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 The material provided here is general information and individual advice should be obtained with an evaluation or assessment by an appropriate physical therapist

Deep vein THROMBOSIS

12/4/2019

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By Logan Chaffin ATC, SPT
 
Deep Vein Thrombosis, most commonly referred to as DVTs, are relatively common not only in the elderly but also young athletic populations. DVTs if identified and treated early on can be a minor setback, however, if left untreated can quickly develop into a very dangerous and potentially life-threatening situation. Your physical therapist is highly trained in not only rehabilitating the joint or muscle that brought you to them, but also to screen for dangerous disease processes like DVTs. Your physical therapist should educate you on the signs and symptoms of DVTs and will be able to answer any questions you may have about possible DVTs.
     Unfortunately for some there are predictors of who will likely get DVTs, however, anyone can get a DVT and any DVT can progress into a life-threatening situation. Women are more likely than men, post-operative patients (most commonly total knee replacements), and the older you are the more likely you are to get a DVT. Considering this, the patient that comes to mind is a 75-year-old woman who just underwent a total knee replacement; however, recent studies have also shown that 1 in 40 young people who undergo an ACL reconstruction will experience a DVT. There are some predisposing factors that you can control such as smoking and being sedentary that both drastically increase your possibility of getting a DVT.
            Some signs and symptoms to look for of a DVT are pain that gradually progresses it is most commonly in the posterior calf that is often described as a cramp or spasm. You should also keep an eye out for redness or warmth that is not present in your other lower extremity. Finally, one other thing to watch for is swelling or prominent deep veins that again are not present in the opposite lower extremity.
            If you suspect that you may be experiencing a DVT consult your physical therapist who will examine you and your symptoms. Using what is known as the Wells clinical prediction rule, they should be able to identify if you are someone who needs to undergo further imaging for a DVT. With a possible DVT it is often better to be safe than sorry and with the ease and relative cheap and easily available doppler ultrasound when in doubt get it checked out.
 
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  2. Willis AA, Warren RF, Craig EV, Adler RS, Cordasco FA, Lyman S, et al. Deep vein thrombosis after reconstructive shoulder arthro- plasty: a prospective observational study. J Shoulder Elbow Surg 2009;18:100-6. 
  3. Bishop, M., Astolfi, M., Padegimas, E., DeLuca, P., & Hammoud, S. (2017). Venous Thromboembolism Within Professional American Sport Leagues. Orthopaedic Journal of Sports Medicine.
  4. Hirsh J, Hull RD, Raskob GE. Clinical features and diag- nosis of venous thrombosis. J Am Coll Cardiol 1986;8 (6 Suppl B):114B–27B. ]
  5. Erickson, Brandon J et al. “Rates of Deep Venous Thrombosis and Pulmonary Embolus After Anterior Cruciate Ligament Reconstruction: A Systematic Review.” Sports health vol. 7,3 (2015): 261-6. doi:10.1177/1941738115576927
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