# DVT and cycling shorts



## sparrow371 (5 Aug 2013)

Hi,

I really hope you will be able to help me with this question as I have just got into cycling and in a short time become addicted!

After a 26 mile cycle ride last week I woke up next morning with a reddened sore right calf and a painful right leg. Due to a family history of DVT and a painful leg during the next 2 days I went to my local A and E dept at the local hospital and they diagnosed my condition as Superficial Thrombophlebitis. 

The Consultant suggested keep cycling as this will assist the blood circulation but he stated the Lycra cycling shorts I wear would not be a good idea as they would restrict the blood flow in the leg. 

I have 3 sets of bib cycle shorts and find them so very comfortable to wear (B'Twin and Giant).

Have you had any questions sent to you on this topic before as I have researched the Internet and it appears DVT among cyclists is fairly common but not a lot has been mentioned about any connection with cycling shorts.

My main question is would wearing the cycling shorts be detrimental now that I have this condition and if so what would be the best thing to wear bearing in mind the need for padding? Would removing the leg grippers make any difference to blood flow or are there loose fitting padded shorts that can be worn that don't restrict circulation but offer the same level of comfort.


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## ColinJ (5 Aug 2013)

I became 3 or 4 stone overweight but carried on wearing the same size lycra shorts and tights, which had therefore became too tight for me. The warning signs were there on several rides when I developed severe leg pains which I now suspect might have been due to clot formation.

You can see the problem in this photo of me on a ride with phil_hg_uk. I am the one on the right.







Phil's tights look much more comfortable to me.

I eventually went on to suffer a severe DVT last year which caused a pulmonary embolism which almost killed me. This year, the problem has come back and it looks as though I will be on Warfarin for life. You are wise to take the problem seriously!

I think that leg grippers could well be an issue if they are too tight, as mine were. (The tights didn't have grippers, but they were so tight that they impeded circulation in each entire leg.) I don't think cutting grippers out is the answer, though you could try doing that and see how you get on. I think if you get the sizing right so the grippers are not excessively tight, then that should be okay. If they leave deep imprints on your legs, then that is probably too tight.

You can get baggy cycling shorts with pads. That's what I am wearing these days while I get my weight down, but I may try out my lycra kit again when it fits properly. My old baggies do not have a liner, and they are very comfortable - see photograph below ...






I bought some new Endura Humvees, which are highly rated by many cyclists, but they have liners with grippers so they are like wearing lycra shorts under the baggies! I am keeping them until the liners feel more comortable. 

So, I would suggest either wearing perfectly fitting lycra without overtight grippers, or baggies without overtight liners.

Good luck, and be vigilant - the damn clots can come back!


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## sparrow371 (5 Aug 2013)

Hi Colin, Thank you for such an informative reply. This is all very new and recent as it all happened within the last week or so. I am off work until next Wednesday but still on antibiotics. Perhaps towards the end of the week I ill get on my bike again and do a short ride. 
My bib short grippers do not leave a mark on my leg and don't appear to be overly tight so still unsure if I should give them a go. I am Not to keen to get the scissors to them at the moment and take the grippers off as I can easily get my finger under them. 
I had not even thought about the shorts until the consultant at the hospital suggested they may well interrupt the blood circulation in my leg. 
I think the only way forward is to get on the bike again and see how it goes....


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## ColinJ (5 Aug 2013)

I'm pretty sure that a couple of long journeys by train/coach/car to Wales and back were what finally got me. I was wearing trousers that were way too tight and they pretty much cut off the blood supply in my legs. There were seams where the legs were attached to the top part of the garment and the DVT formed on the left leg where the seam had been digging in.

Exercise does help to prevent DVTs and to get over them, but dehydration can be a significant factor in DVT formation so avoid that by drinking plenty of water.. 

Good luck ...I wouldn't wish what happened to me on my worst enemy, and I am one of the lucky ones who survived!


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## sparrow371 (6 Aug 2013)

Hi Colin,
That's very interesting about the DVT and long journeys. 3 weeks ago I had a long journey. We had a cycling holiday in the Loire Valley. It took 5 hours to get back to Calais. I only stopped once for about 30 mins. We then took the Channel Tunnel and I had a 3 1/2 hour trip back in this country without any stops so my right leg was in the same position for a very very long time. I did not think about having regular stops on the journey but I now think this may have had added to the problem I now have.
This has really opened my eyes and will be so careful in the future.....Nick


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## shyfire (6 Aug 2013)

sparrow371, maybe the short grippers are the issue specifically with the consultant. Would be interested in what he thinks of compression sports clothing for sport (skins/2xu etc) since they are supposed to improve the blood flow. I used compressions socks and shorts for running a few years ago after a thrombotic episode. This was with doctors approval since it was impossible running with the prescribed compression socks.


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## sparrow371 (6 Aug 2013)

Hi Shyfire, thanks for the above. I am really surprised that this subject is not more prominently discussed.
Unfortunately I won't be seeing the consultant again unless I have a downward turn with the leg. It did make sense what he said about the Lycra shorts constricting the blood flow to the whole leg.
I asked him if it would be ok to carry on cycling in the future and he said it would but what I was wearing (the shorts) might well be the problem.
It would be interesting if a consultant who was interested in cycling would read this thread to get his views!


