What Are the Essentials for a Long Plane Flight?

After a trip to New Zealand, 24 hours of travel time door to door, I have learned a few things about the essentials needed to make your trip more comfortable.  Travel has changed a lot over the years and more people are flying.  So, your comfort on the plane will make a big difference in how you arrive at your destination. I found these items essential to being comfortable, or as comfortable as possible on a plane for a 15 hour leg, from Houston to Auckland New Zealand!

Starting with items from your head down to your feet-

  1. BLANKETS & PILLOWS. If you fly on a long flight the airline will provide a blanket and pillow. However, you will still need a neck pillow. Keeping your neck supported on the flight will make it easier to sleep. You ask why don’t I use the airline pillow? I do use it, but for my lower back. Airline seats have gotten smaller and have NO lumbar support. So I use the airline pillow to provide lumbar support. Then you will need a neck pillow to keep your head supported and prevent a stiff neck.
  2. NOISE-CANCELLING HEADPHONES. I didn’t realize how much the noise on planes disturbs your ability to sleep. My wife had a pair on our last trip and she let me try them. So I ran out and got a pair for this latest trip.  And I can personally testify that you sleep much better on the plane when you can block out all the noise for the engine and other passengers.
  3. CHANGE OF CLOTHES, Fourth is a change of clothes and socks in your carry-on. You never know if the plane will be too hot or too cold. So having a change of clothes will give you options to keep your body temperature at a comfortable level. And traveling for long periods increases our chances for spilling food or drinks on yourself if the plane hits turbulence, or the flight attendant has an accident. The extra socks are important so you can take off your shoes while you are seated. Taking off your shoes can help your feet and legs be more comfortable while flying.
  4. TOOTHBRUSH/TOOTHPASTE. When you travel for 24 hours straight, it’s nice to be about to brush your teeth along the way. Something so simple make you feel more refreshed when you get to your destination.

These are just a few tips to make your long flights more enjoyable and arriving at your destination more rested and refreshed.

What Happens to Your Body When You Experience Trauma?

Have you ever had a fall, injury or other trauma? It could be as simple as a fall off your bike, a slip on the ice, or something bigger, like a car accident. 

When your body experiences trauma there is a physiological response the body goes through to protect itself.  The body’s response is always the same if the trauma is severe enough. Here is a Trauma Flow Chart that explains the process.

Trauma Flowchart






When you have a TRAUMA to your body, an inflammatory response occurs to the injured tissues.  The damaged tissues create a chemical response in the body. Typically when your tissues are damaged by trauma the blood and proteins leak out of the blood vessels. These proteins attract water and cause INFLAMATION and swelling in the region of the trauma. 

This triggers an immune response that starts a change in the tissue structures.  The body starts laying down more collagen tissue to help repair the damaged area. The collagen is stiff, FIBROUS TISSUE that acts as extra support for the damaged area.  This tougher, denser tissue will start to RESTRICT normal movement of the injured area.

Typically, muscles and connective tissue are made up of elastin and collagen. The elastin give us flexibility and the collagen gives us stability.  So when we have a trauma the body tries to protect and support the area by laying down more collagen fibers, leading to a CHANGE IN TISSUES.

Because this change in your tissues is made up of stiffer, more ridged connective tissue, your normal function is impeded. Because we don’t have the same flexibility in the traumatized area, our body has to COMPENSATE for these changes.  The compensation leads to SYMPTOMS locally at the sight of trauma and in many cases, if left untreated, the symptoms can manifest anywhere in your body.

That explains why the trauma to your tailbone, when you fall on the ice, can lead to headaches, if left untreated.

Why Do Sprained Ankles Take So Long To Heal?

Have you ever sprained your ankle? Maybe twisting it on the edge of the curbstone?  If you have a minor injury to your ankle it can swell, turn black & blue, and sometimes be painful to walk on. But why does a simple injury like a sprained ankle take so long to heal?

To understand the complexity of an ankle injury you need to look at the anatomy.

The ankle is made of several bones held together by ligaments. The ligaments give the ankle stability and have less flexibility than a tendon or muscle. The tendons are what attach the muscles to the bones of the foot and ankle.

Depending on the severity or grade of the injury to the ankle, some or all of the anatomical structures can be damaged when you sprain your ankle. The tendons and ligaments are less vascular, meaning they have less blood flow.  This is because they are more like ropes or cables. In comparison, muscles are more like sponges and are more vascularized.

Circulation is one of the keys to healing. So, when you injure a tendon or ligament, it will take longer to heal because tendons and ligaments are less vascularized. A muscle, on the other hand, naturally has more blood flow which can promote faster healing. So a sprained ankle can take up to 12 weeks to heal if you injured the ligaments and tendon.

