Revolutionizing Spine Care…Changing Lives

Health Risks of the Incredible Shrinking Plane Seat

Last year, Dr. Richard Guyer, an orthopedic spine surgeon at Texas Back Institute, logged more than 100,000 air miles. This means he knows a lot more than he wants to know about the misery and health risks of air travel.

With his specialized medical knowledge and his status as a (very) frequent flyer, Dr. Guyer’s thoughts on what the Wall Street Journal (WSJ) calls “The Incredible Shrinking Plane Seat” are experientially based. Recently, he offered several suggestions on how those of us who are planning that long trip to see relatives during the Thanksgiving and Christmas holidays can avoid some of the health problems associated with airline travel. If you haven’t traveled by plane in a while, commercial airlines have become what Dr. Guyer calls “sardine cans” and this situation may be getting worse.

Squeezing in One More Seat

In an effort to increase their highly profitable premium sections – first class and business class – the large air carriers have directed their manufacturers to make more room “up front.” In the process of expanding these premium sections, the economy class has “shrunk” because more seats have been added. Up until now, this reconfiguration has occurred only on planes that fly short trips. However, if recent reports from business publications and news networks are to be believed, this trend is likely to exacerbate.

International carriers such as American, United, Air France, Air Canada and Emirates Airlines have all been adding more seats in economy section and, rather than violating the laws of physics, they’re doing this by making the seats smaller. The October 23, 2013, edition of the WSJ noted, “Now the big carriers are cutting shoulder space by wedging an extra seat into each coach row. That shift is bringing the short-haul standard to long-haul flying.”

The standard size seat for long trips in the 1970s and 1980s was 18 inches. These were found on 747 jumbo and Airbus jets. The seats were widened on the 777, made by Boeing, in the 1990s and early 2000s. Now, in an effort to have more inventory to sell, seats which are only 17 inches wide are coming for these long-haul planes.

While it doesn’t seem this reduced seat size would make much difference, this change has had a domino effect.  It has resulted in more seats, smaller arm rests, more narrow aisles, more bumped elbows, less leg room and more grief for anyone traveling in the economy section. It might also lead to health problems, some of which are life-threatening. This brings us back to the road warrior of Texas Back Institute, Dr. Richard Guyer.

How Dangerous are Crowded Planes?


Most everyone agrees that air travel can be challenging, but can it also be dangerous to one’s health? In the opinion of Dr. Guyer: yes. He notes, “If a passenger is unable to move flying for several hours is a terrible experience. This crowded situation makes it almost impossible to rest, forget about sleeping!”

He added, “Plus, if the passenger has any physical ailment such as muscle strains, back problems, knee or hip problem, these will likely become intolerable after a long flight. The most dangerous condition that occurs when legs are immovable over a long flight is the potential for a blood clot to form in the leg and travel to the lung, causing a life-threatening situation.”

Is there anything that can be done to counteract this situation? Dr. Guyer recommends some exercise. “When I’m on a cramped plane, I pump my feet up and down while I’m seated. This gets circulation moving in the lower leg. I also make it a point to walk to the back of the plane every hour and then do toe-rises and other leg flexing exercises.”

He also suggests taking a “baby” aspirin before the flight. “The passenger should check with his/her doctor before taking this aspirin, but part of the problem of flying involves the extended sedentary position. These mild aspirins thin the blood just a little.”

What about back pain which can occur when a person is forced to stay in a cramped position for several hours? Dr. Guyer said, “If the passenger doesn’t move over change positions over the course of the flight, severe back spasms can occur and the best way to avoid this is to employ one of those airline blankets. Simply fold it several times and place it in your seat just above the hips. After 15 or 20 minutes, remove the blanket and repeat this process over the course of the flight. Changing the support on the back will nourish the muscles and keep blood flowing to the area. This will keep the back from stiffening up.”

What if there are no blankets left? “In a pinch, I have used my suit coat or overcoat rolled up and placed against the seat. The objective is to get a little different support on the lower back for a brief period.”

There Ought to be a Law

Even before the tragedies of 911, the airline industry had been highly regulated. Now, there are even more regulations – from onerous and some say invasive passenger pre-screenings to on-board meal utensils. Is it time for some type of airline regulation related to the size and comfort of the plane’s seats?

Dr. Guyer did not hesitate, “Absolutely. There is copious research supporting the positive effects of adding just 1 inch to the width of the seats. The airlines are transporting human beings, not just cargo and the health of these passengers is in jeopardy. If it takes an FAA regulation to make this happen, I’m in favor of it. It’s time the airlines start to use some common sense and common courtesy.”

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