Question: I’m in my 50s, a lifelong cyclist doing 175 -200 miles per week. As a result of earlier trauma to the lower leg and varicose veins, three years ago I had a deep vein thrombosis (DVT) that resulted in pulmonary embolisms (PE). Luckily the PEs were not big and I was soon back to riding while on Coumadin. Two weeks ago I got another DVT in the same leg, but caught it before it became a PE. I was doing a long, hard climbing ride on a hot day and was dehydrated, which might have contributed.
I’ve just started riding again, short miles, and I feel good although with some mild vein aches in that leg. I’m on Coumadin again and wearing compression. I’ve found very little info online about cycling and DVTs, and no scientific studies about it. Does cycling put me in danger? — Dave C.
Dr. Richard Ellin Responds: Deep vein thrombosis (DVT) is the medical term for a blood clot in one of the veins, most often one of the deep veins in the leg. These can occur spontaneously in people who are genetically at increased risk, and can occur as a result of other factors as well.
Some of these factors are: prolonged immobilization (such as a long car or plane trip, or prolonged bed rest), recent surgery, during and shortly after pregnancy, and due to certain medications (most commonly oral contraceptives). Certain cancers also can increase one’s risk of a DVT.
The symptoms of DVT can include swelling, redness, and warmth of the leg, and pain in the calf or thigh, although some people have no symptoms at all.
Typically, exercise involving the legs (cycling, walking, running) reduces the risk of deep vein thrombosis. I’m not aware of any data that show an increased risk with cycling.
When someone without apparent risk factors has a second venous thrombosis, as you did, Dave, we look for an underlying cause, such as a genetic predisposition.
In your case, presumably your doctors have already done so, but if not you should have a complete hypercoaguability workup (a battery of blood tests). You should also have a complete physical exam and complete screening for the common cancers that we can screen for (PSA for prostate cancer, colonoscopy, chest X-Ray).
Assuming nothing is found, in my opinion there’s no reason not to continue cycling. In my research, I have found no data that show a causative link or correlation between cycling and an increased risk of DVT.
You do raise a couple of other issues worth discussing here. First, cyclists need to pay attention to their hydration and stay hydrated. Too often, riders are underhydrated.
Also, cyclists need to stand and stretch while riding long distances. Doing so helps to avoid compression of the big veins in our legs.
Another thing to keep in mind is that all calf strains are not muscular in nature. DVT should be considered as a possible cause at some point. The literature is full of stories where cyclists went for medical help with calf pain and were treated as if they had a strain, only to wind up with a DVT. Early treatment of this problem can save a cyclist’s life and will allow a rider to return to cycling in a reasonable amount of time.
(Editor’s Note: RBR reader David Osler, who is a physician and suffered from a DVT resulting in a PE, contributed to this column.)
Richard Ellin, MD, FACP, is a board-certified specialist in Internal Medicine who practices in Alpharetta, Georgia. He received his medical degree and completed residency at Emory University, and has been in practice with Kaiser Permanente for 26 years. He is also an avid cyclist.
British cycling are aware of this risk , some of there physios have guidance notes , i had dvt 2 years ago , i was un aware that british cycling knows of this concern untill last week when i saw a physio for a back problem , she has a friend who works there and its quite common knowledge. my dvt came from a poor fitting saddle , i had numbness for 2 weeks prior to the dvt .
Dear Dave, I just came across this forum. I also, developed a DVT after 100miles ride that ended up in a PE. I was in Xarelto which ended as a failure because after couple months a new CT was done and they found another clot in my long. Then, I was switch to Warfarin (Coumadin). Doctor said that I will have to take Warfarin for the rest of my life due to this two PE. I stopped Warfarin after 3 years and 1 years after I stopped I had another PE. Several test were completed and no genetic predisposition was found. Doctors doesn’t know the reasons but what they do know is that I shouldn’t stop my blood thinner medications which is now Eliquis. I never stopped bike riding but my assumptions are the following. Hydrations. Now, I don’t risk to be dehydrated and I have to stand up the bike more often because I frequently get numbness between my legs. My biggest worry was if I had any condition that I was going to pass to my boys but THANKS GOD the doctor said that she didn’t find any abnormal test that I could possibly pass onto my boys.
