Editors Choice

Travel? Don’t Forget This.

HERE’S ME: IPAD TO WATCH FILMS? CHECK. Kindle for reading books and the New York Times? Again, check. Chargers for all my gear. Got it. There is one more item that I bring, one that you too should consider: Compression socks.

Pre-Covid, I took a trip to Lugano (Switzerland) to attend a medical meeting. Great meeting, breathtaking scenery, and fabulous food. I won’t bore you with the story of how I missed a flight on Air Italia as I perched at the Air Italy gate in Milano.

The flights were long and suboptimal for my blood circulation. I always wear compression socks or stockings for longer flights to promote blood vessel (vascular) health.

Travel — Why compression socks?

You probably have seen compression stockings that gently squeeze around the legs at various lengths. Let’s explore how they work and why you should consider flying with them for long trips.

We begin with this important observation: Our blood flow through our veins and back to the heart is augmented by the pump of our calf muscles. Unfortunately, when we travel by air, we typically are not moving around a lot. As a result, our blood can become more stagnant, setting us up to develop dangerous blood clots.

The contractions of your calf muscles help blood get back to the heart.

Photo by Clem Onojeghuo on Unsplash

Compression stockings come in a variety of lengths. These socks gently squeeze our legs more than the usual type of socks. By doing so, you promote better circulation of the blood.

Foot surgeon Georgeanne Botek, DPM of the Cleveland Clinic (USA), reminds us that nearly 90 percent of leg disorders originate in the veins. Compression stockings increase the pressure in the tissues below the skin. Again, Dr. Botek:

“By gently squeezing the legs, compression socks increase the tissue pressure beneath the skin.” She adds that this “reduces excess fluid leakage from the capillaries, increasing the absorption of this tissue fluid by the capillaries and lymphatic vessels.”

Besides reducing swelling, compression socks can drop the ability of superficial veins to expand to fill with blood. This squeezing process can prevent blood from flowing backward and resulting in congestion.

So what’s the big deal with blood pooling in your legs? This process can result in skin changes, vein wall and valve damage, inflammation of the pools (thrombophlebitis), varicose veins, and blood clots.

While blood clots are not expected for most healthy folks, compression socks can keep your blood flowing nicely, reducing clot risk and symptoms like discomfort or swelling.

Compression socks — How to use them

Before you wear them for flying (especially for longer flights such as four or five hours or more), practice wearing them a few times beforehand, I put them on while I am waiting at the gate to board.

Action plan

Besides wearing compression socks, other ways you may reduce your blood clot risk include:

  • Wearing loose-fitting clothing.
  • Maximize your legroom by putting your belongings in the overhead compartments.
  • Hydrate with lots of water before and during your flight.
  • Minimize salty foods.
  • When possible, move — walk the length of the airplane every hour or so if you are on a long flight.
Photo by Johan Van Wambeke on Unsplash

Downsides

Compression socks may not be for you if you have skin that easily bruises or is compromised. For the vast majority of us, the socks are safe. If you don’t know if the socks are appropriate for you, please check with a valued health care professional.

Conclusions

Compression socks may make your long flight or car travel more comfortable. Your doctor may recommend compression stockings if you have a history of blood clots or insufficiency of your veins. You may be a candidate for a prescription pair rather than over-the-counter ones.

Finally, if you have symptoms of a blood clot (deep venous thrombosis or DVT), the condition can be life-threatening. Symptoms may include swelling in one or both legs. Some have persistent leg cramps, while others notice sudden redness or other skin discoloration to the leg. Clots sometimes cause veins that are red or swollen.

If you have concerning symptoms, please see a medical professional immediately.

Thank you for joining me today. Do you wear compression socks? If so, for long flights or car rides? With the pandemic (hopefully) winding down, do you have travel plans?

Michael Hunter, MD

I received an undergraduate degree from Harvard, a medical degree from Yale, and trained in radiation oncology at the University of Pennsylvania. I practice radiation oncology in the Seattle area.

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