Coming back to Heavy Strength Training, Long Distance Running, while recovering and on treatment for unprovoked Deep Vein Thrombosis (DVT

Medical Q&A [Moderated]
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Hi!
My name is Imran and I live in Sweden. I have been following Barbell Medicine for a while and I am subscribed to their YouTube channel. Unfortunately I got a unprovoked DVT (blood clots) in my left leg and I am on treatment with antocoagulants named Eliquis. I will be on these medications for 3-6 months and my doctors are making a medical invastigation in regards to the dvt I got. I have never drank alcohol, never smoked nor taken drugs in my entire life. Neither have I taken anabolic steroids and testosterone in my life, I even asked the nurses and the doctors to take saliva, blood and urine samples to show that I am not nor have taken steroids/PEDs.

When I am searching through Google and YouTube there is very little information on how to come back to Strength training and running after dvt while on medication. I have read some brief answers from Dr.Austin Baraki in this forum from 2019 in regards to Deep vein thrombosis and strength training.

I have been doing bodybuilding, powerlifting training and longdistance running for almost 20 years consistently. I have seen armwrestlers such as Devon Larrat recieving and coming back from DVT and PE, and also many basketball players and marathon runners who also came back from DVT and PE. I read a case study which was made on a thriatlon athlete who came back from DVT but in the same case study it is claimed that he got PTS (Post Thromotic Syndrome) because he trained to intensively to early. As in 3 weeks on treatment with anticoagulants.

One of my question is what the current research shows ? And is it possible to return to powerlifting and longdistance running? My doctors said yes and even encouraged me to train/exercise but it will take a couple of months by gradually increasing intensity based on feeling, but that I will not train to heavy and intensively due to the risk that the blood clot could break off and travel to the lungs which can lead to embolism.

I have also read a couple of webpages where it is claimed that if one trains to heavy or intense to early, it might be a high risk that the blood clot can break of due to increased blood and intra-abdominal pressure. And it is also claimed that if one has DVT above the knee as in the thigh then one has a higher risk to break off, leading to Pulmonary Embolism.

I read an article or a small study of athletes getting dvt for different reasons, but in the article it is claims that when one does heavy intense strength training, it “elevated von Willebrand factor (vWF) and Factor VIII (FVIII) levels, and increased fibrinolytic potential (most evident after short-duration intense activity)”. Link to the article: https://discoveryjournals.org/medicalscience/current_issue/v29/n163/e171ms3708.pdf?

And due to me explaining the context of my situation above, I was wondering if y’all have the knowledge and experience with patients/people/clients on how to workout when coming back to training from dvt while on blood-thinners as Eliquis? And is it possible to do powerlifting when fully restored from DVT?Thanks!

Kind regards, Imran

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Hi Imran,

Although we cannot give personalized/individualized advice to you here via the forum, I am not aware of any direct evidence that, after a DVT has been diagnosed and is being properly treated with an anticoagulant like Apixaban, that any ongoing exercise restrictions are needed (or, on the other hand, that returning to exercise causes excessive risk of harm). Assuming no ongoing symptoms, and consistent use of the anticoagulant medication, I would not routinely restrict someone’s exercise activity.

It is possible to participate in powerlifting activity after a DVT, yes.

The most important thing here is to identify an underlying cause/trigger for the clot, if possible. If no identifiable cause is found, you may be recommended for lifelong anticoagulation, depending on other factors.

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Ok thanks man, because some websites claim that heavy liftning damages the walls of the veins due to blood and intra-abdominal pressure. Here is case studies of athletes getting dvt at the upper extremetis due to repetitive movements associated with their sport

The doctors are doing an medical investigation right now. I have an appointment with a doctor 17th of mars, so I will see what they say. I have a phone appointment with a doctor today because I get a little bit of light dizziness and a slight temporary shortness of breath 1-3 times a week.

Because I have read that anticoagulants have a risk of bleeding but that Eliquis has a lesser or milder risk of bleeeding compared to warfarin and other older blood thinners.

So far the nurses do suspect of it being a genetic factor even though none of my sibling and parents and their relatives have a history of dvt. My brother got a clot due to surgery. But anyways thank you for taking your time to answer.

Best wishes and kind regards, Imran