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Thick calves are often perceived as a relatively unspecific complaint, which does not always have to be accompanied by an externally visible swelling of the calves. Often this only describes the feeling of swollen lower legs or a feeling of pressure in the calves. Depending on the cause of the thickening, there are different treatment options such as Bandages, blood-thinning medication or exercise training are possible. Accompanying are various naturopathic procedures such as hydrotherapy.
In this article, “fat calves” are understood to mean all pathological enlargements of the normal size of the calves or the calf muscle (gastrocnemius muscle), as well as the feeling of swollen calves. Extensions to the calf circumference due to increased fat deposits or massive excess weight are explicitly not taken into account here.
Visibly thick calves can appear as acute swelling in the back of the lower leg and in the form of a chronic enlargement of the circumference. The same applies to the feeling of thick calves, which describes a perceived increase in pressure and tension in this area. At the same time, many sufferers have pain in the calf or lower leg.
Depending on the causes of the thick calves, there may be further complaints, such as tingling in the limbs or numbness in the legs, heel pain, ankle pain and foot pain.
The swelling is often not only limited to the calves, but can also affect the feet or even the entire leg. Leg pain, fat legs and fat feet or swollen feet are sometimes associated with the symptoms of fat calves. The complaints often occur to those affected under stress and towards evening.
Causes of thick calves
Trauma injuries such as fractures of the ankle, fibula or tibia as well as ruptures (tears) of the Achilles tendon or other ligaments in the area of the ankle usually cause violent hematomas, which are often also visible in the calf area. There is a massive swelling, which after a short time appears bluish-dark violet and then yellowish-dark green.
It is not uncommon for the symptoms of thick calves to be caused by vascular diseases such as varicose veins or weak veins. Circulatory disorders, for example in the course of calcification of the arteries, are also considered. A vascular occlusion (thrombosis) can lead to a sudden swelling in the leg area.
Another possible cause of calf swelling is so-called lymphedema. These fluid accumulations in the space between the cells are due to an impairment of the lymphatic system or the lymphatic drainage. This can be caused, for example, by malformations or developmental disorders of the lymphatic vessels, pathological changes due to bacterial, mycogenic and viral infections or damage from surgery, radiation and chemotherapy measures.
Fat calves due to physical exertion
High stress, for example in competitive sports, leads to the feeling of thick calves relatively often, which is increasingly associated with sore muscles in the calf muscles. Accompanying calf cramps may be observed. The thick calves are usually not visible on the outside.
In the course of excessive strain on the muscles, however, a so-called functional compartment syndrome can develop, which also causes externally visible changes. The muscles are trained too much and the muscle volume increases significantly, while the surrounding connective tissue layers (fascia) do not expand accordingly. The pressure on the tissue leads to a circulatory disorder, which causes permanent damage to the muscles and nerves. If there is no therapeutic treatment, the tissue can die. There is a risk of complete loss of the calf muscles. Even massive bruises or bruises sometimes cause a compartment syndrome.
Cause Löfgren syndrome
Occasionally there is also swelling in the calf area as part of the so-called Löfgren syndrome. However, the reddish swellings (erythema nodosum) do not appear on the calves but on the front of the lower leg (the same also applies to the ulcera cruris). The disease is generally characterized by swelling of the lymph nodes, polyarthritis, particularly in the area of the ankle, and inflammation of the subcutaneous fat. Suddenly there appear nodular, swollen and overheated reddened skin, which can reach a diameter of around ten centimeters. At the same time, many sufferers suffer from non-specific symptoms such as chronic fatigue and fever.
Organic causes of calf thickening
A disease of the organs can be considered as the cause. For example, an underactive thyroid (hypothyroidism) or an overactive thyroid (hyperthyroidism) sometimes leads to the formation of a so-called myxedema.
This usually shows up as reddish, but not overheated, swelling in the extremities and face. The skin becomes dry and rough. The swelling is due to the deposition of so-called glycosaminoglycans in the space between the cells. If no therapeutic care is given, those affected are at risk of life-threatening myxedema coma.
Calf swelling due to tissue damage - leg ulcers
In rare cases, a so-called ulcus cruris appears in the calf area. This is damage to the tissue substance, which is usually associated with an open wound that does not heal or hardly heals. The lower leg appears red and swollen around the wound. The leg ulcer ("open leg") can develop, for example, in the course of a chronic compartment syndrome.
Based on the information on the symptoms and their occurrence, initial conclusions can usually be drawn about the possible causes of the thick calves. A physical examination with palpation and, if necessary, listening to the lower leg provides further information. Ulcus cruris and myxedema can usually already be clearly identified in this way. Imaging procedures (ultrasound, computed tomography, magnetic resonance imaging and x-rays) are used, for example, in the case of broken bones and torn ligaments, but also in the case of circulatory disorders and lymphedema to ensure the diagnosis.