If you sprain your ankle it is best to use ice, rest, and elevate the foot and ankle to help reduce swelling.  Sometimes wrapping it with an ace bandage can reduced the pain when you walk. After your ankle starts to heal you may need to do some exercises to help stabilize your ankle. Watch this simple ankle exercise to speed your recovery.

How Long Will It Take?

How long does it take to get better? I get that question all the time in my practice, from patients seeking treatment for everything from headaches and back pain, to plantar fasciitis. Unfortunately, there is no easy answer to that question. There are several factors that have to be considered in order to provide an answer to that question. Let’s explore these factors and discuss when you should seek help in the first place.

Nervous executives waiting for interview

One of the first things I ask my patient about their condition is, “How long ago did it start?” I have patients who come to see me the day after a car accident. Then I have patients who tell me they have had back pain for the past 30 years! The length of time you have had this pain plays a large role in how fast you will heal. The quicker you can get treatment, the faster your body can heal. The longer you wait to seek help, the more your body learns to compensate for an injury. Compensation patterns will increase the amount of time your body needs to heal.

The severity of your injury is the second factor that has to be taken into consideration. The more severe the injury, the longer it may take to heal. If your injury is minor, your potential to heal fast is greater. But that is not always the case.

Other factors that need to be considered are:
• Your age
• How many other injuries have you had in your life
• Your activity level,
• Your diet,
• How well you sleep
• and your mental state – just to name a few
Now you have to take all these factors, and few more, and see how the pieces of the jigsaw puzzle fits together. So there is no easy answer to how long does it take to heal after an injury.

But the general rule is, if you’re not seeing improvement in your condition after an injury within 2 weeks, you should seek outside help. Now that being said, if you have an injury and a bone is sticking out of your skin, you may not want to wait 2 weeks to see if it starts healing!

How Does The Time Change Effect Your Body Clock?

According to the American Massage Therapy Association, research has shown that massage therapy can help improve mood, alleviate feelings of anxiety and depression, and reset circadian rhythms. The result? Improved sleep and more energy.

Back relaxing massage

Improved Mood

The Research: A randomized study of 34 women with stage 1 or 2 breast cancer examined how massage therapy impacted depression and anxiety levels. The massage therapy group received a 30-minute massage three times per week for five weeks, which consisted of stroking, squeezing and stretching techniques to the head, arms, legs, feet and back. The control group received no intervention. Study participants were assessed on the first and last day of the study, and assessment included both immediate effects measures of anxiety, depressed mood and vigor, as well as longer term effects on depression, anxiety and hostility, functioning, body image and coping styles. A subset of 27 women also had blood draw to assay immune measures.

 The Results. The immediate massage therapy effects included reduced anxiety, depressed mood and anger. Longer term effects included reduced depression and hostility, as well as increased serotonin values, NK cell number and lymphocytes.

Serotonin, a neurotransmitter with functions in various parts of the body, works to regulate mood, appetite, sleep, memory and learning.

 Better Sleep

In another study examining the effect of massage therapy on the adjustment of circadian rhythms in full-term infants, researchers measured the rest-activity cycles of infants before and after 14 days of massage therapy, starting at 10 days old and again at six and eight weeks of age.

Rest-activity cycles were measured by actigraphy, and 6-sulphatoxymelatonin excretion was assessed in urine samples at six and eight weeks of age. The concentration of 6-sulphatoxymelatonin in urine correlates well with the level of melatonin in the blood, and melatonin is what helps control sleep and wake cycles.

At 12 weeks, nocturnal 6-sulphatoxymelatonin excretions were significantly higher in the infants receiving massage therapy than those in the control group, suggesting that massage therapy can enhance coordination of the developing circadian system with environmental cues.

Do You Feel Tired All the Time?

Do you regularly experience one or more of the following symptoms?

  • Constant tiredness?
  • Poor concentration?
  • Night sweats?
  • Weight gain?
  • Lack of energy?
  • Forgetfulness?
  • Sexual dysfunction?
  • Frequent urination at night?

Sound like you? If so, there may be an underlying cause that could have a dramatic impact on your health.  Women often suffer from other symptoms of this disorder.


According to ResMed and Mayo Clinic, Sleep Apnea could be one of the reasons you have some or all of these symptoms. Sleep apnea is a disorder that causes your body to stop breathing while you sleep. It’s a potentially fatal condition, with harmful short- and long-term complications, affecting more than 1 in 3 men and 1 in 6 women.1

While snoring is still the strongest predictor of sleep apnea in men and women,6 not everyone who snores has it. And even more importantly, not everyone who has sleep apnea snores.

