Did you know that the average person now spends 9.3 hours per day sitting down? That is more than we spend sleeping each day (average of 7.7 hours). In fact, I’m sure 90% of you are reading this sitting down (with a strained posture I might add). “Yes, obviously Doc Lol,” however, you’ve probably been sitting for more than an hour without taking a break. The reality is, in this day and age, sitting is an integral part of our lives. Most of our jobs and productivity is centered around staring at a computer for large parts of the day. And as demands increase, this translates to further evenings spent behind a computer too, in combination with a lack of activity, movement and rest. This month I’ve decided to write on this concept of “beware of the chair” – something I deal with every day in practice and I hope to provide some great insight as to why prolonged sitting can be harmful, how chiropractic care can help, as well as practical ways to “maximise” your sitting positively, reduce discomfort and safeguard your spinal health.
Every day most of us are seated at our computers and working hard; our lives are demanding and we have deadlines to meet, daily. It is unavoidable. The reality with sitting is that you may not necessarily experience the detrimental effects now at the moment, but bad postural habits that stem from prolonged sitting and computer use can ultimately cause damage in years to come. Computer professionals and enthusiasts often suffer from a combination of symptoms. Research indicates that there is a high prevalence of musculoskeletal pain in the neck, shoulders, upper extremities and low back amongst computer users. It can’t be that bad, can it? Well, let’s unpack this further. There are a few simple negatives first, these being:
- We know that sitting has a strong impact on your metabolism and weight gain, and excessive weight is shown to be a risk factor in the degenerative process of the lumbar spine joints and intervertebral discs.
- Uninterrupted sitting is deleteriously associated with blood pressure and markers of homeostasis.
- As soon as you sit, electrical activity to the leg muscles shuts off, calorie-burning drops and enzymes that help break down fat drop by 90%.
But then there are other more significant factors which I’d like to focus on:
- Due to the length of time and nature of sitting, compression of the low back (referred to as lumbar region) is very common. Your lumbar intervertebral discs (those spongy shock absorbers between each vertebra) are loaded three times more in the sitting position as opposed to when standing. Most of us do not engage our deep abdominal muscles (argh yes those core muscles) or our psoas muscles (commonly known as our hip flexors) whilst sitting, resulting in this increased lumbar disc compression, as well as an increase in our lumbar lordosis (normal curvature of the low back). Furthermore, when we sit for prolonged periods, some muscles shorten and some lengthen. As the brain accommodates to this change in posture, it chooses which muscles become neurologically active and underactive to conform with the new movement pattern. Iliacus and hip flexor muscles = overwork, whilst lumbar multifidi and back extensors = under work. This results in low back pain.
- Prolonged sitting lends itself to a “text neck” or a forward flexed position of the head and neck. And the result of this? Complaints of pain in the upper back and neck, altered postural patterns and those annoying tension headaches. Anyone nodding their heads in agreement? One must remember that neck muscles start at the bottom of the shoulder blades and span up to the base of the skull. Here’s a little perspective as to why a forward flexed head position is detrimental. In the neutral position, the head weighs approximately 4-5kgs. As our head starts to flex (bend) forward whilst constantly looking down at a computer, the head can weigh up to 27kgs (at 60-degree flexion). TWENTY-SEVEN kilograms. And naturally, such a drastic increase in pressure results in the acceleration of spinal degeneration. Accompanying this, the muscles at the back of the neck are then stretched and undergo a large amount of strain to keep the head from falling further forward. This forward flexed posture also inhibits the muscles in the front of the neck creating a further muscle imbalance. Hello, headaches. If I wanted to continue… forward rolled shoulder position, shortened pectoral muscles and an increased thoracic kyphosis further adding to the array of problems and complaints. But I shall stop there.
The reality is, our bodies are exposed to this increased musculoskeletal strain every day especially if we remain unaware of our poor desk habits. This strain translates into long term detrimental effects on our spinal health and it’s not long before we get to the point of saying, “ah these headaches are the normal tension pain from work stress,” or “I’ve had numbness and tingling in my hands for a decent amount of time.” When did daily discomfort or pain become so normal and acceptable? I struggle to believe we are okay with that. For me, I am not only concerned about the ‘now’ and the discomfort you may feel today; I am also concerned about the state of your physical and spinal health in years to come. So what can you do to limit these detrimental effects of prolonged sitting and computer use? Before we dive in, do your own little self ergonomic evaluation first so you become aware of your current situation.
- Does your chair promote good posture and core activation?
- Is it comfortable and at the right height for your desk? Are your feet placed firmly and comfortably on the floor?
- When seated, is the weight of your arms supported at all times?
- Is your monitor placed directly in front of you? And is it at a safe distance away from your eyes to avoid straining (at arm’s length)?
- Is your monitor at eye level?
- Are your keyboard and mouse close enough to prevent excessive reaching?