In order to clearly identify a compartment syndrome, a pressure probe can be inserted into the affected tissue. If a Löfgren syndrome is suspected, a tissue sample (biopsy) may be required to confirm the diagnosis. In addition, blood tests provide important information about inflammatory processes in the organism and possible diseases of the thyroid gland.
Treatment for calf thickening
Treatment is quite variable according to the different triggers. If the complaints are based on excessive stress or a compartment syndrome, the calf muscle is protected, the legs are cooled and raised. In acute compartment syndrome, however, surgical fascia splitting (fasciotomy) may be required to remove the pressure from the tissue.
If myxedema has developed due to a thyroid disease, drug therapy is usually given. In myxedema coma, intravenous administration of thyroid hormones, corticosteroids and glucose is provided. At the same time, attempts are made to stabilize the electrolyte balance.
Löfgren syndrome is also treated with medication in most cases. So-called non-steroidal anti-inflammatory drugs and later also corticoids (subset of corticosteroids) can be used. If there is no healing success based on the medication mentioned, so-called cytostatics may be administered.
In many cases, leg ulcers cannot be managed by conventional means (wound cleaning, healing ointments, bandages), so that surgical removal of the damaged tissue - possibly with subsequent skin grafting - is necessary relatively often.
Circulatory disorders can be treated in different ways depending on the causes. In many cases, exercise training or cardiovascular training can already bring about a significant improvement in blood circulation in the legs. Supplementary anticoagulant and blood-thinning medications are said to facilitate blood flow and thus have a positive effect on blood flow to the extremities. In the worst case, surgery is required for vascular changes, such as varicose veins.
Impairments of the lymphatic drainage can be successfully treated in most cases with physiotherapy, lymphatic drainage and wearing compression stockings. If conventional methods are unsuccessful, surgery may help to restore lymphatic drainage.
Naturopathy for thick calves
At the same time, various naturopathic methods can be used in therapy, for example, hydrotherapy can contribute to a significant improvement in blood circulation in the calves. Kneipp cures in your own bathroom can e.g. in the form of the well-known treading water in the home bath or cold calves.Treading water against thick calves
- Fill the bathtub up to hand-width below the knee with cold water
- Walk up and down in the “stork step” with your toes pointing down
- Run until you feel cold (maximum one minute)
- Get out of the tub and wipe the water with your hands (do not dry off!)
- Immediately put on your stockings and shoes and take care of your foot exercises, walking or similar. for reheating
Important: Make sure you keep your feet warm at the beginning of the application and then rewarm them well. Treading water is not suitable for menstrual problems, chills, cystitis or urinary tract infection, kidney problems, severe arterial circulatory disorders and diseases of the genital organs and the abdomen.
Homeopathic remedies, Schüssler salts and numerous preparations with medicinal plants have also proven their worth in thick calves in connection with circulatory disorders. The horse chestnut is particularly noteworthy here, as it has a decongestant, blood circulation and anti-inflammatory effect. Medicines with horse chestnut (e.g. gels or ointments) are used for venous insufficiency and other vascular diseases, but also for swelling e.g. due to a sprain or bruise.
In the form of a tea, the horse chestnut strengthens the veins and counteracts pain and swelling in the calves due to circulatory disorders.Recipe for horse chestnut tea:
- Put a teaspoon of horse chestnut flowers in a cup
- Pour 250 ml of boiling water over it
- After 10 minutes, strain the infusion
- If necessary, sweeten the tea with a little honey and drink two to three cups of it a day
Other proven home remedies for calf pain and swelling are stone clover and comfrey, which are contained in various venous ointments and are well suited for external use.
If water retention in the legs is the cause of thick calves, simple movement exercises can often help: Stand upright and rock the tips of your toes evenly back and forth to stimulate the pump mechanics of the feet. Another effective exercise that can also be done while sitting or lying down is alternately stretching and pulling up your feet.
Proven home remedies for water in the legs and calf swelling are tea blends with juniper berries, nettle or birch leaves. Furthermore, a regular elevation of the legs often helps if the calves become thick, especially after standing or sitting for a long time.
The manual treatment approaches of Rolfing, osteopathy and chiropractic offer themselves for a functional impairment of the calf muscle, but can also have a positive effect on circulatory disorders and lymphedema. (fp, nr)
Author and source information
This text corresponds to the specifications of the medical literature, medical guidelines and current studies and has been checked by medical doctors.
Dipl. Geogr. Fabian Peters, Barbara Schindewolf-Lensch
- Cornelia Fischer-Börold, Friederike Krumme: Vein disorders: Recognize, alleviate, prevent. Visit - The Health Library, Schlütersche Verlag, 2008
- Otto Braun-Falco, Gerd Plewig, Helmut Heinrich Wolff, Walter H.C. Burgdorf, Michael Landthaler: Dermatology and Venereology, Springer, 2005
- Pschyrembel Online: www.pschyrembel.de (access: 05.09.2019), myxedema