Long-haul flying… with an injury (and how to keep moving)!

Long-haul flying with an injury - Revive Physiotherapy and Pilates

Flying up at 30,000 feet and stuck in a tight economy class seat isn’t the best place to enable maximal injury recovery. For many people, sitting for long periods might have been the cause of their initial injury or even what flares up their pain. So for those lucky enough to be escaping the Melbourne winter, and heading to the northern hemisphere to warm up and catch some sun, this blog is for you… especially if you’re travelling with an injury!

In lieu of walking

Photo by Flickr user Michelle Robinson.

Before flying

  • Avoid heavy meals and excessive caffeine and alcohol consumption. Not only will this impede your digestion, it can cause increased dehydration and lead to poor sleep quality.
  • Walk around the terminal before you fly. This will allow you to stretch out your back and legs prior to take off.
  • Wear layers of loose fitting clothes. Not only does this mean you’ll feel most comfy when you want to sleep, it’ll ensure your clothes aren’t restricting your circulation or digging into already painful areas (especially around your hips and lower back).
  • Apply any stick-on heat patches (Hotteez can be purchased at Revive and last up to 12 hours), heat creams, and take any prescribed analgesia/anti-inflammatories.

What are DVTs?

Deep vein thrombosis (DVT) is a condition in which blood clots form in the body’s deep veins, especially in those of the legs. In some cases, if a blood clot breaks off and gets lodged in a lung, it can lead to a pulmonary embolism and sudden death.

Dehydration from the dry air of a plane cabin can cause the blood to thicken. Combine that with the immobility created by cramped seats and low cabin pressure, and you have a recipe for blood clotting in the legs.

Luckily not everyone is at risk, but your risk does increase after the age of 40. Conditions and circumstances that predispose you to clotting include:

  • cancer
  • chronic heart or respiratory failure
  • a predisposition to clotting
  • varicose veins
  • obesity
  • recently had major surgery, been bed-ridden, or endured a leg injury
  • recently given birth or are pregnant
  • taken oral contraceptives or are undergoing hormone replacement therapy

During your flight

For most people, walking is the number thing you should try and do whilst on board. Always aim for an aisle seat so as not to worry about disturbing your fellow passengers when you get up and out of your seat. As a rule, I advise every hour, but the more often the better!

On your long-haul flights, try walking up the aisle as far as you can, then – if you can – cut across to the other aisle and walk back as far as you can, then return. When you get to the back of the plane near the bathroom and out of the eyesight of other passengers, you might want to perform some standing exercises there too.

The issue you’re recovering from will determine what activity or exercises you should and shouldn’t do while flying. Check with your Physiotherapist as to which exercises are best for you!

Seated exercises

While you’re seated, loosen up your joints and promote circulation with these exercises:

  1. Ankle Circles

Raise your feet off the floor. Point your toes and move them around in a circle, moving one foot clockwise and the other counter clockwise. Repeat 20 times each direction.

  1. Foot lifts

Start with your feet flat on the floor. Keeping your heels on the floor, lift your toes up as high as they can go. Return both feet flat on the floor, then keeping your toes on the floor, lift your heels up as high as you can. Continue to alternate back and forth 20 times.

  1. Knee lifts

Bend one knee and raise that leg off the seat, lower the leg and switch sides. Alternate back and forth, 20 times each side.

  1. Side steps

Alternating sides and keeping your knees together, tap the inside of your foot to the side (it’s like doing the Nut Bush, but seated!). Perform this one 20 times each side.

  1. Knee-to-chest

Bend forward slightly and place your hands around the top of your shin, just below your knee. Pull the knee into your chest. Hold the position for 15 seconds, then slowly lower the leg back down. Switch sides. Repeat 3 times.
Seated stretches when flying

Image courtesy Finavia.

Standing exercises

Stretch your back out and get your blood pumping with these exercises:

  1. Calf raises

Hold onto a seat back or other sturdy object for support. Stand with your feet shoulder distance apart and slowly rise up onto your toes. Hold for 3 seconds, then slowly lower down. Repeat 10 to 20 times.

  1. Marching on the spot

Bend one knee, bringing it up as high as you can. Return to standing and switch sides. Repeat 20 times each side.

  1. Squats

Holding onto a seat or other sturdy object, bend both your knees and push your hips back as if you are going to sit down. Once half way down, straighten both knees again until you are back upright. Repeat 10-15 times.

  1. Sideways leg lift

Holding onto a seat or other sturdy object, lift one foot off the floor and take it directly out to your side, no more than 45 degrees. Ensure your knee remains straight as you lift the leg, then slowly return your foot to the starting position (be careful not to kick any fellow passengers!) Repeat 10 to 15 times each leg.

  1. Wall push-ups

Place your hands on the back wall of the plane or bathroom just below shoulder height and step back so your body is on a slight diagonal. Bend your elbows like you are doing a push-up, so your whole body moves towards your hands, ensuring your back stays straight, controlled and doesn’t sag, then push back to the starting position. Repeat 15 to 20 times.

  1. Quadriceps stretch

Bend one knee bringing the foot up toward your bottom. Keep your knees in line and take hold of the ankle of your lifted foot with the same-side hand. Pull the foot into your bottom, so that the knee is then pointing towards the floor. Hold for 15 seconds, repeat 2 more times then switch sides.

  1. Back arches

Standing with both feet just past shoulder width a part, place both hands on the back of your pelvis/hip bones. Gently push your hips forward and look up, causing your lower back to arch backwards. Hold for a second then slowly return to your starting position. Repeat 10 times.

  1. Forward bend

Separate your feet and bend forward at your hips, keeping a slight bend in your knees too. Reach your fingers to your shins or the floor. Hold for 5 seconds, and then slowly roll up to standing, vertebra by vertebra, to avoid light-headedness. Repeat 3 times.

Hopefully today’s blog answers a lot of questions about what to (and not to!) do to make your next long-haul flight a goodun’ when travelling with an injury (or without!). They should also help ensure you disembark your flight feeling energised for your well-deserved holiday!

If you are currently in pain or recovering from an injury, ask your Physiotherapist if these or other exercises are appropriate for you, as you may risk further pain or injury if performed.


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