee and hip exercises

Bend and straighten your knee slowly and gently 5 times by sliding your foot along the bed. This helps to prevent stiffness and also keeps your circulation going.

Walking

You should be allowed to get out of bed and walk soon after you have eaten your first meal. Walk to and from the bathroom on the first day and if possible a little further.

Analgesia

Take your pain medication as advised by your doctor. Pain relief will help you perform your exercises better and therefore improve your recovery.

Comfort

Elevating your affected leg on a soft pillow may assist your circulation and reduce swelling. Check with your medical staff first.

Applying Surgical Stockings

Before putting on your surgical stockings turn the stocking inside out down to the heel. Slide your foot into the stocking up to the heel then ease it up over your leg – it will hurt! Surgical stockings with a cutout toe hole are easier to put on. Place a plastic bag on the end of your foot then slide the stocking on over the plastic bag. Remove the bag through the toe hole.

Day 2

The pain may be a bit worse on the second day as the local anaesthetic wears off. Take your prescribed or over the counter analgesic medications so you can get yourself moving. 

Bed exercises

Continue your bed exercises as above on an hourly basis.

Walking

Extend the duration of your walking to periods of up to 10 minutes if possible. Try to get up and walk at least once every 2 hours.

Analgesia

Continue to take pain medication as required. It will help you do your exercises so you can recover more quickly.

Day 2 to 5

In place of the bed exercises get out of bed and walk every hour during the day for a short period. Walk continuously for at least 15 minutes twice a day on flat ground. You may find the walking is quite painful to begin with however the longer you walk, the less pain you should experience.

When walking, try to put your full weight on the affected leg and minimise limping as much as possible. Do not rush the weight bearing phase on your affected leg and try to use the muscles of this leg normally. Always wear your surgical stockings when walking. Avoid prolonged sitting or standing and elevate your leg when lying down.

Day 6 onwards

By now the pain should be starting to decrease, though you will likely still feel very tight and stiff. Even if it’s still really uncomfortable it’s important to keep moving and to try to gradually increase the duration of your walking.

Walking

Continue your walking programme for at least 30 minutes everyday. Include some hills. Start each walk slowly and try to put even weight on both legs. Gradually lengthen your stride and increase your speed as you start to feel more comfortable. Ensure that your stride length is the same on both legs.

Using a pedometer may help to encourage you with your walking. I recommend the fitbit which i found incredibly motivating. It logs the number of steps you have taken each day, the distance covered and the calories you’ve burned. Little flashing lights on your wrist band show your progress and give you positive feedback. The fitbit also monitors your sleep quality at night.

Stretches

The muscles and fascia of the calf and / or inner thigh are likely to become very tight following your surgery. These stretches should be performed gently. Listen to your body and do not push into pain. Remember, everyone responds differently to exercises. If you are experiencing any difficulties please ask your doctor or physio for advice.

You will need:

  • A carpeted floor space or exercise mat
  • A strap with a loop (for example resistance tubing, yoga strap or dressing gown cord)

This stretch sequence has 3 parts all done in the same position. Remember, the leg that’s not moving remains bent with the foot on the floor. This helps you stabalize the pelvis and protects your lower back from injury.

  1. Hamstrings:
  • Lie on your back with knees bent, feet flat on the floor
  • Put the loop of your strap around your foot of the operated leg
  • Hold the strap with both hands
  • Lift your foot up high and try to straighten the knee
  • Keep the other foot standing on the floor
  • Slowly lower your leg towards the floor, keeping pelvis stable
  • Raise and lower your leg like this 10 times, breathing fully

2. Calf muscles:

  • Keep your leg up as high as possible, knee straight
  • Having your foot up helps reduce swelling in the calf
  • Gentle flex and extend your ankle 10 times, keeping the knee straight
  • Circle your ankle 5 times in each direction

3. Inner thigh muscles (hip adductors)

  • Do these exercises extra slowly for the maximum benefit
  • Keeping a stretch on the back of your thigh and the knee straight slowly lower your leg out to the side
  • Consciously allow the muscles of the inner thigh to let go
  • You can allow the bent knee (non-operated leg) to move outwards slightly to counterbalance
  • Keep the pelvis as stable as possible – this will help with core strength
  • Bring the leg back to the vertical and repeat 5 times

It’s also fine to do all the above exercises on the non-operated leg.

Massage

Soft tissue massage can be helpful for relieving congestion and breaking down scar tissue, while improving comfort and mobility. Refer to the advice of your surgeon as there are situations in which massage could be inadvisable or dangerous (especially infection or deep vein thrombosis).

You will need to start extremely gently for your safety and comfort. Begin by lightly rubbing in the Hirudoid cream, working it in an upward direction (towards the groin). Don’t use excessive pressure or you will only worsen the brusing.

From approximately 4 weeks after the surgery you can begin to use a bit more pressure and include small circular movements over the lumps in your calf or thigh.

Beyond 6 weeks

See your surgeon for a post operative check. Continue all your exercises until you have no further symptoms. If you’re not normally someone who exercises regularly, consider making a 30 minute walk part of your daily routine for the rest if you’re life.

As little as 2.5 hours of moderate activity every week (ideally as 30 minutes minimum every day) can reduce the chance of your veins recurring as well as improve your general and physical health. You are likely to live both a longer and happier life if you make this simple lifestyle change. If you need motivation go with a friend, join a walking group or buy a fitbit, smart watch or pedometer.

If there are still lumps in your thigh or calf after 6 weeks, use a foam roller to massage the soft tissue daily. A professional massage can really help. It always seems to take twice as long as you think to recover from surgery. I still had some lumps remaining after 4 months. One year after the surgery I still had scars. However in time they all disappeared. I hope you also have a great outcome.

Good luck!