Now That Is The Question . . .
Having now transitioned out of a majority of my clinical work I find myself spending much more time at a desk. Aside from developing material for corporate clients, I also spend time each week reviewing clinical requests for physical therapy (read my spotlight on The Non-Clinical PT). I recall many times in the clinic holding a patient or a part of their body and just feeling my back screaming! At first, the sitting was nice, but now a few years later I have different and mixed feelings. It seems that I am not alone either. From the “sitting is the new smoking” movement to a recent article on NPR’s “Goats and Soda” blog site about how we are just sitting wrong , it would seem the answers to if, when and how we should sit are no where close being found. Further more, in almost every conversation about the consequences of prolonged sitting, back pain is on top of the list. These issues plague almost every workplace, and without great solutions, many employers are left with limited resources for help.
I am here to shed some light on this topic and maybe even give a few rays of hope toward simple solutions.
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We can show you how . . .
First, Sitting is the New Smoking:
Personally, I tend to like this campaign and others similar to it. They get the point across very well and any action to reduce sitting will likely be in a person’s best interest. Basically, the longer you sit the worse it can be for your health. Prolonged sitting is generally figured by simply adding the total amount of time you spend sitting in one day. Various research has been done to show that the higher that number is, the greater your risk of major health complications such as diabetes and heart failure. A quick Google search is all you need to learn more. Similar to the more a person smokes, the greater their risk of major health complications.
You have to remember though, that these are generalized statistics that are talking about increased risk. It can be very difficult for these studies to control for all the other factors in someone’s life that could contribute or diminish that risk; such as diet, exercise, genetics, stress, access to health care, other medical conditions, and many more. Each of those factors can effect your risk just as much as prolonged sitting.
So is sitting that bad for your health? Well, no and yes. Human beings are certainly well suited to sit. It can even be necessary at times. However, does sitting taking place of all the other necessary and recommended daily activities you should be doing? There is a great wealth of information on the benefits of exercise and activity. General recommendations tend to be about 30-45 minutes of moderate intensity exercise/activity 3-5 days a week; at least 150 minutes a week. Additional time may reduce your risks even more. Now, if the average US citizen sits about 13 hours a day (work, commute, meals, TV, social media) and sleeps 8 hours, that leaves only 3 hours a day for non-sedentary activity. Now if you take out time for simple house hold chores, light yardwork, shopping, errands and grooming. That could take most or all of those 3 hours left and none being used for vigorous activity. Does this help explain the point? It is not that sitting is bad, it is being sedentary all the time that is bad for your general health.
Time for a small tangent? Enter the standing desk. Over the past few years there has been a push towards standing desk use to help reduce the time in prolonged sitting. Remember the part about being sedentary that is bad, not really the sitting? Think about that for just a minute. If we just replace a sitting office with a standing office, but the person stays in once place for prolonged periods of time, have we solved the problem? BINGO – no we have not.
So if the problem is being sedentary all the time, what is the solution? So, far, the best solution is to just reduce being sedentary as much as possible. Any breaks from sitting or standing should be active. Walk around the office, go get some air, do some stairs, do some push-ups. Hopefully this is making sense.
So is the $3000 sit-stand combo desk worth it? If it motivates you to take active breaks more than a sitting desk, then it may just be. If you can get up out of your chair and take active breaks, then there maybe little reason for the expense.
Second, the way you sit causes back pain
At first, I really wanted to like the recent article on NPR linked above. They pose a simple solution to eliminate back pain for all those that suffer when they sit. As a physical therapist, I would love one simple solution to help every person I have ever seen for back pain. Unfortunately, a majority of back pain happens for all kinds of reasons and takes a combination of several solutions for relief. The article relates anthropological research of modern day hunter-gatherers in Tanzania. That they spend almost the same amount of time sitting as us urban dwelling people do currently. However, when not sitting, they are more active. The article also states that less people in less industrialized nations sit for very long times, but in a different position. With the pelvis tipping more forward and the back straight.
I agree that sitting with poor posture can certainly be bad on your back. I feel it anytime I go on a road trip (Car makers could do SO MUCH better with car seats). Unfortunately, a couple studies on bushmen and a picture of a man at a loom in India hardly tell the whole story. In my experience, when asked, most people know how to sit well. Upright with the pelvis tilted slightly forward, shoulders open and subtle curves to the spine. The real issue is that it comes down to time. Our bodies dislike any prolonged position. Most people change positions hundreds of times a day. Just take sleeping as an example. Even in deep sleep, our bodies will automatically change our position to take pressure off areas and place it on others. Have you ever noticed that if you have to stand in a line for any amount of time you switch from one leg to the other, maybe you sway, take small steps. Now think of a man sitting at the loom, he will have to move his arms up and down, shift his weight and stay active to weave. This is very different from sitting in front of a computer screen and just moving your finger tips or wrist. How much time are you spending in ONE position? After a while your body needs you to change position to get relief. The question is do we listen to our bodies? Often that answer is no, we have enough control of our bodies to just slump back in the chair and keep right on working.
To say there is less back pain in those that have a more rural or survivalist lifestyle is not really a fair comparison. Even in the NPR article Raichlen states “There hasn’t been a ton of studies looking into muscle and joint pain in the Hadza” Tanzanian bushmen. That does not mean it does not exist.
On the contrary, there are several studies to show that back pain is just as common in rural and farming communities as there are in cities. Similarly in generally less developed countries compared to others. Many of these people sit much less, but have just as much incidence of back pain. Many of these people also have less access to health care, and in turn have lower reports of back pain just due to less report of it. Again, this does not mean it is not there. The evidence is not clear either way.
So, I think you get the point that we still do not fully understand how sitting affects us and what we should do to combat it. What is much more clear is our understanding of what a highly sedentary lifestyle can do to the human body. You could lay in bed all day and say you don’t sit too much, but would that be any better?
I will agree that there are probably better positions to sit in than others; and that these positions may also reduce back pain, neck pain or other discomforts. I am not going to agree that there is ONE perfect sitting position for all 7.4 billion people on this earth. Nor is there enough convincing evidence to show that every person that has back pain with sitting should become a bushman.
May I give a suggestion? How about just being more aware of the time you spend being sedentary and try to reduce it. You could even make small changes over time. Let it become habitual. Find reasons to get out of your chair. Instead of instant messaging and texting everyone in the office, walk over to them. You could even have your conversation while you both walk. As soon as you notice your posture going to pot, get out of the chair and move about. Find activities you enjoy doing that involve vigorous activity. There are so many helps for this in our tech heavy age. Set reminders on your phones or use an activity tracker. There are all kinds of apps that have simple exercise routines you could easily do at work or home. An interesting note about physical activity, not only does it help reduce your risk of major health issues, it is also the most well documented way to reduce and eliminate back pain! Just focus on reducing your total time being sedentary and that will get you headed in the right direction.
As always, we are ready to help your company integrate these simple solutions.
We can help you improve productivity and reduce costs associated with these types of employee issues and many others. We look forward to hearing from you.