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All in Vein

Vascularity in bodybuilding is controversial. The term refers to the extent of superficial prominence of blood vessels, or veins, that are just below the skin’s surface.

Vascularity in bodybuilding is controversial. The term refers to the extent of superficial prominence of blood vessels, or veins, that are just below the skin’s surface. Of course, you don’t have to be a bodybuilder to show prominent vascularity. You can readily see a lot of veins on many thin people. Conditioned bodybuilders and other athletes show prominent vascularity for the same reason that thin people do: low subcutaneous bodyfat, which is the fat that lies just under the skin.

Having an extensive amount of vascularity is not only desirable but sought after by competitive bodybuilders. From a judging perspective, a bodybuilder who displays it is said to be in contest condition—at least as far as bodyfat is concerned. All those veins sticking out somehow make the competitor seem more muscular. It’s certainly plausible when you consider that contestants with excess bodyfat rarely show any degree of vascularity.

[*Get the latest e-book collection of Vince’s methods, quotes, workouts and advice Vince Gironda: Legend & Myth by Alan Palmieri, one of Vince’s students. Read the Iron Man magazine review here.]

Not having prominent veins doesn’t mean that you’re out of shape or that you have too much bodyfat. The location of superficial blood vessels is also a factor, one that depends on genetics. Some bodybuilders can be “ripped” yet not display a lot of vascularity. Their great conditioning is still apparent, however, because of their obvious muscularity, which may include cross-striations in certain muscle groups, such as the thighs and triceps, that would not appear if they had too much bodyfat. In many bodybuilders the veins never show, and the reason is simple: Their blood vessels lie deeper under the skin than those of other competitors.

Although prized by many bodybuilders, vascularity is controversial for a number of reasons. Many people believe that having extensive vascularity points to anabolic drug use. The thinking is that drugs selectively help reduce subcutaneous fat stores more than is possible through exercise and diet. To a certain extent, that’s true. One has only to compare a drug-free, or natural, bodybuilder to a self-professed anabolic-drug user whose vascularity is much more evident. Again, however, genetics enters the picture; many bodybuilders who’ve never used any form of anabolic drugs can also show prominent vascularity with low bodyfat if they have blood vessels located closer to the surface of the skin. Drugs besides steroids that may affect vascularity, such as thyroid hormone, growth hormone and clenbuterol, work by reducing bodyfat, including the kind under the skin.

Some bodybuilders have even contemplated using drugs that raise blood pressure because they believe that it will bring the veins out. It won’t, but it may bring on a heart attack or stroke. Other bodybuilders sip wine shortly before going onstage at a contest, thinking that it will rapidly dilate blood vessels and produce a more vascular appearance. Alcohol does dilate blood vessels, but only small ones in the skin that aren’t readily apparent. The good news is that the dilation makes you feel warmer, even if not more vascular-looking. The same holds true with downing some niacin, a B-complex vitamin known to cause blood vessel dilation. Again, you’ll feel warm, and the increased blood circulation produced by the niacin will make you look flushed, or redder, and that may blend in with your tan, natural or otherwise. As for making you appear more vascular under the posing lights, sorry, no cigar—okay, one for you, former Governor Schwarzenegger.

Perhaps the most idiotic technique ever devised for producing greater vascularity is to engage in blood doping by using drugs such as EPO analogs that increase red blood cell concentration. That it doesn’t work is evident when you view elite cyclists, many of whom engage in blood doping. I don’t recall ever seeing a particularly vascular cyclist—do you?

Vascularity is also controversial because of the way the public outside bodybuilding reacts to it. Ever since I began training more than four decades ago, I’ve heard people express disgust about “all those veins sticking out” on bodybuilders. Rather than admire the fact that those veins are “sticking out” because of low bodyfat, people express revulsion, often commenting that they are ugly and don’t look natural. Most people don’t have large muscles and prominent veins. Even comic book superheros who have large muscles, such as Superman and Batman, never show prominent vascularity. On the other hand, the superheros wear costumes that may obscure it. In recent years the fake Batman costume that actors have worn in movies has highlighted more vascularity and abdominal definition, perhaps because of the influence of real-life bodybuilders.

In the past, prominent vascularity was rare in bodybuilding competition. While some muscles, such as the biceps, did show a vein or two, you didn’t see the vascularity so abundant today—yet another reason it’s associated with drug use. Vince Gironda, one of the greatest bodybuilding competitors ever, once told me that he often lost to far less muscular bodybuilders because of his then-rare high vascularity. Most bodybuilders in the late ’40s and ’50s just didn’t show many veins. It made a guy like Vince stand out—which at that time wasn’t good. “The judges just didn’t know what to do with me, so they would place me third or fourth to men who were far less muscular than me,” Vince said.

