Over 200,000 Americans will develop blood clots, also known as deep vein thrombosis (DVT), this year alone. Fifty thousand will develop pulmonary embolism (PE), [i] causing 25,000 deaths per year in the United States.[ii]
In general terms, if you are healthy, you have a very low risk of developing DVT. However, the LONGFLIT study in the early 2000s showed that up to 6 people with risk factors out of a hundred on a plane may develop DVT after long flights. These studies even concluded that being stuck in the middle seat may increase the risk of developing DVT up to four-fold! [iii], [iv]
As an interesting side note, many passengers have sued airlines for cramping them in economy-class seats. Still, a study debunked the concept of “economy class syndrome” when they compared the risk of developing blood clots between first class and economy and found no differences. The issue is not about comfort but the ability to move. Since then, most airlines published recommendations to decrease the risk of DVT by methods of hydration, loose-fit clothing, and a specific set of exercises. Numerous academic medical institutions have also supported these statements about exercise during air travel.
Source: American Airlines Magazine
Source: American Airlines MagazineIf you have any risk factors, your legs swell up during long trips or have any concerns about developing blood clots, I would recommend the following:
- Get an aisle seat, if possible
- Wear prescription compression stockings. Note that I said “prescription” hoses, not the ones you buy online. This is because regular sizes at the stores may not be the best fit, and you may end up overpaying for regular socks or, worse, choke your legs with very tight compression, which could potentially promote blood clots rather than prevent them.
- Do stretching exercises while sitting. Although foot dorsiflexion (toes up) improves venous return the best, leg stretching, ankle rotation, and foot pumps are also helpful.
- Take frequent breaks, walk down the aisle, or visit the bathroom frequently, even to refresh yourself.
The reality is that one does not develop DVT just by sitting, but some people may have an inherited risk factor that may predispose them to blood clots. In some people, the risks may be very evident (recent fractures, surgeries, or even use of contraceptives), but in some, the risks may not be as clear. Your doctor must do a thorough medical history to track the breadcrumbs that will lead to an accurate diagnosis. Only then you will receive the proper medical care.
I value your opinion. Let me know if this article is helpful to you.
Best,
Dr.E
PS: If you would like to know more about prescription compression stockings, read “Compression stockings: Dos and Don’ts”