How a calf injury could have led to blood clots in Jalen Hurts’ lungs

By Jen Christensen, CNN

(CNN) — Superstar Philadelphia Eagles quarterback Jalen Hurts, 28, may be out for the rest of the season after the team said Monday that doctors have diagnosed him with deep vein thrombosis and blood clots in his lungs.

Deep vein thrombosis happens when a blood clot forms in a deep vein, typically in the lower leg, thigh or pelvis.

Pulmonary critical care expert Dr. Parth Rali tells patients to think of the body’s deep veins as highways carrying blood from the legs to the heart and then to the lungs, where it is oxygenated. The oxygen then travels to cells throughout the body to produce energy.

A clot forms when red blood cells, platelets and a sticky protein called fibrin clump together, creating something almost like a gummy worm, said Dr. Syed T. Zaidi, a vascular surgeon at Orlando Health. The clot can safely dissolve once the body no longer needs it to stop a bleed or heal an injury, but it can become dangerous if it blocks blood flow to organs such as the heart, lungs or brain.

What causes blood clots?

A clot can form because of an injury, such as a hit or cut. Hurts’ case might have been caused by a calf injury he received during an October 4 game against the Los Angeles Rams. He had been stepped on by another player’s cleat, according to the Eagles.

“The injury can create this inflammatory process around it, and it puts you at risk for developing a blood clot,” Zaidi said.

Clots can also be caused by inactivity, such as sitting on a long flight or being immobile after surgery.

Some people may also have a genetic predisposition to develop blood clots.

Smoking and certain conditions, such as cancer, diabetes and Covid-19, can raise the risk of clots, as can atrial fibrillation and being overweight or obese. Some medications, including birth control and hormone replacement therapy, can also increase the risk. Hormonal shifts and physical pressure from the uterus can raise the risk of a clot forming during pregnancy and for six to 12 weeks after birth.

Sometimes, the cause of a clot isn’t clear.

Blood clot symptoms

Some people with clots have symptoms, but others may not. A clot in a leg can cause swelling, cramping and pain. Sometimes, the skin near the clot may feel warm to the touch or turn purple or red.

Rali said people often notice they have a clot when calf pain does not improve with regular stretching and hydration after about five days. Sometimes, that leg will look swollen compared with the other.

“If something just does not sound or feel normal, I say don’t wait. Get an ultrasound, and we can make a diagnosis,” Rali said.

Superficial and deep clots

A superficial clot forms in superficial veins, which are often visible just below the skin in subcutaneous fat.

With a mild or smaller superficial clot, doctors focus on reducing inflammation and easing pain. Patients are usually told to apply a warm compress, such as a washcloth, a few times a day. Doctors may also tell them to elevate the affected leg or arm to improve blood flow while resting, take a pain reliever such as ibuprofen, stay active to keep blood from pooling and possibly wear compression socks or an elastic bandage.

Doctors typically do a follow-up scan a week or two after the initial detection to make sure the clot has not grown or moved, which would require further treatment.

In Hurts’ case, he told trainers about the leg injury before taking a flight from Philadelphia to London. When he got to the UK, an ultrasound showed superficial vein thrombosis in his left calf. The Eagles said doctors “concluded that activity and movement were important,” and he played against the Jacksonville Jaguars in London and then returned to Philadelphia.

After two days of treatment and a practice session, an ultrasound showed “small movement” in the blood clot, and the Eagles said Hurts would not play against the Carolina Panthers on Sunday. On Monday, the team announced that the clot had moved into his lungs.

Some patients with a clot in a superficial vein may also have an undetected clot in a deep vein in the muscle, or a clot could travel from a superficial vein to a deep vein and create a more serious situation.

A long flight, such as the ones Hurts took between Philadelphia and London, could exacerbate a clot.

“You’re sitting around, and maybe you’re a little dehydrated, and your blood gets a little bit thicker,” Zaidi said.

