Long-distance travel, whether by car, train, or airplane can be associated with leg discomfort
and increased risk. Lack of leg movement gives way to swelling of the feet and legs. The
swelling contributes to leg fatigue, discomfort, and the sensation of leg
heaviness. Activity restriction in a confined seated position results in the diminished
flow of blood from the legs back to the heart.
When you are traveling, it becomes harder for your body to transport blood from your lower extremities back up to your heart because your body stays in the same position for hours. It is even more difficult when traveling by plane since the barometric pressure in the cabin is lower than usual. In fact, it is equal to the pressure exerted if you were standing on top of a small mountain (an elevation of about 1800 to 2400 meters above sea level).
The likelihood of a thrombus
Did you know that the Scurr study showed that 10% of travelers who did not wear compression stockings ended up with a calf phlebitis?
If you already have pre-existing risk factors, it may lead to a more serious problem: travel-related thrombus. You may have heard the media refer to it as “economy class syndrome (ECS)”. A travel-related thrombus is a venous thrombosis (blood clot in a vein) associated with spending more than 5 hours of travel in a seated position. The venous thrombosis may be limited to a deep vein (DVT), or a fragment could flow to the lungs and lodge causing a pulmonary embolism (PE).
A traveler not wearing graduated compression stockings is 12.5 times more likely to develop DVT.
Blood clots can sometimes form in the legs during travel because of immobility for long periods of time, often sitting in cramped spaces with little leg room.
Wearing gradient compression stockings appeared to be effective in reducing the risk of deep vein thrombosis.
Advice for travelers
- Drink plenty of non-alcoholic fluids, especially water
- Perform ankle movements regularly: be sure to move
- Flexing, tensing, and rotating are all good ways to get blood circulating when your feet start to feel numb, tingly or painful
- Stretch and exercise your legs at least once every hour
- Elevate legs when possible
- Avoid high-heeled footwear and restrictive clothing
- Wear JOBST® gradient compression hosiery
- Seek medical advice if you have or are concerned about any risk factor
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Hsich, H. Journal of Advanced Nursing /Wizard Communications. Aviation Health.51:83-98. June 200