Holidays often mean long journeys; Here are a few travel tips!

Posted by Phil Heler, MD on July 23, 2019

The demands of holiday travel to your sunny destination often means lots of sitting, avoid a trip to an Osteopath on your well deserved break by following these simple tips.

We have eventually come around to that time of year when we finally enjoy a well-deserved break (if you haven’t already!). For many of us with younger families this probably means some form of travel as we seek to break our routines and get away from home during school holidays (and absorb the exorbitant price increases in travel and accommodation). As a family we generally have a staycation and go away on frequent small one or two-day visits around the UK.  I will certainly be fully engaged, and I anticipate carrying on with my weekly health related articles after the school holidays have finished.

Whilst on the subject of holidays, oddly enough we do see quite a few people at the clinic who unfortunately acquire upper or lower back pain during their holiday period. One of the single worst presentations I have ever seen at the clinic was a Canadian gentleman who flew to Manchester from Toronto and then had a whistle stop tour of Wales and Scotland over 10 days (we are only a small island after all!) and then pulled up at the Palace Hotel and, much to his detriment,  immediately  lifted his heavy suitcase out his boot. He was carried into the clinic that day by his two sons barely able to walk. He was due to give his daughter away at the church in Hartington two days later. Thankfully he was able to walk down the aisle after some intensive treatment, but I will never forget him bursting through the clinic door supported by two burly lads!

This is not what we sign up for when we go on holiday…a trip to the osteopath! The demands of modern-day travel mean we spend long periods of time spent sitting either behind the wheel of a car or cramped in an economy aircraft seat (if you turn left when boarding a plane this might not apply) or more than likely both. Sitting is clearly the common denominator.  Many drivers particularly, according to the RAC, report aches and pains from driving such as lower back pain, stiff shoulders and neck, headaches or leg cramps through prolonged use of the pedals. Prolonged exposure to driving has shown to be a clear risk factor specifically for lower back pain, with the risk dramatically increasing for anyone who drives for more than 20 hours a week. According to some statistics I have found on average we spend 31 hours behind the wheel in the UK, so it seems we are all at risk even without holiday! However, this risk still applies to a single journey to somewhere like Devon or Cornwall for example. In fact, our worst ever journey was to Exmoor which took us 9.5 We have all been there! However, it’s not just the act of sitting that is bad for our lower back, there are of course other associated car related injuries. Getting in and out of the vehicle can be uncomfortable for 10% of us people according to a study at Loughborough University. Reaching and pulling the boot door down to close is difficult for 12% people, while even turning to adjust headrests or adjustable seatbelt fixings can be antagonistic! That is before we take the suitcase out of the boot!

Let’s face it, many of us choose cars based on what they look like, the fuel consumption, safety, just about anything apart from how suitable they are for our backs and posture. Clearly car designs have improved but car makers can only do so much. The major problem is that the human body isn’t designed to spend long periods of time sitting down. Doing this is exactly what driving entails and the issue with driving is that it is combined with using our feet which means we can’t support or stabilise our lower body, as we might when sitting in a chair. We all think we know how to sit in a car, but it’s not as simple as you might think. In one survey I found while I was researching this article when asked, only 30 per cent of drivers sat in the right position in the car while driving, and just 42 per cent could identify the right position that they should theoretically be sitting in. Ergonomics, as many of us know, is the study of people’s efficiency in their working environment and the equipment they use. Vehicle designers use the same principles when designing car interiors, so that drivers can easily see and reach what they need to drive the vehicle while sitting comfortably. The RAC website recommends these cars for comfort. Some of the cars with a good reputation for comfort include:

But not everyone’s the same shape or size, so designs are often a compromise of the options that suit the most people. Below is a brief summary of advice from experts in driving ergonomics at Loughborough University and the Royal Society for the Prevention of Accidents.

  1. Make sure your seat is high enough to give you good vision of the road while still allowing clearance above your head. Your hips should be at least as high as your knees.
  2. Move the seat until you can easily push down the pedals fully.
  3. If your seat is adjustable, make sure your thighs are supported without pressure around your knees.
  4. Check the angle of the back seat, if you recline too far, you’ll have to bend your neck too much to face forward. Then adjust the lumbar support where possible so it comfortably fills the arch of your back. This can really help with lower back pain.
  5. If your steering wheel is adjustable, make sure you can reach it easily and that it doesn’t obstruct your view of anything vital on the dashboard.
  6. Adjust the head restraint so that it’s as high as the top of your head and as close to the rear of your head as possible to avoid whiplash injuries.
  7. Put on your seatbelt and make sure it is adjusted correctly so it is tight with the lap belt over the pelvic region and the diagonal strap over the shoulder, not the neck – adjusting the height of the fixing if possible.

One thing that is very easy to do is start slumping or get in the habit of driving with one arm out of the window or resting on the gearstick. Keep both hands on the steering wheel as much as possible, as this prevents one shoulder from having to work harder than the other, and the likelihood of twisting your spine. Position your satnav so it’s comfortably in a place that is easy to see without blocking your view of the road or making you twist your body awkwardly.  Take frequent breaks, the Highway Code recommends a break of 15 minutes at least every two hours. Use the break to get out of the car and change your position, take a walk, do some stretches if you find that helps. If possible, share the driving responsibility.

The other key issue is lifting heavy suitcases in and out of the car as demonstrated by my story at the beginning. According to the U.S. Consumer Product Safety Commission, more than 85,000 people were treated in emergency rooms, doctors’ offices, and clinics for injuries related to luggage in 2017. Injuries to the back, neck, and shoulder may be caused by struggling with heavy, over-packed luggage. Key to lifting is simply lift with your legs! Whether you’re picking up your luggage from the baggage claim carousal or throwing it into the trunk of a car, any serious, heavy lifting should be done through your legs and as opposed to stooping forward with straight legs and employing your upper limb. If a two-wheeler suitcase is your go-to travel piece, you may want to think again. Dragging a heavy luggage behind you is a big strain on the shoulder. A four-wheel carry-on or suitcase, on the other hand, can easily be rolled at your side. Keeping baggage close to the body eliminates unnecessary spinal and muscle stress so you’ll be more likely to arrive at your destination ache free! I am also less likely to see at the clinic!

Posted by Phil Heler, MD