Last year, the NY Times published an article about the health detriments of sitting, citing research that found an association of prolonged sitting (greater than 3 hours per day) and early death. An earlier NY Times article from 2011 discusses the specific effects of sitting – absent muscle activity, a decrease in metabolism, decrease in insulin effectiveness, increase in obesity likelihood, and a decrease in HDL (the “good” triglycerides). The physiological observations in this study all lead to this realization: More Sitting = Shorter Lifespan.
So – what is it about sitting that is so detrimental to the spine? As a point of reference, let’s discuss the design of the spine. The entire spine consists of seven cervical vertebrae, twelve thoracic vertebrae that have strong articulations with the ribcage (and sternum in the front), five lumbar vertebrae, and the sacrum (or tailbone). In between each vertebrae is a disc. The cervical and lumbar regions have a forward curvature (or lordosis) while the thoracic spine has a backwards curvature, or kyphosis. These natural curves provide shock absorption in movement, as well as nutrient exchange for the discs. The lumbar spine moves primarily in flexion & extension, with minimal rotation. A lumbar disc herniation, or “slipped disc”, is often created by the “perfect recipe” of combined flexion and rotation.
Why is this anatomy lesson so important? Sitting is a flexion based position, and a poor workplace setup may contribute to the high prevalence of low back pain. Prolonged sitting positions place strain on tendons, ligaments, muscles, fascia, joints and discs of the lumbar spine. That stress often decreases the blood flow and nutrient exchange for discs and surrounding soft tissue. Poor sitting posture may also be exacerbated by tight hamstrings, hips, glutes, repetitive movements, or by placing a load on top of dysfunction (i.e., weight training, heavy lifting).
For our patients who are desk bound (what I lovingly refer to as Desk Jockeys – I used to be one myself!): work environments are not one size fits all. There has been an increase in use of laptops for workforce, which makes it difficult to adjust your computer screen properly. Desks are usually a standard height, which may pose a problem for those humans who fall on the short or very tall ends of the spectrum. Adjustable desk chairs certainly help with this issue, but it is not the absolute solution to the problem.
Other solutions to the problem of sitting may include
- Standing desks – more positions, more options!
- Standing for significant parts of your workday is a good alternative, but can be fatiguing
- Treadmill desks – also fatiguing, and difficult to work on
- Take a cue from the Japanese – have business meetings standing up!
- Move – take more breaks, get up and move; recess & play
As a Functional Manual Therapist, we work on sitting properly. Many patients have a self-perception that they have “bad posture”. But when I ask them what “good posture” is, they often respond with specific joint angles that they’ve heard of before. Proper posture should not ascribe to a visual aesthetic; rather, it should be the product of function. FMT addresses the function of sitting, both as a static and dynamic activity.
If you’re having low back pain, it is important for you to address not only the pain, but understand how you are using your body in your daily life, even when you’re sitting at work. Sitting is unavoidable, but let’s at least do it properly!
Sit More = Live Less
Move More = Live More
Mark M Lusk, DPT, OCS, CFMT