Blood clots are nature’s way of helping stanch the flow of blood from a cut or wound. But blood can also clot while in the body — and that’s a danger.
Deep vein thrombosis, or DVT, is the clinical name for this occurrence. When a blood clot, called a thrombus, forms in one or more of the deep veins in your body, usually in your legs, it can cause pain or swelling. It also can cause no noticeable symptoms.
If one of the clots breaks free, it can travel through the bloodstream and get caught in your lungs, blocking blood flow. This is known as a venous thromboembolism, or VTE, and can obviously be very serious and even fatal.
There are many potential causes and risk factors of DVT:
— Injury to a vein.
— Certain medications.
— Limited movement.
— Sitting for long periods of time.
— Being overweight or obese.
— Being age 60 or older.
DVT and VTE can and often is treated successfully, with anticoagulant “blood-thinner” medication or surgery. Once DVT or VTE is treated, doctors recommend that patients be sure to stay active. “You want people to exercise, because the lack of exercise causes clots,” says Ellen Hillegass, a physical therapist with American Physical Therapy Association board certification in cardiovascular and pulmonary clinical specialty. She is an adjunct professor at Mercer University in Atlanta and at Western Carolina University in North Carolina. Hillegass is also the president and CEO of Cardiopulmonary Specialists, a private consulting firm that provides consulting and education on cardiac and pulmonary rehabilitation.
Hillegass has published a lot of research on treating blood clot patients and, in fact, is a co-author for the original and recently updated APTAs clinical practice guideline on VTE.
Any Exercise Will Do
What specific exercises does Hillegass recommend for these patients? “Any,” she answers. The object is to keep blood circulating. “You want movement, the opposite of immobility,” she explains.
Any aerobic activity works the entire circulatory system, including:
The North American Thrombosis Forum says that walking is a great way to start exercising again after treatment, or for the first time for that matter, once you are cleared by your doctor. They recommend that you 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.
The NATF says that strength training is also important part, and it is 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. He or she can work with you to create an individualized strength training routine.
Hillegass also suggests wearing compression stockings, which can make exercising more comfortable if you feel pain or experience swelling during or after exercise. If you feel consistent pain from certain exercises, she suggests trying something else. For example, if bearing weight on your legs hurts too much, try a non-weightbearing activity like biking or swimming.
Finally, be aware of shortness of breath. “If you had a pulmonary embolism, you can get a condition called chronic thromboembolic pulmonary hypertension,” Hillegass warns. The CHEST Foundation says that CTEPH is a rare and progressive form of pulmonary high blood pressure, caused by blood clots that don’t dissolve in the lungs. 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 pulmonologist,” Hillegass says.
Movement Without Exercise
It’s important for everyone, but especially those with a history of blood clots, to move often throughout the day. “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.”
If you are working at your desk at home or at the office, stand up and take a short walk every hour. If you are on a long trip by plane, train or automobile, try to do the same. And if you can’t get up — you’re stuck in the middle seat or your meeting runs on forever — flex and pump your feet, ankles and legs as much as you can.
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