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## slowfen (7 Aug 2013)

The issue with cycling shorts would be the gripper as this is a narrow band which would cause constriction in a small area.For cycle shorts this would not affect the blood flow in the arteries or deep veins, but would slow/stop blood flow in the superficial veins.
Compression garments such as hosiery/sports wear etc work by compressing generally, this aids the flow of blood in the veins, especially the deep veins, and are used to help prevent DVT ( Often called TED stockings in hospital)

The issue of DVT and long journeys is well established (and is not a modern problem, it was certainly known about in WW2 for the bomber crews) and although normally associated with planes and long haul flights, any form of long travel, in one position will cause problems ( think car, coach etc). Hence the use of flight socks, (should be called travel socks). On any extended journey, it is worth making sure you are well hydrated, have breaks to get up and walk, also to keep moving your feet and legs so that you can feel the foot and calf muscles tense and relax ( you can find cushions which help do this)

I am not a consultant, but this area does over lap with my area of work


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## sparrow371 (7 Aug 2013)

Hi,

Your reply is most useful and very comprehensive. I am still off work at the moment as it is fairly recent. I am hoping to get on my bike at the weekend and just do a few miles to see how it goes.

I was diagnosed with superficial thrombophlebitis which is in the surface veins in my right leg which is a lot better than having it in the deep vein. 

Reading your reply I think the gripper needs to come off as this could well be the problem so I can still wear the cycling bibshorts. 

The journey from the Loire valley is probably the cause of my problems. I just wished I was a bit more savvy about taking breaks and hydrating.

Thanks again, Nick


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## screenman (8 Aug 2013)

You would think if this was a problem that the pro's would get it in long tours etc. all the time. Many a medic does not like cyclist, so maybe a second opinion.


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## sparrow371 (8 Aug 2013)

Hi,
I can see where you are coming from but I think the pro's are made aware of this condition by their fitness guru's when they travel on their tour bus when travelling. 
I am certain mine is a result of travelling in the car in France for 5 hours only having one short stop and then having another 3 1/2 hours in this country without a stop. 
Hindsight is a wonderful thing!


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## ColinJ (8 Aug 2013)

screenman said:


> You would think if this was a problem that the pro's would get it in long tours etc. all the time.





sparrow371 said:


> Hi,
> I can see where you are coming from but I think the pro's are made aware of this condition by their fitness guru's when they travel on their tour bus when travelling.


It can happen to pro athletes, but presumably they usually do get a lot of good advice and medical supervision to keep them safe. This young pro rider wasn't quite so lucky though ...


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## sparrow371 (8 Aug 2013)

Hi Colin,

Interesting piece about the young pro rider. I just wished I knew more about the subject prior to my journey. I only thought it occurred on long haul aircraft. I am vigilant and move about on the aircraft when I go diving in Egypt to stop this.


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## screenman (8 Aug 2013)

Please accept my apologies, I thought the suggestion was that the shorts may have caused the condition.


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## sparrow371 (8 Aug 2013)

No problem. It wasn't the shorts that caused the condition but they may have aggravated it. It was interesting what slowfen said in his reply. Debate now is when to wear them again?


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## ColinJ (8 Aug 2013)

Once I am finally clot-free, I will definitely wear lycra again, but I will make sure that it fits properly!


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## sparrow371 (8 Aug 2013)

I am of the same opinion Colin. Will keep the lycra shorts off to start with and see how it goes.Hoping to get on my bike at the beginning of next week for the first time. Really miss it. 
My partner and I have something o aim for in the London 100 next year if we get accepted in the ballot on Monday. Sixty miles is he most i have done when we were in France a month ago!
I read your profile this afternoon and it saw you have been through the mill this last year. Hopefully you will get back to full fitness soon


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## ColinJ (8 Aug 2013)

sparrow371 said:


> I read your profile this afternoon and it saw you have been through the mill this last year. Hopefully you will get back to full fitness soon


Thanks - and the same to you too! 

There is a HUGE thread on my illness - here. I didn't think that I would be so ill for so long, but as you can see I only managed to be drug-free for about 3 months before the clots came back.


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## sparrow371 (8 Aug 2013)

Hi,

I have just read your 33 page blog/diary. You were so so ill. After reading what you went through I realise i have got off very lightly. Thank you for all your replies and advice it's greatly appreciated.


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## ColinJ (8 Aug 2013)

I've seen my consultant today, so I will update the other thread with the latest news in the ongoing saga!


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## sparrow371 (9 Aug 2013)

Hi Colin.... Just read your last blog! Hopefully they will find the reason for the clotting and you will be able to get more miles on your bike and walking. I have been reading up on affects of vitamin K foods (the Mrs thought she have been poisoning me!) but looks as though I eat mostly low vitamin K foods but certainly makes you more mindful!


