What to Do When Flying Is Literally a Pain in The Butt (or Back, or Neck…)

Dr. Jeremy James: DC, CSCS

Having just gotten back from a very long 14-hour flight from Sydney, Australia, I can empathize with my frequent-flying patients who tell me that the worst thing for their back is a plane flight. Back and neck pain are extremely common during and after long flights. This is due to an unpleasantly (but appropriately) named process called creep. Simply, creep causes deformation in the ligaments and other tissues in your back and neck when they are subjected to load. As you sit in that impossibly cramped little airplane seat (who designed these things anyway), creep sets in and causes the various tissues in your back to change, setting you up for painful spasm during the flight and potential injury after the flight, especially when lifting that heavy suitcase. How can you fight creep? Move!

  • Change positions in your seat often. Cross one leg over the other, shift your weight from side to side, put a pillow behind your low back, even slouch from time to time (yes, it’s okay for short bouts).
  • Get up and walk. If you aren’t sleeping, get up and walk to the back of the plane. While there, try a few of these dynamic stretches and movements. Do this for at least five minutes. Try to do this at least every half hour if you can. Don’t worry, you won’t look crazy! I see more and more people doing variations of these when I fly now.
  • After you get off the plane, make sure you give your body as much time as you can to rebound from the creep process before you pick anything up. You won’t have time to fully recover as this takes several hours, but the more time the better. Walk around a bit if you have time. Stand for a while. This will minimize your chances of straining your back when you pick up that heavy suitcase. When you do lift, use your butt, not your back.
  • Remember that prevention and preparation are key. The proper, regular exercises build endurance in the postural muscles that support the spine resulting in a better defense against the negative effects of creep. Building endurance in the core is key. Practice these exercises as mentioned in my previous blogs.


Standing Hip Flexor Stretch with Gentle Back Extension: Ease into this position until you feel a slight stretch in the groin and thigh of the rear leg. Open the chest and gently extend the spine. Hold for five to 10 seconds while breathing. Repeat a few times then switch legs.

hip flexor stretch ​​Pec Stretch/Chest Opening: Use a corner or doorframe for this one. Place your hand on the wall and step forward until you feel a gentle stretch in the chest. Turn your head to the opposite side and slightly downward. Hold for five to 10 seconds while breathing. Repeat a few times then switch arms/legs.

pec stretch

Squats: Stand with legs shoulder width apart and feet forward or slightly outturned. Squat back at a 45-degree angle so that your butt drops behind you, not below you. Keep the back still. Then drive upward using the glutes to extend the hip. If you are doing this right, you should feel the muscles in your butt working more than the muscles in your thighs. A trick that can help activate the glutes is to push outward with the heels (“spreading the floor with the feet”) as you rise. This should make you feel the glutes working. Again, if your knees are dropping in you are probably not using the glutes. Do this for 10-15 reps.


Seated Relief Position: Sit with your buttocks at the edge of your seat. Spread your legs apart slightly. Turn your toes out slightly. Rest your weight on your legs and feet. Tilt your pelvis slightly forward and Lift your chest up, gently increasing the curve of your lower back. Turn your palms up. Breathe for 10 seconds. Repeat a few times.

seated relief position


As always, feel free to send us a message with all your questions about spine health and fitness at backinstitute@aspenclub.com. Good luck!

Out of Pain. Into Possibility. Jeremy James.