A common question following a clot is "How soon can I be active?" and "How soon can I exercise?"
Patients with a newly diagnosed deep vein thrombosis (DVT) or pulmonary embolism (PE) should use common sense and listen to their body. Physically, they should only do what they feel comfortable doing. They do not speed up recovery by pushing themselves aggressively through symptoms of pain and swelling. But they also do not make things worse by being active.
For most patients, it is fine to be physically active right after the diagnosis of an acute DVT or PE – walking, doing light household or other light work. However, if somebody has a lot of leg pain from the DVT or shortness of breath from the PE, the person should take it easy. Having a blood clot is a stress to the body and the body needs time to heal and recover. It is appropriate to take time off from work and let the body recover if needed. However, if the DVT or PE was small and the patient feels fine and wants to go back to work, then that is certainly fine, too.
Many patients worry that by being physically active, it will cause a DVT to break off and become a PE. The risk of clot breaking off and forming a PE is mostly present in the first few days, up to approximately 4 weeks, while the clot is still fresh and fragile and not scarred. However, study has shown that patients who do light activity following a clot are no more likely to develop PE than those who don't. (ref 1)
You should discuss with your physician whether or not physical activity is appropriate for you, how much activity is recommended, and how soon you can begin.
It appears that being highly active one month after a DVT is not detrimental; it may, actually be beneficial and lead to less symptoms of post-thrombotic syndrome. This can be used as an argument to encourage individuals to return to physical activity relatively soon after a DVT.
Exercise, sports, yoga
No official guidelines exist as to when and how quickly an athlete might return to exercising. Each patient will need an individualized exercise plan. It seems appropriate to refrain from any athletic activities for the first 10-14 days after an acute DVT or PE until the clot is more attached to the blood vessel wall and the risk of having the clot break loose (causing a PE) has decreased. To lessen deconditioning during this period of relative inactivity, the athlete may do some strength training – arm and trunk exercises in the case of a leg DVT, leg and trunk exercises in the case of an arm DVT. The athlete may then increase activity between week 2 and 4 and return to pre-clot activity levels by week 4, if the body lets him/her. A similar approach is probably wise regarding yoga: it seems safest to take it easy and avoid yoga activities associated with more extreme body positions in the first 4 weeks after a clot.
Athletes: read about special considerations related to clotting in athletes
1. Aschwanden M et al. Acute deep vein thrombosis: early mobilization does not increase the frequency of pulmonary embolism. Journal of Thrombosis and Haemostasis 2001;volume 85:pages 42–6.