Alexandra MacKenzie, Occupational Therapist and Certified Hand Therapist at the Hand Therapy Center at Hospital for Special Surgery, answers readers’ questions on summer travel tips for joint pain.
Q 1. I’m going on vacation soon and I’m worried about the long flight. What can I do to make sitting for so long easier on my joints?
Being in any one position for a prolonged period of time is hard on our joints, especially in the small confines of an airplane seat. Joints require movement to stay healthy. Movement not only keeps the soft tissues limber, it also stimulates the production of synovial fluid that keeps the joints lubricated. If you can, ask for an aisle seat. This will allow you to stretch your legs out a little bit and it will also make it easier to get out of your seat more frequently. Keep the area under the seat in front of you clear so that you can stretch out your legs. Take walks up and down the aisle, and alternate sitting with standing. Sometimes a small pillow or towel roll placed in the small of the back is helpful for your spine. If you have a hard time standing from a low seat, bring a cushion to sit on which will raise the height of your sitting surface. While you are sitting, you can do what I like to call “airplane yoga.” No special equipment is required and you can move without disturbing your neighbor. Start with rolling your ankles in circles. Bend and straighten your knees one at a time. Sit up straight and gently rotate your body side to side. Reach up to the ceiling, the way you would stretch when just waking up and open and close your fingers all the way. None of these motions should be painful and doing them periodically during the flight should help you stay more limber than if you were just sitting still for several hours.
Q2. I have severe arthritis and I’m traveling to a non-English speaking country. What steps can I take to ensure I can find medical care for myself while abroad, should I need it?
Accidents and illness can occur anytime, even when we’re on vacation. Be prepared! Make sure you have all of your prescriptions filled prior to your trip. Carry a list of your medications with dosages and frequency written down. Ask your doctor or pharmacist to write down the generic equivalent as the name brand that you are used to here because the name brand may not be available in another country. Write down your medical history including any illnesses and surgeries, as well as the name and contact information of your physician(s). It is a good idea to get travel medical insurance prior to your trip because your own medical insurance is unlikely to cover out-of-country expenses. Travel health insurance is relatively inexpensive and may give you some peace of mind. Always read the fine print and make sure that things like medical evacuations and pre-existing conditions are covered. Purchase insurance from a reputable company – there are several websites that compare different plans and different rates: www.insuremytrip.com www.squaremouth.com and www.tripinsurancestore.com.
Q3. I’d like to do some tours while on vacation, but standing and walking for long periods of time can be painful. Any tips on how to stay comfortable?
If possible, call the tour company in advance to find out more details about the tour you are taking. Are there steep hills to climb? Are there elevators? What are the walking surfaces like? Cobblestones look pretty but they are hard to walk on for prolonged periods. Are there opportunities to sit and take breaks? Hiring a private guide or taking a smaller group tour may allow you to customize the tour more freely. This is helpful if you are feeling less ambitious once the tour starts and want to slow the pace. Taking bus or boat tours allows you to travel from sight to sight with less walking and you can also stay onboard if you are not feeling well. Many museums have wheelchairs that can be borrowed. Wear comfortable shoes and clothes that are easy to move in. Plan your trip for when the weather is a little cooler and for a time of year that there are fewer crowds. Don’t try to pack too much into one day, and if you had a heavy day of touring, allow yourself to take a day of rest and recuperation. It is okay to not visit every museum or historic site a city has to offer – sometimes it is fun to just sit and people watch.
Q4. Do you have any tips in terms of packing or carrying luggage?
Over-packing is one of the most common travel errors that people make. Do you really need to pack 12 pairs of shoes, that evening gown and all of your snorkel equipment? It is possible to pack less and still have plenty of variety in your daily wardrobe. When choosing what to bring, find out about the climate of where you are traveling to. Choose clothes that you can mix and match (for example, you should be able to wear each top with more than one bottom), choose clothes that are less likely to wrinkle or show dirt, and accessorize with a scarf or with jewelry. Don’t worry about bringing a different outfit for each day that you are there. People won’t remember that you wore the same outfit 3 days earlier (and so what if you did?). Most hotels, even in the most developing of countries, offer laundry service or can direct you to a local business who can launder your clothes. If you forget to pack something, it is likely that you can find it where you are going, and then you will have a souvenir! Comfortable shoes are very important – if buying a new pair for your travels, be sure to break them in prior to spending all day in a foreign country in them. There are many shoe brands that are comfortable as well as stylish and should follow the same rule as being able to be worn with more than one outfit.
Wheeled luggage bags are one of the finest inventions in our lifetime. I like bags with good quality wheels that can roll on either 2 wheels or upright on all 4 wheels. The luggage itself though does not need to be expensive. Cheaper luggage is usually lighter because there are fewer bells and whistles. If you are going to be doing any lifting of your bags, the bag itself should not be heavier than all of the great things that you’re bringing. I always like to leave room in my bag to bring back a little something to remember my trip by. However, if you find yourself doing some major purchasing, look into shipping items back home so that you don’t have to carry them around for your entire vacation. Even something as simple as spices can get very heavy very quickly. For maximal organization, I like to pack my clothes in lightweight nylon packing cubes. Rolling your clothes up prevents wrinkles and allows you to pack a little more in. A computer tablet is also great to bring on trips (just don’t forget that charger). You can fit many books, including your guidebook on your tablet and you can download maps and different travel apps. You can also make the print larger on a tablet, making it easier to read. No matter how many books you’ve downloaded, your tablet will still weigh the same!
Q5. I notice my joints hurt after I get off a plane. Anything I can do in-flight or after to help relieve the pain?
If you know that you are going to be in one position for a while, it is a good idea to stretch prior to getting on the plane. It may seem counter-intuitive to stretch before sitting still, but doing this will help condition your joints to the hard work of doing nothing and you may find that you can go a little longer before needing to stretch again. The airplane yoga described in the 1st question is always good to do in-flight. Any stretches you do should not be painful. Remember to move slowly and move in a range that is not painful. If you need to heat or ice your joints, there are single use commercial products available at drugstores or sporting goods stores. Drinking lots of water to stay hydrated will help your joints and muscles stay healthy. Bon voyage!
Alexandra MacKenzie OTR/L, CHT is the Section Manager of the Hand Therapy Center at Hospital for Special Surgery. Alexandra co-authored a chapter in the American Society of Hand Therapists. Test Prep for the CHT Exam (3rd Edition), and was a contributing author to “Smart Design: The Art of Splinting”, published by Hospital for Special Surgery. She is also an experienced and enthusiastic world traveler, most recently visiting India.