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Sunday, August 9, 2009

Endurance Athletes and DVT's (blood clots)

Two of my running friends have developed DVT's in the past six months. Two healthy runners in their early 40's. This surprised me, as I always think of DVT's (blood clots) as something that happens to an older, more sedentary, less healthy population.
As I did some research, some very interesting information has come to light. If you are an endurance athlete, please read on. DVT's do not just happen to folks in hospital beds, if you are an endurance athlete, you need to be aware of this condition and a few facts!!

What it is: DVT- deep vein thrombosis. Layman's term: blood clot. Why this is bad: this blood clot can break off from where it's formed, travel through your bloodstream, block oxygen and blood to your brain, and KILL YOU. Or the blood clot can stay in your leg (or arm) and cause swelling, pain, even tissue necrosis in the area if left alone long enough.


SO why is this happening to an otherwise fit athlete? Atheletes tend to have a lower resting heart rate. This results in blood flowing slower through the body.
Dehydration-this plays a factor in your blood viscosity. More dehyrdation leads to thicker blood.
Trauma? Falls, bruises? Nah, this never happens in an ultra. (Non runners would call this "trauma") Ultra runners? Well, we took a face plant eight hours ago. No big deal, right? I got a little banged up. Due to this trauma, there may be a clot forming at the spot in the cell wal. This is your body functioning normally.

After the race is over, we get into our car, or onto an airplane, and travel hours back to where we came from. We spend hours in a cramped position. Meanwhile, the thickened blood is pooling.The body is still dehydrated. The body is forced into the worst position to get the blood pumping throughout the body again. This is where the start of a clot in the legs (in the deep veins) can begin.

According to a www.airhealth.org 85% of air travel thrombosis are atheletes.


What can you do to help minimize your risk of a DVT?
Keep hydrated or get hydrated after the event. Keep hydrated on the plane! Keep legs moving. Get up and move every 15 minutes. Do not stay seated for prolonged periouds of time. Stop the car every 1/2 hour and get out and walk. Move your legs and change position during the car ride. If you inured yourself or became dehydrated you are at a higher risk!

What are some symptoms of a clot forming?
If a clot forms, it usually feels like a cramp in the leg, sometimes causing significant pain and swelling. There may also be a bruising or swelling behind the knee. If your doctor says it's just a sprain ask for an ultrasound of the area.

If you have chest symptoms and you are being told you have a chest infection, anxiety attack, heart attack, or anything else other than PE (pulmonary embolism), ask for a blood oxygen measurement. They will attach a pulse ox to your finger. If the reading is less than 80, you should be checked for a PE.



What else can you do?

Hydration

Movement-as much as possible after a race

Compression Stockings-compression stockings (not support hose) work by being very tight around the ankles, and become looser up the leg. By being constrictive, they will force the increase of the velocity of the blood. The blood will move faster.

Being aware of your body. www.airhealth.org publishes a free leaflet http://www.airhealth.org/leaflet.html that you can use as a wallet card to help remind you of what else to do after that long run!


Oh, it won't happen to me.....
It happens to athletes. ALL THE TIME. I have 2 friends in 6 months. Some other names and their accounts:
Frey Maxim professional triathlete http://freybird.blogspot.com/2009/01/deep-vein-thrombosis-for-cyclist.html
Steve Lehman endurance biker http://www.tristatevelo.com/node/87


More articles:
http://www.trifuel.com/triathlon/health/your-last-tri-race-clot-die-001509.php
http://www.airhealth.org/index.html
http://blog.garymoller.com/2008/01/how-to-prevent-deep-vein-thrombosis-in.html


And on a personal note, I am going to have my calf checked out. I've had a pain in my left calf for about 2-3 months now. The pain comes and goes. I've had a massage, which has not helped, and the pain is still there. I've been thinking it is just a knot, but with all the reading I have been doing, I think I would like to rule out a clot!

10 comments:

  1. Kim,

    BRILLIANT post. You are the trail goddess in so many ways, one of which was the time you took to research and write this motivating piece. I think it is a great thing you did here.

    Your worshipper...

    Mikey

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  2. Great post. Until recently I thought the same as you. Given how much travelling I do, I was a bit surprised to find out the same as you.

    Also, pretty astounding stories in the comments here...

    Thanks for sharing!

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  3. Thanks for the information, this was passed along by another. I have had a constant battle with a left calf "injury" and I'm really now wondering if this should be checked out. They ruled out stress fractures and settled on nerve compression and it's better but the tightness never really goes away (comes and goes especially after runs). Did you intially go see a primary care physician to get it checked???

