2. Il ritorno venoso per chi studia la
performance è un aspetto rilevante
Il carico interno ed il recupero sono
influenzati dal ritorno venoso
Pressione circolatoria e gittata
cardiaca ( volume di sangue espulso
per minuto) ne sono influenzati
La microcircolazione cutanea e
l’eliminazione di tossine ne sono
influenzate
Il ritorno linfatico è ad esso collegato
Physiol Rev. 2008 Jul;88(3):1009-86. doi:
10.1152/physrev.00045.2006.
Regulation of coronary blood flow during exercise.
Duncker DJ1, Bache RJ.
3. I fattori regolanti il ritorno venoso sono noti, valvole,
spremitura venosa, gradiente di pressione etc.
favoriscono il ritorno al cuore del sangue.
4.
5. Il ruolo rilevante del piede
Gli archi del piede formano
una volta che favoriscono il
cedimento della stessa con
conseguente aumento di
pressione a questo livello, è
chiaro che il movimento
amplifica tale effetto.
Il letto capillare presente nella
volta podalica suggerisce che vi
sia una importante stasi venosa e
ormai molti sostengono che il
ritorno venoso inizi dal piede.
Anat Rec (Hoboken). 2010 Mar;293(3):370-8. doi:
10.1002/ar.21085.
The anatomy and physiology of the venous foot pump.
Corley GJ1, Broderick BJ, Nestor SM, Breen PP, Grace
PA, Quondamatteo F, Olaighin G.
6. Dermatol Surg. 2014 Mar;40(3):225-33. doi: 10.1111/dsu.12381. Epub 2013 Dec 23.
The foot venous system: anatomy, physiology and relevance to clinical practice.
Ricci S1, Moro L, Antonelli Incalzi R.
Abstract
OBJECTIVE:
This review aims to summarize present knowledge of foot venous return, with a special interest in clinical
and research implications.
METHODS:
It is based on the latest available publications on foot anatomy and hemodynamics.
MATERIALS ANATOMY:
Five systems are described: the superficial veins of the sole, the deep veins of the sole (with particular
attention to thelateral plantar vein), the superficial dorsal plexus, the marginal veins and the dorsal arch
and the perforating system. The Foot Pump: The physiology of venous return is briefly described, with an
emphasis on the differences between standing and walking and the interplay of the foot and calf venous
systems.
RESULTS:
The hypothesis that the foot and calf venous systems may be in conflict in several clinical conditions
(localization of leg ulcers, corona phlebectatica, foot vein dilatation, arteriovenous fistulas of the foot, foot-
free bandaging) is presented, briefly discussed, and mechanistically interpreted.
CONCLUSIONS:
Foot venous return could be more important than is commonly thought. Certain clinical conditions could be
explained by a conflict between the mechanisms of the foot pump and the leg pumps most proximal to the
foot, rather than by generic pump insufficiency, with possible effects on treatment and compression
strategies.
7. Perché definirlo cuore venoso? Ovviamente perché da
questo punto parte il ritorno venoso
J Vasc Surg. 1996 Nov;24(5):819-24.
Venous outflow of the leg: anatomy and physiologic mechanism of the plantar
venous plexus.
White JV1, Katz ML, Cisek P, Kreithen J.
8. Phlebology. 2015 Apr;30(3):180-93. doi: 10.1177/0268355513517686. Epub 2014 Jan 10.
Anatomy of the veno-muscular pumps of the lower limb.
Uhl JF1, Gillot C2.
Author information
Abstract
OBJECTIVE:
To study the anatomy of the veno-muscular pumps of the lower limb, particularly the calf pump, the most
powerful of the lower limb, and to confirm its crucial importance in venous return.
RESULTS:
The foot pump is the starter of the venous return. The calf pump can be divided into two anatomical parts:
the leg pump located in the veins of the soleus muscle and the popliteal pump ending in the popliteal vein
with the unique above-knee collector of the medial gastrocnemial veins. At the leg level, the lateral veins of
the soleus are the bigger ones. They drain vertically into the fibular veins. The medial veins of the soleus,
smaller, join the posterior tibial veins horizontally. At the popliteal level, medial gastrocnemial veins are the
largest veins, which end uniquely as a large collector into the popliteal vein above the knee joint. This
explains the power of the gastrocnemial pump: during walking, the high speed of the blood ejection during
each muscular systole acts like a nozzle creating a powerful jet into the popliteal vein. This also explains the
aspiration (Venturi) effect on the deep veins below. Finally, the thigh pump of the semimembranosus
muscles pushes the blood of the deep femoral vein together with the quadriceps veins into the common
femoral vein.
