Effort Thrombosis

Description

Effort thrombosis is clotting (thrombosis) of the veins of the upper extremity associated with repetitive vigorous activity, strenuous activity, or trauma. It results in fatigue, heaviness, pain, weakness, and swelling of the upper extremity (hand, forearm, arm, and shoulder).

Common signs and symptoms

• Fatigue, often associated with or exacerbated by activity

• Numbness and heaviness of the upper extremity

• Dull, aching pain

• Cramping in the arm

• Swelling of the upper extremity with dilated superficial veins (engorged veins near the skin’s surface) and a feeling of fullness in the arm

• Poor circulation characterized by coldness, swelling, and blue discoloration in the hands and fingers

• Tenderness in the armpit

Causes

Causes include clotting of the main deep vein of the upper extremity. Sports that require overhead positioning of the arm may stretch the vein, resulting in small tears within the vein. This predisposes to clotting, particularly in those individuals with a tendency to clot, such as those with a history of clots who are taking oral contraceptive medications or who are dehydrated. Alternatively, the vein may be compressed between various structures, including tendons, the first rib, and the clavicle.

Factors that increase risk

• Prolonged periods of inactivity

• Dehydration

• Oral contraceptive medications

• Sports that require repetitive overhead activities, such as baseball (throwing), volleyball, and tennis

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