Your heart pumps blood through arteries, but it’s more difficult to get that blood pumped back to the lungs and heart though veins, especially against gravity. Down with a push is easy, up without one is hard.
Your muscles do some of the pushing back. When you move and walk your muscles squeeze and provide some pressure to your veins.
But when you’re sitting in a seat… for hours… with your legs bent… sometimes the blood backs up, and it can clot up. (It’s called thrombosis.) It’s not super common but if you’re older, or pregnant, have cancer, or dehydrated, the risk of it happening is higher. Thrombosis can dissolve in its own, or it can be fatal.
Solutions are to get up an walk during the flight, flex your legs and feet, wear compression on your legs to help the ‘push’ back up to your lungs and heart, and stay hydrated. If you’re particularly at risk, your doctor might prescribe anticoagulants.
Compression is one thing that can help lower the risk of a blood clot in your veins.
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