THROMBOSIS

[ezwater]

As I get accustomed to kneeling really low again (after a break due to knee injury), I'm asking myself, why am I doing this when I am taking various things to thin my blood and avoid clotting??

Kneeling low for long periods, especially for those as old as I am, carries some risk of thrombosis. I try to get out of the boat at least every mile (which makes for solo padddling because the butt boaters run off), and I take my aspirin and omega-3, but I'm wondering, is this smart? Is it time to go to open boat or (the shame of it) kayak??

[squeakyknee]

Or find a boat that you can be stable in w/ a high saddle.
The saddle in my wheelboy is almost 10inches tall and super comfy. I'm 6'2" and it doesn't mess w/ my balance at all(or maybe I just have a good brace) not really sure.
I do have to get out and stretch on occasion, but only after many days in a row of paddling, And my OC-1 is actually LESS comfy.Prolly because I like to really cram into it tightly.

[Jim]

A couple of weeks ago I was paddling in the back yard of a friend of mine and he came down to watch. He is a forensic anthropologist and his first question, after seeing me in a boat, was about getting deep vein thromboses. I told him that I have never heard of a paddler getting one.

So now I am curious- any C-boaters out there ever encounter a blood clot?

I suspect that there is enough wiggling around under those thigh straps to keep things pumping. However, it may be something to worry about for those at elevated risk (e.g., smokers, birth control pills).

So, who has encountered blood clots in themselves or others?

[Jim P]

I have, not deep vien but peripheral artery clots. About a year ago after a day on the Lower yough, the next day I had some pain around the inside of my knees. I thought it might be bruises from the knee straps as I do tend to crank things down tight. It got progressively worse until I went to the doctor. After a sonogram, it turns out I had clots in both legs a couple in each.

Never had any issues before this, doc says i have good circulation and a strong pulse in my feet. She says stop boating. So I take a month off. During that month I tweak the outfitting in my boat (Zoom) trying to get rid of any pressure points as well as raising the saddle from 8 to 9 inches. After a month I start back easy on short trips to Little Falls (about a two mile run). Getting out frequently to bounce around on shore. I also am taking aspirin daily to thin the blood at this point. All is well or so it seems. After about 4-5 trips, we have a recurrance. As the Zoom is so narrow, I figure raising the saddle further will result in far too much time upside down. While this would help perfect my roll, it would be a pain. So Zoom is sold and I pick up a Yak to play with. Stayed out of the OC from August to January last year before venturing out in the OC1 again.

Still struggling with rolling the yak today. But I have spent a lot of time in the old Ocoee and the Tandem boats this year. Both saddles in these boats are at 9 3/4 inches. Always take an aspirin b4 I go out. Probably about 25 days in the OC this year, no problems yet.

So it seems that the higher saddle solves a lot of the problems. One other thing I did was to lower the ankle blocks on all of my boats effectively opening up the angle of compression on the knee at a given saddle hieght. The result of this is my feet kill me and it is difficult to get out of the boat and walk at first as my feet are like useless flippers for a few minutes. Will be experimenting with raising them back a bit over time for improved comfort!

[sbroam]

Does the fact that you are active in the boat, as opposed to sitting still in the seat of an airliner, mitigate the clotting risk? I'm remembering some advice once shouted to me as I was griping about my feet going to sleep while crammed in a slalom boat - "If they're going to sleep, you're not paddling hard enough!"

[Helly]

definitely improves circulation in the legs. If your legs are going numb this is an indication you could be compromising the nerves and circulation and is not good.

Higher saddle helps. Also placing the ankle blocks directly under the ankle is NOT good...this cuts off circulation to the feet and promotes blood stasis in the leg. I know a lot of men who prefer these, and maybe it is because they are built different. I know I can't tolerate it.

I think it helps to support both the knee, and the upper portion of the shin, but not at the ankle itself. Having foot braces and padding toward the outside of the boat to help support the ankle allows you to paddle in different positions also.

I have not heard of folks getting clots, but I can see how it might happen if one were stationary in the boat.

[John Coraor]

In my experience, continuous hard paddling does help to maintain good circulation in the legs. My most enjoyable trips are typcially in small groups with a high percentage of other c-boaters who understand that sitting in eddys and floating through flatwater sections is not conducive to avoiding leg pain. All these factors help to keep the trip, and me, moving continuously. Having other c-boaters along also ensures that there are other paddlers who understand the need for knee breaks.

John

[sbroam]

...Having other c-boaters along also ensures that there are other paddlers who understand the need for knee breaks.

Having c-boaters along also promotes a higher level of discourse, increases the odds of more refined selection of refreshments, and encourages personal growth and development! I'm not saying kayakers discourage such things, I have many friends that are kayakers, I'm just sayin'...

