Teacher with child

A Back To School Special Article

You are the pillars of our society.

Whether you’re a nurse or a teacher, you are helping our loved ones and families every single day with your acts of giving and selflessness. In short, you are saving us all.

But it’s time to focus more on your health and yourself.

By profession, teachers put themselves at an increased chance of musculoskeletal disorders (MSDs) because they stand all day. And in part, these disorders can lead to painful, unsightly venous insufficiency in the form of spider veins, varicose veins, and deep vein thrombosis, to name a few.

Researchers at the Institute for Work & Health in Toronto found that standing all day is much worse than sitting all day. People working in jobs that require standing were about twice as likely to develop heart disease compared to people whose jobs require them to sit for prolonged periods. Prolonged standing makes it more difficult for your body to properly circulate your blood from your feet back up to your heart—which places more stress on your heart, which is your body’s one-and-only pump.

For nurses, the research underscores a portion of the physical stress they endure daily. In one study, the incidence rate of MSDs was 46.0 cases per 10,000 full-time nurses, which was dramatically higher than the rate for all professions at 29.4 cases per 10,000 workers.

Teachers also report a higher rate of MSDs, relative to other occupations, ranging from 39% to 95%.

Overwhelming research, cited in 17 separate studies that reviewed adverse health risks associated with prolonged standing, places chronic venous insufficiency (e.g., spider and varicose veins) at the top of the list of adverse health risks that nurses and teachers may face.

Health concerns tied to prolonged standing have become a global issue. The Dutch Health Council defines prolonged standing as standing for more than four hours daily or at your desk without moving. Waterloo University recommends that employees avoid standing more than 15-30 minutes an hour in Canada. In Switzerland, the advice favors a mixed bag: sitting (60% of your work shift), standing (20%), and moving around (20%).

 Unfortunately, teachers don’t also have the luxury of moving around. However, there is a bright side to this occupational hazard.

Here are four ways teachers can save their legs:

1. Wear Compression Stockings

Compression stockings provide pressure to your legs to improve your blood circulation, which prevents leg swelling and, over time, venuous disorders such as spider veins and varicose veins. Standing for more prolonged periods strains your heart and veins, pushing your blood from your feet back to your heart against the force of gravity throughout the day.

Compression stockings can reduce occupational leg swelling, which is welcome news for teachers. These stockings offer different pressure levels based on the material's elasticity and stiffness, the shape of your leg, and your specific movements. Low pressure refers to less than 20 mmHG or class 1. Medium compression ranges between 20-30 mmHG or class 2; high compression is pressure greater than 30 mmHG or class 3.

Even research shows that compression stockings can help prevent the reoccurrence of venous ulcers, a slow-healing sore on your leg due to poor circulation, and deep vein thrombosis, which occurs when a blood clot forms in one of the deeper veins in your body.

2. Use An Anti-Fatigue Mat

The material used in anti-fatigue mats forces your calf and leg muscles to very slightly move again and again, even if you’re standing in place. These micro-movements, which you most likely won’t even notice, counter the negative physical effects of prolonged standing. Every time your calf muscle contracts, it sends blood back to your heart, supporting better circulation.

Several research studies support the health benefits, mostly in a manufacturing setting on an assembly line where workers stand in place for long periods. But a few studies have also been done in a healthcare setting. One specific study examined the musculoskeletal effects endured by surgeons who stand for long periods in the operating room on different types of flooring. In all, 70% of participating surgeons said they would recommend using anti-fatigue mats to a friend, 65% preferred the mats to hard concrete floors, and 45% said the mat helped reduce their MSD-related symptoms. To corroborate their opinions, leg volume was slightly higher among surgeons who didn’t use the mats.

Woman sitting on couch
3. Start Stretching With Resistance Bands

Movement will help improve your circulation, which will lessen the chances for spider veins and varicose veins. Stretching is a good place to start, especially with resistance bands.

The American College of Sports Medicine supports a static stretch with a 15-30-second hold, repeating three to five times on alternate sides of your body. Of course, you should consult your primary health care provider before you begin a new exercise program.

“Teachers are working and standing for so long, they don’t realize that a stretch can go a long way to protect their health,” says Dr. Claudia Rios-Datta, who is a pioneer in cryo-sclerotherapy, which quickly turned spider vein treatments into pain-free, minimally invasive, outpatient procedures in 2000. “Standing for long periods can cause blood to pool in the leg veins because our calf muscles act as a pump to move the blood through the veins. When the calf muscle pump isn’t working properly, the blood flow in the legs and feet is impaired, and this can lead to vein disease like vein reflux that manifests as varicose veins as well as deeper venous disease like chronic venous insufficiency and deep vein thrombosis.”

Here are a few stretches that will get the blood flowing back to your heart:

Seated Calf Stretch: While seated on the floor with legs extended, wrap a resistance band or a towel, if that’s handy, around one foot and hold the band with both hands. Slowly pull your toes toward your shin until you feel the stretch.

Lying Hip Stretch: As you lie on the floor with the band around your right foot, straighten out the left leg on the floor and slowly lower the right leg across your body and to the left as low as you can. Feel the stretch on your right side.

Lateral Bank Walk: Stand in a partial squat position with a band wrapped above your knees. With knees bent and arms forward, take eight steps to your left. Keep your feet parallel throughout the stretch. Now, repeat the motion in the opposite direction.

4. Leverage Minimally Invasive Innovation

If your legs need more than lifestyle changes, your solution may include a state-of-the-art, minimally invasive procedure that could be done in less than an hour. And it gets better: No cuts, sutures, or downtime. Things have changed dramatically in this field of medicine.

Varicose veins can appear blue, red, or flesh-tone and bulge from the skin. They are often found on the thighs, the front and back of calves, or the inside of the legs near the ankles and feet. In contrast, spider veins, which tend to be red, are smaller than varicose veins and don’t bulge. They are found on the legs—and even the face.

Varicose and spider veins occur when the valves in your leg veins stop working properly. Unlike arteries, veins play an important role in directing blood flow from your feet back to your heart, working against the forces of gravity in most situations. When your valves don’t close correctly, your blood stays in the vein, which weakens the walls and causes it to bulge or create new veins to mitigate the buildup of pressure. 

Microphlebectomy is a brief procedure that is only offered by skilled vein clinics and remains one of the best options for treating bulging varicose veins. Under local anesthesia, the vein is removed in small sections through tiny incisions during the procedure, provided in an office setting.

Spider veins, which impact more than half of women, can often be the first indication of an underlying condition called chronic venous insufficiency. Sclerotherapy is the most common technique for treating spider veins. This medical procedure involves the injection of a sclerosant into a vein to collapse it. 

Radiofrequency ablation-deemed the standard for today’s treatments for venous insufficiency, involves a small catheter that delivers heat to close the abnormal vein. The procedure is minimally invasive and can be done in the office.

VenaSeal uses a special glue to close damaged veins, and ClariVein, which uses a catheter to treat the diseased vein chemically and mechanically, are other examples of minimally invasive medical procedures. Both procedures are safe and equally as effective as radiofrequency ablation.

For nurses and teachers, who are constantly on their feet to help us, taking proactive steps to counter the negative health aspects of prolonged standing can go a long way toward protecting their legs.

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