The vast majority of patients we see in our office suffer from the effects of positional monotony, whether it be nine hours of Netflix, Stranger Things, eight hours behind a screen tediously picking through spreadsheets, seven hours of Grand Theft Auto in your simulated Mclaren, or six hours sitting in real traffic on your morning and afternoon commute through JBLM. When we endure these long periods of repetitive NON motion while sitting, we experience high tension without movement placing unique and unsustainable strains on our neck and back structures. And, as it turns out, we bring many of the same unwanted bodily displeasures as experienced with repetitive motion activities, such as sore necks, sore backs, muscle tension, trigger points, headaches, to name a few.
The simplest strategies for combating these related issues boil down to committing to continuous and frequent positional change. The mantra, “your next position is your best position”, is useful. How frequent you ask? A general rule of thumb is that no more than 20-30 minutes maximum should be spent in any one position without movement. What does that look like in a car without taking three days to get from Seattle to Portland? Move the back of your seat by ten degrees forward or backward every 10 to 20 minutes. Also, queue up some 1970’s R & B and dance in your seat to Earth Wind, and Fire, or Cool and the Gang. This will help prevent positional stress and sleepiness as well. In addition, commit to at least one rest stop for every two hours of driving. That doesn’t mean you have to pack a picnic, but do take the time to stretch and move your legs for a few moments and allow your back a reprieve from bending. This can be accomplished in less than a five minute pit stop.
We get a lot of questions about which supports to use while driving. This depends on many factors, such as, what kind of vehicle are you driving? What are the seats like? What is your back like? How long is the drive? In general, driving is a seated posture that removes the contour of your lumbar spine because your back is bending forward in this position. There are the traditional lumbar contoured back cushions that can help to maintain some contour. While this can help a bit, it’s no replacement for moving or changing positions frequently. Like with any chair, whether “ergonomic” or not, a car seat compromises your back when movement ceases for prolonged periods of time. An alternative to a lumbar contour cushion would be to fold up a hand towel into about a 6X6 inch square and place this directly under and behind your sacrum (base of spine). Many in car racing circles have found that sacral support prolongs comfort and staves off fatigue when driving for longer periods of time. Another useful support that we have prescribed for many of our commuters/travelers, is a foam wedge that is placed on the seat that minimizes hip flexion while seated. This improves your ability to maintain lumbar contour.
A few additional tidbits for making car travel more back friendly would be to bring an ice pack, throw it in the cooler, and after an hour into your travel, sneak it between your t-shirt and the seat back for 15 minutes. Do set a timer, as too much ice is not helpful, and neither is frostbite. Lastly, avoid reaching into the back of your car to lift an item, such as a purse or backpack to the front seat. As with most low back injuries, the combination of loading and rotating/bending your spine is sure way to bring on low back irritation.
Hopefully you find with a few basic actions, your car rides are smoother and you arrive at your destination with less back pain, and a little left in the tank for another dance.