Good luck riding and be safe
d
I am to new at clotting. Avid bicyclist great way to keep the weight down. Eliquis user. Numbness pressure in the ankles. Best to stay mobile always moving. I wear compression socks. Feel like support. Clots have traveled to my lungs. Doctors say I’m doing alright. Pain and swelling my take a year to hang around. I’m feeling the excess weight. Ready to do something for it. My medical history doesn’t go past me. Should I cycle
I have been on Warfarin for years (due to PE and DVT following idle periods (surgery/illness)); tested and have no genetic predispositions for clotting. After two 20 mile rides last week, I had a DVT in my leg. I am convinced that when you feel numbness (butt or leg), it is time to stand up for a period to get blood flowing.
I am also avid cyclist. Now 67 y.o. Retired fro 5 years. Cycled all my life. In my 40 I developed kidney stones from drinking coffee and Pepsicola during rides*a lot of it to hydrate the body….fool me!). About few years later I started suffering from swollen ankles. It became more and more clear that it happens when I consume sugar or things with preservatives. I visited various doctors and they told me I do not have diabetes (even Last year did).
But lately as I am riding with a large group in Spain about 300 km in a week (3 x 100 aprox.) I developed severe problem between my legs caused by either shorts or seat or both. Always when I bike my ankle swelling disappears. But 3 weeks ago I came home and about 3 hours later my both calves swelled and the right one was in pain> I thought it is a muscle. But then I also noticed unusually bad abrasion between the legs and bunch of small bumps,which looked like a hemorrhoid under the skin…..clearly smaller vain bulging out in little bumps…..when I looked closely under magnification mirror, when I stretched the skin, the bumps became bluish, just like hemorrhoids. I punctured some of them with desinfected needle and dark red blood came out.
So today I started to search for what it can be and found there is something like DVT….It is possible I have that,because my whole area under my sack and towards the sides feel painful and lightly swollen and the pain runs inside of my legs,when I sit for long time at the computer. I would say the way it feels is like the wains are in pain on the inside of my legs. Pain is just light and kind of dull and it terminates somewhere in area of calves.
And as I sit the pain worsens little bit and the ankle swelling gets also worse…..especially – as I said earlier,when I consume sugar or food with preservatives (like salami or canned stuff).
I will probably visit doctor fro possibility of DVT but the hemorrhage of the superficial veins under my sac is what…I do not find anything about it….. Can someone tell me what is it? It is now 3 weeks and it is almost gone,though the deep vain pain persists…..So far no Embolism I would know about.
Why on earth would you try and diagnose something yourself that can kill you!! See a bloody Dr.
Can i do cycling…. I had a dvt past two years
Why wouldn’t the compression at the hip joint with every pedal stroke not cause constriction to the veins? Could that be why DVT presents in cyclists?
It seems like in the doctors reply asking if he had checked into the root cause of the DVT he missed the part that said, “As a result of earlier trauma to the lower leg and varicose veins, three years ago I had a deep vein thrombosis (DVT) that resulted in pulmonary embolisms (PE).”. The trauma was probably it as it keeps happening in that leg.
With all these stories of dvt in the leg areas and numbness to the groin areas ,as a former long distance cyclist , who stopped about 22 yrs ago and is now bk in the saddle…and also experienced dvt’s …i have come to realise that first mistake we make as cyclist do NOT” having a proper bike fitting…and a proper seat….we need center cut out seats…that do not compress the perinum veins that run along the prostate area….the flat narrow seat that our hip (sit bones)…should be sitting on…( But they are NOT’ due to a narrow seat that the prostate seems to press on that also presses on the perinum veins , which due to our body structure run slightly different but none the less are compressed)…if we get the correct bike fitting , so that our hip bones are sitting on the seat…and with the center cut out design…the results will , can and should be…no numbness or any type of pain…and with proper fluids being drank during the ride…the body should not be dehydrated….thus…no kind of Dvt should occur….just my 10c..
To those cyclists who have not had a proper bike fitting.. and still experience numbness.. I suggest you go to your local bike shop and enquire about it there…if not go to you tube and type in bike fitting …Their are plenty of short videos on the topic that show how to do it yourself….I have been doing my own.. yesterday I did a practice run after dropping my seat a inch below the gooseneck ..rode about 12 miles.. and experienced no pain.. but if felt weird as my legs did not straighten all the way out..so today I will go up a inch and a half and see how it will feel…
Yes, me too. Spinning and DVT. In my case, I had full blood work up and yearly physical one month before double P.E. My heart stopped. Luckily, there were several certified people around me that began CPR, until the ambulance arrived. 6 days in the hospital. More blood tests. No DNA related to DVT. After 6 months and various blood tests no cause. Low resting heart rate, low healthy blood pressure, absolutely no pain or symptoms leading up to event. Cycling for 50 minutes, the lights turned out and I woke up 2 days laters in hospital wondering what in the hell happened. Eliquis for life.
