The world can be a dangerous place for a cyclist. Pot holes, car doors and bike lanes that suddenly disappear when you most need them the most are all perils we have to deal with every day. But does the fact you ride a bike make you more likely to suffer a life-threatening illness? Economy-class syndrome has had a lot of press in recent years with cramped long-haul flights being blamed for the formation of deep-vein thrombosis (DVT) that can cause a stroke or pulmonary embolism. But when a study found 85 per cent of people suffering “economy class syndrome” were athletic and, particularly, endurance athletes it made it sound like any cyclist heading to the Gold Coast should pre-book their ambulance. But provided you take a few simple precautions, cyclists are at no greater risk of developing a DVT on long-distance travel than any other person. A DVT is a blood clot that forms in the deep veins of the leg. If it loses its attachment to the inside of the vein it can leave the leg and lodge in the lungs or the brain. DVTs can form because blood making its way back up the veins of the legs to the heart generally requires some mechanical help, and under normal circumstances contracting the muscles of the legs compresses the vein and forces the blood to flow. Small valves in the veins ensure the flow is toward the heart. Sitting still for long periods of time, however, allows blood to pool in the veins and there is conjecture that the confinement
of long-distance international flights may contribute to the risk of DVT. The real danger of a DVT occurs if the clot leaves the vein and travels through the circulatory system. A pulmonary embolism (PE) occurs when the clot has blocked off one of the main arteries to the lungs. It is estimated that 80 per cent of PEs are linked to deep vein thrombosis, with around one third of people who experience a major pulmonary embolism dying. The symptoms of a DVT may include pain and tenderness in the leg that can extend into the foot. The lower leg, ankle and foot can also appear swollen, red and warmer than normal. The risk factors normally associated with the formation of a thrombus include coronary heart disease, obesity, smoking, pregnancy, high-dose combined oral contraceptive pill, and, supposedly, sitting still for long periods of time. There is still some conjecture whether “economy-class syndrome” even exists with a recent Dutch study finding no link between DVT and long-distance travel of any kind, but there is now enough evidence from other studies that the syndrome is real and that travellers, in particular endurance athletes, should take precautions. There are several factors that could make athletes more susceptible to DVTs. Athletes could be more prone because they may
be travelling dehydrated after training or competition. Dehydration reduces the amount of plasma in the blood but the number of red blood cells stays the same so the blood becomes thicker and more resistant to normal flow. Ensuring you are adequately rehydrated before you fly may be enough to lower any risk back to normal levels. Avoiding alcohol and caffeine drinks while on board can help to keep you hydrated. There is also a theory that the severe fatigue and inflammation associated with endurance events can increase the blood’s tendency to clot. This is increased if there has been trauma to the lower legs as can happen in a fall. Another theory is that athletes tend to mistake the early symptoms of a DVT for a cramp or muscle strain and ignore the warning signs until it is too late. You could also adopt the sort of precautions that professional athletes like the English soccer team have by breaking long flights into two smaller segments and wearing compression stockings during the flights. If you’re still concerned speak to your doctor about taking half an aspirin before you fly. Aspirin stops platelets in the blood from initiating the clotting process and that’s why people at risk of heart attack or stroke are routinely prescribe up to 150mg (about half a tablet) of aspirin a day. Do all that and the only danger you’ll face
is the in-flight meal.

Take precautions
1 Wearing loose clothing
2 Avoid cigarettes and alcohol
3 Drink plenty of water
4 Move about the cabin whenever possible
5 Don’t sit with your legs crossed
6 Perform leg and foot stretches and
exercises every half hour

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