Meet the cankles / Although this body part has a funny side, it also may be a sign of serious health problems

Have you heard it? The cackling about cankles?
Maybe the new buzz on this stocky body part has you shunning shorts or sandals. Or maybe you're doing leg exercises like mad to plump up those calf muscles.
A cankle -- if you're in the dark -- is the merging of calf and ankle into one continuous, taperless chunk of leg. It's a "condition" recently spotlighted on TV morning shows and talk shows, on the pages of Facebook and the Wall Street Journal, and on such Web sites as www.saynotocankles.com.
Cankles are nothing new. As long as there have been calves and ankles, some of us have had a less-than-pinup-style melding of the two.
"It's an age-old problem that just recently received a name," says Sindy Wolthoff, owner of Pink Fitness for Women in Layton.
The slang originated in the 2001 movie "Shallow Hal," say Wolthoff and others. But cankles have also popped up in "Weeds" episodes, in Hillary Clinton impersonations, and even in teen sensation Miley Cyrus' book ("Miles to Go") in which the star's father tells her: "All the Cyrus women have cankles. You should be proud."
The new flurry of attention -- from serious to silly -- was triggered by the declaration of "Cankles Awareness Month" in July by the Gold's Gym chain. The humorous ad campaign called cankles America's fastest growing "aesthetic affliction" and admonished, "Friends don't let friends get cankles."
Gary Nielsen, owner of Gold's Gyms in Ogden, Roy and Layton, says his franchise didn't piggyback on that national campaign, but he has heard joking about cankles on shows like "Ellen" and "The View."
Although cankles have a funny side, Nielsen says, they're evidence of serious obesity problems in our society.
If the campaign offers "a humorous way for people to examine their bodies and try to do something about it," that's a good thing, he says.
No bare legs
Cankles are something women fret about, says Brandi Ryan, a fitness instructor in Layton and North Ogden.
"I've played sports with some women who don't like to wear shorts because they have cankles," says Ryan.
Cycling instructor Jeni Carlton, at Pink Fitness, agrees, saying she knows a woman who tried compression stockings and heated creams to reduce the size of her ankles.
"Cankle" isn't an anatomical term; it's a word from the Urban Dictionary -- like "muffin top," says Fabio Comana, an exercise physiologist for the American Council on Exercise.
"There's nothing scientific about cankles," Comana says in a phone interview from San Diego.
Obesity is one reason women, or men, develop cankles, Comana says, but it's not the only reason.
In most cases, the condition is genetic -- say, a case of large ankle bones and small calves.
"DNA is going to determine the size of your muscles and the shape of your body," he says.
Because of genetics, our bodies also deposit fat in different locations, Comana says. Gender plays a role in that as well, since women tend to gain weight through the hips, thighs and legs while men accumulate it in the stomach area, he says.
Heavy ankles can also be associated with medical problems such as Type 2 diabetes or peripheral vascular disease, a circulatory disorder, Comana says. Pregnant women, too, may temporarily suffer from enlarged ankles due to fluid retention.
Getting a leg up
If cankle-afflicted, what is a body to do?
Wolthoff says she thinks women can see some improvement through exercises that work the legs or calves, such as ellipticals, treadmills or dance classes.
Lourdes Rios, a Pink instructor, says she has noticed better definition in her calves since she started doing Zumba, a type of aerobics done to Latin music.
However, Ryan says, "As far as there being a specific ankle exercise, I don't know of one."
Exercising and eating right -- the mantra of health and fitness advocates everywhere -- is the best way to tackle weight loss, say Ryan and others.
"It's going to affect everything from head to toes ... from your flappy underarms to your waist to your cankles," Nielsen says.
Spot reducing will not work for cankles or any other body area, says Molly Smith, professor of human performance at Weber State University. A saying she likes to share with students is: "If spot-reducing worked, people who chew gum would have skinny faces."
When it comes to how the body sheds fat from various areas, Smith says, "We have no choices on that."
Smith says men naturally have more musculature in their calves. Women have more subcutaneous muscle fat there, so they typically don't get as much definition unless they are high-performance athletes like Olympians, she says.
Fat or muscle?
Plastic surgery for cankles isn't as common as liposuction, breast augmentation or face lifts, says Eric Ashby, of Layton, but he does do a handful of procedures every year.
Ashby says a correct diagnosis of the cause of the cankles is important. Liposuction or liposculpture will work for fatty deposits, but not all cankles fit into that category.
Some people have larger calf muscles going into the ankle which gives a "full look" that cannot be changed, he says.
Others may have lymphedema, a condition that causes fluid retention in the limbs, Ashby says. Instead of just swollen tissue, there is permanent thickening of the tissue, he says.
"Liposuction is not going to help and may actually damage the lymphatic system more," he says.
Without knowing what the exact problem is, "Somebody will be trying to make an improvement they can't make," Ashby says.
'Let it be'
The recent press about cankles is overblown, says Comana, and victimizes women by giving them one more aspect of their body image to worry about.
Obesity or diabetes are valid concerns, he says, but if you aren't overweight and are in good health, "Let it be."
"You can have a completely healthy and fruitful life and have cankles," Comana says.
Smith agrees, saying, "I would think (people) would be more concerned about fat around the middle than they would with less definition in their calves."
Too much central body fat is a dangerous condition -- the "crux of death" -- for women and men, the professor says.
Ryan says her philosophy is to focus on an active lifestyle and overall health rather than zeroing in on specific body parts like hips, ankles -- or cankles.
"Focus on a part of your body that you are happy with," she says.
Maybe you don't have perfect ankles, she says, but maybe you work on your abs -- and "you could be happy with that six-pack."