Varicose Veins and Yoga in a Hot Room
Dr. Kathie M. Black, PhD
This post is an answer to a great question I received this week from a fellow yoga teacher. It was such a great question and consequent research adventure for me that I felt it was important to share with the rest of the world. Enjoy!
Question: I have had a student ask the question as to whether yoga in a hot room is valuable for varicose veins. Her doctor told her absolutely no as it causes too much vasodilation. Do you have any research you can point me to suggesting the real facts?
Peace, Beth ox
Hi Beth – let’s start with an exploration into why vasodilation might be a bad thing… here are the definitions from Wikipedia on Varicose Veins and Vasodilation:
Varicose veins are veins that have become enlarged and tortuous. The term commonly refers to the veins on the leg, although varicose veins can occur elsewhere. Veins have leaflet valves to prevent blood from flowing backwards (retrograde flow or reflux). Leg muscles pump the veins to return blood to the heart (the calf muscle pump mechanism), against the effects of gravity. When veins become varicose, the leaflets of the valves no longer meet properly, and the valves do not work (valvular incompetence). This allows blood to flow backwards and they enlarge even more. Varicose veins are most common in the superficial veins of the legs, which are subject to high pressure when standing. Besides being a cosmetic problem, varicose veins can be painful, especially when standing. Severe long-standing varicose veins can lead to leg swelling, venouseczema, skin thickening (lipodermatosclerosis) and ulceration. Life-threatening complications are uncommon, but varicose veins may be confused with deep vein thrombosis, which may be life-threatening.[medical citation needed]
Vasodilation (or vasodilatation) refers to the widening of blood vessels. It results from relaxation of smooth muscle cells within the vessel walls, in particular in the large veins, large arteries, and smaller arterioles. In essence, the process is the opposite of vasoconstriction, which is the narrowing of blood vessels.
When blood vessels dilate, the flow of blood is increased due to a decrease in vascular resistance. Therefore, dilation of arterial blood vessels (mainly the arterioles) decreases blood pressure. The response may be intrinsic (due to local processes in the surrounding tissue) or extrinsic (due to hormones or the nervous system). In addition, the response may be localized to a specific organ (depending on the metabolic needs of a particular tissue, as during strenuous exercise), or it may be systemic (seen throughout the entire systemic circulation).
So, to deconstruct vasodilation, what the doctor is probably referring to is the chance that excessive heat could cause a drop in blood pressure – which might result in fainting, falling, etc. as well as the blood flow back into the veins (see first paragraph).
Here is what I think on the situation: Heat is one of the leading treatments for painful varicose veins. Site after site and research study after research study listed applying heat packs as one of the best ways to reduce the pain of varicose veins. Heat helps speed blood circulation and moves blood away from the smaller veins and is sent back through the system in the larger pathways.
Common causes of varicose veins are people who are on their feet all day, genetics, or even those of us who hyper extend our knees. One of the key ingredients to good blood flow is adequate temperature of the body and clear air pathways. When people are typically practicing yoga in extremely hot temperatures (as some studios can get), their breathing becomes shallow, less oxygen is taken in, and blood flow is restricted. Couple this with improper alignment with locking up or impeding blood flow through the joints, and you can end up with an increase in symptomology of varicose veins. Interestingly, there was no specific clinical research on varicose veins and hot yoga – only listed as one of the many maladies that are helped with yoga.
There are some easy answers for your student to continue practicing yoga, though; and one of these is to use infrared heat in the studio rather than forced air or traditional heating. Infrared heat heats objects, not the surrounding air, so the student will be able to breathe better and have better oxygen flow to the system. In addition, infrared heat aids in better circulation throughout the entire body, so this will help ensure the blood pathways are clear. In addition to having infrared heat in the studio, I would encourage the student to have an infrared sauna in their home where they can have a full session with infrared therapy to increase their blood flow. Infrared heat and infrared probes are all listed as the leading forms of therapy for diagnosis as well as reduction of varicose veins. If you’d like more information about heating your studio with infrared, please see Yoga Panels.com and let them know I’ve sent you. If you’d like to refer your student to find her own infrared sauna, please see Blackstone Saunas. Through the past nine years I have researched and followed the research on the health benefits on infrared and am finding it increasingly used in therapy for increased circulation.
Another great thing that you have in your teacher’s tool kit are the universal principles of alignment that ensure your student has proper body alignment that will allow for blood movement through the joints flow easily. Encourage your student to always have the “micro-bend” in the knee and to practice “legs up the wall” daily. You cannot over emphasize the value of this 15-minute daily practice. If you are actively planning practices for this student, I would recommend Yin and Restoratives with lots of legs up the wall and some gentle Hatha. A Flow or Vinyasa practice will help with circulation; however, if the student has problems with locking their knees, there could be several problematic areas with these styles. Walking, simple walking around the block a few times followed by a gentle restorative practice (that includes legs up the wall – with lots of variety as you go along) will help this student. Personally, I discourage yoga in very hot rooms unless it is a Yin or Restorative – and then only if heated by infrared as the temperatures do not have to be as high and the students get the great benefits of infrared as well as more comfort in breathing.
Heat & Healing,
Heat to Heal