Newswise — As the NBA prepares for Game 3 of this year’s Finals between the Oklahoma City Thunder and the Indiana Pacers, some league players are still recovering from a condition not typically associated with athletes at the pinnacle of physical health.
So how did two elite players - like Damian Lillard of the Milwaukee Bucks and Victor Wembanyama of the San Antonio Spurs - both end up sidelined this season by deep vein thrombosis (DVT) - a condition typically associated with older adults or those with limited mobility?
“DVT is the formation of a blood clot in a deep vein, most commonly in the legs,” explains Katherine Teter, MD, a vascular surgeon with Hackensack Meridian Hackensack University Medical Center (HUMC). “Think of it like a traffic jam in your circulatory system, which not only can limit mobility, it can put you at risk for a pulmonary embolism- a piece breaking off and traveling to the lungs.” This type of clot, she says, is most commonly caused by immobility and may seem counterintuitive in young, active individuals. Yet, these recent cases highlight a sometimes overlooked risk, even for those at the peak of their game.
Consider the story of 18-year-old Simon Falcones-Sarmiento. Active and healthy, Simon suddenly experienced pain in his left leg that radiated to his back while working at his restaurant job. He played soccer regularly and was always on his feet, so the pain was unexpected.
Eventually accompanied by swelling and redness, Simon went to the emergency room where imaging confirmed an extensive DVT, not only spanning the entire leg but extending up into the large veins in the pelvis. The clot was significant enough that he could barely walk at this point.
“Simon’s case was severe enough that we thought the limb may be at risk of permanent damage if blood flow wasn't restored quickly,” says Dr. Teter who decided to perform a surgical procedure known as a venous thrombectomy. “Essentially, I inserted a small suction catheter and a device that looks like a butterfly net into the veins to capture and remove the clot.” This was all accomplished minimally invasively without incisions.
In Simon’s case, intravascular ultrasound used during his surgery demonstrated a significant anatomic narrowing likely contributing to his clot: May-Thurner Syndrome. This was successfully treated with a stent following removal of the blood clots to help decrease the chances of recurrence. He has returned to his fully active lifestyle and reported feeling significant improvement shortly after the surgery.
So, why does DVT happen, especially in young active adults? Dr. Teter says several factors can contribute to the condition including:
Prolonged periods of immobility: Long flights or bus rides, especially after strenuous exercise, can significantly reduce blood flow in the legs, increasing the risk of clot formation. This is compounded by athletes often being tall and having larger leg musculature, which can further restrict blood flow in cramped seating.
Dehydration: Intense training and competition can lead to dehydration, which thickens the blood and makes it more prone to clotting.
Injury: Muscle injuries, particularly to the legs, can damage blood vessels and trigger the clotting cascade. Direct trauma, such as a blow to the leg, can also cause DVT.
Surgery: Athletes sometimes require surgery for injuries, which is a known risk factor for DVT due to immobility and the body's natural inflammatory response to surgery.
Genetic predisposition: Some individuals have a genetic predisposition to blood clotting disorders, which can increase their risk of DVT even without other risk factors. While not specific to athletes, it can be a contributing factor.
“Staying active, maintaining a healthy weight, staying hydrated, and avoiding long periods of immobility are all important steps in reducing your risk of DVT,” says Dr. Teter who recently joined the new Department of Vascular Surgery at HUMC under the direction of Caron Rockman, MD, FACS, RPVI, Chair, Department of Vascular Surgery.
If you suspect you might have DVT, seek medical attention immediately. Early diagnosis and treatment are crucial to preventing serious complications.
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