By Michael J. Chamberland, DC
Some of the more common complaints I consistently hear from patients in my chiropractic practice are related to recurrent neck/shoulder and back/hip pain, or arm numbness/tingling, while sitting, specifically while driving a vehicle.
As you have probably noticed, not all vehicle seats are designed equally and most definitely aren’t one-size-fits-all.
Due to the financial barrier and other constraints of switching cars strictly because of uncomfortable seats, you likely need to deal with what you’ve got … until you can’t—much like many things in life. Here are some general recommendations my patients have found helpful in reducing unnecessary strain on their bodies while driving and that have subsequently improved symptoms.
Overview of the Solution
Here we break down the solution into several steps to help you find the best driving position possible. Also below you will find a few simple exercises that you can perform while driving longer distances—to be performed only in safe conditions—to assist in improving blood flow and reducing soft tissue and joint tightness.
Seat Positioning
- The general seat position (achieved by sliding forward and backward) should be at a comfortable distance from the gas and brake pedals and steering wheel, such that your knees are slightly bent and you can easily contact the brake and gas pedals without reaching or extending your leg, or without having your knees bent too much which can lead to restricted blood flow behind the knee.
- In addition, having your knees too flexed can lead to more difficulty controlling full and free ankle/foot movement. This can potentially affect your ability to properly control and operate the gas or brake pedal. It also can lead to cramping in the lower leg or thigh muscles.
- Whenever possible, always try to keep your left foot placed over the floor pedestal on the left near the door. (The pedestal is that little plastic or hard rubber rectangle on your carpet roughly the same distance from your driver seat as the gas pedal.) This will allow you to have a more squared-up and balanced alignment/posture to help reduce torsion (twisting) in your legs, pelvis and spine, which can lead to pain and nerve irritation.
I’ve had many patients tell me they never noticed the pedestal in their vehicle. (Side note: A Jeep Wrangler doesn’t have one.) Also, many people like to have their right foot on the gas with their left foot hanging out by their seat, causing a lot of twist in the pelvis. I’ve even had people tell me they regularly put their left foot up on the dash or out the window while driving, which I tell them is not safe. It certainly would not turn out well if they got into an accident; be prepared for a leg and pelvic fracture at minimum.
Backrest Positioning
- The upright backrest should be positioned typically at 95-105 degrees, which is a slight recline, as this seated position has shown through research to decrease the axial loading of the spine and intervertebral discs, compared to sitting straight upright or flexed/hunched forward. This position helps reduce the risk of forming a disc herniation that may negatively affect the spinal cord or nerve roots.
- When the seat back is too far reclined, you then need to reach for the steering wheel unnecessarily, which leads to increased shoulder and neck stress.
- If your vehicle steering wheel has a tilt and telescoping feature, you can then set the appropriate positioning such that your shoulders/upper arms are relaxed to your side with elbows roughly half bent, neutral wrist, with wheel within easy reach. Remember that it’s best having your hands positioned from about 9 and 3 o’clock to 10 and 2.
Adjusting Armrests
- If your vehicle has adjustable armrests and you typically use them, match the center armrest height with the door armrest so that it is equal. This will assist in keeping pelvis, spine and shoulders in better alignment.
Adjusting Mirrors
- Once you have found the ideal seat position for yourself, it’s now time to make sure the rearview and sideview mirrors are all set properly to offer a clear view.
- If your vehicle has this upgraded option, you can then digitally set your personal seat position, so if someone else uses the vehicle, you can quickly return to your preferred seat and mirror settings without going through this process again.
Seated Exercises to Combat Prolonged Sitting
Heel and Toe Raises
Alternate slowly pointing your foot/feet down (plantar flexion) and lifting up (dorsiflexion) 5-10 times. This movement promotes activation of the lower leg muscles, which will pump blood up the legs and back toward the heart. Improving circulation helps reduce the risk of deep vein thrombosis (DVT), which may occur with prolonged periods of static sitting in a vehicle, plane, or elsewhere. DVT is when a clot forms in a vein due to blood stagnation, and if broken-free, can lodge in the heart, lungs or brain, causing serious health problems and even rapid death. DVT requires immediate medical attention.
Static Foot Push-and-Pull
When in a safe driving environment, such as on the interstate when you can use cruise control, position your feet symmetrically on the floor just short of the pedals, about hip width. Keep them in position while pushing them away from your body for 3 seconds, and then pull toward you for 3 seconds. Repeat 2-5 times, to promote muscular action in your legs and hips, again to promote blood flow and general muscle activation. This movement, when you are contracting muscles without lengthening or shortening—they stay the same length— is called isometric exercise or contraction.
Mini-Squats
With your feet symmetrically placed as described above, gently and fully contract all the muscles in your legs and buttock while slightly lifting off the seat, hold for 2-3 seconds, then gently lower back down. Repeat 2-5 times, again to promote muscular action and improve blood flow and reduce stress on your knees, hips and lower spine.
Shoulder/Scapular Retraction and Chest Lifts
Gently lift your chest/sternum straight upwards to the sky and glide your shoulders back and down while holding for 3-5 seconds. Repeat 3-5 times to improve thoracic spinal and shoulder movement to avoid unnecessary muscular tightness and discomfort. I recommend checking online for Bruegger’s postural exercises, to perform when not driving.
Neck Retractions
Looking and holding your head level and straight, gently glide your head and neck backwards until touching the headrest. Hold for 2-5 seconds and repeat 3-5 times. This will help with reducing forward head posture and associated short and tight muscles in the front of your chest, neck and shoulders. Being notably tight in these areas may contribute to thoracic outlet syndrome (TOS), which typically presents as paresthesia (numbness and tingling and other altered sensations) in your arms and hands while driving, or during other postures when your arms are in front or above the body, but otherwise it may not be symptomatic.
Here’s to less symptomatic and more comfortable driving in your near future! Be Well!
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Michael J. Chamberland, DC, is a chiropractor at Gifford’s Sharon Health Center where our team provides rehabilitative medicine (physical and occupational therapy and athletic training). For more information, or if you have questions about what chiropractic or rehabilitative medicine can do for you, please call 802-763-8000.
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