To stand or not to stand?

Standing desks are all the rage at workplaces now. But are they actually good for your health?

Dr. Cindy Asbjornsen says that specific to vein health, the short answer is: maybe.

In 2015, a meta-analysis in the Annals of Internal Medicine found that “prolonged sedentary time was independently associated with deleterious health outcomes regardless of physical activity." 

The studies showed that physical inactivity (the fourth-leading risk factor for death for people all around the world, according to the World Health Organization) can lead to premature death from cardiovascular issues and cancer, as well as cause chronic conditions such as Type 2 diabetes.

Too much sitting can also increase the risk of getting varicose veins. If you already have vein issues, you may notice that symptoms get worse after sitting for prolonged periods of time.

So is standing any better? Compared with the research on prolonged sitting, relatively little research has been done to study the health effects of prolonged occupational standing. The few studies that do exist have demonstrated a relationship between prolonged standing at work and various health outcomes such as elevated risk of heart disease and musculoskeletal pain. 

We covered this subject in a previous issue of Vein Health News. In the article “Standing on the job: How at-risk occupations put a strain on veins,” we discussed the risks of people with jobs that keep them on their feet all day, such as teachers, hair dressers, medical professionals, and many others. We can add to that list people who work at a standing desk all day.

From a venous standpoint (so to speak), remaining in the same position too long – whether you’re sitting or standing – leads to poor blood circulation (hydrostatic venous pressure) and blood pooling in the lower limbs, which can lead to varicose veins over time.

If you do opt for a standing desk, consider using a balance board to keep you continuously contracting and relaxing your calf muscles, not to mention strengthening your core muscles. (Whether this helps with work productivity depends on the individual!)


If you choose to stick with a traditional sitting desk, an exercise ball chair, motion stool, or “wobble chair,” can provide you with the same kind of calf muscle readjustments throughout the day.

There are also adjustable desks that allow you to switch between sitting and standing positions throughout the day.

In conclusion, if you find standing desks more comfortable or effective, then by all means, use one. 

Regardless of the kind of desk you use, take regular breaks from standing or sitting for extended periods of time. Set your alarm to remind you to take a brief walk, or simply do some deep knee bends, or other stretching exercises. 

Perhaps the simplest circulation-promoting exercise is the calf pump. In this simple toe-tap exercise, you tap both of your feet for a minute or two, going back and forth between heels and toes. This squeezes the deep veins in the legs and forces the blood to circulate through the leg. It feels great whether you’ve been sitting or standing for a long period of time. 

To learn more about venous health and treatment of varicose veins, spider veins, and related issues, contact us at the Vein Healthcare Center.

Healthy Veins seminar with Dr. Cindy

Dr. Cindy Asbjornsen, Founder of the Vein Healthcare Center, truly loves to educate people -- patients and doctors, alike -- about vein health.

Dr. Asbjornsen recently gave a community seminar at Coastal Pharmacy & Wellness in Portland, Maine, where she discussed the basics of how veins work...and what to do when they don't. And, she explained what phlebology is!

Participants asked tons of great questions, including what do do about the so-called "Economy Class Syndrome" and DVT. 

Dr. Asbjornsen explained that you don't need to be in economy class (or even on an airplane) to be at risk for bad circulation. It's really about sitting in the same position for too long. A long car ride, for example, can have the same effect. 

Dr. Cindy's simple and practical advice for keeping your veins healthy during a lengthy car ride is three-fold. One, do the calf pump frequently (also known as "the foot pump"). Two, stay hydrated. Three, stop for restroom breaks! That will get your calf muscles moving AND give you a reason to keep drinking water during the ride.

Click here to watch the vein seminar. Click here to contact schedule an appointment, or to ask us any questions. We look forward to hearing from you!

Dos and don'ts for holiday healthy legs

Venous disease -- including spider veins, varicose veins, and leg ulcers -- does not stop for the holidays. But don't worry! We at the Vein Healthcare Center in Maine, have some tips to help you alleviate the symptoms of vein disease and prevent them from getting worse.

As you're out and about this holiday season, DO wear loose-fitting clothing. Santa’s red suit, for example, is roomy and comfortable and wouldn’t impede circulation in his lower body.

