Abstract
Chronic venous disease is a highly prevalent disorder. Risk factors are obesity, smoking, orthostasis, and family history. Pathophysiology encompasses changes such as venous hypertension, reflux, valve incompetencies, and calf-muscle weakness. Patients complain about skin changes, leg edema, pain, and ulcers. Possible recurrence of varicoses and surgery complications shift the focus on conservative approaches. The mainstay is compression therapy, applied by using multi-layer compression bandages or adequate compression stockings. Active exercises tackle muscle pump weakness, ankle joint restrictions, and physical activity. Aerobic exercises focus on lower limb activities (walking, cycling, aqua exercises) and are complemented by resistance exercises and muscle stretching. The gait pattern needs analysis and adaptation. Breathing exercises and manual lymphatic drainage act as a supplement. A critical factor for success is the patient’s adherence to lifestyle changes and health behavior. Therapists must motivate, guide, and educate their patients. They advise them on clothes/shoes and activities of daily life.