The Philadelphia Eagles quarterback was struck in the calf during an Oct. 4 game and sought treatment four days later, according to a statement from the team. An ultrasound in London revealed the clot, but doctors cleared him to play in the team’s game there the next day.
What makes a clot superficial—and when does it become dangerous? We asked doctors to explain.
“You have a really well interconnected network of veins,” says Dr. William Shutze, a vascular surgeon at Texas Vascular Associates in Dallas and vice president of the Society for Vascular Surgery (who was not involved in Hurts’ care). Think of it as “a very well developed road and highway system,” with multiple routes to get where you need to go.
A superficial clot forms in one of the veins near the skin. The area can become red, warm, and tender. “It’s usually very uncomfortable,” Shutze says. Some develop in varicose veins; others form where a needle or IV has irritated a vein.
Deep vein thrombosis involves a clot farther inside the body. Its symptoms can be more widespread—the whole calf or ankle might become swollen and painful, Moll says. You can’t feel the deep vein itself.
Doctors use ultrasound to assess the clot and check for deep-vein involvement, Shutze says. They’re particularly concerned about superficial clots longer than 5 centimeters or within 3 centimeters of where a superficial vein joins a deep one.
How do these clots happen—and how are they treated?
Being in excellent shape doesn’t make someone immune to a blood clot. An injury can damage a vein, while prolonged inactivity slows blood flow. Surgery, certain inherited clotting disorders, cancer, and pregnancy can also increase risk, says Dr. Alina Mitina, an emergency medicine physician at Hackensack University Medical Center in New Jersey (who was not involved in Hurts’ care).
A clot can form within hours of an injury or develop over several days, he adds. If your leg already hurts from getting hit, you might not realize there’s another reason it’s sore.
Some superficial clots can be managed with warm compresses, anti-inflammatory medication, elevation, and monitoring. Others need blood thinners to help keep the clot from growing—even if it hasn’t reached a deep vein.
That doesn’t necessarily mean spending recovery on the couch. “We like them to be active because we want to keep the blood flowing,” Shutze says.
In football, “you have constant significant contact,” Moll says, which raises the risk of serious bleeding, including inside the head or muscles.
What symptoms shouldn’t you ignore?
Pay attention when discomfort feels different, persists, or worsens. Pain, swelling, discoloration, and warmth can signal a clot. Mitina says patients sometimes describe tightness in the leg; redness around a superficial clot can resemble an infection.
Unexplained shortness of breath, chest pain, coughing up blood, or fainting require emergency care because they can signal a pulmonary embolism. Moll also flags an unexplained cough and fast heart rate as possible warning signs.
And getting checked once doesn’t mean you should brush off symptoms that persist or worsen. “If something feels weird or symptoms aren’t getting better, always return to the ER,” Mitina says. “You know your body best.”
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