When Joy Mann went in for a massage, the masseuse thought something was awry.

The therapist suggested that Mann, an avid runner, see a doctor for little knots in her legs. Mann was later diagnosed with a blood clot.

When Mann told The World-Herald about her experience, it made us wonder how common a problem blood clots are for runners.

The takeaway: It can happen, but it’s rare. So you should keep running, said Nebraska Medicine’s Dr. Natalie Ronshaugen, but you can take precautions.

“Don’t let the idea of a clot scare you away from running because running has so many health benefits. Clotting is just something to be aware of,” said Ronshaugen, a sports medicine physician.

While practicing hospital medicine, she saw one running-related clot. In two years of practicing sports medicine, she’s seen no cases.

Ronshaugen, who didn’t treat Mann, said a few factors are at play with endurance athletes and blood clots.

The body makes more red blood cells while running to compensate for needing more oxygen. That makes the blood thicker.

Whenever there’s trauma to the body — which can include running a marathon, surgery, giving birth or a car crash — changes occur to the “clotting cascade.” The so-called cascade is a chain reaction of enzymes in the body that causes blood to clot.

Runners who fly to and from races face increased risk.

Other things that increase risk of clots include long-distance running, birth control pills, pregnancy, smoking and genetics.

Ronshaugen gave these tips to prevent running-related clots:

  • Stay well-hydrated.
  • If you’re taking a long trip after a race, make frequent stops. Walk around and get your blood moving.
  • Wear compression tights when traveling.
  • Don’t smoke.

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