DO walk for at least thirty minutes a day-- like in a mall or large department store! The calf muscle contractions caused by walking can go a long way toward venous disease prevention and help keep the muscles of the lower legs healthy. And when you're out and on your feet, DO take a break every hour or so.

Now for a few DON'Ts. DON'T wear high-heeled shoes (or boots), as they shorten the muscles in your calf and prevent deep veins from working at their full capacity.

If you're taking any holiday trips long distances -- by plane, train, or automobile -- DON'T forget to wear compression stockings to keep the blood in your lower limbs moving in the right direction.

This last DON'T shouldn't surprise you: DON'T smoke. Smoking (even a corncob pipe) and exposure to second-hand smoke constricts veins and affects overall circulation.

Tips like these can help alleviate (or prevent) the symptoms of vein disease, but if you are experiencing symptoms, consider being screened by a Board-certified phlebologist like Dr. Cindy Asbjornsen. Contact us to schedule an evaluation appointment, or to find out more about vein health and treatment.

Vein tips for hot days

Heat dilates veins. That means that varicose veins (or "leaky" veins) and other symptoms can worsen in warmer weather. 

Here are some quick tips for vein relief:

• Stay as cool as possible. 
• Stay hydrated. Drink plenty of water.
• Take a walk. If the temperature outside is too hot, try a stroll through the mall or another climate-controlled building.
• Go for a swim. Like walking, swimming pumps the calf muscles and improves circulation. Plus, a swim can cool you off!
• Elevate the legs whenever possible.
• Schedule an evaluation with a Board certified phlebologist.

Click here for additional ways to ease symptoms of vein disease. Click here to schedule an appointment for a complete evaluation of your vein health so you can treat the problem at its source.

Be aware of DVT and travel safely this summer

Summer may be BBQ season, but it’s also the time when people travel long distances in planes, trains, and automobiles. For us in vein healthcare, that means increased risks of Deep Vein Thombosis, or DVT.

The deep vein system carries about 80% of blood from the feet back up to the heart. Deep veins are located under the muscle and connective tissue layers in the legs. A blood clot in a deep vein can be dangerous because the high pressure in the system could cause the clot to break free from the vein wall and enter the blood stream. The DVT could then travel up through the legs into another part of the body such as the lungs, where it would become a pulmonary embolism (PE).

DVT or PE symptoms are often misinterpreted as something less serious. A blood clot in the leg may feel like a “charley horse,” shin splints, or a twisted ankle. Symptoms from PE are often attributed to a pulled muscle in the chest, costochondritis (inflammation of the joint between ribs and breast bone), asthma, or a “touch of pneumonia.”

So what are some of the signs to look for? For DVT, the leg may be warm to the touch; swelling in the leg (can also occur in the arm); leg (or arm) pain or tenderness; reddish or bluish skin discoloration.

For PE, be aware of a sudden shortness of breath; sharp, stabbing chest pain (may get worse with deep breath); rapid heart rate or breathing; feeling lightheaded or fainting; unexplained coughing, sometimes with bloody mucus.

In half of DVT and PE cases, no symptoms present at all—but both conditions are medical emergencies. Any of these symptoms should be regarded as a DVT or PE until proven otherwise, especially if someone is in a risk category (including whether there is a history of blood clots in your family).

Awareness is key-- and so is prevention. When traveling long distances, stay well hydrated, stretch legs your legs and pump your feet periodically, avoid or moderate alcohol and caffeine, and consider wearing graduated compression stockings on your trip.

To find out more about DVT and other vein issues, contact us at the Vein Healthcare Center. We will evaluate your vein health — including spider veins, varicose veins, and leg ulcers.

We love compression!

At the Vein Healthcare Center, we talk about graduated compression. A lot. 


In fact, Dr. Asbjornsen wears 20-30mmHg socks or stockings almost every day. Doctors are always on their feet, and graduated compression fights—and beats—gravity, keeping the blood circulating from the legs back up to the heart.


In our last issue of Vein Health News, the cover story was all about caring for your legs and feet when you’re constantly using them. Our colleague Tom Musone from the compression company Juzo gave us six tips about how to use compression to make your legs feel better:

1. Wearing compression every day can prevent edema (leg swelling), alleviate venous symptoms, and make your legs feel better overall.