“A big thing we worry about with these thromboses, or these blood clots, is the risk of having a pulmonary embolism, which is when the blood clot travels through your lungs, affects the blood flow to your lung,” Zaidi said.

This could cause the person to stop breathing or lead to heart failure. But with prompt treatment, people can recover.

What is a pulmonary embolism?

About 60,000 to 100,000 people in the US die each year from venous thromboembolism, which includes deep vein thrombosis and pulmonary embolism, according to the US Centers for Disease Control and Prevention.

A pulmonary embolism can happen when a clot breaks off and travels through the bloodstream to the lungs. Bilateral pulmonary emboli, like those Hurts has, mean blood clots are blocking arteries in both lungs.

Symptoms of a pulmonary embolism include chest pain that can worsen when breathing deeply or coughing. A person may suddenly feel short of breath and develop a cough with blood-streaked mucus. They may feel faint or seem confused.

In addition to low blood oxygen levels and low blood pressure, a pulmonary embolism can affect the heart, causing a fast or irregular heart rate, right-sided heart failure or sudden cardiac arrest.

“You may think your asthma is firing up or you have a viral infection, but if things are not making sense to your routine progress of things, don’t ignore the signs,” Rali said.

How are serious clots treated?

When clots are in the lungs, patients often need medications called blood thinners, such as heparin or warfarin, to help the body dissolve them.

People often have to take blood thinners for three to six months.

“When you are on a blood thinner, you are at high risk of bleeding, particularly if you are involved in contact sports,” said Rali, director of the Pulmonary Embolism Response Team Program at Temple Health. “The duration for the blood clot is minimum three months, because that’s what time it usually takes for our body to dissolve the blood clot.”

Rali said doctors advise people who are taking blood thinners to avoid activities likely to cause injury, like football or skydiving.

“Unfortunately, that means his doctors would ask him not to be involved in any form of contact activity, which of course involves what he does all the time,” Rali, an Eagles fan, said of Hurts.

Hurts’ prognosis

Clots are common, Rali said. In the US alone, nearly 900,000 people are diagnosed with a blood clot in the leg or lung each year.

Hurts is not the first professional athlete to miss games because of blood clots. Carolina Panthers right tackle Taylor Moton missed part of the season after blood clots were found in his lung. San Antonio Spurs superstar Victor Wembanyama missed 30 games in the 2024-25 season because of deep vein thrombosis. NBA star Chris Bosh had to retire because of a clotting condition.

Tennis star Serena Williams, who needed surgery to remove a blood clot from her lungs in 2011 and nearly died from a pulmonary embolism and related complications after she gave birth to daughter in September 2017.

“Given awareness of the risk, treatment and full recovery time are the elements that Hurts will need to happen,” Rali said.

The Eagles said Hurts has a good prognosis, is expected to make a full recovery and can play football after he stops taking blood thinners.

Some people may need additional treatment. Doctors can use catheters to enter blood vessels in the lungs and dissolve or extract the clots. Surgery may be needed to open the heart and remove a clot there.

“You have multiple different options that you can offer, depending on the severity of the blood clot,” Rali said.

How to avoid blood clots

Physical activity can help prevent deep vein thrombosis, so it’s important to lead that active lifestyle your doctor is always telling you about. If you have a job where you have to sit at a desk for hours at a time, doctors suggest you should stand frequently, get up and stretch and take some walking breaks so you are moving your feet and legs.

You should even try to move around on a long flight. Getting up once an hour and walking around can help. If that’s not possible, Zaidi recommends doing calf pumps while seated. “It can make a big difference,” he said.

Staying hydrated on long flights is also key since dehydration can lead to the development of blood clots, and compression socks can help keep blood from pooling in the lower limbs.

Other ways to avoid deep vein thrombosis include quitting smoking, maintaining a healthy weight, drinking water throughout the day and avoiding crossing your legs when sitting.

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