Tips for combating aches and pains on long flights

For most of us, long flights aren’t exactly a fun experience. It's simply the only way to get to our preferred destination. When you land, however, you don’t want to feel like a pretzel, all tied up from sitting for hours at a time in an uncomfortable seat. It's one of the biggest issues with long-haul flights. We really shouldn’t be sitting in one position for such a great length of time. Our bodies aren't designed for it.

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It’s not just about being uncomfortable. Staying immobile on a flight can actually cause real damage to our bodies.

“Sitting for prolonged periods of time on a flight can wreak havoc on your body," said Dr. Karena Wu, physical therapist and owner of ActiveCare Physical Therapy in New York City and India. "It leads to joint stiffness, muscle tightness, fluid stagnation and issues with other organ systems like digestion, metabolism, fatigue and dehydration. The body fatigues when sitting fully upright for hours on end, and travelers contort themselves into awkward positions when trying to rest their body parts.”

New York City orthopedist David T. Neuman, CEO and co-founder of Pop-doc.com, stresses that sitting (or lying down) also slows the blood flow in the extremities of the body.

"This can lead to clotting of the blood in the veins (deep venous thrombosis) and can pose a severe threat to one’s health. A blood clot that travels to the lungs can cause shortness of breath, difficulty breathing and even death (pulmonary embolism)."

Here are a few things to keep in mind if you want to avoid aches and pains from a long flight.

Movement is key

Whether or not you have to get up to use the bathroom, Wu says it's important to move around the plane.

“I typically recommend that people stand up every hour to stretch their legs and decompress the spine a bit. The aisles of the plane are tight but any standing in place exercise can be done without bothering your plane mates too much," she explained. "Calf raises activate the calf muscles to help use them as a pump to help with venous return to the heart. Standing backbends help to reverse the curve in the low back and stretch the front of the hips open.”

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Frequent flyer Peter Shankman logs up to 350,000 miles a year, with many of those being on overseas flights. The futurist-in-residence for BluShark Digital said he knows the importance of moving around. He stands up every two hours, heads to the galley and drops for squats and or push-ups. Since this behavior may raise a few eyebrows, he points out that he first asks the flight attendants for permission. “So far I've never been told no,” Shankman noted.

Neuman says Shankman is doing the right thing. He shares that on a recent round trip from New York to Dubai on Emirates, he made sure to walk the aisles often and spend two to four minutes in the galley or near the bathrooms to perform some gentle stretching activities (lower back range of motion, heel raises, quadriceps stretch and others).

Exercise while sitting

You don’t want to sit in the same position for the whole flight. Instead, you also want to move around in your seat and even “exercise” a bit within your limited space. Wu says, “Movement and muscle activation help to combat aches and pains from sitting on a long flight.”

She recommends ankle pumps, knee straightening and knee lifts. She says these “can unkink the body and move the soft tissues around the joints.” Glute squeezes are also easy and “can help activate the hip muscles which are in an overstretched position when sitting.” The physical therapist often takes 14-hour flights from New York to Mumbai, India, so these are things she does herself.

“Any type of lower body movement and muscle contraction will help the stagnation of fluid in the lower extremities," she notes. "They help to pump the vessels so that fluid is not pooling down toward the feet.”

Neuman echos that, "By simply moving the toes (making a fist with the toes and then fully straightening them several times in a row) back and forth, and moving the ankles (up and down, side to side, circles in both directions) will stimulate blood flow to the feet and from the feet."

To avoid kinks in the neck, the frequent traveler also recommends neck motions: "There are seven planes of motion the neck moves in, and each can be done slowly, in control, and while seated."

Hydrate to keep cramps at bay

Filmmaker Cassius Michael Kim has already logged 50,000 miles in 2022 as he travels the world interviewing people. He just completed a 17,000-mile trip from San Francisco to Kuala Lumpur, Malaysia (via Singapore). He says one of the most important things on flights is making sure to hydrate. “There’s no easier place to dehydrate and cramp your muscles than on an airplane,” said Kim.

Shankman agrees, telling us he drinks as much water as he can handle and avoids the airplane meals. There's typically a lot of sodium in airline food, which can cause dehydration.

How to sleep on long flights

If you’ve ever slept on a long flight, chances are the first word you utter when you wake up is "ow."

Sleeping in an upright seat can be tricky, but Wu says, “It is best to not torque the spine, cross the legs or bend the joints into the extreme ranges of motion. This way you do not compress the tissues more, restrict blood flow or kink the spinal column.”

This may seem odd, but she stresses that the best position is a neutral one. “A lumbar roll (or your scarf, shirt or hoodie rolled up) in the low back can help keep the spinal column in the best biomechanical position to reduce stress on the intervertebral discs and low back muscles.”

Wu adds that “neck pillows and the headrest supports pushed out keep the head in a more neutral position but allows the neck muscles to relax enough to get some good rest.” Unfortunately, no matter what position you try, some people are unable to sleep in the coach cabin.

Kim says no matter what he tries, he simply can’t sleep in an upright chair. Instead, he tries to fly business class whenever he goes overseas. Clearly, a lie-flat chair is ideal to get comfortable, pain-free rest. He says on his recent flight to Singapore, he was fortunate to get a seat that folds forward into what the airline calls a spacious fully flat bed.

Related: Best business-class seats to book using American Express Rewards points

What to do when you get off the plane

When the flight ends, the recovery begins.

You don’t want to start your trip off on a sore note. After exiting the plane (perhaps as soon as you check in to your hotel room), Wu recommends mobility exercises like cat/cow or downward-facing dog into upward-facing dog to help mobilize the joints and restore appropriate muscle balance activation.

She says the sphinx position or McKenzie extensions (lying on your stomach or standing) can also help elongate the front side of your body and compress the backside. This helps restore the natural curve in the lower back. If possible, she also recommends light cardio and weights (or moderate to heavy if you're extremely fit). This will help to pump fluid throughout the body and tighten up the muscles and soft tissues: “Exercise your heart and skeletal muscles to help combat the stagnant nature of the long-haul flights.”