2. Make sure you wear graduated compression stockings. That means the pressure is highest at the foot and ankle and gradually decreases as the garment rises up the leg. This pressure gradient makes it easier for the body to pump blood up towards the heart and more difficult for gravity to pull blood downward.

3. Compression also increases the pressure in the subcutaneous tissue, which helps to reduce and prevent swelling by moving excess fluid back into the capillaries.

4. Gradient compression is expressed in millimeters of mercury, or mmHg. Unless otherwise directed by a medical professional, look for 15-20 mmHg or 20-30 mmHg.

5. Current evidence supports wearing either knee-high or thigh-high style compression stockings when standing for prolonged periods. A good fit is the most important factor.

6. Get fitted by a certified fitter to find the brand, product, and style that’s right for you. These days there are dozens to choose from.


Dr. Asbjornsen swears that even if she weren’t a vein specialist prescribing compression stockings to patients, she would still tout the benefits of wearing it, because her legs feel so good at the end of the day!


If you have any questions about graduated compression for venous relief, prevention, or both, contact us at the Vein Healthcare Center. We’re happy to educate about the benefits of compression.

How exercise impacts veins (and vice versa)

In our last post we began discussing how physically active people experiencing leg pain are possibly experiencing the effects of vein insufficiency. In this post we take a closer look.

During exercise your muscles require more oxygen, so veins dilate to increase the volume of blood flowing through the circulatory system—but if your veins are not working properly, that means more blood can pool in your legs. On the other hand, exercise is beneficial from a venous standpoint because anything that improves the function of the foot and calf muscle pumps to get the blood back up to the heart is good.

Walking is the best exercise for improving the muscle-pump function, especially following vein treatment. Although walking can help manage the symptoms, it does not prevent vein problems. Neither does exercise cause vein problems, except in extreme cases. Physical activities that require your legs to support heavier weight over prolonged periods of time, such as weightlifting or backpacking can put someone at increased risk for developing venous issues. Repeated exposure to increased intra-abdominal pressure, or pressure that is transmitted to lower extremities, can cause the normal system of valves and veins to weaken over time and become incompetent.

Repetitive motion sports such as endurance running, cycling and tennis can also put a lot of stress on your leg veins and over time may overcome a normal venous system.

In general, exercise (and working out the muscle pumps) is not detrimental for the vast majority of athletes who are participating in a more typical spectrum of activity. In fact, maximizing the efficiency of that system is beneficial.

Depending on each individual’s degree of vein disease, he or she may become more symptomatic because the foot pump no longer counters the vein insufficiency. One person’s level of activity, for instance, may be associated with the progression of vein disease if they have some pre-existing risk factors, such as age or family history.

While exercise can influence vein dysfunction, it doesn’t necessarily prevent it or cause it. But can poorly performing veins affect athletic performance? The short answer is yes. If the venous system is not working correctly, then the “extra” de-oxygenated blood (and blood waste products like lactate) can cause discomfort, cramping, fatigue, or other conditions that diminish performance.

Even if legs feel great during training, vein issues can also cause legs to hurt after exertion and slow your recovery.

In our next post about athletes, exercise, and veins, we’ll turn to treatments to fix the problem. And be sure to visit the Vein Healthcare Center in South Portland, Maine to learn more about your options for treatment.

A round-up of “how to’s”

Over the years, we’ve posted a lot of quick tips for vein care at home, so as a year-end gift we’re putting them all in one place!

• How to tell if you have venous disease
• How to keep your veins healthy in the winter
• How to do the “foot pump”
• How to properly elevate your legs
• How to treat venous symptoms naturally
• Quick tips for coping with spider veins 

Don’t forget that while these “how to’s” can help with the symptoms of vein disease, an evaluation by a qualified phlebologist can give you a complete picture of your venous health and options for treatment. If you ever have any questions, don’t hesitate to contact us at the Vein Healthcare Center.

Happy holidays from all of us at VHC!

New technology uses old-fashioned principles

What’s the best exercise for helping the veins return blood from the legs back up (against gravity) to the heart? Believe it or not, it’s good old-fashioned walking. Walking causes the

rhythmic contraction of calf muscles and helps promote blood flow to the heart.

What if you can’t walk for one reason or another? The foot pump is one way. Or you can try treadling!