Another bodybuilder with the same problem was Bob Hinds. I recall viewing a photo of him on the cover of Iron Man around 1959, when he was at his physical peak. His vascularity was astonishing, easily rivaling any of the current bodybuilding competitors. Yet like Gironda, Hinds suffered the same discouraging fate in competition. His highest placing in the Mr. America contest was eighth in 1956, although he did place third in the voting for the most-muscular award. He stopped competing not long after that.

While vascularity is now common in competitive bodybuilders, particularly among the professional elite, there is a type of vascularity that isn’t so pretty: the tortured, twisted, bloated veins you often see on competitors. You don’t have to be a doctor to recognize such monstrosities as varicose veins. Even those who admire high normal vascularity are often taken aback when they see a bodybuilder whose extensive varicose veins look like a highway map to nowhere. They’re just painful to view. The question is, What causes varicose veins like that in bodybuilders?

Veins are the blood vessels that carry blood back to the heart. To prevent a backflow of the blood from the effects of gravity, they have small leaflet valves. The muscles work like auxiliary pumps, helping the veins distribute blood back to the heart. Varicose veins are the result of a failure of the one-way leaflet valves. When that happens, the blood flows backward into the veins, raising the internal blood pressure on their thin walls and eventually enlarging the veins. It usually affects the superficial veins lying closer to the skin surface.

So varicose veins obviously have a negative appearance, but they can also be painful, particularly if you’re standing or walking. They can itch, and scratching the itch can cause skin ulcers, compounding the problem. Varicose veins in the legs feel achy and heavy, especially after exercise. They can also cause leg cramps and are related to restless leg syndrome, which can interfere with sleep and upset your metabolism and recovery. Varicose veins are more common in women and often appear during pregnancy, which points to an underlying hormonal component. Those whose work requires prolonged standing often develop extensive varicose veins in their legs. My stepfather, Jack, always had a severe case of varicose veins in his legs because of his work, which forced him to stand on his feet for hours every day.

While women are more likely to have varicose veins than men, men aren’t immune to the condition, as bodybuilders prove. Recent studies have shown that hormone imbalances do indeed play a role. Estrogen may explain why women have more varicose veins than men. Older men, particularly those low in testosterone, experience a greater incidence of varicose veins, as do those who have a genetic condition called Klinefelter’s syndrome, characterized by high estrogen and low testosterone. Could estrogen be one of the causes of varicose veins?

[*Get the latest e-book collection of Vince’s methods, quotes, workouts and advice Vince Gironda: Legend & Myth by Alan Palmieri, one of Vince’s students. Read the Iron Man magazine review here.]

Both androgen and estrogen receptors are found in veins. A recent study examined hormonal receptors and various hormones in the large saphenous vein in the legs of men who did and didn’t have varicose veins.1 Those who had varicose veins showed more estrogen relative to free, or active, testosterone in their bodies, and their androgen receptor activity was downgraded, likely due to a local negative feedback caused by the greater concentration of estrogen. That has implications for men whether or not they’re bodybuilders.

For nonbodybuilders, the major story is that having an imbalance of estrogen to testosterone may set the stage for the appearance of varicose veins. Whether that happens depends on other factors, such as genetic predisposition, diet, exercise and amount of time spent standing on your feet. For bodybuilders who use anabolic drugs, the point is that some steroids can convert into estrogen through the actions of the enzyme aromatase, which is found throughout the body, particularly in fat tissue. When men age, they tend to lose muscle and gain fat, which would predispose them to higher estrogen counts and, in due course, varicose veins. Most bodybuilders who use anabolic steroids that can convert into estrogen know the score and take aromatase blockers or estrogen antagonists, such as Nolvadex.

Still, you have to wonder how many top bodybuilders who have a lot of varicose veins got that way through an unfortunate combination of excess estrogen and heredity. Perhaps even certain styles of training are involved, although since the muscles assist the veins in returning blood to the heart, reducing pressure on veins, exercise would be an unlikely source of the problem. There’s not much a bodybuilder can do to prevent varicose veins, other than being aware of the effect of estrogen while doing everything you can to maintain normal testosterone. Some studies show that nutrients that strengthen the vein walls, such as vitamin C and bioflavonoids, offer some preventive effects, as do herbs that contain natural silicon, such as horsetail.

The other option: Just live with it, or resort to medical solutions for the removal of varicose veins.

Editor’s note: Jerry Brainum has been an exercise and nutrition researcher and journalist for more than 25 years. He’s worked with pro bodybuilders as well as many Olympic and professional athletes. To get his new e-book, Natural Anabolics—Nutrients, Compounds and Supplements That Can Accelerate Muscle Growth Without Drugs, visit  IM


1 Kendler, M., et al. (2010). Elevated sex steroid hormones in great saphenous veins in men. J Vasc Surg. 51:639-646.


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