Thigh muscle pump function during ambulation

This report addresses the mechanical aspects of the thigh muscle pump during human locomotion, specifically treadmill walking. The study establishes a correlation between the stride cycle and venous pressure changes within the thigh intermuscular and superficial venous network. The study demonstrated that the direction of blood flow from superficial veins is not anterograde; rather, the primary route for blood outflow from the superficial venous network at the thigh level is towards intramuscular veins through perforating veins. The aforementioned data, when considered alongside recently published data regarding calf muscle pump function, strongly suggest that the physiologic direction of blood flow in perforating veins is only from superficial to deep veins. Conversely, the occurrence of reverse flow should be regarded as pathological, even if observed in a healthy subject with so-called bi-directional perforating veins. The role of bi-directional perforating veins has been a topic of long-standing debate in the literature, with opinions divided as to whether they are a physiological or pathological phenomenon. This new data is valuable for future research on the pathophysiology of chronic venous insufficiency.