Your body contains a network of arteries and veins through which blood flows, carrying nutrients to the cells. Arteries are the vessels that carry blood from the heart to the brain, internal organs, arms and legs. Blood clots in an artery can cause a stroke or heart attack.
Veins carry blood back to the heart from the rest of your body. Clots that form in the deep veins of the legs, pelvis, or abdomen are called deep vein thrombosis (DVT). If a piece of blood clot breaks off from a leg and travels to the lung, it can cause a Pulmonary Embolism (PE). A PE is a serious medical emergency that can be fatal in some cases.
DVT usually affects older people who are obese, bedridden, have heart or lung disease, or have had a major operation. Other risk factors for DVT include being overweight, smoking, taking birth control pills or hormone therapy, pregnancy and childbirth, cancer or other health issues, and a genetic predisposition to blood clots.
Young people who are otherwise healthy and fit can develop DVT, too. A major risk factor is sitting still for long stretches, such as on plane rides and road trips, or while playing video games. Travel on long haul flights, where the cramped conditions and prolonged immobility causes blood to pool in the legs, is notorious for leading to blood clots.
Any long distance journey lasting 4 hours or more – whether by plane, car, bus or train – doubles your risk of deep vein thrombosis (DVT) and pulmonary embolism (PE). Some studies show that the risk of DVT is quadrupled with air travel, with longer flights carrying the greatest risk.
It seems to be not just inactivity or cramped space that’s a problem – other risk factors are also involved, such as reduced oxygen saturation in the cabin, dehydration, and reduced cabin pressure which causes swelling in the lower legs.
Another risk factor that is not widely recognized is that people who are extremely tall (over 6 feet) or short (less than 5 feet) are at increased risk for a travel thrombosis. If you are tall, blood has to flow further through the veins and is more likely to become sluggish. If you are short, the back of the seat will press more against the back of your legs, slowing your circulation.
How to prevent travel-related DVT
DVT and PE can be prevented in many cases, and there are things you can do on long flights to reduce your risk.
Book an aisle seat. An aisle seat will allow you to move your legs a little bit more, which will help improve circulation and reduce the risk of blood clots. Booking your flight early will help you to get an aisle seat. You may also be able to pay a little more for a row with extra leg room. If you can afford it, this may be another option to give yourself more space to stretch out. Recline your seat as much as possible and don’t cross your legs or ankles.
Store your luggage overhead. If you have carry-on baggage, place it in the overhead container. Avoid putting anything at your feet, since it will reduce the amount of room that you have for stretching your legs.
Wear loose-fitting, comfortable clothing. Tight clothing will restrict your circulation. To improve circulation, it can also help to take off your shoes. It will be easier to stretch your feet and toes without shoes.
Don’t sit with your legs crossed. Sitting too long is bad enough, but especially don’t sit with your legs or ankles crossed, because this restricts your circulation even more.
Do foot stretches. Flex your toes back towards your chest. Then, point them towards the ground. Repeat this exercise six to eight times for one set of foot stretches. Do this foot stretch about every half hour.
Stretch your toes. Every so often, you should do a simple toe stretch by pressing your toes to the ground and then raising them up to the ceiling. Complete five to eight repetitions. You can do the toe stretch after doing your foot stretch.
Pull your knees to your chest. Grab your knee and pull your leg up to your chest. Hold it for 15 seconds. Then, let it back down to the floor. Repeat the movement on your other side for one complete repetition. Complete 10 repetitions during your flight.
Press the balls of your feet to the ground periodically. Push your heels, and then the balls of your feet down hard against the floor or footrest, lifting them up and down every so often to increase the blood flow through your lower legs and feet.
Roll your ankles. Roll your right ankle in a clock-wise direction. Then, roll it in a counter-clockwise direction. Once you have rolled it in each direction, you have completed one repetition. Complete six repetitions per foot.
Lift your legs. Engage your core and lift your legs off the ground. Try lifting them 6 inches off the ground. Hold them up for 30 seconds or as long possible. Relax, and place your feet back on the ground. Repeat this exercise six times.
Walk up and down the aisle. Whenever you see the seat belt sign go off, you should take the opportunity to walk around and stretch your legs. Aim to walk up and down the aisle at least once an hour during a long flight. (Another good reason to get an aisle seat.)
Stay hydrated by drinking plenty of water. Drink plenty of water before the trip, and bring a water bottle with you. When you finish it, ask the flight attendant to refill it for you. If you rely on the small cups of water they give you during the flight, you will not get adequate hydration.
Avoid sleeping pills on long flights. If you take a sleeping pill, you could fall asleep and get a blood clot. Instead, you could try taking a series of short, ten-minute naps.
Avoid drinking alcohol. You should avoid alcohol both prior to your flight and during the flight, since it could put you to sleep and cause you to be immobile for a long period of time. A blood clot could form while you are sleeping in an uncomfortable position.
Go for a walk right after the trip. To improve your circulation after a long flight, it is important to take a nice walk. You will likely have to walk to pick up your luggage, which will help a little bit. In addition, you could take a walk outside when you get to your destination.
Could You Spot Pulmonary Embolism Symptoms?
It’s important to remain vigilant about the signs and symptoms of blood clots. These include:
Deep Vein Thrombosis – DVT
- Swelling, usually in your leg.
- Leg pain or tenderness, usually described as a cramp or Charley horse.
- Reddish or bluish skin discoloration in the affected leg.
- Leg warm to touch.
- Sweating and anxiety.
Pulmonary Embolism – PE
- Sudden shortness of breath.
- Sharp, stabbing chest pain; may get worse with deep breaths.
- Rapid heart rate.
- Fainting or passing out.
- Unexplained cough or coughing up blood.
The best way to prevent a pulmonary embolism is to maintain a healthy weight and an active lifestyle. Keeping your blood flowing when you’re sedentary for long periods of time is vital for preventing a dangerous blood clot and deep vein thrombosis. If you have any risk factors, then it is especially important to take precautions. If you should experience any of the symptoms, seek immediate medical attention.