The gastrocnemius veins are paired deep veins that run inside the medial and lateral heads of the gastrocnemius muscle. They collect blood from the muscle and empty into the popliteal vein behind the knee, the medial ones often close to where the small saphenous vein joins. Together with the soleal veins they form the main reservoir squeezed by the calf muscle pump.
| Origin | Intramuscular venous channels of the medial and lateral heads of gastrocnemius |
|---|---|
| Course | Run upward within each head of gastrocnemius and leave its upper part to end in the popliteal vein in the popliteal fossa |
| Branches |
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Thrombosis confined to the gastrocnemius veins (calf muscle vein thrombosis) is common on ultrasound in patients with calf pain, particularly after injury, surgery or immobility. It carries a lower risk of embolism than thrombosis of the main deep veins but can extend into the popliteal vein, so patients are either treated or rescanned. It can mimic or accompany a medial gastrocnemius strain (tennis leg).
A clot within the gastrocnemius veins causes calf pain and tenderness, sometimes with swelling. Management is either anticoagulation or repeat ultrasound to check for extension into the popliteal vein.
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