It’s hour five of a cross country flight, and you’ve got a problem. No, not the kid kicking the back of your seat. It’s your ankles: they’re as red and puffy as a pair of birthday balloons. Your feet won’t fit back into your shoes, and your calves are starting to ache.
You’ve fallen feet-first into one of the most common issues of frequent flight, and there’s no undoing it now. You’re just going to have to lace up those now-too-tight shoes and get on with your day.
Or are you?
Sitting for a long time is bad for you
Before we starting talking solutions (hint: compression socks), let’s talk about why this happens in the first place.
Roughly 100,000 times per day, our hearts send oxygen rich blood out to our muscle and organs through the arteries. Once our bodies absorb that oxygen, the veins send it back to the heart and lungs to be re-oxygenated and make the trip again.
But: the heart isn’t strong enough to force the blood back up your veins by itself.
Even under the best of circumstances, they need some help to get all of that spent blood back to the heart, which they get from a clever combination of one-way valves and the muscular action of your moving legs — when the muscles contract, they squeeze the blood and cause it to move, much like your heart would.
When you bend your knees, smash a bunch of bodyweight onto your thighs (where several of your most important veins live), and then don’t move those legs for 4-6 hours, this ingenious system of one-way valves can’t do its job. Low-oxygen blood pools in your feet, ankles, and calves, causing swelling that can stick around for days.
Thankfully, the commonly cited threat of Deep Vein Thrombosis or Thromboembolism is probably not a concern for people not already at risk. But: this swelling can impair exercise performance, make your shoes tight and uncomfortable, and even increase your likelihood of varicose veins (which happen when one of those fancy one-way valves blows out).
Preventing the problems of sitting for too long
To be clear, we’re talking about sitting for a single, specific long time, not sitting all day, every day.
You’ve probably heard how sitting too much is outrageously bad for you. Those reports aren’t wrong: extended daily bouts of sitting are a risk factor a whole host of gnarly problems, including increased fat mass, elevated blood pressure, and higher likelihood of death from any cause.
But, these are the chronic problems of sitting too much — the byproduct of sitting too much over the course of years or decades. You don’t develop them over the course of a flight from JFK to LAX.
The swelling we’re talking is an acute problem; one that happens relatively quickly as a byproduct of sitting too long, but also goes away pretty quickly. The nice thing about acute problems? They have acute solutions.
1. Wear Compression Socks and/or Tights
Compression gear is the single best purchase you can make to improve your in-flight and post-flight quality of life. Way more valuable than an inflatable neck pillow.
It works by gently squeezing your feet and legs (more at the bottom, less at the top), which helps return spent blood just enough that your your veins can do their jobs without any leg movement.
If you take one thing away from this article, have it be this: wear compression socks. Or compression pants. Or both. They can be worn invisibly under your regular clothes. The very best ones cost like fifty bucks, and some are as cheap as twenty. They are very, very, very fucking worth it. All of the other tips are supplemental.
Before compression socks, I just accepted that achy, heavy-legged feeling that started in the air and lasted for a day or more after as part of flying — and because I was flying 2+ times a week, I was living with this problem for four or more days a week, every week.
I pretty rarely gush over gear, and I’m loathe to describe any tool or object as must-have. This is a rare exception — compression gear is in fact a must-have for any flight over two hours. It really does help that much. Heck, there’s even clinical research that proves just how great it is at almost completely counteracting lower extremity swelling.
A couple of recommendations for when (not if) you go shopping:
- Go for high-calf compression socks, or tights with a full-foot covering.
- Look for a rated pressure gradation of around 20-30 mmHg — without this rated gradation, you’re just wearing expensive stockings.
- Carefully read the sizing charts when you buy, and measure your legs if necessary. Compression gear needs to fit almost perfectly to work correctly.
- If you’re looking for a recommendation, I’ve linked to a few options below. I don’t claim that these are the definitive best, just ones I actually own and know do the job.
- Go2 Socks come in a variety of fun (and plain) colors, and are machine washable — I own a few pairs of each. (ps: that’s an Amazon affiliate link, which means I get a small commission if you use it. Here’s a non-affiliate link if you prefer.)
- Physix Socks (non-affiliate link)
- Absolute Support Tights (non-affiliate link) are the tights I own. Here’s a comparable women’s pair (non-affiliate link) that I can’t personally vouch for, but meets all of my requirements: 20-30 mmhg, foot covering, good reviews.
- You can also get compression tights that don’t have a foot covering and wear them over compression socks, although this combo can get a little warm.
2. Don’t sit, as much as possible
Get up and walk around at every opportunity. It won’t do enough to stop the problem entirely (and won’t reduce your risk of blood clots), but it’s better than doing nothing at all — I’ve personally found it to help, and a variety of medical professionals recommend it.
That said, don’t freak out if you’re in a window seat or trying to get some sleep and can’t get up every 20-30 minutes. It’s preferable, but it’s not make-or-break.
3. Stay Hydrated
It may sound counterintuitive that you can drink more water to reduce swelling, but it really is the case. Hypohydration (the technical term for non-critical dehydration) slows the return of spent blood.
Why? When the body doesn’t have enough water, your blood is literally thicker, which means the heart can’t push it around as well. The problem you already had with pooling blood in your your feet and ankles gets worse, because while just as much blood is going in, even less can escape . Drinking more water prevents this.
Undoing the Damage
If you found this article because you’re currently suffering from swollen, achy airline ankles, I have some bad news: there’s no immediate remedy. It’s gonna take at least a few hours for that feeling and swelling to go away, no matter what.
But we can speed up the process. Here’s how:
You know the scene at the beginning of Christmas classic Die Hard where hero John McLane’s seatmate tells him to take his shoes off and “make fists with his feet?”
Turns out, it’s not just a convenient way to get Bruce Willis barefoot for the third act — moving your feet, legs, and ankles really does loosen up stiff tissues and start helping your veins push blood back towards your heart.
Movement is the single best way to quickly recover, although some light jogging, jump-rope, or just jumping up and down are all better movement options than feet-fists.
This works for the same reason movement does — the problem is caused by blood pooling in your feet because your veins couldn’t fight gravity without some help. So, give them some gravitational assistance by putting your feet up, ideally higher than your heart (the classic example is lying in bed with pillows under your feet).
Yep, all of the same things that can prevent swollen legs can also help fix them, again for the same reasons: they help your veins get the excess fluid out of your feet and calves as quickly as possible, even after the fact.
So go buy some compression gear. You can thank me after your next flight.