Stay Healthy and Pain-free while Traveling

Preventing pain and discomfort while traveling:

An interview with Mary Ann Wilmarth, PT, DPT, MS, OCS, MTC, Cert MDT

drwilmarth

Do you spend lots of time traveling by car, bus, train or airplane? Have you experienced (or are you concerned about) the potential physical impacts of such frequent travel? Read on for advice from a highly experienced Doctor of Physical Therapy on physical impacts of travel and what you can do to keep your body healthy and happy while on the go. Let us know in the comments if you find this information helpful and if you have more questions!

I’ve traveled about three times more than usual in the past 12 months. Between scholarly activities and fitness blogging, I’ve been to Nuevo Vallarta (Mexico), Milan (Italy), Savannah, GA, Anaheim, CA, Singapore, Minneapolis, MN, Chicago, IL (numerous times) and a few more places I can’t remember right now! Upcoming trips include Phoenix, AZ, maybe New Zealand, Ghana, Los Angeles, CA, and….I’m already tired, so I’ll stop there. As you may know, staying fit and healthy (and hydrated!) can be a challenge during frequent travel and I’ve certainly felt some negative effects.

So, you can imagine my excitement when I received the opportunity to talk with Mary Ann Wilmarth, PT, DPT, MS, OCS, MTC, Cert MDT about how to take care of your body and stay healthy while traveling. Dr. Wilmarth is the chief of physical therapy at Harvard University and owner of Back2back Physical Therapy, whose mission is to optimize function via body balance. Dr. Wilmarth is also a member and spokesperson for the American Physical Therapy Association (APTA). You can learn more about Dr. Wilmarth here.

Details of my interview with Dr. Wilmarth are below. You can find other useful information at the APTA’s website, www.moveforwardpt.com. There are tips available on lots of different topics, such as: Running, Healthy cycling, Avoiding overtraining, Soreness vs. Pain, and How to recover from a workout. You can also follow Move Forward on Facebook and Twitter at:

Twitter: @MoveForwardPT

Facebook: http://www.facebook.com/move4wardpt/


 

One of your specialties is optimizing function via body balance. What does that mean?

My focus is on keeping the body balanced – front to back and side to side. I get the body in balance so that you can function, whether it’s at work or at play. So that whatever it is that you’re doing, you can do it as best as you can. But, we have to start by balancing the body.

Do imbalances in the body ever come from frequent travel, such as travel by car or airplane?

Absolutely. I see it all the time now. People are traveling so much on a daily basis; so many people are: (1) traveling to work, (2) traveling on planes every day to work, (3) commuting or traveling to conferences, (4) traveling to do speeches, and things like that. It’s so much more prevalent than it used to be.

What are some of the physical or general impacts of frequent travel? 

One of the things that I see is imbalances with posture; Posture issues often develop when people have problems with their necks and low backs. Some of those problems come from sitting on planes and trains and cars – none of those seats are good for your low back. The seats don’t provide enough support, and so they cause problems with the low back that can lead all the way up into the upper back and neck.

Particularly, if you’re frequently sitting in airplane seats for hours on end, your low back isn’t supported and your neck’s kind of crunched forward. As a result, all your muscles and ligaments are overstretched in the back, making your back less strong. Even though people may exercise regularly, sometimes it’s not enough to balance or to overcome the time that is spent sitting in those seats, throwing the back off balance. So, it’s important for people to make sure that they have adequate back support when they’re sitting in their car or on an airplane. One way to do this is by using a cushion – such as a pillow, airplane blanket, towel, scarf, sweater, etc. – placed behind the low back area. It’s also important to have something behind the neck – like a neck pillow or head rest -  to make sure the neck is in a neutral position.

In addition to lumbar support, are there any stretches or exercises pre-flight or post-flight that we should do?

Absolutely. You should definitely stretch out your calves. That’s most important when you’re flying, especially for things like preventing blood clots. Be sure to stretch your calves both with the knee straight and with the knee bent so you’re hitting both the gastroc and the soleus. Also, do ankle pumps and circles throughout the flight to make sure the muscles are moving and getting blood flow.

Another thing to do before the flight is stand up, put your hands on your hips with your fingers placed as if they’re going in your back pockets, and then gently arch back so you’re getting some extension in your low back. As you’re arching back, you’re getting a gentle stretch on the front of your hips. Stretching in this manner is the opposite of your positioning when you’re sitting in your seat and can help to balance the effects.