i had a thrombus operation last October due to extreme pain and numbness in my left leg.Im on eliquis. Fast forward to the summer I am trying to go out cycling but am still experiencing pain and some numbness in the leg and discomfort.I tried to stay hydrated and stretching during exercising but am concerned about the pain. i am 65 years of age in generally good health no diabetes and want to cycle but am unsure of how and why I still have pain
i had a thrombus operation last October due to extreme pain and numbness in my left leg.Im on eliquis. Fast forward to the summer I am trying to go out cycling but am still experiencing pain and some numbness in the leg and discomfort.I tried to stay hydrated and stretching during exercising but am concerned about the pain. i am 65 years of age in generally good health no diabetes and want to cycle but am unsure of how and why I still have pain
Well, this thread may have saved my life. Rode 27 miles on Monday, had pain and swelling in
My right calf on Tuesday. Was planning to ride to work on Wednesday but woke up with more pain. I started doing some research and came across this thread, and decided to go to MD instead of just pushing through the pain. Diagnosed with DVT in femoral vein (thigh) and popliteal vein (calf). Prescribed Xarelto and praying for no PE. Following up with a hematologist next week.
I have DVT and have had blood clot in my left leg and on Eliquis I just got out of the Hospital 1week ago and still experiencing pain in my calf and behind my knee going into deep in my thigh! Also effective my lungs following up with Lung DR. I want to ride my bike but not sure if it’s ok or not?
I am a stationary bike rider, then at some point I developed DVT. Will I ever be able to bike again? I experienced a swollen left leg and pain when I was diagnosed 🙁
No family history, could the riding be the cause?
I have had 3 occurrences of DVT over the last 4 years. All happened about 1 1/2 months after I had increased my riding to two rides per week. All in lower left calf. Dehydration was a factor. In each instance, I woke up in the middle of the night with what I can only describe as ‘the mother of all cramps’ in my calf. My foot was ‘locked’ pointing forward, and it took my wife a full minute of pushing on the ball of my foot before it was relieved. It was so painful, I didn’t even have the presence of mind to stretch it out myself. Sound familiar to anyone?
Wow, I am only a daily stationary bike rider, but I am a new sufferer of DVT in the left leg. Woke up with my leg two times its size 🙁
Is my favorite exercise derailed long term? 🙁
I suffered a DVT last year. It came 16 days after getting the J&J vaccine. I was back on my bike after about 30 days. I am still taking blood thinners, but hope to wean off those later this year.
I’m so glad I found this thread. I bought stationary bike and have only gotten to ride 3 times. I do have varicose veins and genetic factors. I had numbness while riding every time. Now I have a superficial phlebitis in my leg. I’m going to return the bike and go back to walking
This has been an instructuve forum. I have not biked for a year but recently developed a DVT in my right calf, even as a huge walker with no obvious cause. Apparently healing but concern is reoccurence. Could be genetic. Anyway will start cycling again soon.
My father develop DVT and he was also a very active cyclist. At first, no one could figure out the reason he developed DVT. He even did a genetic exam that haven’t show any pre disposition for the disease. After a couple of years, we started to find some similar cases similar to my father’s, active cyclists that developed DVT, so there’s probably a correlation with cycling and DVT. Unfortunately, the answers specialists gave when we tried to associate cycling with DVT might be based in studies that could be outdated or not taking in consideration these very thin saddle models, that pressure a lot a man’s prostate. It would be nice if a scientific research is done in this regard, in order to avoid other people to have the same problems that my Father is going through, and maybe save lives, because DVT is no joke.
I am a pretty fit 54 year old and have cycled all my life and commute everyday to work on my bike only about 6 miles a day plus recreational cycling. I had a aching pain at the back of my knee one evening then next day extreme swelling and pain in my calf. Went to the doctors thinking it was a strain but I asked the doctor if I could have a dvt….she said no but thought it could be a Bakers cyst or tendon damage, she booked me a ultra sound scan but I waited 6 weeks trying to carry on my daily routine. When I went for my scan they said I was lucky to be walking in and I had a dvt in the back of my knee. A day in hospital and Elquius thinners for 5 months. I have still cycled everyday but now thinking it could be caused by cycling. I am currently waiting for the thinners to fully clear my system so I can have more tests to rule out any other causes. Still get mild pain/aching in the area behind my knee.