Interview with Dr. Rahul Shah

If you travel frequently for business or pleasure, then you know it can be a pain—both literally and figuratively.

Even if you can’t control traffic congestion, you can take steps to protect yourself from travel-related pains. Dr. Rahul Shah, a board-certified orthopedic spine and neck surgeon in southern New Jersey, discusses the issue and offers solutions for healthier travel.

How can travel affect muscles and bones?

Travel poses an extra load on your system, such as sitting for a length of time, that you’re not used to. When that load mismatches what you can handle, then you have a challenge. For example, it’s physically hard to get to the airport two hours before takeoff and then wait another hour to board and then another on the tarmac before you take off. This can irritate areas that are potentially more prone to being fatigued.

And that’s just flying. With driving, you may be in a relentless stop-and-go scenario, and that can pose its own challenge. The third piece of this problem is luggage. Handling that amount of weight—lugging it in and out of a car, taking it from a conveyor belt, and potentially carrying pieces with you on a plane—significantly increases the load placed on the back, neck, and any other body part that holds the head over the pelvis, which often work harder to function in such environments.

What other physical health dangers exist with flying?

Sitting stationary for a long period of time can cause blood clots and potentially irritate and put stress on the hinges in the lower back. In addition, sleeping on a plane flops your head around, which can cause you to strain your neck and experience restless sleep.

And here’s an underdiscussed issue: overhead luggage compartments. Using them can cause strains, and a sizable number of injuries happen every year because suitcases from the overhead bins fall on people’s heads. So my advice is to be extra vigilant at the end of the plane ride.

Also, when you leave the plane, you may need to get your luggage off a conveyor belt. And bending and twisting to do so can be problematic because that’s where the lower back is very fragile—especially since you’ve been point-loading that area the whole flight, so your back’s already going to be tight.

Limbering up those areas with gentle stretching or walking will help. Walking, in particular, will send blood flow to the areas that need it, like the muscles in your pelvis, lower back, and legs, so that your body is primed and regains its harmony.

Do you have suggestions for long car rides?

If you’re nearing the end of a road trip, try limbering yourself up so that you’re ready for the postdrive phase. Also, taking bathroom breaks is helpful because they force you to get out of the car, walk, and move around, so you use your muscles. When you’re driving eight hours at a time with one very small break, you’re going to overfatigue the muscles inside your neck and lower back, so I would definitely encourage stopping at least every hour or so. If nothing else, when you’re at a stop sign or light, do isometric exercises for the neck, which will activate different muscles and help disperse the load. I do the same exact thing in the operating room if my neck starts to get stiff.

If someone’s physically fit, are they more naturally able to deal with travel?

They’ll have better resilience because their muscles are primed. Here’s the thing, though: it all depends on how mindful you are. If you are in great shape and torque to take a fifty-pound bag off a moving conveyor belt, you can still pop a disk in your back. You could be sixty-five or seventy and have a significantly arthritic back and take that same fifty-pound suitcase off the belt if you pay attention to the way you move. If you bend, torque, or twist with any load at any age, you could potentially wrench your back. Irrespective of what shape you’re in, if you’re not mindful, it won’t end well.

What tips do you recommend for all-day excursions?

Do activities like steps during the week before travel. It’ll prime your body for the rigors of the trip and help you handle additional loads, and it also makes you aware of your physical challenges.

Also, when you go on vacation, you don’t control your surroundings—the bed that you sleep in, the pillows you rest your head on, or when or where are you going. So I would recommend paying attention to things that you can control, such as getting adequate sleep. It may be helpful to take a pillow from home because it’s the one that works best for you, particularly if you have a very sensitive area in your neck or upper back. In addition, you should always stay hydrated.

Finally, know your limits beforehand so you can recognize when you start to fatigue. If you overdo it, you’re going to potentially trigger a whole cascade of events that might cause you to have problems. For example, say you typically take 4,000 steps a day at home. Now you’re at Disney and could do 14,000. By the time you get to 10,000 or 12,000 steps, your knees may suddenly bother you or you’ll tweak something because your body is trying to compensate.

What travel advice would you give to people with preexisting conditions?

Not all back pain is created equal. It’s important to get any back pain checked to make sure it’s not a symptom of another problem, such as with the kidneys or other internal organs.

Also, with back or neck pain, understand your limitations beforehand. If you know that you can’t lift more than fifteen to twenty pounds, great. If you’re not sure, test yourself. But don’t go in more than 4 or 5 percent increments until you discover what you can take to avoid tweaking an already fragile area.

If you have problems with your neck, one of the key things to do is avoid doing a lot of overhead activity. It’s uncomfortable, and whenever you put your arm over your head, you basically thrust your neck forward to act as a counterbalance. Finally, try to avoid doing one prolonged activity. After about twenty minutes or so, build in some rest periods or change up your activity so that your muscles don’t become overtired.

Overall, can travel make bad problems worse? Or, with the correct preparation and knowing your limitations, is it easy to manage?

The latter. A similar question is: How safe is it to drive the highway? It’s very dangerous, right? But most people do it quite well because they have the appropriate preparation and mindset. The same is true with travel because we live with our bodies all the time—nobody knows our bodies better than ourselves. If you make the best of what you have and prepare well, the odds are overwhelmingly in your favor to enjoy your travel.