Hincapie's legs - why those veins?
 

So why does he have this major vein-popping out thing going on?
I'm curious what causes this. At least from what I've seen, if someone
gets it, that get it really bad. I've not seen it on many women though.

There's a guy on my race team who has the same "condition"--maybe not quite as prominent as Hincapie's legs, but very recognizable as the same thing.

because he forgot to use the search engine.

+1

side effect of too much Optygen.

Or not enough. The study wasn't conclusive.

Nice one. :D

They're varcicose veins. It comes from a failure of the one-way valves in the leg veins that usually keep blood moving up toward the heart. Because of the back-pressure that develops, the veins enlarge.

Wheres the love for your favorite Snicklefritz? :rolleyes:

I guess my question would be if there's anything about cycling or other specific jobs or sports that might contribute to varicose veins. My wife used to stand and work at the lab bench all day long, and she says that contributed to her varicose veins, but I guess there are some congenital factors too.

Yeah that's what I was wondering. What's the scoop DrPete? :)
You must be really busy because I haven't seen any new photoshop masterpieces from you lately.

It's mainly congenital. I think the only thing specific about cycling is that you notice more because of all the shaved legs. At least that's the opinion of the vascular surgeons I work with...

I stand a lot at work and have the genes, so it's only a matter of time. Good thing I can get a deal on getting them fixed. :D

yeah, you could probably even fix them yourself after work. :D

Hey - Dr. Pete
Ignoring the cosmetic issues, would vericose veins be something that would impact racing/riding performance? I mean, if the result is due to a lack of blood flow up to the heart on the way through the circulatory system, I would take the logical assumption that this would impact blood/oxygen flow, no?

So these check valves fail shut? Or open?

If they fail shut then there's no blood flowing through there at all, and if they fail open then the blood goes backwards in between heart beats. Neither one sounds like it would cause a build up of pressure, must be something else going on.

It really wouldn't. The main symptoms that you get with varicose veins are legs that feel sort of tired/fatigued/heavy, but many people don't even have these symptoms and it's purely a cosmetic thing. The amount of reflux it takes into the superficial veins of the legs to cause varicose veins is pretty small when compared to the total venous return from the leg.

Clear as mud? :)

The valves fail open, but you're forgetting that gravity is at play too. The reason that veins in the legs have one-way valves is because gravity is working on the blood too, and when standing your legs are far below the pump. So the pressure in the deep veins of the legs is relatively high. That's why patients who have symptoms generally only notice them when standing or walking for a while. If you elevate your legs, for instance, gravity is working for you so the blood will go back to the heart even if the valves are incompetent.

The other thing to remember is that the legs have two systems of veins--the deep (big, high pressure, high flow) and the superficial (small, low pressure, low flow, but visible). As long as the deep system is open, you can totally eliminate the superficial system (a la vein stripping surgery) and have no problems.

he's been genetically engineered to maximize sites of EPO injection :D

Sean Yates pwns Hincapie....they were truly frightening.

Makes George's legs look like Mariah Carey's.

Well the pressure in your leg veins would be the same whether the valves are working or not - because the elevation gain back to your heart is the same. The valves help to prevent backflow in between pulses of pressure.

I'm seeing this from a hydraulic engineer viewpoint, not a medical one, but physics is physics.

It takes minimal back pressure to dilate the superficial veins, though. In addition to reflux down the vein, there are connecting veins called perforators which, if incompetent, also release some pressure from the deep system to the superficial system, and again it doesn't take much added pressure to plump up the superficial system.

there are other factors that contribute to the pressure and subsequent venous return in the deep system, like the contraction of the calf muscles, which has been shown to assist in venous return.

I'm probably just doing a poor job of describing things in engineer-ese. There's a reason I was a biology major. :)

From here on out I am going to use this phrase whenever I am discussing failed valves.

Hey, it's the doctor word for it... :)

while this is true from a physics standpoint, veins are not arteries. As such, when you mention pulses of pressure, you are likely talking about heart "pulse pressure" which is nonexistant in these superficial viens. The valves DO maintain compartmentalization of fluid (blood), and assuming evenly spaced valves (not quite true), when one fails, the one below has to deal with the gravitational pressure (weight/mass) of twice as much blood on a single valve. This in turn causes other valves to fail, and before you know it, varicosities.

All this way and no pics????

:( :( :( :(

http://i102.photobucket.com/albums/m...18/14ty3gp.jpg
http://i102.photobucket.com/albums/m...4_hincapie.jpg