The fall of 2003 was an extremely busy travel period for me. The travel schtick began with doing contract work for the Active Network at the expo of the Hawaiian Ironman race. I stayed for the race, and the day after the race I boarded a plane back to Colorado.
After a short six-hour layover in Denver and a bag exchange coordinated with my husband Del, it was back on a plane to the Washington Dulles Airport for another layover. Then off I went to Frankfurt, Germany, Athens and finally to Vouligmeni, Greece. I traveled to Greece for the World Cup race that was the test event prior to the 2004 Olympic Games. By the time I arrived in Vouligmeni I had monster jet lag and cankles.
The urban-slang term "cankle" is loosely defined as an unfortunate condition where there is no discernable change in the diameter of the lower leg between the knee and the foot. The calf and ankle seem to blend together. There are various causes for cankles; my condition was caused by travel.
I was a little worried because I had never seen my legs look that way. They not only looked bad, they felt bad. Walking in my regular shoes felt strange and running was really uncomfortable. In fact, I couldn't run much at all.
My skin felt like the surface of a water balloon, and it took several days for my ankle bones to reappear. Randy Wilber, the U.S. Olympic Committee exercise physiologist that was doing work at the race site, told me that lower-leg swelling is common after long flights--even for athletes.
One of the recommendations that would be made for American athletes traveling to the Olympic Games would be to consider wearing compression stockings. He said the stockings really work to help eliminate lower-leg swelling. After talking to Randy, I decided I would not leave Greece without wearing a pair of compression stockings for the flights back to the U.S.A.
That experience made me curious about lower-extremity swelling and travel. I investigated and found that leg and foot swelling is quite common during air travel. Some people experience problems on shorter flights, while others do not experience problems unless flight time is four hours or longer.
Contributors to the swelling include inactivity, the position of your legs while seated, low cabin pressure, low humidity, dehydration and certain medications. A small amount of lower-leg and foot swelling that goes away quickly isn't a major problem, but there is a condition called deep vein thrombosis (DVT) that is a major problem.
DVT is a condition where blood clots form in the body's deep veins, particularly the legs. Sometimes a clot can break off and travel elsewhere in the body where it can cause major problems, such as obstructing a vessel in the lungs causing pulmonary embolism.
Airhealth.org says, "About 85 percent of air travel thrombosis victims are athletic, usually endurance-type athletes like marathoners. People with slower resting blood flow are at greater risk of stasis, stagnant blood subject to clotting. Also, they are more likely to have bruises and sore muscles that can trigger clotting."
I don't know that endurance athletes need to be paranoid about DVT, but it is good to be aware of the condition. To learn more about DVT, consult the reference list at the end of the column.
After my experience in 2003, I wear compression stockings for long bouts of air travel. I also use the compression stockings for long bouts of car travel where there will be minimal stops. The biggest reason I wear the stockings and take a few extra precautions during travel is that my legs feel much better when I arrive at my destination. If my legs feel good, my workout quality is improved and my overall attitude is much better.
Whether you're traveling for races or to holiday gatherings, this is a gentle reminder to be sure to take good care of legs when you're in the air or on the road.
Tips to Reduce Lower-leg Swelling During Travel
- Avoid wearing tight clothing, particularly around your waist.
- Drink enough fluid to keep your urine light in color.
- Include an isotonic drink.
- Try to move your legs and stretch your ankles once per hour. Take a short walk if possible. When you walk, the muscles in your legs contract and compress your veins which helps move blood back to your heart.
- Elevate your feet and legs when possible.
- Draw circles with your toes to rotate your ankles if you are stuck in one position and cannot walk.
- Avoid alcohol and sedatives because they both promote inactivity.
- Consider wearing compression stockings. Do not confuse compression stockings with support stockings. Compression stockings are graduated with much more pressure at the ankle and less pressure toward the knee. It is best to purchase stockings that require a lower leg measurement to be sure you get the appropriate size.
References