Ankle Oedema in the aircraft

Two weeks ago my girlfriend and I had the pleasure of flying home to Canada for a week to attend a good friend’s wedding. The flights took us a route home which was “backwards” more or less, however it did save us a little money.

Our flight path from Brisbane to Toronto:

  • From Brisbane to Perth
  • From Perth to Abu Dhabi
  • From Abu Dhabi to Toronto

This totalled a little over 30 hours of in air flying time. By the time I finally arrived in Toronto, I noticed that my ankles felt really tight while I was waiting at the luggage carousel. When I rolled up my pant legs, I noticed that both my ankles were significantly swollen.

During the flights I moved around as much as I usually would, up for a walk every couple hours, and tried to keep my legs/feet quite active even while I was sitting in the seat. I had hope this would be enough to prevent ankle swelling, however I was quite wrong.

So, why do our ankles swell when we fly, especially on those long trips? Is this dangerous? How do we prevent it?

Let’s start with why this happens. Whenever we are sitting for a long period of time in a plane, the muscles in our legs that are usually responsible for pumping blood and fluid back up are legs are not being used at all. Over time, this will lead to an increase in fluid and blood pooling in our lower limbs (ankles).

Additionally, on long flights in a low air pressure aircraft cabin, it is easy avoid drinking lots of water. Firstly, the stress of flights sometimes makes an alcoholic beverage a more appealing choice, and secondly a lot of people avoid too much water because they do not want to be getting up and going to the toilets on a regular basis while flying. This makes it very easy to become mildly dehydrated on airplanes. Being dehydrated can reduce your blood circulation, making it that much easier for fluid to pool in your ankles on those long flights.

Is this dangerous? The ankle swelling itself is not dangerous, however the reasons which cause it can also cause things like blood clots or deep vein thromboses (blood clot in your calf), which can be seriously dangerous and has the potential to cause death. So although the ankle swelling itself is not a reason for concern, the reasons which caused the ankle swelling is definitely reason enough to take it seriously and take any necessary precautions to prevent it.

How do we prevent it?

  • The biggest thing you can do to prevent poor circulation and subsequent ankle swelling is movement. Aim to get up on a half hourly basis (Assuming you are not asleep) for a walk around the cabin. Aim to be up walking for at least 3-5 minutes each time.
  • It is crucial to stay hydrated. This means drinking water before and during the flights. Even if you are having a glass of wine or a beer, try and also have a bottle of water on the go as well.
  • It is important to keep your feet and legs moving as much as possible even while you are seated. Pump your ankles from side to side and up and down on a regular basis.
  • Some people wear compression stockings while flying to prevent blood clots in their legs. There is evidence suggesting that wearing these stockings can significantly reduce your chance of a blood clot which is great, however it is important to remember that stockings are NOT a substitute for any other of the above precautionary measures, most importantly exercise and frequent movement on a plane.

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