We talked to two specialists in aviation medicine who assured us that there is no reason why atmospheric changes in airplanes would cause feet to swell. Both assured us that the reason your feet swell up on a plane is the same reason they swell up on the ground—inactivity. Your heart is not the only organ in the body that acts as a pump; so do the muscles of the legs. Walking or flexing a leg muscle assists the pumping effect. On a plane, you are not only confined in movement but sitting with the legs perpendicular to the floor. If you sit for prolonged periods without muscular activity, blood and other fluids collect in the foot with the assistance of gravity. It doesn’t really matter whether you leave your shoes on or off during periods of inactivity. If left on, they will provide external support, but they will inhibit circulation, feel tight—and will not prevent feet from swelling, in any case. If you take your shoes off, you will feel more comfortable, but you’ll have a tough time putting your shoes back on, and most of us don’t take our shoehorns along on planes. The pooling of fluids in the feet can happen just as easily in a bus, a train, or an office. Most people’s feet swell during the day, which is why the American Podiatric Association recommends buying shoes during the middle of the afternoon. Many people require a shoe a half size to a full size larger in the afternoon than when they wake up. If your feet swelling becomes a problem, consider airplane aerobics. A few laps around a wide-body plane will do wonders for your feet and will build up your appetite for that wholesome and delicious airplane meal that awaits you
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