If you’ve ever fallen and scraped your knee, you know that any bleeding eventually stops, thanks to blood clots. Clotting is nature’s way of helping stanch the blood flow from a cut or wound.
More specifically, after getting a superficial scrape, the damage to small blood vessels causes bleeding. The body responds by activating platelets, tiny cells that form a plug to stop the blood. When a scab forms over your wounded knee, it means your body has reached the end of the clotting process. But blood can also clot while inside the body — and that can be dangerous.
What Is a Blood Clot?
Medical professionals refer to internal blood clots under the umbrella term “venous thromboembolism,” or VTE. Usually, a VTE occurs in one of two ways:
— Deep vein thrombosis, or DVT, a clot that forms in a deep vein, most often in the leg. Often, signs and symptoms include redness, warmth or tenderness in the affected area. The pain typically worsens with movement and feels like a cramping sensation.
— Pulmonary embolism, or PE, a complication of a DVT. A PE occurs when a clot breaks free and lodges itself into a vessel that supplies the lungs. This clot then blocks the lung’s blood flow. A PE usually manifests as sudden shortness of breath or chest pain.
VTEs are common; the CDC estimates more than 900,000 people are affected by them each year. They’re often diagnosed with a combination of symptom evaluation, imaging results and a blood test.
[READ: Understanding the Causes of Right-Side Chest Pain]
Risk Factors for Blood Clots
Blood clots can be fatal, so it’s important to understand what puts you at risk. The Society for Vascular Medicine groups potential causes and risk factors for VTEs into five main categories:
— Immobility. Hospitalization and long-distance travel that requires sitting for more than eight hours are common culprits. This is why movement and exercise can help prevent blood clots (more on that later on).
— Surgery or trauma. Orthopedic surgery is commonly associated with DVTs, especially with large joint replacements. Injuries, such as breaking a bone or tearing a muscle, also force the body to clot in order to heal itself. Sometimes, the body exaggerates its clotting response, which can lead to VTEs.
— Increased estrogen. Hormonal birth control, pregnancy and postpartum stages or hormone replacement therapy can all increase VTE risk.
— Medical conditions. This may include cancer or inflammatory diseases, such as irritable bowel syndrome or lupus.
— Lifestyle and genetics. A family history of blood clots or clotting disorders increases VTE risk. Lifestyle factors, such as being age 60 or older, smoking, a sedentary lifestyle or obesity, are also major risk factors.
For patients that already have DVT, all of the above risk factors also put them at risk for dislodging their clot to become a potentially life-threatening pulmonary embolism. However, DVT and VTE caught early can and often are treated successfully with anticoagulant “blood-thinner” medication like warfarin or with surgery.
[READ The Most Common Signs of Poor Circulation and How to Improve Them]
Exercise After a Blood Clot
Once your DVT or VTE is treated, you should maintain or begin a more active lifestyle.
“You want people to exercise because the lack of exercise causes clots,” explains Ellen Hillegass, a physical therapist with American Physical Therapy Association board certification in cardiovascular and pulmonary clinical specialty. She also serves as a professor in the physical therapy department at South College in Atlanta.
However, you should ease into an exercise program, says Dr. Geoffrey Barnes, a cardiologist and president-elect of the Anticoagulation Forum. Barnes is also a vascular medicine specialist at the University of Michigan.
Barnes recommends avoiding vigorous exercise in the first week after a DVT and two weeks after a PE. Following these more restful periods, patients can slowly and steadily ramp up their activity levels.
After that? “Any exercise,” Hillegass recommends.
If you want to work the entire circulatory system, you might consider aerobic activities, such as:
— Walking.
— Running.
— Biking.
— Swimming.
Keep in mind that you should avoid any exercise that could lead to bleeding or injury, Barnes says. Most patients take blood thinners after a VTE to help prevent future clots. Blood thinners, however, place the body at higher risk for bruising and internal bleeding. For this reason, Barnes generally steers patients away from skiing, snowboarding, kickboxing or mixed martial arts.
[READ 10 Questions to Ask a Personal Trainer Before Hiring Them]
Sample Workout Plan After a Blood Clot
Walking is a great way to start exercising again, once you are cleared by your medical provider, notes the North American Thrombosis Forum, or NATF. In general, you should pick a walking route that is close to home, relatively flat and has places to rest along the way, such as a local park.
Warm up with a slow walk for five minutes, then increase your activity each week:
— Week 1: Walk for five minutes at a comfortable pace, three to four times per day.
— Week 2: Walk for 10 minutes, three times per day.
— Week 3: Walk for 15 minutes two times per day.
— Week 4: Walk for 30 minutes, once daily.
Set a goal to walk for 30 to 45 minutes, five to seven days per week.
NATF says that strength training is a key part of physical health as well, and it’s safe to return to your regular routine if you already do strength training. If you don’t and want to start, ask your primary care physician for a referral to a professional physical therapist or trainer. They can work with you to create an individualized strength training routine.
Movement Without Exercise
It’s important for everyone, but especially those with a history of blood clots, to move often throughout the day, even if they’re not engaging in regular workouts.
“Clots happen from stasis, so if you don’t do a lot of exercise, get up and move,” Hillegass says. “You don’t need to run a 10K.”
You can try a gentle range of motion exercises, such as:
— Ankle circles.
— A seated knee march.
— Shoulder rolls.
These work well if you have to stay seated, like if you’re stuck in the middle seat on a plane or your meeting runs forever. If you are able to get up, try standing to stretch your legs or take a short walk every hour.
Moving Forward After a Blood Clot
There are multiple strategies you can try to make exercising after a blood clot more pleasant.
Hillegass recommends approaches like:
— Wearing compression stockings to reduce pain and swelling.
— Starting with non-weight-bearing activities, such as biking or swimming.
— Trying various forms of exercise to see what feels comfortable.
As you’re exercising, though, you should be on the lookout for shortness of breath.
“If you had a pulmonary embolism, you can get a condition called chronic thromboembolic pulmonary hypertension,” Hillegass warns.
CTEPH is a rare and progressive form of pulmonary high blood pressure caused by blood clots that don’t dissolve in the lungs, according to the CHEST Foundation. These clots cause scar-like tissue that clogs up or narrows the small blood vessels in the lungs.
“If you develop shortness of breath, you should be evaluated by a pulmonologist,” Hillegass says.
Your provider should also provide close medical follow-up after a blood clot to ensure your health is improving, Barnes adds.
“Your doctor will review your medications and how well you are recovering,” he explains. “Staying active, including regular exercise, is a great way to reduce your risk of future blood clots by helping to keep the blood in your legs circulating properly.”
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Exercising Safely After Having a Blood Clot originally appeared on usnews.com
Update 07/13/23: This story was previously published at an earlier date and has been updated with new information.