In addition, women often show subtler, atypical symptoms such as insomnia, morning headaches, depression and anxiety.7 These symptoms often lead to misdiagnoses, such as depression, insomnia, or menopausal side effects.8

Obstructive sleep apnea (OSA), which more than 80% of sleep apnea patients have, occurs when enlarged and/or relaxed throat muscles obstruct your upper airway, blocking air from entering and leaving your lungs.

When the muscles relax, your airway narrows or closes as you breathe in. You can’t get enough air, which can lower the oxygen level in your blood. Your brain senses your inability to breathe and briefly rouses you from sleep so that you can reopen your airway. This awakening is usually so brief that you don’t remember it.

You might snort, choke, or gasp. This pattern can repeat itself five to 30 times or more each hour, all night, impairing your ability to reach the deep, restful phases of sleep.

Long term effect of sleep apnea can be daytime fatigue, high blood pressure, increased risk of heart attack or strokes, risk of developing diabetes, liver problems, depression and memory loss. Lack of sleep can have a dramatic effect on your pain levers too.

If you have these symptoms, be sure to ask your doctor about whether you might have sleep apnea. There are simple tests to determine if you have sleep apnea. And treatment can be easy.



Does Your Shoulder Hurt? Here’s Why

Happy New Year! I hope your new year is off to a great start.

Do you know that more than 4.5 million Americans visit their doctors every year complaining of shoulder pain? Are you one of them?

The 2 most common injuries contributing to shoulder pain complaints tend to be rotator cuff tears and impingement syndrome.  Even though back and neck pain are the most common pain complaints we see in my office, shoulder pain ranks third.  There can be several reasons for shoulder pain, so it is important to find a healthcare practitioner who can evaluate your condition and treat it properly.  Read the rest of my blog if you want to learn more about preventing shoulder injuries.

The shoulder joint is one of the most mobile joints in your body.  But because of its mobility we lose stability.  A knee joint flexes and extends in one plane. Your shoulder joint flexes, extends, abducts, adduces, internally rotates, externally rotates and many combinations of these movements in many plans of motion. Anatomically, the only place the shoulder bones attach to the trunk of your body is at the sternum and clavicle or collar bone to breast bone. So it is more susceptible to injury because of its instability.

shoulder joint

Your shoulder bones are held to your body by only one small joint. The rest of the shoulder complex is held to your body by muscles, tendons and ligaments. So repetitive stress and strains can easily injure your shoulder.

One of the most common shoulder injuries is a tear to the rotator cuff muscles. There are 4 muscles that make up the rotator cuff complex. If those muscles are weak or tight they can be injured more easily. The pain from a rotator cuff tear unusually shows up on the side of your upper arm.

The other common injury for shoulders is call an impingement.  This is when the muscles of the anterior shoulder are too tight and pull the arm forward. This over stretches the tendons and muscles of the shoulder.  The pain from this injury usually shows up in the front of your upper arm.

This simple shoulder stretch can help keep your muscles relaxed and prevent injuries.

Click Here To Watch Video

shoulder ex

The other changes you need to make to prevent shoulder injuries is to not do excessive overhead arm movements  or any repetitive arm movements can cause repetitive stress and strain to the shoulder joint.  So be careful if your use your arm repetitively for anything from using a mouse on the computer to painting your walls in your house.  It’s always better to prevent an injury than it is to treat it after it is broken.

Why Do I Have All These New Pains?

This time of year, it is very common for strange and unknown pains to start showing up. Are you one of the thousands of people who suffer from unexplained aches and pains this time of year? I see a common pattern this time of year in my clinic. Patients are complaining about old pains showing up again or new pains appearing from seemingly nowhere. And most people don’t know why. If you want to know “the why” read on.

My practice is focused on treating pain and dysfunction. So it is normal for patients to call for an appointment because something hurts. But this time of year more patients are calling for an appointment because all these new and unexplained pains are showing up for them. They have new neck pain, shoulder pain, low back pain or even cramping and pain in their calves. I always ask, “What started the pain?” For most patients they can’t think of a trauma or injury that could have led to their complaint.

But after asking lots of questions and doing a thorough evaluation and treatment I usually can pinpoint the cause of these new complaints. I call it “Holiday Stress and Strain Syndrome”. This is the time of year when people are putting up Christmas decorations and preparing for the Holidays. They put up lights on the house or decorate the tree. So they are up and down ladders and reaching above their heads to hang lights or put up decorations. Sometimes it’s just many hours in the kitchen preparing the Holiday meals.

