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Covering sports injuries from the perspective of a certified athletic trainer and backed by analytics.

Understanding Brandon Ingram’s Deep Vein Thrombosis

A frustrating season for the Los Angeles Lakers took a turn for the worse over the weekend when it was revealed forward Brandon Ingram will miss the remainder of the season after developing a blood clot in his ailing shoulder. The official diagnosis from the Lakers was a deep vein thrombosis (DVT) in his sore right shoulder. A DVT is a clot that develops in one of the major veins of the body. DVTs usually develop in the lower extremities and can be life threatening if dislodged. When this occurs, the clot is capable of traveling to the lungs, resulting in a pulmonary embolism (PE) that can block blood flow to the area.

Clots development is relative uncommon in elite athletes though multiple risk factors exist. For example, long distance travel, dehydration, and even being tall can increase the chances of a clot developing. DVTs can be a complication following surgery as seen in multiple NBA players including Anderson Varejao, Udonis Haslem, and Tyreke Evans. These factors were explored extensively in a 2017 study that took an in-depth look at venous thromboembolism development in professional athletes in the four major sports leagues.

The work performed by the Lakers medical staff should be praised as the early detection may have saved Ingram’s life. In the meantime, the third-year forward will likely be placed on anticoagulant medication. The medicine is designed to thin the blood and prevent additional clots from developing. However, the medicine has an unfortunate side effect. Individuals taking blood thinners are vulnerable to excessive bleeding or significant internal bleeding following any trauma from a direct impact or laceration. As a result, athletes taking blood thinners are usually withheld from sports until they are off the medication and all the existing clots have been absorbed. This usually occurs between three to six months from the start of medication.

Ingram’s long-term prognosis will likely be linked to what caused the clot to form. If it is linked to isolated trauma, then Ingram should be fine moving forward. However, there are several causes that could cloud Ingram’s future. It is likely that Ingram will now be tested to determine if the DVT was the result of a previously undiagnosed genetic disorder. A hereditary disorder for clotting would leave Ingram vulnerable to developing another DVT or potential PE.

Venous thromboembolism development can also be linked to an anatomical impingement often seen in individuals suffering from thoracic outlet syndrome (TOS). TOS entered the basketball lexicon earlier this season when Markelle Fultz, the top pick in the 2017 NBA draft, was diagnosed with the condition. In these cases, surgery may be warranted to remove the root of the problem.

Still nothing is guaranteed at this point. Former All-Star Chris Bosh was forced into an early retirement after battling recurring blood clots despite never being diagnosed with TOS or a hereditary disorder.

For now, Ingram will sit for the remaining 17 games of the Lakers schedule. Hopefully the clots resolve in the offseason and the up-and-coming talent resumes play to start the 2019-20 season. However, where he takes the court next remains similarly in doubt as trade rumors continue to circulate.

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