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## ColinJ (9 Aug 2013)

sparrow371 said:


> Hi Colin.... Just read your last blog! Hopefully they will find the reason for the clotting and you will be able to get more miles on your bike and walking. I have been reading up on affects of vitamin K foods (the Mrs thought she have been poisoning me!) but looks as though I eat mostly low vitamin K foods but certainly makes you more mindful!


The advice one gets on vitamin K is all over the place! 

Warfarin is a vitamin K antagonist - it interferes with the way the body uses it. Vitamin K is used (among other things) as part of the clotting mechanism, so interfering with that mechanism reduces the chance of clotting. Some doctors and nurses then think that 2 plus 2 equals 37.6! You want to reduce the amount of vitamin K available for clotting, therefore vitamin K is bad, therefore don't eat it, and if you _do_ eat it, you are being very stupid indeed ... One nurse actually accused me of attempting suicide by continuing to 'eat my greens'! THIS IS ALL WRONG!

More sensible doctors understand that it is a case of eating a healthy diet including vitamin K, and then adjusting the drug dose to fit in with that! Research has shown that a good, consistent intake of vitamin K helps to stabilise INR levels.- article. 

I ate plenty of K-rich broccoli, iceberg lettuce, spring onions etc. while on Warfarin and my INR levels remained stable for 7 months. People eating only small amounts of vitamin K tend to have much more chance of dangerous fluctuations in their INR levels than those eating a healthier diet.

The crucial thing is to be *consistent*. What you don't want to do is eat lots of vit K foods for a couple of weeks, then eat none for the next couple of weeks and so on ... If your diet is consistent, then the drug dose is more likely to be consistent, and *that* is what you want.


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## sparrow371 (9 Aug 2013)

Cheers Colin,

A very interesting piece!


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## sparrow371 (13 Aug 2013)

Big day today. First time back on the bike and done 9miles and leg is feeling ok..good times! Me and the Mrs also put our names in for the ballot for next years London Surrey 100! Don't find out until February but fingers crossed!


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## sparrow371 (19 Aug 2013)

I thought this reply was very informative and well worth the read especially with the link. Thanks to Andy for this reply!


Hi Nick

This leaflet might answer some of your concerns http://www.patient.co.uk/health/Phlebitis.htm

As a humble GP and cyclist (not a consultant!) I would say the chances of cycling shorts compressing the deep veins and causing a DVT would be minimal if not zero. To be tight enough to do that, they would be horribly uncomfortable to wear. Compressing the superficial veins needs less pressure, and if you have varicose veins, that might be an issue. Wider elastic at the bottom of the shorts (as on some high-end ones) would be sensible. 

If you've had a bout of thrombophlebitis with a Family History of DVT, it might be worth discussing that with your GP to see if further tests on your clotting are required.

Andy Ward


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## Reid (14 Oct 2013)

Wow! This blog has really opened my eyes. I'm 65. Overweight by 2 st and diagnosed with DVT in August 2013. Currently, still on Coumadin. I had no idea being HEALTHY could be so dangerous. I was lucky. I had the swollen calf, pain in left leg, warm leg. No PE. I was so lucky. I'm back to 20-25 mi per week and surfing. HR: 56. BP: below normal. No meds for BP. As a matter of fact, I was taken off 3 yrs ago because I started cycling and some wt came off. Family history is diabetes. Glucose is in normal range most of the time. Will I give up cycling? No. Will I continue to wear bibs? Yes. I may even go up one size....just to be sure. I wear an athletic compression calf sock when I ride. From what I've read here, I am one of the lucky ones without PE. I appreciate all the comments here. I'm making some changes, tomorrow, in my riding, rehydration, &clothing.


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## Reid (14 Oct 2013)

ColinJ said:


> The advice one gets on vitamin K is all over the place!
> 
> Warfarin is a vitamin K antagonist - it interferes with the way the body uses it. Vitamin K is used (among other things) as part of the clotting mechanism, so interfering with that mechanism reduces the chance of clotting. Some doctors and nurses then think that 2 plus 2 equals 37.6! You want to reduce the amount of vitamin K available for clotting, therefore vitamin K is bad, therefore don't eat it, and if you _do_ eat it, you are being very stupid indeed ... One nurse actually accused me of attempting suicide by continuing to 'eat my greens'! THIS IS ALL WRONG!
> 
> ...


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## ColinJ (14 Oct 2013)

Good luck Reid! People don't realise how common major clotting problems are. I read that there are about a million people on Warfarin in the UK. The paramedics who took me to hospital told me that barely a week goes by without them having to pick up an emergency DVT/PE patient!

One person dies of it every 6 minutes in the USA. That is more people than died in 9/11, every 2 weeks! We lose about 25,000 a year in the UK - more than due to breast cancer, HIV/AIDS and deaths on the roads combined.

Be vigilant!


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## sparrow371 (14 Oct 2013)

Hi Colin and Reid,
It is such an under reported condition but your blog Colin hopefully will bring it to the attention of other riders. I am progressing well now on the warfarin and getting on my bike more regularly.
My partner and I are currently planning a weeks cycling around Holland next June. As you said just be mindful and more in the future!
On the19th September I had a letter published in cycling weekly about riding with DVT and cycling shorts. More publicity about DVT!


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