XMas lights

Anytime you are doing something new or different with your body it can put a strain or stress on it. So it is not a major trauma that causes your pain, but lots of little stresses and strains that become cumulative that start new pains or lead to old ones returning. Up and down ladders can lead to calf pain and leg cramps at night. Click here for a good stretch for your calf muscles.  Reaching over your head to hang lights can stain your shoulders. And looking up to decorate the house or tree can strain your neck. Even standing in the kitchen for longer than you normally do can lead to low back pain from having a weak core.
These are just a few of the complaints I hear this time of year. But remember mental and emotional stress can also lead to physical pain too. The mental stress of the Holidays can lead to headaches or low back pain, to name a few. Our mental state of mind has a physical effect on our body.

So you don’t have to have a big trauma or injury to start the aches and pains to show up this time of year. It can be due to the mental or repetitive stresses and strains that can cause pain to ruin your Holiday plans.

Are You Experiencing Swelling in Your Legs ?

If you have swelling in your legs, feet, arms or hands, you may have a problem with your Lymphatic System. What is your Lymphatic System, you ask? The Lymphatic System is called the “second circulatory system of the body.” Your heart, arteries, veins and capillaries make up your primary circulator system. This is the system that circulates your blood throughout your body, delivering oxygen and nutrients to every tissue, organ, and cell of your body.

Your Lymphatic System is called your secondary circulatory system because it picks up the waste materials and fluids of the body that can’t be sent back to the heart by your veins. This fluid needs to cleaned and purified before it goes back into general circulation. Your Lymphatic System conducts this purification, provides for the transportation of proteins throughout the body, and is the first line of defense against invading bacteria, viruses and toxins.

So why does this system have problems that can cause the fluids to backup and swell your extremities? There can be several reasons, and some include problems with your heart or kidneys. But I want to discuss the mechanical reasons you can have problems with your Lymphatic System, which are unrelated to heart or kidney disease.

Body Cavities

All your vital structures, arteries, veins, lymph vessels and nerve bundles run vertically in your body. You also have 4 horizontal diaphragms that divide the major cavities in your body. The 3 major cavities are your Cranial, Thoracic and Abdominal cavities. If any of these horizontal diaphragms are restricted they will prevent the normal flow of blood and lymph between these cavities. This can lead to swelling in your extremities.

A good manual therapist can evaluate your diaphragms and release any restrictions that may be contributing to the swelling in your legs or arms. You will also need to take corrective action to prevent the diaphragms from tightening back up after treatment. This usually includes corrective stretching and postural changes.

Brain Endurance and the Desire to Exercise

Endurance training causes new mitochondria — the “power plants” that use oxygen and glucose to produce ATP — to grow in your muscles.


This, in a nutshell, is why your endurance improves, because you’re able to keep your muscles aerobically fueled for longer. These adaptations take place mainly in the muscles you use during training: legs for runners, arms and legs for swimmers, and so on.


But the muscles aren’t the only place where oxygen and glucose are needed: at rest, your brain sucks up 20 percent of your body’s oxygen supply and 25 percent of its glucose. A neat new study in the American Journal of Physiology suggests that aerobic exercise causes new mitochondria to grow in your brain as well as your muscles, which has a couple of interesting implications. The study was done in mice: an eight-week treadmill running program produced the usual changes (increased time to exhaustion, higher mitochondria in muscles), but also produced a series of changes suggesting that new mitochondria had grown in the brain.


One reason this is significant is that figuring out how to boost mitochondria in the brain would be helpful for “various central nervous system diseases and age-related dementia that are often characterized by mitochondrial dysfunction.” That includes, for example, Alzheimer’s disease.


The other is the possible role of brain mitochondria in “central fatigue,” which the researchers define as “the progressive reduction in voluntary drive to motor neurons during exercise.”


The idea is that your body’s absolute top priority is making sure that your brain ALWAYS has enough energy. During intense exercise, your muscles are using oxygen and energy so rapidly that your brain’s oxygen levels start to drop. To prevent disaster, your brain automatically starts to recruit fewer muscle fibers for a given level of effort, so that more resources can be diverted to the brain. You experience this as fatigue: you’re pushing just as hard as before, but you’re getting slower/weaker. But if you have more mitochondria in your brain, you can make use of available energy more efficiently so you won’t have to shut down your muscles quite as soon.


Another interesting wrinkle in the discussion:

What they mean by “voluntary activity” is how much mice, when left to their own devices, decide to run on a wheel in their cage. Researchers have found that the “impulse to exercise” tends to decline with age — so before your body starts to fail, your brain just isn’t as enthusiastic about doing lots of exercise as it used to be. There are some possible hints here that this phenomenon could be linked to declining levels of brain mitochondria. In other words, regular exercise doesn’t just preserve your ability to exercise — it also preserves your desire.

  Alex Hutchinson