Christina’s note: See an example of this stretch at http://www.yogabasics.com/YB-NEW/wp-content/uploads/2013/12/StandBackbend_9559.jpg

I’m 6 feet tall and I get a lot of discomfort in my hips and legs when driving and when traveling by plane. Why does that happen for taller people?

Part of it can come from tightness that starts from the low back going into the leg. It can also come from pressure against the hips and legs from the seat. The other part can come from obstructed blood flow,  so on the flight it’s important to: (1) make sure you have enough water so you’re not dehydrated at all, (2) do the other stretches that I mentioned, and (3) make sure you’re getting up and moving around frequently.

Another thing you can do is a hip flexor stretch when you’re on a plane. This will help because the hip flexors get really tight when you’re sitting there for long periods of time. When you’re doing a quad stretch, tighten your abdominals at the same time, then you’ll get a more intense stretch.

You can even put one foot up on a chair and tighten up the abdominals at the same time and you should feel it all the way from the abs down into the hip flexors down into the quads and that will really help to loosen things up. And if you do that every time you get up from your chair, it should help for you.

Another one that I like: if you have a chair or something that’s about chair level, put one foot on the chair, then lean into the leg on the chair, for a nice stretch. Then turn your upper body outward as you lean into the chair so you’re getting an extra rotation of the hip. This way, you get a good chest stretch, and then when you rotate outward, you get a buttocks stretch and the front of the hip [stretch] on the other leg as you’re standing and it’s kind of like a win-win. You can even do this on an airplace if you’re in an aisle seat.

Christina’s note: See an example of this stretch at http://exercisemenu.com/lsuhep/wp-content/uploads/2012/09/Roational-Hip-Flexor-Stretch.jpg 

We’ve already talked about how bad the seats are, but then when you put the seat tray down and try to work on a computer or otherwise do things using the tray, how much does that throw off your body alignment?

Good question. It depends because, if you’re lucky enough to have all the stars in alignment and everything in your body fits and the tray can move forward and you’re in neutral so that your shoulders and hips are lined up when you’re sitting and you can put your laptop there and it all works out, then, lucky for you, go for it. However, I’ve had lots of patients who’ve used the tray just because it’s there and it doesn’t fit them at all; they’re just working on these long flights and end up having pain that can turn into chronic pain because they just kept focusing on their work and not proper care at all. So you have to be careful with that.

What I usually recommend for my patients is to think of ear, shoulder, and hip in a straight line when you’re sitting and having support for your low back. Then see how close you can get the tray to you, and if you can keep your elbows by your side while you’re typing, you’re fine. But if you can’t, then what I usually recommend is to bring your laptop bag, or something that’s firmer, with your laptop up onto your lap so that you can type with your hands by your side and spine neutral (not reaching forward). When you’re sitting in a neutral position with a good neutral spine position, there’s a study that shows you have about 140% of your body weight in your low back. As soon as you lean forward and get out of that neutral position, it can go up to about 185%, so you want to stay in that neutral position as much as you can.

You mentioned staying hydrated by drinking enough water. Does what you eat before or during the flight matter at all?

It does. And that can be a little bit more individualized for people, but I just recommend that you know your body and what works well for you and don’t start experimenting on flights. Know things that you tolerate well on a flight and eat it before the flight and on the flight. And if there’s any kind of allergies or things like that, then you don’t want to deal with that when you’re flying.

In general, were there any other tips that you wanted to share?

The most important thing is to make sure people keep moving, whether you’re on flights or cars or whatever motor vehicle you’re traveling in. The body likes movement, so whether you’re doing fifty easy stretches or actually getting up and moving, you want to keep the blood flowing, the muscles working, and the body in alignment when it’s resting. Balance those two things – (1) keep it neutral when you’re resting and (2) move as frequently as you can.

Usually, getting up every thirty minutes, even if it’s just standing, doing a couple of stretches and sitting back down, helps a lot. And stay active during your trip, even if it’s just with simple exercises using your own body weight. People often say, “Oh, I can’t exercise when I’m away.” Well, walking is the best exercise that you can do anywhere.


 

If you would like to contact APTA to talk with a physical therapist on other topics, contact Erin Wendel, Senior Media Relations Specialist, at erinwendel@apta.org.

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