QUESTION:
Hello, I have a question about a new client I just picked up. She has poor blood circulation in her lower left leg, and both legs swell up on a regular basis. She has a very strong accent and can be quite hard to understand, so communicating with her is very difficult. Her son's are both medical doctors and told her to come see me to help her out. I have requested a medical release form from her, but was wondering if you have any research articles or info on poor blood circulation and lower extremity exercises for this problem. Thank you for your time, Adam.

Poor Blood Circulation and Movement:
As a practitioner in the health care field, you need to start asking the “why” questions when it comes to clients these days. More and more are coming in, not only to loose weight, but most have a long list of other dysfunctions going on. You have asked the “why” question, which is a great start. The key here is that realizing that as trainers, exercise is not the answering to it all. It is the old hammer and nail saying: “If you have a hammer, than all you see is nails.” Meaning, as a massage therapist, trainer, etc, you think your discipline can fix all. Not saying you think this, but in this client’s case, exercise might be further down on her totem pole of healing.

I am going to give you some directions to look into. Do the research, assess your client (if you don’t’ know how, refer out!) and you will answer the “why” question.

When it comes to poor blood circulation, here are some reasons why:
1. Lack of exercise in the past (what is her training age?): If she is beginning exercise with you and has not done much in the past, this can cause blood circulation issues. Make sure you have assessed and designed a program to fit her needs at this time. Her current program might not seem to challenging, but if the body is responding this way, well, that is enough proof for me that it is too challenging.

2. Peripheral Vascular Disease: This is poor circulation to the LE’s. PVD can be caused from hardening of the arteries, increased LDL, increased triglycerides, smoking, HBP, improper diet, Rx drugs, thyroid dysfunction, nerve entrapments, diabetes, obesity, insulin resistance, and lack of physical exercise.

3. Raynaud’s Disease: This is constriction and spasms of the blood vessels, but typically in the UE’s.

4. Deep Vein Thrombosis: This is formation of a blood clot in the LE’s that can cause pain and swelling from lack of movement.

5. In Chinese medicine, the kidneys, spleen and lungs govern water in the body. If there is a dysfunction in any one of these from improper diet, too much sex, living or working in a wet environment, or lack of qi in the body, water or dampness and accumulate.

6. Lymphoedema: The lymph is a circulatory detox system of the CNS. Any dysfunction from lack of movement can inhibit lymph flow.

7. Adrenal gland stress: Any time the body is stressed physically, nutritionally (Sonia Lapp from the Institute of Functional Medicine states that the #1 stress response to the body is food intake or poor food intake), mentally or emotionally, your body release CRH, ACTH and cortisol. Keep in mind that the HPA axis is on the same neurological loop as the HPT and HPG axes. When cortisol goes up (causes vasoconstriction), blood sugar levels go up, when blood sugar levels go up to adapt to the stress insulin goes up, when insulin continually goes up from not adapting to stress you develop insulin resistance, when you develop insulin resistance, you produce more androgens, when you produce more androgens you produce more Estrone, when you produce more Estrone, you release more GnRH, when you produce more GnRH you release more FSH and less LH, when this happens you get acne, water retention, high BP, fat around the midsection, increased hair growth and water retention. This is due to a lot of things but mostly because cortisol, along with Aldosterone helps to shuttle Na+ back into the kidney tubules. When this is dysfunction, you affect the rennin angiotension system, hence water retention.

8. Altered biological pump mechanisms: These include the brain-heart-GI system. They all work in tune with one another to balance the biologically rhythms of the body. If one is out of tune, they all are. Example: The heart has been shown to have 5x more electrical amps than the brain. If one has lack of love for self, is in an unhealthy relationship (most common), etc, you can create imbalances in the brain and GI system. How many people do you know that have GI problems? It is one of the most common reasons why people visit their MD’s, which typically does not alleviate the problem. Reason, if you have lack of love for self (4th chakra), you end up creating lack of fluidity in life/self, low self worth and lack of security. These are all related to the first 3 chakras which govern GI issues, adrenal issues and kidney issues (water). You can correlate any chakra (if these energetic principles do not work for you) to any one of the endocrine glands, nerve plexus, etc.

What to do (Keep in mind us the only ones that you feel she needs from below):
1. I would assess your client so you know exactly what she needs and in what order. Otherwise you will be sending her everywhere to do everything, which is tiring and financially draining.

2. I would focus more on her nutrition and lifestyle principles at this time. “You are what you eat!” When it comes to physiology, food, thought, emotions, and physical activity can through it out of wacky.

3. Refer her to BioHealth Diagnostics for a Adrenal Stress and Hormone lab (#205).

4. Refer her to a TCM (acupuncturist) from some acupuncture, cupping and herbal treatments.

5. Refer her to a lymph massage therapist

6. If she is on any Rx meds, do some research to see if this could be the root cause.

7. Assess your client physically so you know her skill level and that you are starting her at the right level. If her program does not match her needs, physiological needs, etc, you will get a symptom (increased pain, decrease in progression, increased in constipation, difficulty sleeping, edema, etc)

8. There are lots of herbs through Designs for Health that you could order to help with edema and poor blood circulation, one of them being Cayenne.

9. Last but not least, I would recommend her doing some daily movement meditations (Qi Gong, Tai Chi, Yoga, etc). This will help create fluidity within the body and body systems, as well as balance the biological pumps of the body (brain-heart-GI system)

Good luck!

Joshua Rubin