Doctor Giovanni Bonalumi, vascular surgeon, warns about the possible risks for bodybuilders
Body building, weightlifting e thrombosis: a risk that is rarely talked about, but which unfortunately is confirmed by the medical literature (and experience). “Not just the body building and the weightlifting, but also the Greco-Roman fight and similar sports, which aim at building the muscular body, face increased risks both thrombotic and functional vascular “, explains to Official Active Dr. Giovanni Bonalumi, vascular surgeon, Head of the Vascular Surgery Unit of the Institute of Care of the City of Pavia (San Donato Group).
Thrombosis and body building: the direct causes, from diet to anabolics –
But what are the causes of the thrombosis in the bodybuilder? “There are two types of causes: direct and indirect. The first indirect cause is the unbalanced diet, extremely high-protein, almost completely free of sugars and fibers, aimed at increasing lean muscle mass and reducing fat mass “, explains Dr. Bonalumi, who specifies:” hyperprotein diet it is a risk for the protein itself, but because the increase in protein in the blood leads to an increase in chetonic bodies that clog the liver. And if the liver is not functioning well it does not produce the substances that prevent the thrombotic risk. In other words, liver failure due to increased chetonic bodies and of proteins it makes the liver work badly which thus produces fewer factors that prevent thrombosis ”.
But diet is not the only direct cause of thrombosis in body builders: “Even the use of doping substances it is an indirect cause. In particular the erythrocyte (Epo), drug that increases the mass of red blood cells and therefore the thickness of the blood, consequently increases the thrombotic risk. A similar argument applies to anabolic steroids (AAS), especially the androgen hormones (the family of testosterone): they increase blood coagulability and platelet aggregation, determining both a peripheral, venous thrombotic risk and an arterial thrombotic risk. The anabolic steroids can cause acute or chronic effects mainly due to the fact that they increase the blood count and cause hypercoagulability, leading over time to thromboembolism venous and arterial, so much so that anabolic cerebral infarcts are also described ”, adds Dr. Bonalumi.
The indirect causes of thrombosis in bodybuilders: from vasodilation to compression of the veins –
In addition to direct causes, there are other indirect causes that may involve the risk of thrombosis in the bodybuilder: “Who practices body building often deliberately searches for the varicose veins of the arms because they are a symptom of the disappearance of the fat mass, of the subcutaneous fat. However, in this way there is a dilation of the veins, and this leads to an increase in the thrombotic risk. Furthermore i bodybuilder they do extremely important exercises in anaerobiosi. This, while on the one hand increases muscle mass and reduces fat mass, on the other hand leads to an increase in glycogen, a particular sugar that is metabolized by the liver and can induce imbalances in the fat metabolism. For this reason, those who practice body building often have low but high cholesterol levels triglycerides. Furthermore, this situation of anaerobiosis and these very intense contracting exercises thicken the wall of the left ventricle of the heart, creating a situation of oxygen deficiency that can lead to an imbalance between the amount of oxygen that reaches the heart wall and the need for oxygen, which in a thicker wall is greater. You can thus have situations of angina, cardiac thrombosis and arrhythmia“, Says Dr. Bonalumi.
Then there is the risk di compression: “The exaggerated development of some muscles, especially of the thoracic outlet, in particular of the scalene muscles and the small pectoral muscles, it can lead to a reduction of the space in which the artery, vein and nerve pass over the collarbone. And this leads to an increased risk of thrombosis, because the vein narrows and runs into axillary thrombosis, especially among bodybuilders who develop their pectorals a lot ”.
The risk of thrombosis of the inferior vena cava –
One of the most dangerous thrombosis for those who practice body building and the thrombosis of the inferior vena cava, or the largest vein in our body, which connects the heart to the lower limbs through the belly. “This thrombosis can occur in bodybuilders who use the weight lifting belts: the compression carried out at the abdominal level by these belts can cause thrombosis in the inferior vena cava. Fortunately, these are rare cases, but they do exist ”, warns Dr. Bonalumi.
Paget-Schroetter syndrome and Mondor syndrome –
Between thrombosis that can affect those who do body building there are also two specific syndromes: that of Paget-Schroetter and that of Mondor. “In Paget-Schroetter syndrome there is a compression at the level of the thoracic outlet, a chronic occlusion of the deep veins. Important collateral circles develop, with large varicose veins, because the blood to return from the shoulders and chest to the heart finds the obstruction and must therefore dilate the superficial veins. And then there is the Mondor syndrome, quite frequent: it is weep very painful of the superficial veins of the abdominal wall due to the dilatation, the stasis of these veins of the abdominal wall ”, explains the surgeon.
Body building and hemorrhoid risk –
The venous effects are also seen on the hemorrhoids: “Almost all bodybuilders have le hemorrhoids, due to the dilation of the veins and the enormous efforts, which cause an increase in abdominal pressure and a consequent dilation of the veins of the haemorrhoidal plexus ”, adds Dr. Bonalumi.
Symptoms of thrombosis in bodybuilders –
But are there any symptoms that should raise the alarm? “Sometimes pathological symptoms are sought, such as large varicose veins, especially in the arms and legs. It is not known that these large varicose veins can lead to thrombosis. When this occurs the limb becomes extremely hard, sore. At that point an echo Doppler is done to have a certain diagnosis and then a therapy based on oral anticoagulants is followed for at least six months. Of course, suspending the causes that produced the thrombosis, such as excessive bodybuilding efforts. Recall that one thrombosis ruin the vein for life. Going to the gym in moderation, with a critical sense, without using anabolics or erythropoietins does more good than harm, as well as increasing the trophism of the muscles with measure improves cardiac and functional metabolism, as well as posture. But the body building exasperated leads to major cardiac, vascular and thrombotic risks ”, warns Dr. Bonalumi.
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