[ezwater]

Thanks for the feedback. There is little room for raising the seat in my c-1s. My Millbrook Wide Ride could have a higher seat, but it is actually not that stable, so a higher seat may not work. My Dagger Zealot has much more initial and secondary stability, but if I raise the seat much, my thighs are pushing up under the front of the cockpit.

I agree about activity, but at my age, there are limits. One thing that helps is consciously contracting and relaxing different leg muscle groups frequently.

[KNeal]

This is actually an important and relevant issue for us c-boaters since we fit one risk factor for deep vein thrombosis--seated/kneeling stationary position for long periods; however, the jury is out on definitive causes. I have not heard of DVT cases involving canoers, but I'll see if I can find out anything new about this issue and get it on here.

Pre-exisiting risk factors, such as heart disease and high blood cholesterol, may contribute--but I'm just interjecting my opinion here. Has anyone heard if taking 81mg. of aspirin makes a different with peripheral blood flow (in the arms and legs) and lower the risk for DVT?

KNeal

Add-on: Helly pointed out,

The way to combat this is to not allow your legs to go numb, and hop out of the boat periodically, or if driving moving your legs either in or out of the car.

That is the most pertinent info. for us and the risk for DVT. If your legs are falling asleep while boating, you need to get out of the boat and move around frequently AND get your seat adjusted to prevent this.

I do like to play "Doctor" whenever I can (appropriately ), and I have an excellent resource available with my wife who is also a clinician.

By the way, skinnier guys ("Squeaky" and the like) are at a much lower risk for numb legs and DVT. Note that my name does not fit in that category.

[Helly]

have a lot to do with it. However, anything that promotes blood stasis or pooling in the extremities for prolonged periods of time such as air travel, travelling in a car for hours at a time, laying in bed for prolonged periods of time (particularly due to illness) can set up a scenario for clots in the legs. If one is generally active this will offset this.
Risk factors include: age (over 40yrs, but particularly over 60yrs agewise), heart failure, previous clots, surgeries over 2hr, recent stroke, heart attack, respiratory disease of any kind, obesity, family history of clots, and various other diseases along with something causing blood pooling can set one up for a DVT.

The way to combat this is to not allow your legs to go numb, and hop out of the boat periodically, or if driving moving your legs either in or out of the car.

Aspirin really doesn;t do much to prevent clots on the venous side of the circulation (venous leg clots, clots in the lungs), but works to prevent the risk of stroke and heart attack.

Now there are folks who have what is called PVD or peripheral vascular disease that involves both arterial and venous cirulatory system, and they may be on aspirin to prevent arterial clots.

I've personally not heard of boaters getting DVTs, but with the general principle where folks sitting on a 6 or 7inch saddle or wear clothing that constricts blood flow in their legs and may invariably cut off some circulation to their legs, I think could cause problems. There are folks who also may have either a genetic predisposition or acquired blood abnormality (blood factor deficiency) that may be known or not known that sets them up for clots.

Sorry if I sound like I'm preaching, but I'm a clinician that just happens to be implementing a program in our hospital where patients are screened for a variety of risk factors, and if several are present, require some sort of prophylaxis either mechanical or pharmacological to help keep them from getting a blood clot in the leg, or worse in the lung. Either type of clot can lead to some disability. It is just not as widely publicly known like stroke or heart attacks are.

Perhaps you have seen some commercials talking about prolonged air travel???

[maryfromkansas]

This is an interesting discussion and a very timely one. I have been wondering for the last week if I might have a DVT or another real problem going on in my leg. Last weekend while canoeing, I noticed the back of my right knee felt odd. It felt like it popped but it doesn't feel sore to the touch and I have full use of the knee. I was just hoping I had strained it, but I have been noticing odd sensations in my right leg all week. I have felt around for swelling or hot spots but I cannot pinpoint anything. I guess I will make a doctor appointment for next week.

I have a Zoom and noticed the 8 inch saddle is a lot less comfortable then my 9 inch Ocoee saddle. I could try replacing it but it might not be worth it if I really have messed my leg up.

I have been whitewater canoeing for 15 years and I figured someday I would have to pay for all this fun.

[ezwater]

Thanks for the additional comments. I have been encouraged by the increasing tolerance of my old legs to kneeling in my Wide Ride. The saddle is already pretty high, and I don't want to raise it more because the Wide Ride is actually less stable than my Zealot or my old Phoenix. Maybe I will see if I can raise the seat in the Zealot and try IT again..... The Zealot actually is easier to manage on the easy stuff I paddle than is the Wide Ride. Could be time for a glass Atom....