ALEXANDRIA, VA, March 22, 2007 - The dangers of long flights in cramped quarters has once again been brought to the media forefront with the recent news of Vice President Dick Cheney being treated for a blood clot in his left leg following a travel-laden overseas trip. Two weeks ago, Cheney, 66, complained of minor discomfort in his calf after spending 65 hours on a plane during a nine-day, round-the-world trip.
According to Susan Scherer, PT, PhD, Associate Professor of Physical Therapy at Regis University in Denver and member of the American Physical Therapy Association Cardiovascular and Pulmonary Section, blood clots, called deep vein thrombosis (DVT), can occur after periods of being immobile, such as on long plane flights.
Scherer notes that the risk of DVT increases during travel of 8 hours or more1 and that an estimated 10 percent of passengers on long flights may develop a DVT.² A clot in the legs may dislodge and travel to the lungs, called pulmonary embolus. The symptoms of leg DVT include swelling in one or both legs and tenderness in the calf. Symptoms of a pulmonary embolus include shortness of breath and a high heart rate. “People who experience any of these symptoms should always see the doctor, especially if they occur following a long period of immobilization,” she says.
Compression stockings² are recommended to help reduce the risk of DVT. “The compression helps keep excess blood from remaining in the leg veins, helping to prevent clot formation,” says Scherer. Physical therapists also suggest that when you have little room to move and stretch, do some simple, seated exercises to keep the blood flowing, the joints mobile, and the muscles relaxed while en route. The APTA “In Flight Fitness Guide,” featuring a selection of recommended exercises, follows this release. The exercises can also be found on APTA’s Web site at www.apta.org.
“Simple exercise can help prevent other typical symptoms experienced by people who fly, including leg cramping, toe cramping, and general lower-body aching,” says former American Physical Therapy Association (APTA) President Marilyn Moffat, PT, PhD, DPT. “Sitting still for long periods may lead to swelling of the feet, which becomes obvious to many passengers when they try to put their shoes back on at the end of their flight,” Moffat says.
APTA suggests that passengers not stay seated for the duration of the flight and recommends that passengers walk up and down the aisle of the plane every hour or so to work the leg muscles and ease the back – that is, if the captain has turned off the "Fasten Seat Belt" sign!
"Performing these exercises will keep the leg muscles from contracting and will help relieve stiffness during the flight. The exercises also will help prevent fluid build-up in the legs, and stretching the back and the muscles around the torso will prevent stiffening," says Moffat. Moffat notes that if you have an existing back problem, appropriate guidance should be given to you by your physical therapist before any extensive flying.
"Sitting in such a cramped position also puts a lot of stress on the lower back, especially for people who have pre-existing back problems. If you have brought along hand luggage or a rolling case that fits under the seat, use them as foot rests to elevate your feet so that your knees are slightly higher than your hips when you are sitting,” suggests Moffat.
Another consideration while flying is the dehydration that occurs from the high altitudes at which planes fly and the dry, pressurized cabin air. These conditions may lead to muscle cramping and aching, so APTA advises passengers to drink plenty of water before and during the flight.
The American Physical Therapy Association (www.apta.org) is a national organization representing nearly 70,000 physical therapists, physical therapist assistants, and students nationwide. Its goal is to foster advancements in physical therapist education, practice and research. Consumers can access “Find a PT” to find a physical therapist in their area, as well as physical therapy news and information at www.apta.org/consumer.
1. Aryal KR, Al-Khaffaf H. Venous thromboembolic complications following air travel: what's the quantitative risk? A literature review. Eur J Vasc Endovasc Surg 2006;31:187-99.
2. Scurr JH, Machin SJ, Bailey-King S, Mackie IJ, McDonald S, Smith PD. Frequency and prevention of symptomless deep-vein thrombosis in long-haul flights: a randomised trial. Lancet 2001;357:1485-9.
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