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Health & Exercise Forum


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Sep 27, 2022

As more of us become more comfortable living with COVID 19, travel plans have exploded. For 2 ½ years many have put air travel for family vacations on hold and we are eager to get back to air travel. As you may have gathered from my previous columns, travel is one of my passions. My family and I have been fortunate to have visited many spiritual places of natural wonder and beauty that we call our National Parks. Many of the parks are on the west coast and require some preparation to endure the many hours of travel by airplane through different time zones. Moreover, travel to other countries and continents, often requiring 8, 10, 16 or more non-stop hours on a plane can really take a toll on your mind and body and gave new meaning to the term “jet lag.”  


According to the Mayo Clinic, jet lag, also known as jet lag disorder, is a sleep disorder that can occur in people who travel through different time zones in a short period of time, such as a flight from New York City to Los Angeles. Obviously, the further the distance traveled and the more time zones entered, the more significant and drastic the symptoms, as found, for example, in those traveling from the United States to Asia.

Sunlight has a direct impact on our internal clock by regulating melatonin, a hormone that regulates sleep and wake cycles in the body. Travel through different time zones can affect the amount and duration of sunlight and therefore, impact the regulation of these cycles. The inability to regulate the cycles results in many symptoms.


  • Sleep Disturbance – some experience insomnia, restlessness or waking up in the middle of the night, while others suffer from excessive tiredness or sleepiness
  • Generalized Malaise – overall sense of not feeling well
  • Muscle and Body Aches – generalized soreness
  • Fatigue – general feeling of weakness, tiredness and fatigue
  • Gastrointestinal Irritability – constipation or diarrhea
  • Menstrual Cycle Changes – menstrual symptoms out of cycle
  • Easily Distracted – difficulty concentrating or focusing


  • Plan for a travel day or two – if time permits, it is wise to arrive a day or two early to acclimate to your new environment before you engage in demanding tours or physical activity. Olympic athletes keenly understand the importance of this strategy.
  • Plan for the new zone – before you get on the plane, set your watch to the time zone of your destination. By doing this, you can begin to mentally and physically prepare by eating, drinking, and sleeping accordingly. For example, don’t ingest caffeine shortly before you need to sleep on the plane. Conversely, consider using a sleep aid at a time which allows you to get at least 8 hours of uninterrupted sleep and wake up to daytime in your new time zone.
  • Plan for the trip – try to get on a healthy schedule, eat well and get plenty of rest before you travel  
  • Hydrate – the importance of hydration cannot be overstated. Air cabin climate and pressure promotes dehydration and dehydration will make jet lag symptoms worse. Keep in mind, alcohol and caffeine will increase dehydration, especially as you sleep
  • Sleep – is an essential component to jet lag prevention. Use earplugs, eye masks, headphones and sleep aids if necessary. However, be sure to time your sleep according to the time zone you’re traveling to, not in presently. Therefore, it may be necessary to stay awake until the timing is right. Consult your physician about the best sleep aid for you and do not combine a sleep aid with alcohol.
  • Avoid blood clots – keep moving! During the time that you are awake on the plane, set a timer to do exercises and intermittent walking on the plane. Every 15 -20 minutes perform a different exercise. Alternate between arms, legs and walking. Do 30 to 60 repetitions. Also, based on your medical history, ask your physician if taking an over-the –counter blood thinner, such as an 81mg of aspirin, or a natural product like vitamin E is appropriate.   


Posture Exercises

Posture exercises are designed to keep your body more upright and prevent rounded shoulders and forward head/neck.

  • Row-The-Boat - Pinch shoulder blades together as if you are rowing a boat.
  • I-Don’t-Know – Shrug shoulders up toward the ears as you do when you say “I    don’t know.”
  • Chin Tucks – Bring your head back over your shoulders and tuck your chin in

Arm Exercises

  • Bicep Curls – sit in chair and bend your elbows up and down
  • Wrist Curls – as above but bend your wrists up and down
  • Chair Push-ups – Push up with your arms as if getting out of a chair

Leg Exercises

  • Hip Hikes – Sit in chair and march by hiking your hip and lifting up your heel 4-6 inches off the floor
  • Leg Kicks – Sit in chair and kick your knee out straight – then bend it down to the floor
  • Hips In and Out – Sit in chair and bring your knees/hips in and out
  • Toe Raise/Heel Raise – Sit in a chair and raise your toes up/down – then raise your heels up/down

Breathing Exercises

  • Diaphragmatic Breathing - The diaphragm muscle is essential for breathing. While sitting, put one hand on your abdomen and the other on your chest. Slowly inhale through your nose and try to separate the hand on your stomach from the hand on your chest. Then, slowly exhale through pursed lips.

Read Dr. Mackarey’s Health & Exercise Forum – every Monday

This article is not intended as a substitute for medical treatment. If you have questions related to your medical condition, please contact your family physician. For further inquires related to this topic email:

Paul J. Mackarey PT, DHSc, OCS is a Doctor  in Health Sciences specializing in orthopaedic and sports physical therapy. Dr. Mackarey is in private practice and is an associate professor of clinical medicine at GCSOM.