"I’m cautiously optimistic.” Doctors reveal true feelings on Spurs’ Victor Wembanyama’s blood clot and his recovery (EXCLUSIVE)

Despite numerous unanswered questions facing Victor Wembanyama’s recent blood clot, a handful of outside medical doctors validated the San Antonio Spurs’ belief that he can fully recover and return in the 2025-26 season.

“I’m cautiously optimistic,” said Mo Emam, the director of primary care sports medicine at Johns Hopkins.

Three medical experts that talked to Sportskeeda don’t have access to Wembanyama’s medical records that confirmed he has deep vein thrombosis in his right shoulder. These medical experts also don’t work directly with the Spurs. But considering their expertise in blood clots, they offered plenty of perspective on Wembanyama’s injury, his expected treatment and his likely recovery timeline.

The panel included:

Theodore Bryan, MD, interventional radiologist with Providence St. Joseph Hospital in Orange County, Calif.

Michael Del Rosario, MD, hematologist/oncologist, private practice

Mohammed Emam, director of primary care sports medicine, Johns Hopkins in Baltimore, MD

Editor’s note: The following one-on-one conversations have been edited and condensed. Their interviews with Sportskeeda were also conducted separately.

What was your reaction when you heard the news about Victor?

Bryan: “Your first thought when you hear about a young athlete getting a blood clot is that you wonder if they have something called ‘Paget-Schroetter Syndrome.’ I certainly have no way of knowing if that is what happened. But that is a condition where someone that uses their upper extremity a lot and forms a blood clot in the deep veins. It’s thought that repeated trauma and obstruction in the area leads to a blood clot. It’s more common in males and especially young players.”

Del Rosario: “I treat deep-vein thrombosis on a daily basis. Basically what that is is when a blood clot forms in a deep vein. When I heard about that with Victor Wembanyama having that in the right shoulder, that actually is very rare. It happens only about 5-10% of the time with the arms and shoulders.

It usually happens in the leg. I do have young patients similar to him. Obviously not 7-foot-4, but they are young athletes. Usually this is related to the constant arm movement that can stress the shoulder vein. The term for it is called ‘effort thrombosis’ and the medical term is ‘Paget-Schroetter Syndrome.’ That happens when the shoulder vein gets squeezed by a collar bone or a rib. That can cause a clot. When you squeeze a vein or blood vessel, that can decrease blood flow and cause a clot.”

Emam: “I wouldn’t say surprised. But definitely for an athlete presumably healthy that has undergone tons of medical clearances and physicals, it is unusual, especially with the location of the clot. It’s heard of, but this is not the most common location where one would get a blood clot. There are so many questions. What was the cause of the clot? Does he have any underlying risk factor that has been missed? I’m pretty sure he’s gone through extensive work after the diagnosis to try to clarify the cause of the clot.”

What is your level of concern?

Bryan: “It’s definitely treatable, but it’s not a simple or straight forward treatment. The first thing is you have to deal with the blood clot. That can be dealt with one of two ways. You can place somebody on anticoagulation for a long time and let the bloodclot resolve. Or you can have a catheter directive where you insert a device into the veins to physically remove the clot. If it is ‘Paget-Schroetter Syndrome,’ the last step is that you have to decompress that vein. That can include removing the first rib surgically.”

Del Rosario: “If caught early, I think it’s manageable. I think the San Antonio Spurs did that there. The big risk with these things is that the blood clot can move to the lungs. But at least from is reported on the news, it doesn’t sound like he has that.”

Emam: “This is a concerning injury and a concerning condition. It is a potentially life-threatening condition if gone missed or if the athlete did not get the accurate medical attention early on. I’m cautiously optimistic. It’s my understanding that this was caught early.”

What do you think it can do for Victor that the Spurs have shut him down for the rest of the season?

Bryan: “It gives them time to manage this and ensure he has a long and meaningful career as opposed to trying to put a quick fix on this and risk a blood clot happening again.”

Del Rosario: “Shutting him down makes sense. He’s the star and you don’t want to ruin the organization. It’s extremely beneficial to shut him down now. Typically the treatment for this would be a type of blood thinner with an injection or some pills to break up the clot and stop new ones from forming. Usually you would have a patient on a blood thinner for three to six months. When you’re on a blood thinner like that, it’s hard to play in contact sports like basketball because he’s at risk for getting serious bleeding. Most likely, it will also give him more time to do more tests to see what is causing the clots. Sometimes, it’s a genetic abnormality, extra rib or a weird area in the collar bone that can be fixed with surgery.”

Emam: “I think the decision to sit him for the rest of the season is wise. I don’t think this is a condition you want to risk with an early return to play without the full course of treatment. So I’m cautiously optimistic.

Hopefully they intervened early on as well. If that’s the case, then he can be cleared to play. But there is a lot of work that needs to be done to clarify his condition. Is this provoked or unprovoked? Is there any underlying condition? Sometimes that can happen because of hereditary blood disorders. If that’s the case, he might need life-long treatment. If that’s not the case and it’s a first-time clot and there’s no risk-factors, most athletes could be cleared within three to six months from the beginning of treatment.”

What will be the key things for recovery?

Bryan: “That is difficult for me to say. It depends on if I’m suspecting is going on is in fact going on. But if it is indeed PSS, it will be about resolving the clot and removing the underlying obstruction. It’s tricky because this is somebody that is being asked to get big, get muscle and use their arm a lot. That also can contribute to the added risk of this clot forming again.”