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  4. I am so happy to find this article. I just found out today I have a blood clot in my left leg and it has already spread to my knee. The doctors did not tell me how common blood clots are after knee surgery. I had knee surgery on my left knee over a week ago and my post-op was scheduled 2 weeks later. I personally think the post-op should never be 2 weeks out...1 at the most! I had to call and call to get someone to listen to my symptoms, which were VERY mild! I had mild tightness in my left calf that felt like a small muscle cramp...that's it. I didn't think it could possibly be a blood clot because I'm very active and don't have a history of blood clots. I went in for the ultrasound today and was shocked at the news. They already gave me my first shot of coumadin today and now I'll have 7 more shots this week plus pills I'll be taking for a good 6 months! I have no idea how long it will be before I exercise again. I teach fitness classes so I'm very concerned. Thank you for your post and anyone who is reading this with info please share! Also, if you have knee surgery be extra careful! I followed all of the precautions and still ended up with a blood clot so they can happen to anyone!

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  5. Thanks for posting this. I wish I had read it before I got my pulmonary embolisms. I ended up in the hospital. I won't repeat all of the details, they are basically the same as have been already stated. I will be very careful from now on, that is a given.

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  6. my God, i thought you were going to chip in with some decisive insght at the end there, not leave it with ‘we leave it to you to decide’.

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  7. Hi Kim, I am glad I found your post and see that I am not alone with this condition. I am 43, not an athlete but a physically fit guy, who is currently recovering from a DVT/PE. Doctors believe the DVT came from a calf strain after exercising too hard on a step machine - combined with dehydration - caused the clot that traveled to my lungs. And as a risk factor I have varicose veins on my calves. Before having my PE, I was exercising 4 or 5 times a week, and probably not paying attention to hydrate myself properly before going to the gym. I also made lifestyle changes, like stopping alcohol, going to bed earlier on every night and making healthier choices with my diet. Also drinking lots of fluids everyday. When I returned to the gym, I felt like my dignity was given back to me... I started exercising agin with moderation. That has been so beneficial!!! Doctors put me on coumadin for a year or so. I thank God that I am still here to write this post... Thank you again for your support.

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  8. Me too. Very fit, very active runner, cyclist, swimmer who has been running forever. Last fall, ran Chicago Marathon in 3:30 and felt fine despite the heat. Jogged a 10-K the following weekend and a 10-miler the weekend after. Also several flights. When I ran San Antonio Half I was in very good shape but just couldn't run much faster than 7:20-7:30 miles. I finished and was fine. But a few days later, I couldn't complete an easy 4-mile run or swim. SO I took a few days off and instead of getting better, I got worse. Had trouble breathing through my mouth. The doctor said I had bronchitis and gave me antibiotics and I felt better for a few days. Then it felt like I had broken ribs and I began spitting up blood. Uh oh. I had some test and the doctor immediately ordered me into the hospital. Yikes! Blood clots in my lungs. Made no sense and they still can't figure out the cause. My guess is dehydration (I live and train in Texas). I'm much better, but still on blood thinners and leading my normal active life (I'm 60). Hopefully, they won't return.

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  9. Thank you for posting this, even tho it's old it was helpful to me.

    I'm 47 and just had a DVT from my groin to my calf and PEs in both lungs. I was working out regularly -- used to do Sprint Tris and still train to get back to it when the kids' schedules will allow. Skipped a week or so with a cold (was that the initial blood clot??) and then did a 10-mile ride followed by a 1 mile run. Bad calf pain and swelling the next day. Went to podiatrist because I thought I might need new orthotics (I've torn both plantar fascia ligaments and need orthotics to run) . He diagnosed a possible torn muscle and sent me for an MRI. MRI showed severe strain but no tearing of the calf muscle. Doc prescribed PT. Went to PT the next week and the therapist sent me straight to the ER. 4 nites in the hospital including having an IVC filter put in and clot-busters directly into the leg.

    It's been 4 weeks now, and I'm back on the bike for 20 mi,n keeping my HR down, and I can walk up to 20 min. Hematologist is checking for genetic factors, but the consensus seems to be the BC pills are the culprit. Kind of a perfect storm of inactivity, injury, and hormones.

    I had not read about dehydration's impact on DVT before, but it makes sense. I often get headaches after I run, and I think they're due to dehydration. I'll make it a point to watch out for that when/if I get back to it.

    In the meantime, I'm hoping for negative results on the genetic factors (I have 2 kids and would hate to pass this on). I'm off the Lovenox shots but on Coumadin and the docs estimate a minimum of 6-12 months. Leg is still swollen, so I'm wearing my attractive socks and hoping I'm one of the lucky ones.

    I guess I AM one of the lucky ones, since I'm still here.

    Thanks for posting this.

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