Q I have been running for 20 years. I noticed recently that the veins in my temples become very swollen when I run. My doctor has told me not to worry but has not suggested a possible cause. Is it safe to continue to run?
A I am sure it is. This phenomenon, common to far more runners than you might imagine, is in part linked to the basic design of our skulls. During times of strenuous activity, such as running, sweat evaporates from the scalp, forehead and face and this evaporation helps to cool blood draining from the head. Veins also dilate to facilitate heat loss and reduce the risk of overheating.
It may also be the case that as you become older your veins simply have a natural tendency to engorge with blood more than they used to, in order to assist this temperature control system. Remember that as a general point a vein becomes engorged when there is pressure at some point beyond it. So, heavy breathing during running or other vigorous exercise, singing a song very loudly or shouting (think of an army sergeant major) may all cause veins to become increasingly prominent in the head and neck. However, this does not mean there is any underlying serious problem.
You should check that your blood pressure is normal though. For many people this has a natural tendency to rise with age for no obvious reason (known as primary or essential hypertension). However, people who exercise regularly are more likely to have normal blood pressure than those who don’t, or who are overweight and lead a sedentary lifestyle.
Should your blood pressure be raised this could explain why your veins are more swollen than normal after 20 years of running experience. However, I am sure your doctor has already checked this and so my second opinion is the same as your first – don’t worry, and keep on running.
— Dr Roger Henderson, marathon runner and general practitioner