CONCLUSION:
The veno-muscular pumps of the lower limb create a chain of events by their successive activation during
walking. They play the role of a peripheral heart, which combined with venous valves serve to avoid
gravitational reflux during muscular diastole. A stiffness of the ankle or/and the dispersion of the collectors
inside the gastrocnemius could impair this powerful pump and so worsen venous return, causing
development of severe chronic venous insufficiency.
10. Sebbene sia dubbioso
sui valori mostrati in
questa immagine,
questa evidenzia la
criticità di chi fosse
seduto
11. L’ambiente influisce grandemente sul ritorno venoso, pavimentazioni,
posture e calzature sono spesso causa di cattivi flussi di ritorno del sangue
al cuore
12. Appare evidente che in questo esempio differenze di livello tra avampiede e retro
piede scaricano in modo differente l’arco plantare e attivano in modo negativo il
movimento della caviglia, importante articolazione per il ritorno venoso.
13. La gravità, i baricentri corporei
elementi destabilizzanti ma
anche elementi primari , da
considerare, nella ricerca degli
equilibri corporei.
Ovviamente posture improprie o
disequilibranti tenderanno a
gravare maggiormente su alcune
catene muscolari e a chiudere
angoli articolari essenziali per il
passaggio del flusso venoso, es
nella postura seduta la chiusura
del ginocchio.
14.
15.
16.
17. Int J Sports Med. 1996 Jan;17(1):17-21.
Cycling cadence alters exercise hemodynamics.
Gotshall RW1, Bauer TA, Fahrner SL.
Author information
Abstract
Previous studies on cycling cadence have focused on the economy of the cadence, in search of
the optimal pedal cadence. The purpose of this study was to determine the hemodynamic
changes associated with varying pedal cadence at a constant workload. It was hypothesized that
increased pedal cadence would enhance the skeletal muscle pump, resulting in elevation of
cardiac output. Seven cyclists were enlisted to cycle at 200 watts at pedal cadences of 70, 90
and 110 rpm (random order). Oxygen uptake, heart rate, stroke volume, cardiac output, blood
pressure, and vascular resistance were determined. As has been previously shown, oxygen
uptake increased with increased cadence (70, 90, 110 rpm) at this workload. Heart rate, stroke
volume, cardiac output and blood pressure were increased, and vascular resistance decreased,
with increased cadence. Cardiac output increased (34%) in excess of the increase in oxygen
uptake (15%) as shown by the decrease (-14.5%) in the arterial-venous oxygen difference
occurring with increasing cadence. Apparently, even though the workload was constant, the
increase in pedal cadence resulted in a more effective skeletal-muscle pump which increased
muscle blood flow and venous return. It is not known if this might contribute to the natural
selection of higher cadences by cycling athletes, even though there is reduced economy.
22. Questo è lo spettro delle frequenza della luce, appare evidente la frequenza FIR,
I BENEFICI NEGLI SPORTIVI:
incrementa le prestazioni atletiche;
accelera il recupero dopo l'attività fisico/sportiva;
evita il sovraffaticamento aumentando la concentrazione e la lucidità;
riduce il dolore muscolare tardivo non favorendo la formazione di acido lattico;
aiuta il rilassamento muscolare diminuendo la tensione dei muscoli;
riduce infiammazione e gonfiori;
allevia spasmi muscolari;
supporta ed accelera la riabilitazione post trauma e accelera il recupero da traumi muscolari ed articolari
(contratture, dorsalgia, lombalgia, sciatalgia, artrite, artrosi, periartrite, distorsioni....)
accelera tutti i processi di guarigione, stimolando la riparazione cellulare e massimizzandone la salute (una
cellula sana vuol dire corpo sano).
23. Protocollo:
• 30 minuti in posizione seduta con
arto sospeso.
• Con calza normale
• Con calza a compressione graduata.
• Termografia della gamba e del piede
Risultati attesi:
Maggior calore nella zona del meso
piede
Calza sportiva convenzionale
