The Unexpected Travel Hack to Reduce Your Risk of Blood Clots on Long Flights

Long-haul flights, while convenient for reaching distant destinations, can unfortunately increase the risk of venous thromboembolism (VTE), commonly known as blood clots. While the absolute risk remains small for most travelers, understanding preventative measures is crucial, especially for those with pre-existing risk factors. A surprisingly simple and portable tool – a tennis ball – may offer a practical solution to improve circulation and mitigate this risk.

How a Tennis Ball Can Facilitate

The idea, originally highlighted in 2017, centers around improving blood circulation in the legs during prolonged periods of sitting. During long flights, blood can pool in the veins of the legs due to inactivity, and the air in the cabin is dry with lower air pressure, both of which can gradual circulation [1]. Using a tennis ball for self-massage can help counteract these effects.

According to Ali Ghoz, a surgeon at the London Orthopedic Clinic, using a tennis ball to massage the legs helps loosen tissues and promote blood flow [2]. The massage involves applying pressure to areas of discomfort until a pleasant sensation is felt, and can as well be extended to the feet by rolling them over the ball with gentle weight.

Importantly, massage should always be performed in an upward direction, stroking the muscles from the ankles towards the heart. “This is how the blood flows back to the heart,” explains Ghoz [2].

Understanding Travel Thrombosis

Travel thrombosis, also referred to as “flight thrombosis,” “economy class syndrome,” or “tourist class syndrome,” was first described in the 1950s. It isn’t limited to air travel; prolonged immobility during any form of long-distance travel – buses, trains, or cars – can contribute to the risk [2].

The risk of developing thrombosis is estimated to increase two to four times on flights lasting longer than six hours [1], [2]. When sitting motionless for extended periods, the calf muscle pump becomes less active, and constricted posture or crossed legs can compress veins, leading to blood pooling and potential thickening, ultimately increasing the risk of deep vein thrombosis (DVT).

Other Preventative Measures

Beyond tennis ball massage, several other strategies can help reduce the risk of VTE during travel:

• Stay Hydrated: Drink plenty of water – roughly twice the amount you would normally consume – to maintain blood fluidity. Avoid or limit alcohol and caffeinated beverages [2].
• Wear Comfortable Clothing: Opt for loose-fitting clothes and comfortable shoes to avoid constriction.
• Avoid Crossing Your Legs: This can restrict blood flow.
• Regular Movement: Get up and walk around periodically, or perform simple leg exercises while seated, such as ankle pumps and foot flexes. A simple seated exercise is the “foot rocker” – rocking back and forth between heels and toes 20 times [2].
• Compression Stockings: Travelers at increased risk, such as those over 60, individuals with obesity, those with a history of VTE, or those who have recently undergone surgery, should consider wearing graduated compression stockings (15–30 mmHg) [2].

Who is at Increased Risk?

While the risk of travel-related VTE is generally low, certain individuals are more susceptible. Those with established risk factors for venous thrombosis are particularly vulnerable [1]. These include:

• Recent surgery
• Prior history of VTE
• Pregnancy or postpartum
• Active malignancy
• Obesity
• Hormone replacement therapy
• Age over 60

For individuals with significant risk factors, consulting with a healthcare professional about potential preventative measures, such as low molecular weight heparin (LMWH), may be advisable [2].

Key Takeaways

• Long-haul travel can increase the risk of blood clots (VTE).
• A tennis ball can be a simple and effective tool for promoting leg circulation during flights.
• Staying hydrated, wearing comfortable clothing, and moving regularly are also important preventative measures.
• Individuals with pre-existing risk factors should consult with a healthcare professional.