Venous Insufficiency and how heavy can I lift now

Medical Q&A [Moderated]
1

Hi Dr. Feigenbaum and Dr. Baraki,
I was recently diagnosed with venous insufficiency in both legs, but most noticeable in the left leg with chronic edema in the ankle. I’m a 59.5yo female.
I noticed the edema about 2 years ago and saw a vascular specialist a year ago. She said there is nothing to be done and that continued heavy lifting puts a lot of pressure on my veins and the condition will just get worse. I mentioned this to my primary doctor and she offered that at menopause, everything gets floppy including your veins. So, it’s likely that my floppy veins can’t handle the pressure of powerlifting and heavy barbell lifting. I’m pretty concerned about this condition as it is, but also making this condition worse with lifting. FYI, 18 months ago I started on HRT after becoming more educated on benefits and hoping to be able to gain those benefits, but I have already spent 8 years in menopause, so a lot of “damage” has already occurred. One example of this is going from normal bone density prior to menopause and becoming osteoporotic 2-3 years after menopause. Powerlifting helped me to reverse some of this luckily, but now I’ve got the venus insufficiency tugging at me to reduce weight training.
My questions are:
How heavy can I lift to not further exacerbate the venous insufficiency and edema? How will my training now need to change?
Will the HRT help with strengthening my veins at this point? or I’ve already gone too many years without it and it won’t help.

Additional context:
Prior to starting to powerlift, I would have called myself “fit”, but I hadn’t really done any consistent weight training and was losing muscle tone. What I was doing was: 10 years of gym climbing and some bodyweight exercise in my 50’s, a year or two of crossfit in my late 40’s, 3-4 years of kettlebell training in my early 40’s, machine weights in my late 20’s. Running for 30 years which I stopped 10 years ago. So, starting into menopause I wasn’t really doing any consistent weight training until I started powerlifting.

If this question is better answered through a consult, I can do that. Just thought I’d start here first.

2

Hi there,

Sorry to hear about this issue.

I’m pretty concerned about this condition as it is, but also making this condition worse with lifting.

Can you describe what your specific concerns are about this condition?

How heavy can I lift to not further exacerbate the venous insufficiency and edema? How will my training now need to change?

Unfortunately there is no specific load that we (or anyone else) can tell you for this purpose, nor is are there specific strength training guidelines for venous insufficiency.

Will the HRT help with strengthening my veins at this point? or I’ve already gone too many years without it and it won’t help.

I’m not sure about this, and it would be really hard to predict your response anyway. If you are on it for other symptoms, I would simply see how things go with time.

The bottom line: venous insufficiency is a diagnosis that is mostly cosmetic in nature (although there can be some complications in particularly severe cases). The risks of NOT strength training – particularly if you already have osteoporosis – are likely much higher than the risks of training, even accounting for potential exacerbation of venous issues. With that said, I remain unconvinced that strength training is going to be the major factor in progression of venous insufficiency anyway.

If I were in your situation I would continue training as normally as possible, given the myriad health benefits that it will provide that far outweigh the risks of varicose veins, and seek out at least a second opinion from another vascular specialist, as I am also skeptical about this claim that there are no potential treatment options at all.