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Covid and Calf Pain

16 Apr

Covid and calf pain – what you need to know: 

As we all know covid has come with some pretty strange side effects and although it has been in our lives for a little over two years there is still a lot we don’t know. As more people are infected with the virus, we are learning more about its potentially harmful impacts, its mechanisms and how to treat it. One lesser-known side effect of the SARs- Covid virus is its potential to cause blood clots. 

Our ability to form blood clots is crucial to our survival, when we cut or damage tissue, we produce proteins that attract platelets and cells called clotting factors. These help us to stop bleeding and initiate healing. However, clotting can be a problem if it occurs inside blood vessels such as in the brain (stroke) or heart (heart attack). 

A few key things that could increase your risk of developing a clot include non-modifiable risk factors such as

  • Underlying health conditions (including heart disease or diabetes)
  • Recent covid infection including severity of infection and vaccine status
  • Individual or family history of blot clots

Or, modifiable risk factors such as

  • Periods of inactivity such as
    • long haul flights
    • bed rest
  • General activity levels
  • Current smoking status
  • Medications including female hormonal contraception

How does this relate to physiotherapy?

In recent months at Anatomy rehab, we have seen a notable increase in presentation of deep vein thrombosis (DVT). DVT is the formation of clot in a peripheral vein, it can occur spontaneously, following trauma or periods of inactivity. While DVT is not something that physiotherapy treat it does present in a similar way to musculoskeletal pain meaning your physiotherapist might be the first healthcare professional you see. To ensure you receive appropriate care, it is important that you seek physiotherapists that are well trained and highly skilled (such as those at Anatomy rehab). As physiotherapists we take a detailed history of your current complaint as well as a comprehensive medical history to help us diagnose the cause of your pain. It is important to note that DVT most commonly occurs in the lower leg, but can occur in any peripheral vein. In the case of DVT a few things symptoms you should look out for are:

  • Pain, swelling or tightness without a history of trauma.
  • Numbness or pins and needles and fatigue in the limb
  • Worsening of symptoms with exertion

*DVT has the potential the be life threatening if untreated so, if you note any shortness of breath, chest pain or discomfort, weakness or difficulty moving or speaking, or you suspect you could have a DVT then you should seek immediate medical care.

To confirm a DVT diagnosis a scan such as duplex ultrasound will be done and you may also have a blood test to look at your blood characteristics.

How can you reduce your risk?

Unfortunately, some risk factors you can’t change, however there is a few ways you can reduce your risk of developing blood clots following covid.

✅ Severity of the disease is an important indicator of clot risk factor post covid. We know that vaccinations reduce the severity of the disease so a good place to start is making sure you are up to date on your vaccine and boosters.

✅ While rest is important when sick or injured it is important to keep moving little and often, avoid long periods of best if possible. If you are not well enough to go for a walk (even around the house), try to keep your feet and legs moving at regular intervals throughout the day and once able start with short frequent walks.

✅ Smoking has negative effects on peripheral blood flow and increases likelihood of blood clot formation, so if you currently smoke try to reduce or quit.

If you have had a recent covid infection or think you might be having DVT symptoms then do not hesitate to see a medical professional.

By Physio: Lucy Woodham 

References:

LONGCHAMP, G., MANZOCCHI-BESSON, S., LONGCHAMP, A., RIGHINI, M., ROBERT-EBADI, H. & BLONDON, M. 2021. Proximal deep vein thrombosis and pulmonary embolism in COVID-19 patients: a systematic review and meta-analysis. Thrombosis Journal, 19, 15. Available: 10.1186/s12959-021-00266-x

MUMOLI, N., DENTALI, F., CONTE, G., COLOMBO, A., CAPRA, R., PORTA, C., ROTIROTI, G., ZURETTI, F., CEI, M., TANGIANU, F., EVANGELISTA, I., VITALE, J., MAZZONE, A. & GIARRETTA, I. 2022. Upper extremity deep vein thrombosis in COVID-19: Incidence and correlated risk factors in a cohort of non-ICU patients. PLOS ONE, 17, e0262522. Available: 10.1371/journal.pone.0262522

SUH, Y. J., HONG, H., OHANA, M., BOMPARD, F., REVEL, M.-P., VALLE, C., GERVAISE, A., POISSY, J., SUSEN, S., HÉKIMIAN, G., ARTIFONI, M., PERIARD, D., CONTOU, D., DELALOYE, J., SANCHEZ, B., FANG, C., GARZILLO, G., ROBBIE, H. & YOON, S. H. 2021. Pulmonary Embolism and Deep Vein Thrombosis in COVID-19: A Systematic Review and Meta-Analysis. Radiology, 298, E70-E80. Available: 10.1148/radiol.2020203557

While the mechanism for this increase in clotting is unclear, we now know that there is an elevated risk of blot clots during and in the two weeks following recovery from covid infection. In musculoskeletal physiotherapy blood clots are rare, however they can present similar to soft tissue injuries so it is important that your physiotherapist is aware of your health status including recent covid infection.