- Is the office aircon placed correctly within the office to avoid blowing cold air directly onto your neck and upper back?
- When talking on your cellphone or work telephone receiver, is it held correctly with one hand to the ear in order to avoid jamming the telephone between your ear and shoulder?
If you answered yes to all the above questions, you’re off to a good start. These questions give you a good indication as to whether or not your workspace ergonomics are contributing negatively to your daily musculoskeletal strain. With the simple groundwork in place, here are a few more important things to implement: Take intermittent short breaks. Sitting needs to be interrupted. It takes about a minute or two to stand up, walk around, do a quick stretch and then return to your desk. Set a reminder on your phone if you have too. At least every 60-90 minutes, until you get into the firm habit of giving yourself a break from the computer screen and seated position. Trust me, your spine will thank you later. And surprisingly enough, you think you’re being more productive by slaving away for hours without taking a break, that is a myth. Research repetitively shows that there is reduced fatigue and improved cognitive ability when taking regular breaks from prolonged sitting. Movement is your friend.
Following on from this, if you can afford it and if your office space supports it, get a sit-to-stand desk, or work standing up for part of the day. This relieves that sitting position and can ultimately assist in maintaining a better posture for longer periods of time. Furthermore, remember all those factors from the beginning of this blog? Well, your lumbar intervertebral discs aren’t excessively loaded or compressed as much, deep abdominal and psoas muscles actually have a chance to activate adequately which results in maintaining normal lumbar lordosis and reducing the predisposition to low back pain. Working in the standing position further prevents you from looking up and down, assuming your monitor is at eye level, and this helps to alleviate the strain placed on the muscles at the back of the skull. Removing this strain will reduce the risk of imbalance between the neck extensors and flexors. If the sit-to-stand desk is not an option (I mean, not many have the cash dollar for that), then invest in a better chair. And better doesn’t necessarily mean more expensive. I often say to my patients, get a pilates exercise/swiss ball (the correct size for your height). They are relatively inexpensive and trust me if you aren’t maintaining the correct posture whilst sitting on it, I am sure you’ll be falling over more than sitting. Using a Pilates exercise ball is massively beneficial as it helps to absorb the increased spinal load, it provides a softer cushion for the gluteal (bum) region and if you ask anyone of my patients who have used one, it definitely makes you activate and utilise the deep abdominal muscles to stabilise your spine. It practically forces you to be seated in the upright position.
Better yet, invest in a FitChair. I’ll allow a patient review to speak for itself. “As I work within a corporate environment I find I spend more time sitting at work then I do standing or even sleeping in my bed. After suffering frequently with upper back pain and slouching, I decided to invest in a FitChair for work. Because hey, spending more time sitting at work then sleeping in my bed at home – it was a worthwhile investment. I have been using it for a few months now and I have seen and felt amazing results. I no longer slough, my posture has improved, my back and stomach muscles have strengthened, and I haven’t experienced much back pain since. To be honest, if you’re considering buying one, I do warn you that for the first week your abs feel like they are working and you will feel a bit tired, but after that it is super comfy. When I travel for work, my other work colleagues jump at the opportunity to use my chair. I couldn’t think of using another chair again.” – Casey Nielson
Which brings me to the final point, seek chiropractic care, for many reasons. Ergonomic advice. Postural assessment. Education on, and correction of posture. To remove spinal dysfunction and restore joint mobility. To reduce strain and tension. To alleviate discomfort and musculoskeletal pain. To safeguard your spinal health. And, and, and! I could unpack every single one of these statements, but promoting chiropractic care is not the main point here. It’s as simple as: “low back pain and neck pain are the leading causes of missed work” and “on average we sit more than we sleep nowadays.” You cannot neglect this alarming information.
According to the ongoing conversations I have outside of practice, as well as my general observation of individuals postures (it’s a habit as a chiropractor), it seems that we are well aware of our incorrect or strained postures but not enough for it to motivate us to do something about it. And I think it’s because we are under the false impression that it is not detrimental. It kinda is, but not really. Or, we know it’s detrimental but it’s just too much effort to actively work at improving it. Yes, it does require effort, not just for one week, persistent effort in actual fact, but I can guarantee you’ll wish you preserved your health when your future self is on the brink of spinal surgery due to degenerative processes, or you’re living in a state of 7/10 pain rating and consider this the norm. I know I sound harsh or like the bearer of bad news, that’s not my intention. My intention is to make you realise that your wellness and health is wealth; it’s worth fighting for. And it’s in the smallest investments and simplest changes that we can achieve that.
“Being proactive about your health will result in less time, money and pain to keep you injury-free.” – Dr Dunaway. (Article is written from a combination of my experiences and the various research I have read over time, hence collective knowledge with no specific reference to particular articles).
Doc Lol x
Inspiring you to Move. Heal. Excel.