Swollen Legs When Flying: 6 Questions and Answers

Have you ever gotten off a plane, looked down at your swollen legs — and become alarmed at their size?

Rest assured. It’s usually not a serious problem. Swollen ankles, feet and legs are common among travelers—especially older ones. With aging, many people experience edema (excess fluid buildup in the tissues) after long flights.

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This post, originally published in October 2016 has been updated. Due to the coronavirus pandemic, most international travel is currently on hiatus but this information may prove helpful when people start flying again.

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Although temporary, swollen legs can be more than unattractive. Depending on the extent of the swelling, you may experience discomfort from the stretching of your skin, or have a tough time getting your shoes back on (if you’ve taken them off during a flight).

What causes leg swelling when you’re flying?

The amount of legroom on flights seems to constantly be shrinking. And depending on the placement of your seat and the pattern of turbulence, it can be difficult to get up and stretch, especially on lights-out overnight flights across the ocean.

Being seated in one fixed position in a cramped space for a long period of time causes fluid to leave the blood and move into surrounding tissues. 

Is swelling more prevalent with age?

Aging makes many things more complicated, including leg swelling. Older people are prone to experience more significant swelling and tightness after long flights than younger people for a variety of age-related reasons. For example, their veins don’t circulate blood as well as they used to, and they are more likely to be taking certain prescribed medications (e.g. blood pressure-lowering medications like calcium channel blockers).

What can you do to prevent swelling?

There are a number of common sense ways to prevent or reduce swollen legs and ankles on long flights:

• Maintain a healthy body weight,
• Seek out flights and seats with more legroom, when possible,
• Limit salt intake on the day of and during the flight (I always wonder why airlines offer pretzels and salted peanuts with drinks),
• Keep hydrated and avoid excessive alcohol intake,
• Opt for loose, non-binding clothing, and shoes that easily slip off,
• Wear compression stockings,
• Avoid keeping your legs crossed for long periods of time,
• Wiggle your toes and move your legs in circles during the flight, and tighten and loosen your leg muscles, and
• Get up, move, and walk up and down the aisle several times during the flight (your bladder will thank you, too).

What do I need to know about compression socks?

According to an article in Healthline, there are three different types of compression socks: 

• Graduated compression socks, usually prescribed by a healthcare professional
• Nonmedical support hosiery (intended to provide support and improve circulation), widely available in stores and online
• Anti-embolism stockings, also prescribed by a professional, intended to prevent DVT.

Although compression socks aren’t likely to pose problems for most individuals, wearers do need to be cautious of potential skin problems (burning, chafing, bruising, and broken skin) that can lead to infections, and of any signs of impaired circulation on a long flight.

Note: Because long-distance air travel post-surgery can increase the risk of blood clots in the legs, travelers should consult their physician concerning how soon after surgery they can safely fly, and what precautions they should take to minimize the risk of DVT when they do. 

In general or orthopedic surgery settings, graduated compression socks have been shown to be a literal lifesaver. A meta-analysis of 19 studies involving 1681 individuals, found them effective in lowering the risk of DVT in hospitalized patients. More effectiveness research needs to be conducted on outpatients.

If your legs swell, what can you do afterward?

If your legs, ankles or feet are swollen after getting off the plane, it’s wise to elevate them (above your heart) to lessen the swelling.

Is swelling dangerous?

According to a recent publication from the Mayo Clinic, swelling caused by inactivity during travel (e.g. on planes or long car rides) is usually harmless. However, it is prudent to seek medical attention if you experience any of the following, especially if the swelling is frequent and persistent,:

• Swelling that is is red or warm to the touch (this could be a sign of a clot),
• Pain, tenderness or swelling in one leg (as opposed to both),
• Any chest pain associated with swelling, and
• Swelling that doesn’t dissipate after several hours of activity.

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Sources:

• Mayo Clinic: What causes leg and foot swelling during travel? 
• Healthy Advice: Preventing DVT when traveling
• Medline Plus: Foot, leg and ankle swelling
• PubMed: Prevention of edema, flight microangiopathy and venous thrombosis in long flights with elastic stockings
• Medical News Today: What can cause socks to leave marks on legs?

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