A treadle is a foot-powered pedal or level used for circular motion, such as in a potter's wheel or sewing machine. At the Vein Healthcare Center, we sometimes recommend that patients use a machine called the CV2. Named for the natural “second heart” of the calf pump, the CV2 is essentially a treadle that uses momentum to keep the pedal—and the calf muscles—moving up and down for a long period of time and with minimal effort. It was invented by a physical therapist who used the concept of a sewing machine pedal in his design.

To learn more about this simply elegant machine, click here to read our latest issue of Vein Health News (Page 13 in the “New Alternatives” issue).

One Patient’s Perspective

As the busy fall season kicks into high gear, we thought we'd take a minute to share a testimonial from one of our happy patients. Lucille used to do a lot of sitting because her legs felt so heavy and swollen. But now she walks at least 30 minutes every day!

"Dr. Asbjornsen is a rational, competent and caring physician. That's uncommon! From the first appointment, the doctor and her staff were very professional and continually demonstrated how much they care for their patients. Everyone was very thorough in educating me about each step of the process, from the evaluation to the follow-up—and they were pleasant too.

The group at the Vein Healthcare Center has restored my faith in the medical system. They are the cream of the crop. They're superlative!"

–      Lucille L., 69, Lewiston, ME

To read more about Lucille’s experience, check out the “One Patient’s Perspective” column in the latest issue of Vein Health News.

To see more of what our patients are saying, click here.

High heels and crossed legs

High-heeled shoes are often associated with bad veins, but have you ever wondered why? It’s all about the ability to move the ankle, also known as ankle motility. The calf muscle acts as a pump to push blood against gravity from the feet and legs, back up to the heart.

If the ankle does not have full range of motion, it is considered an independent risk factor for venous disease. When one is wearing high heels, the calf muscle cannot be fully extended, which decreases its power within the pumping mechanism. 

In a similar vein (sorry!) many patients at the Vein Healthcare Center have asked if crossing their legs causes varicose veins. The answer is: we don’t currently know. There is no research supporting this claim, but anecdotally, Dr. Asbjornsen will occasionally see a patient who crosses one leg over the other and experiences issues with her or his small saphenous, a vein that begins at the back of the knee and extends down the backside of the leg. Continuous pressure on this vein may damage the valves, or at least impede flow, which could create permanent damage. 

To learn more about risk factors for vein disease, including environmental risks, feel free to explore the Vein Healthcare Center’s website, or request an appointment online. Or if you’d like to talk with someone in person, call us at 207-221-7799. We look forward to hearing from you!

The risks of…sitting?

Are you sitting down? Chances are, you are! It seems like our whole world was designed to keep us in a seated position, usually in front of a screen, whether during work or leisure time.

Earlier this year, a recent article found that this overwhelmingly sedentary behavior increases our risk of getting preventable conditions, even if we exercise. The studies showed that physical inactivity (the fourth-leading risk factor for death for people all around the world, according to the World Health Organization) can lead to premature death from cardiovascular issues and cancer, as well as cause chronic conditions such as Type 2 diabetes.

Too much sitting can also increase the risk of getting varicose veins—and if you already have vein issues, you may notice that symptoms get worse after sitting for prolonged periods of time.

Why? The heart pumps oxygen-rich blood throughout the body through the arteries. Veins then carry blood from all the extremities back up to the heart. The blood in the legs travels up against gravity, so when the valves in the veins become damaged, blood flows back into the legs which leads to a “pooling” of blood in the veins that can manifest as varicose veins or spider veins. 

When you sit (or stand) in the same position for a long time, the blood doesn’t circulate properly and, over time, this can lead to varicose veins.

There are a several ways to help reduce the risk of getting varicose veins from sitting for too long:

• Sit properly. Focus on good posture and avoid crossing your legs or sitting in ways that can compress veins for prolonged periods.

• Elevate. Occasionally, rest your legs above your heart – for as long as 30 minutes or as briefly as three minutes. (For more tips on elevation, click here.)

• Take a break. Take frequent walking breaks to avoid sitting or standing for periods of more than two hours.

• Pump it. If you can’t move around that often – or are flying on an airplane – try flexing and pointing your foot to get the blood moving in your legs. (Click here to learn more about “the foot pump.”)

Of course, the best way to reduce your risk of getting varicose veins from sitting all day is to move around more – and be aware of just how much time you spend sitting down.