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| "PLANES, TRAINS AND AUTOMOBILES… Whatever the mode of travel, there are a number of problems that may arise from sitting in a confined space. Sitting immobile for prolonged periods of time can put considerable stress on muscles and joints. This can lead to feeling stiff, cramped and sore with a sense of fatigue after the journey. On long flights, circulation may be compromised in some people and clots (or deep vein thrombus) may form, leading to a serious and sometimes fatal outcome if the clot blocks a major blood vessel. Good posture plays a key role in the prevention of back pain and excessive strain on the joints, ligaments and veins. However, any posture, no matter how good it is, can become uncomfortable over an extended period of time. Therefore, it is important to make frequent posture changes to help minimize discomfort. The Canadian Physiotherapy Association recommends the following posture tips: • When travelling by car, wear a seatbelt and keep headrest lowered to a position that is in the center of the back of your head. In a plane or train, adjust the seat to an upright position so that your seat is at the back of the chair. If the hollow in your back is not supported, try a lumbar roll or rolled up T-shirt; • Keep shoulders in line with trunk and upper back to allow for even loading through the spine; • Hips and knees should be as close to a 90 degree angle as possible to maintain good spinal alignment. Depending on transportation policy, a backpack or other piece of carry-on luggage can act as a footrest to bring legs and knees to a comfortable height; • Position the arm rest so your elbows are bent to 90 degrees. If your arm rest is too low, use a small pillow under your forearm. • Shift your weight frequently to reduce prolonged pressure points when sitting, including moving hips and knees. If you're driving, change the angle of the steering wheel at rest stops as a way to change your sitting position. According to the British Medical Association, in a report entitled "The Impact of Flying on Passenger Health", travelers should occasionally walk or stand in the plane (depending on airline policy) or perform seated exercises, which have been shown to increase blood flow in the deep veins of the legs. Canadian physiotherapists recommend doing one exercise from each of the following groups before, during and after the journey, to maintain good general circulation, and decrease stiffness by moving the joints. Slowly stretch until a gentle tension is felt in the muscle (this should not be painful). Take relaxed breaths and do each exercise slowly. Repeat each stretch twice on both sides.Head and neck • Chin Tuck; tuck in chin, keeping head level, move backwards creating a double chin; • Head Turn; turn head over right shoulder and back to centre; • Head Tilt; bring ear towards shoulder without turning head or lifting shoulder; • Neck Bend; tuck in chin and slowly bring towards chest. Slowly return to start position; • Neck Extension; raise chin to ceiling and look up as far as you can. Slowly return to start position; Shoulders • Shoulder Stretch; link fingers together and push up with palms facing upwards; • Shoulders Back; squeeze shoulder blades together. Expand rib cage with each breath; • Shoulders Forward; cross arms across chest and hold back of shoulders with hands. Hug shoulders forward so that a stretch is felt between shoulder blades; • Shoulder Roll; Shrug shoulders. Make circles with one shoulder, then the other. Touch shoulder blades together and relax. Repeat three or four times. Trunk • Body Twist; turn body and head to look over right shoulder. Reach left hand across the body to hold on to top right edge of chair. Repeat on opposite side; • Back Arch; arch back until pelvis tilts forward. Try to breath normally; • Back Slump; slump forwards and bring shoulders towards knees as far as comfortable. Keep stomach relaxed. Pelvis should tilt backwards; • Body Stretch; find suitable location and stand with feet shoulder-width apart and as tall as you can. Push hips forward without losing balance and reach arms straight above head, linking fingers with palms facing upwards.Foot and ankle • Sitting Calf Stretch; keep left heel on floor, lift toes and the front of the foot as far off the floor as possible. Repeat on opposite side; • Foot Pumping; pump each foot several times, as if working a car accelerator, to bring back circulation to feet and ankles. • Heel Lifts; lean forward and rest elbows on knees. Keeping full weight on elbows, lift heels off the floor as far as you can, keeping balls of feet in contact with floor. Gently lower down and repeat several times; • Ankle Circles; lift left foot off floor and pull upwards and at the same time roll foot inwards. Then push the foot downwards and roll it outwards. Repeat 20 times on each side. For all seated stretches and exercises, sit tall in the seat with your ear, shoulder and hip roughly in line with each other, and feet slightly apart. Arms should be resting comfortably with your hands in your lap. Exercises should be performed on both sides of the body. It is especially important to remember to exercise if using a laptop computer or doing other work while traveling. Many people become so engrossed that they fail to take a break for hours at a time and end up with pain and stiffness in the neck or hands upon reaching their destination.
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