Del Rosario: “The main thing for him is they’re probably most likely going to have him get evaluated by a surgeon to take a look if he has an extra rib or a misplaced collar bone that can be squeezing the vein. They’ll then take care of that during this season or in the offseason.”

Emam: “The resolution of the clot is important. Basketball is a contact sport. So there are a lot of factors and considerations that should be taken with ‘return to play.’ Once you start an athlete on anticoagulant medication, there is also the risk of bleeding, especially in contact sports. It’s not like once you start the medication that you can be cleared right away. You want to make sure the clot resolves. Even if the clot resolves early on, you should still continue the treatment because you want to make sure there is not a recurring clot. While the athlete is on anticoagulant medication, there has to be a very careful consideration with return to play because of bleeding risk. Athletes typically will turn to full activity if imaging confirms there is a full clot resolution and if the athlete doesn’t have any symptoms.

The tricky part is if there an underlying or hereditary disorder that can lead to clotting. Long-term treatment for anticoagulant would have to be considered then. Instead of three to six months, we may be talking about retirement. But I’m hopeful that is not the condition.”

Lots of NBA fans recall that Chris Bosh ended his NBA career early after multiple blood clots were found in his lungs. What are the keys to ensure blood clots don’t spread?

Bryan: “The main treatment in the short term to medium term is about six months with taking anticoagulation. But you don’t really want a guy playing a contact sport on full dose of anticoagulation. You hope that ultimately you can remove the obstruction so they don’t need to be on anticoagulation. The risk of playing basketball hard while on blood thinners is that with any contact injury you’re going to carry greater risk of bleeding. It’s not really ideal.”

Del Rosario: “Early diagnosis and early treatment is key. As long as he doesn’t have it spread to the lungs, I think he can make a 100% recovery. Brandon Ingram also had something extremely similar in 2019. He came back and is still doing pretty well right now. Shutting Victor down early in the long term makes sense. They can put him on some blood thinners for a few months, get evaluated for surgery and get him recovered after surgery.”

Emam: “If one has a clot and then that clot dislodges, in most cases, what happens is the clot will travel to the major veins to return to the heart. That will then pump into the lungs, and then they will have clots in the lungs. That can be life threatening. But I’m cautiously optimistic because they caught this early. Once he starts on anticoagulation, they should closely monitor him to make sure that clot resolves and there are no clots that have traveled to the lungs.”

The Spurs have expressed optimism that Victor will be fully recovered by the beginning of next season, which would be in the fall. From an outsider’s perspective, what do you think of that expectation?

Bryan: “I think that’s certainly possible. I think the question is if there is an underlying cause for the bloodclots. If there is a vein that is narrow and there is not good blood flow, that would have to be addressed. But the bloodclot itself should get resolved within the next few months. Then the question is, ‘Does a surgery need to happen to remove the underlying obstruction?’

Del Rosario: “I think he should be a go for 100% next season. As long as the blood clot is in the right shoulder and hasn’t spread to the lungs, I think he should be able to make a 100% recovery. He is a specimen at 7-foot-4 and is doing intense activity with the NBA. That definitely plays a role with hydration, muscle use and travel time.”

Emam: “I’m cautiously optimistic. I wouldn’t tell you this is a 100% case scenario that he would be cleared by next season. But in the majority of cases, once they start treatment and the clot resolves, there is a period of rest. Then he will start some light activity. You want to avoid full rest, but you also don’t want to clear him until the clot resolves. Assuming he had the right diagnosis early start and started the anticoagulation treatment early on, he should be cleared within three to six months.”

Beyond what we already discussed, what else is important to add that can give readers a better understanding of the injury that Victor has?

Bryan: “There is a fear of that clot being dislodged from where it is and going into the lungs. That can cause a whole host of problems. The other necessary thing is to make sure there are aren’t any genetic conditions that make it more likely to form blood clots than another person. There are a lot of questions that remain to be answered that will have to be addressed before we really know why Victor got this bloodclot and what is the best way to deal with it going forward.”

Del Rosario: “It’s a bump in the road. I don’t think this is the end of this career. I think he’ll come back.”

Emam: “There are a lot of other causes for blood clots. It’s not just hereditary causes. In contact sports, trauma or injury can be a cause. It is relatively uncommon, but we have seen conditions with thoracic outlet syndrome, which is when athletes have a compression of their major veins in the shoulder. Most clots happen in the legs. But it may happen in the big veins in the shoulder, but it’s not very common. Some athletes have a certain anatomy where there are structures that cause compression of the deep veins in the arms or shoulder. That can cause a clot as well. I’m sure he’ll have that evaluation as well.

If all the work doesn’t reveal the cause, that’s not necessarily a bad thing. But he still would have to go through three to six months with imaging and making sure the clot is resolved before being cleared. But they will have to make sure there are no underlying hereditary conditions and no underlying blood disease. If that is ruled out, we are looking at a very good outcome. If we have not ruled this out, and it may take some time, then I don’t think any medical expert can make a definitive opinion regarding return to play. I’m sure he has seen high-level medical professionals. The fact they have announced there is not a deeper layer, I’m cautiously optimistic.”

Mark Medina is an NBA insider for Sportskeeda. Follow him on X, Blue Sky, Instagram, Facebook and Threads.