Blood clots are a danger for athletes — and everyone else

Philadelphia Eagles quarterback Jalen Hurts is expected to miss the rest of the 2026 NFL season after being diagnosed with deep vein thrombosis and bilateral pulmonary emboli — blood clots in both lungs.

Despite being a professional athlete in exceptional health, Hurts was a victim of a perfect storm. In week four of the NFL season, he suffered trauma to his calf — a muscle with a generous blood supply. He developed a hematoma — a localized collection of blood outside the blood vessels, often resulting in a black-and-blue mark. Then, he developed a superficial blood clot — not in the deep vein. He flew seven-plus hours to London, played a football game and flew home. The clot moved from his leg into the deep vein system and traveled to his lungs.

This problem, especially when associated with flying — which alone is a risk factor for DVT — does not occur only in athletes, but the general public as well. With a little planning, though, you can minimize the risk.

Have you noticed that being in a car or on an airplane for more than three hours can lead to soreness, stiffness and swelling in your legs and neck, and back pain? Also, as people age and encounter other health issues, they are vulnerable to developing a more serious problem associated with long trips: the DVT that Hurts suffers from.

DVT is a blood clot that forms in a deep vein. The deep veins pass through the muscles and cannot be seen like the veins just under your skin. While it may occur in your arms, when traveling it is much more common in the legs, especially the calf muscles. When a blood clot forms in a leg vein it usually sticks to the vein wall. Often, pain and swelling lead you to the doctor, and treatment is rendered before serious complications develop. But there are two possible complications: (1) A pulmonary embolus occurs when a part of the clot lodged in a deep vein breaks off and gets lodged in the lung, a very serious problem that can be fatal. (2) Post-thrombotic syndrome, which occurs when you have pain and swelling in your calf after a DVT.

Risk factors for travel-related DVT

The following risk factors for DVT significantly increase the potential for problems when traveling on long trips by air, especially more than five hours. Trains, cars and buses also create a risk, but air travel creates a greater risk because of reduced cabin pressure, reduced cabin oxygen levels, dehydration and alcoholic drinks, which may increase dehydration and immobility.

• Immobility, such as sitting on a plane, slows down blood flow, especially in the legs.

• Genetic blood clotting — inherited factor V Leiden — which is relatively rare.

• Contraceptive pills can lead to increased blood clotting.

• Hormone replacement therapy can lead to increased blood clotting.

• Previous vein damage, such as a trauma, surgery or previous DVT.

• Being over 40 years old. DVT risk increases with age, especially associated with poor health.

• Recent surgery or trauma, such as total joint replacement, hip fracture, trauma and hematoma.

• Pregnancy: 1 in 1,000 pregnant women will get a DVT.

• Obesity — a health and mobility risk.

• Family history of DVT increases risk.

• Heart failure increases risk.

Tips for preventing travel-related DVT

• Exercise. Keep your calf and foot muscles moving every 30 minutes. In your seat, you can perform: heel raises — push toes down and heels up; toe raises — lift toes up and heels down; leg kicks — extend leg up and down; hip hike — raise knee up 4-6 inches and down; leg squeeze — squeeze knees together and apart.

• Wear elastic compression stockings when you travel on long trips and have risk factors.

• Anticoagulant medication: If you are at high risk of DVT, your physician may discuss the use of medication to prevent clots. Sometimes a simple aspirin may do the trick.

• Keep moving; walk around the cabin every 30-45 minutes.

• Drink plenty of water, stay hydrated, and avoid alcohol.

Preventing travel-related neck, back pain

Airplane seats are C-shaped and force you to round your neck and back forward. These exercises are designed to stretch and extend your back in the opposite direction. Perform them slowly, hold for three to five seconds and repeat 10 times each hour.

• Chin tuck: Tuck your chin back to bring your head over your shoulders.

• Shoulder blade pinch: Pinch your shoulder blades together.

• Standing extension: While standing, put your hands behind your back and extend your lower back 10-20 degrees.

• Bend your knees up toward your chest, one at a time.

• Arch your lower back slightly.

• When you’re sitting in an airplane seat, take the neck pillow in the overhead compartment and place it in the small of your lower back. While sitting or standing up, perform postural exercises every 30-45 minutes.

Paul J. Mackarey, P.T., D.H.Sc., is a doctor in health sciences specializing in orthopedic and sports physical therapy. He is in private practice in Scranton and Clarks Summit and is an associate professor of clinical medicine at Geisinger Commonwealth School of Medicine. Email: mackareypt@gmail.com.