Recently, the sports world has been reminded of the significant health issue of deep vein thrombosis (DVT), a type of blood clot that has affected prominent NBA players such as Victor Wembanyama and Damian Lillard. This condition is not new to athletes and has previously impacted stars like tennis champion Serena Williams, hockey icon Zdeno Chára, and basketball Hall of Famer Chris Bosh.
Dr. J. Sawalla Guseh, who directs the cardiovascular performance program at Massachusetts General Hospital, clarifies that while athletes are not generally at more risk for clots like DVT than the general population, certain conditions prevalent in sports can heighten their chances of developing them. DVT specifically involves clots forming in deep veins of the legs, arms, or pelvis, which can lead to a pulmonary embolism if they move to the lungs—a potentially fatal condition.
The terms venous thromboembolism (VTE) encompass both DVT and pulmonary embolism, with the American Heart Association reporting nearly 1.3 million VTE cases in the U.S. in 2021. While the likelihood of individuals under 40 experiencing VTE is approximately 1 in 10,000, cases involving athletes usually receive significant attention, especially when professional players are sidelined due to health issues.
In athletes, DVT risks are often linked to injuries that can disrupt blood flow, surgical procedures following injuries, or immobilization due to casts. Such situations can lead to slower blood movement, increasing clotting risk. Likewise, repetitive motions in sports like baseball and tennis can potentially cause conditions like effort thrombosis. Furthermore, some athletes may be predisposed to thoracic outlet syndrome, especially if they build significant muscle in the chest and shoulder areas, narrowing passageways for blood vessels.
In addition to physical stressors, factors like frequent long-haul flights, common among professional athletes, can slightly elevate the risk of blood clots due to prolonged immobility and changes in cabin pressure. Dehydration from travel or intense exercise might also contribute by thickening the blood, promoting clotting, and female athletes using estrogen-based contraceptives face additional clot risks.
As Dr. Mary Cushman from the University of Vermont Medical Center indicates, the presence of symptoms such as swelling, pain, or discoloration in limbs, particularly after recent surgeries, should be treated as emergencies. Pulmonary embolism signs include chest pain and difficulty breathing, warranting immediate medical attention.
The standard treatment for clots involves blood thinners, and the duration depends on whether the clot is due to identifiable causes like surgery (provoked) or not (unprovoked). Provoked clots usually carry a low recurrence risk, often allowing patients to stop treatment after a few months. However, unprovoked clots may necessitate ongoing management. Fortunately, advancements in medication have made treatment more manageable, with some offering temporary cessation options suitable for athletes at high risk of injury during competitions.
Preventative measures can be vital in reducing VTE risks. It’s recommended to stay hydrated, especially while traveling, and to move regularly on long flights or bus rides. In addition, compression socks and light activities like walking can help reduce risks during recovery from injuries.
The importance of personalized treatment is particularly crucial for athletes, whose careers, as noted by Cushman, are often short. Indeed, dealing with health conditions like DVT in a sports context requires tailored interventions to enable athletes to maintain their career trajectories without compromising their health.