With international borders open and air travel back in full swing (albeit a few staffing shortages and delays), now seems like an appropriate time to discuss air travel and lymphoedema. When we fly, there are factors that impact on how quickly or slowly lymph moves around the body. Because of this, it is important to have strategies you can use if you have or are at risk of developing lymphoedema and are planning to fly.
Let’s have a look at what happens when we fly….
Altitude
Even though the cabin of the aeroplane is pressurised, it is not pressurised to sea level pressure. The change in pressure within the plane causes a few things to happen to our body. Firstly, our blood oxygen level sits slightly lower than normal which can cause us to become more lethargic. Secondly, our blood vessels relax and become more leaky resulting in more fluid in the tissues than normal.
Immobility
Depending on the length of your flight, you may be sitting for up to 14 hours in a cramped seat (unless you’re lucky enough to have a first class ticket). Despite best efforts, it is difficult to get up and move about on flights which can mean our muscle pumps are inactive.for long periods of time Our muscle pumps are responsible for 1/3 of our lymphatic movement so in some individuals this inactivity may be enough to cause swelling to worsen.
Extra activity leading up to and after flights
The lead up to and following a trip can cause extra work/ load on our bodies. Think activities like packing bags, cleaning the house, lifting heavy suitcases on and off conveyor belts and in and out of car boots. All these activities place extra strain on our body in a short period of time which can result in increases in swelling.
Dehydration
Aeroplane cabins run at a very low humidity level which causes our skin and body to become dehydrated. You would think this would mean less swelling for your body but in fact this can worsen swelling as your body tries to hold onto what fluid it has. In addition to this, aeroplane food can often be high in salt and depending on ones preference, drinks may contain caffeine or alcohol all of which can further the body’s dehydration.
Does this mean I shouldn’t fly?
No!
Like anything in life there are risks and benefits and it is important to weigh these up. Lymphoedema is a lifelong condition, you can’t avoid travelling to see family and friends or ticking off your bucket list items – this will only bring you resentment and reduced quality of life. What I recommend is balancing the risks with risk reduction strategies to minimise the impact on your condition.
Air travel risk reduction strategies
Wear your compression garment!
Compression will increase the tissue pressure to help prevent fluid accumulating in the tissues. Compression garments will also make our muscles more effective at pumping the lymph away when we do move. That said, compression garments must fit well as ill fitting compression can be worse than no compression at all. If you are not sure about what compression is needed, please reach out and we can assist with getting you fitted for compression that meets your needs.
Move your body and limb
Get those muscle pumps working to help push any fluid accumulating in your tissues back towards the heart. For arms that are at risk or have lymphoedema, open and close your hands, bend your wrists up and down and bend and straighten your elbows to stimulate your lymphatics. For legs, walk when possible, stand up and sit down from your seat when able, march your legs in sitting, bend and straighten your knees and point and flex your feet to get the lymph moving.
Take some deep breaths
Remember that deep breathing changes the pressure inside your chest which creates a pump effect to push lymph fluid back towards the heart. Deep breathing also increase your blood oxygen levels which can help to fight fatigue. Try to remember to take at least 10 slow, deep breaths every half hour to hour during the flight.
Reduce the load on your body in the lead up to travel
Instead of lifting bags, get a trolley, use bags with wheels and try to only pack a light carry on to reduce how much weight you are lugging through the airport. Try to prioritise what activities have to occur before you leave and what can wait until your return so that you are not overloading your lymphatics.
Keep hydrated
Make sure you are drinking plenty of water – it can be useful to pack a larger bottle of water so you don’t need to rely on airline staff to supply you with water. Try to avoid alcohol and caffeine as well as salty foods where possible as these can increase dehydration.
Self massage to arm or leg prior to flight and afterwards
Extra swelling from flights usually clears within 48 hours but to speed up the process, clear the extra fluid with self lymphatic drainage as per your therapists instructions.
If you have a pool, use it!
The water (hydrostatic) pressure on our limbs can help effectively move your lymph back towards your central circulation which will reduce the swelling in arms or legs. Walking in chest level water or swimming in the pool also activates our muscle pumps so its a win – win.
Enjoy your travels and remember if you are unsure about travelling or would like to discuss strategies specific to your condition, please reach out to us at Calm and Connection Physiotherapy on 0437 194 826 or email hello@calmphysiotherapy.com.au.
Until next time, safe travels.
Jenny Romanczukiewicz
Physiotherapist
ALA accredited lymphoedema practitioner
