[Physical therapy of venous diseases]

If physical therapy like compression stockings and supervised outpatient vascular exercise programmes are begun early, subjective complaints can be alleviated and ankle flexibility and venous drainage can be improved. Incapacitating congestive diseases such as dermatolipofasciitis and ulcus cruris can be avoided. Once chronic venous congestion has led to joint capsule atrophy, stiffening of the ankle and muscular atrophy in the lower leg, expensive therapeutic measures involving professional physiotherapeutic care become unavoidable. In our own experience physiotherapy is most effective in combination with biomechanical stimulation therapy. Once the patient's equine gait has been eliminated, conventional walking exercise can gradually restore a physiological gait. After successful physiotherapy, an outpatient vascular exercise programme combined with optimized compression therapy contribute decisively to long-term therapeutic success in patients with advanced chronic venous insufficiency. Like coronary sports, vascular exercise programmes are covered by public health insurance. Along with compression therapy, they represent an efficient, cost-effective basic therapy for chronic venous insufficiency.