Health & Exercise Forum

Guest Columnist: Janet Caputo, PT, OCS

The ability of the blood to clot to close and heal a wound is something most of us take for granted. However, when this system is not working properly, serious health problems can occur. Fortunately, it is treatable and preventable in most cases. There is good news for those with an active lifestyle. Researchers from Leiden University in the Netherlands evaluated almost 8,000 people ages 18 to 70 and found that regular participation in sports and exercise significantly reduces the risk of blood clots. Some specific findings that are noteworthy are; women received more benefit than men, obese people (body mass index or 30 or more) were four-times more at risk, even those only participating in sport or exercise once a week reduced their risks. So, this is another reason to KEEP ON MOVING!

Symptoms and Complications

If a blood clot from a vein travels to your lungs, a life-threatening pulmonary embolism can develop. It can be fatal even with prompt medical intervention. Because blood clots can develop without any sign, if any of the following signs of a pulmonary embolism develops, seek medical attention.

• Unexplained, sudden shortness of breath
• Chest pain
• Coughing up blood
• Sense of anxiety or nervousness are often associated with these symptoms

Another possible complication after a blood clot in a vein is a condition known as post-phlebitic or post-thrombotic syndrome, caused by damage to your veins from the blood clot and reduces blood flow in the affected areas. The symptoms may not occur until a few years after the clot resolves and include:

• Swelling in your leg
• Leg pain
• Skin discoloration

A blood clot that blocks an artery can result in various conditions. If the clot occludes one of the coronary arteries that supply your heart, you can experience a heart attack. A stroke occurs when the clot forms in one of the arteries within your brain. Poor circulation in your legs (i.e. peripheral vascular disease) can be caused by clots in the arteries of your legs. Blood clots from atrial fibrillation can travel through your bloodstream and cause a stroke or may occlude the arteries to your bowel resulting in a loss of blood supply to your bowel or even possible tissue death of your intestines.

Since a blood clot can result in devastating consequences, even death, your primary goal should be PREVENTION. Prevent blood clots from occurring, from worsening, or from happening again by following these simple suggestions:

• Check in with your doctor regularly: Routine blood work prescribed by your physician can determine if your current medications or treatments need to be modified.
• Watch how much vitamin K you are eating: Vitamin K helps your blood to clot and can interfere with the effectiveness of your blood thinner. Foods high in vitamin K include green, leafy vegetables and canola and soybean oils. Ask your physician about your consumption of such foods.
• Take any prescribed medications as directed: Whether you are taking a blood thinner (e.g. warfarin) or an anti-platelet (e.g. Plavix®), daily dosage must be consistent and regular. If you have difficulty remembering to take these medications, purchase a pill case which allows you to organize your medications and will prevent you from forgetting to take them or allow you to determine if you have already taken them. For an additional reminder, set an alarm for your next scheduled dosage at least until you develop a consistent routine for taking your pills.
• Exercise your lower calf muscles: This is especially important if you will be sitting for a long time. Whenever possible, get up and walk around. If for some reason you can’t get up to walk around, perform heel and toe raises from a seated position. To perform a heel raise from the seated position, place your feet flat on the floor and move your heels up and down while keeping your toes on the floor. To perform the toe raise, place your feet flat on the floor and move your toes up and down while keeping your heels on the floor. If you are lying down or on strict bed rest, perform ankle pumps by alternately moving your ankles up and down by pulling your toes toward your nose then pointing your toes away from your nose. Repeat this movement 10 to 20 times every thirty to sixty minutes.
• Move: If you have been on bed-rest because of surgery or other factors, the sooner you get out of bed and get walking and moving, the less likely blood clots will develop.
• Make lifestyle changes: Lose weight, quit smoking, and control your blood pressure. Obesity, smoking, and high blood pressure all increase your risk for developing blood clots.
• Wear compression stockings: These garments, which exert a specified amount of pressure (10 mm Hg to 30 mm Hg) to your lower legs, help control edema and prevent blood clots from forming in your legs. Your doctor may recommend a pair for you especially if you are recovering from a blood clot, have a reduced capacity to move around, or if you are considered a person who is at high risk for developing a blood clot.

CONTRIBUTING AUTHOR: Janet Caputo, PT, OCS is clinical director of physical therapy at Mackarey & Mackarey Physical Therapy Consultants, LLC in downtown Scranton where she practices orthopedic and sports physical therapy. She is currently a Doctor of Physical Therapy student at the University of Scranton.

MEDICAL EXPERT REVIEWER: Anthony J. Yanni, MD, Chief Medical Officer, Mercy Health Partners, Scranton, PA.

Read Part 1 about detecting blood clots. And, read Part 3, which covers the association between blood clots and flying.

This article is not intended as a substitute for medical treatment. If you have questions related to your medical condition, please contact your family physician. For further inquires related to this topic email: drpmackarey@msn.com

Paul J. Mackarey PT, DHSc, OCS is a Doctor in Health Sciences specializing in orthopaedic and sports physical therapy. Dr. Mackarey is in private practice and is an affiliated faculty member at the University of Scranton, PT Dept.