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SA JOURNAL OF DIABETES & VASCULAR DISEASE
VOLUME 9 NUMBER 2 • JUNE 2012
87
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EXERCISE AFTER ANTICOAGULATION
OF DEEP-VEIN THROMBOSIS
S Afr J Diabetes Vasc Dis
2012;
9
:
87–88.
I
n the past, strict bed rest for seven to 10 days
was advised on being diagnosed with deep-vein
thrombosis (DVT). The assumption was that any
movement may dislodge a blood clot, causing a pul-
monary embolism (PE). However, recent evidence
shows that there is no higher risk of this occurring in
appropriately treated patients who are mobile than in
those on bed rest. Early mobilisation (taking a daily
walk) may also reduce symptoms and speed up re-
covery.
HOW DO I START?
Exercise patterns after anticoagulation of DVT may
vary, depending on your condition. Consult your
treating physician on when to start. This could be as
soon as the second day after the start of your treat-
ment. You should always exercise under supervision
for the first few days; therefore ask a friend or family
member to accompany you. Use compression stock-
ings to help reduce pain and swelling before, during
and after exercise.
HOW MUCH SHOULD I DO?
It is advisable to move around as much as possible.
Studies show that an average daily walking distance
of 0.6 to 12 km has been associated with improve-
ments in pain and swelling and no increased risk of
PE, when compared to bed rest.
ATHLETES AND PEOPLE FOLLOWING
A REGULAR EXERCISE ROUTINE
There are no official guidelines on when to return to
high-intensity exercise, but it seems appropriate to re-
frain from these types of activities for the first 10 to 14
days after an acute DVT or PE. To limit deconditioning
during this period of relative inactivity, strength training
of the trunk and unaffected limbs may be done. Activ-
ity may then be increased between weeks two and
four, with a return to pre-clot activity by week four.
Being on anticoagulation medication increases
the risk of bleeding. Contact sports should therefore
be avoided while on treatment. Runners, cyclists or
triathletes may continue their sport but should adapt
their activities to avoid trauma.
Stephan Nel
Stephan Nel Fisioterapeute/
Physiotherapists
Tel: 021 900 6244/6414
Fax: 021 900 6773
e-mail: stephangnel@gmail.com