A pulmonary embolism — or a blood clot in the lung — affects around 1 in 1,000 people in the United States every year, according to the American Lung Association.
An embolism often starts as a blood clot in your leg, where it breaks off the vein wall and travels to the lungs. Once stuck inside your lung, a pulmonary embolism can cause symptoms that limit your lung function and capacity.
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If you've had a pulmonary embolism treated by your doctor (through medication or surgery), there are certain exercises you can do in recovery to improve lung capacity and blood circulation, while reducing the risk of future blood clots.
Here, learn the symptoms and complications of a pulmonary embolism, and five exercises to help you in recovery.
How Do Blood Clots Happen?
Blood clots can develop for a variety of reasons, including restricted blood flow for extended periods of time (such as bed rest or long flights). Other causes include family history, certain medications, heart attack and smoking, per the Mayo Clinic. While blood clots can be life-threatening in severe cases, they can also be treated and resolved if diagnosed early by your doctor.
Talk with your doctor if you think you're at risk of blood clots. They can discuss lifestyle changes and treatment options, if needed.
Symptoms of a Pulmonary Embolism
A pulmonary embolism causes a spectrum of symptoms including, per the Mayo Clinic:
- Shortness of breath
- Pleurisy (sharp chest pain felt with deep breaths)
- Cough (that may produce bloody or blood-streaked mucus)
- Irregular heartbeat
- Clammy/discolored skin
While these symptoms help determine a diagnosis, symptoms like shortness of breath and cough (without blood) can continue weeks after treatment, per the American Heart Association (AHA).
Routine checkups with your cardiologist, pulmonologist and/or primary care doctor are important throughout your entire healing process.
5 Exercises for Pulmonary Embolism Recovery
A pulmonary embolism causes your lungs to contract and lose volume.
That's why after your medical treatment (with anticoagulant medication such as warfarin, surgery or a combination of both), your doctor may prescribe an exercise routine to help re-inflate the lungs, according to the Mayo Clinic.
Your doctor will determine the best exercises for you personally, but that routine may include any of the common techniques below.
1. Coughing and Deep Breathing
Coughing and deep breathing are some of the first exercises prescribed to you after a pulmonary embolism surgery. That's because they are simple and can test lung function post-operation, according to Penn Medicine.
Some doctors may also recommend using a device called an incentive spirometer, which allows you to inhale against a fixed resistance.
Most routines can be done without an incentive spirometer, though, as long as you are in an upright position. Here's one to try, per Roswell Park Comprehensive Cancer Center:
- Take a deep breath through your nose.
- Hold your breath for a few seconds.
- Exhale slowly and gently through pursed lips.
- Repeat for a second breath.
- On your third breath, cough instead of breathing out.
- Repeat this two more times.
If you have an incentive spirometer, follow this exercise, per Roswell Park Comprehensive Cancer Center:
- Place the mouthpiece in your mouth.
- Draw in air as if you were drinking from a straw.
- Take slow, deep breaths to hold the piston (the piece inside the device) up as long as possible.
- Repeat 10 more times.
Walking routines are low-impact, and can be a helpful part of recovery from a pulmonary embolism. It can also help prevent the development of other blood clots, per the North American Thrombosis Forum (NATF).
You can start small by walking across your bedroom at your own pace. As you become stronger, try walking around your home or down the street. Eventually, aim to walk at a moderate-to-brisk pace for 30 minutes, five days a week, to improve your lung capacity and circulation.
Remember to wear well-fitted, comfortable walking shoes to prevent injury and increase stability.
3. Ankle Flexes
A small September 2016 study in Medical Science Monitor found ankle movement may help prevent deep vein thrombosis (blood clots in the legs) after surgery. And we know that movement of any kind can help improve overall blood circulation, per Harvard Health Publishing.
Try adding this ankle flex exercise to your routine, per the American Academy of Orthopaedic Surgeons (AAOS):
- Sit on the floor with your legs straight out in front of you.
- Flex your right foot.
- Slowly point your right foot. (If this feels too easy, wrap a resistance band around the sole of your foot.)
- Hold the pointed position for 5 seconds.
- Alternate between flexing and pointing 10 times. Rest as needed.
- Repeat the exercise on your left foot.
To relieve stiff ankles and knees in the morning, try ankle flexes off the edge of your bed. You can do this by straightening your right leg out in front of you, flexing and pointing your foot 10 times. Then, do the same on the left leg.
4. Calf Raises
Strength training is also an important part of maintaining your overall health, according to NAFT.
That said, try focusing on exercises that strengthen your lower leg muscles — a common place for blood clots to form. Here's a simple calf raise exercise (i.e., standing on your toes) to add to your routine, per the National Library of Medicine:
- Hold onto the back of a chair for support.
- Stand with your back straight, slightly bending both knees.
- Lift your heels until you're standing on tiptoes. (Hold for 5 seconds.)
- Slowly lower your heels to the floor.
- Relax for 10 seconds.
- Repeat 10 times.
If you want to try a faster version, lift and lower your heels 10 times without stopping. Relax for 20 seconds. Repeat this exercise twice.
If you want to improve blood circulation now, but also lower your risk of future blood clots, cardio exercise like swimming is a great option.
When you swim, your body also has to adapt to holding and controlling your breath, which can help increase lung capacity and endurance, according to Northwestern Medicine.
- Start by swimming for 30 seconds and resting for 30 seconds, as many times as desired.
- Try a kickboard or flippers to help build leg strength.
- Try a variety of strokes and find your favorite (like backstroke or butterfly).
- Swim comfortably at your own pace.
Is It Safe to Exercise With a Pulmonary Embolism?
You should not exercise with a blood clot in your lung, but exercise can be a helpful part of your recovery process once you've been treated by a doctor for a pulmonary embolism.
In fact, a small July 2020 study in Phlebology found starting exercise as early as four weeks after a pulmonary embolism is safe in people without active blood clotting.
Symptoms like chest pain and shortness of breath can linger several weeks after a pulmonary embolism, according to the AHA. This can limit the effectiveness of lung-targeted coughing and deep breathing exercises.
If you are still experiencing pain, try alternatives that involve the entire body instead of just the lungs, like walking.
Should You Continue to Monitor Symptoms After a Pulmonary Embolism?
It is important to monitor symptoms and continue routine checkups with your cardiologist, pulmonologist or primary care doctor while in recovery from a pulmonary embolism. This is especially true if you've incorporated an exercise routine.
It's also important to note that exercising while taking anticoagulants may increase the risk of falling, so talk with your doctor prior to starting an exercise routine.
Always reach out to your doctor if you are unsure about your symptoms and recovery progress, or if symptoms worsen or persist longer than six weeks.
- Mayo Clinic: "Blood Clots"
- Medical Science Monitor: "Active Ankle Movements Prevent Formation of Lower-Extremity Deep Venous Thrombosis After Orthopedic Surgery"
- National Library of Medicine: "Exercises to Help Prevent Falls"
- Phlebology: "Safety of exercise therapy after acute pulmonary embolism"
- AAOS: "Foot and Ankle Conditioning Program"
- National Library of Medicine: "Pulmonary Embolism"
- Mayo Clinic: "Pulmonary Embolism"
- American Heart Association: "A Patient’s Guide to Recovery After Deep Vein Thrombosis or Pulmonary Embolism"
- Harvard Health: "Exercise and Your Arteries"
- U.S. Masters Swimming: "Fitness: Starting a Swimming Routine"