Sitting Is The New Smoking…

Sitting can have far reaching implications into aspects of your health that may surprise you including: cardiovascular & respiratory health, gastrointestinal health, fall injury risk, increased risk of cancer, psychological health, and as broad as “all-cause mortality”. Think that is a bit of an exaggeration? Keep reading!

Sitting is a sedentary activity. In other words, you’re not moving. It’s probably not surprising to hear that inactivity is bad. However, you may not know just how bad it can really be. A study in 2015 published in Annals of Internal Medicine (Sedentary time and it’s association with risk for disease incidence, mortality, and hospitalization in adults) found that with 6-12 hours/day of sitting there was a more than 91% increase in type II diabetes with overall mortality increase of up to 24%. Heart disease mortality went up 18%. Cancer mortality went up 17% and chances of developing cancer up 13%.

Sitting is bad for your posture, which is a broader part of health and wellness than you might have considered. This is actually a very old concept. Charles Darwin (1872) said it very well…“proud and successful human beings are likely to display an upright and erect bearing”. Similarly, Dr. Steven Weineger said, “Posture is a mark of character and strength: both structurally and personally”. Just take a second to think about how healthy/happy a person appears when they have an erect posture versus the forward leaning posture and rounded back that we associate with old age. Sitting at a work station with poor ergonomics is even worse. A 2014 study published in Arthritis and Care Research found an 8x increased risk of low back pain in people working in an awkward or asymmetric position. This is echoed by the finding that 3/4 of dentists have neck pain (Journal of Clinical Diagn Res 2013 Oct.7(10) 2261-4). Another study found that reducing forward head position by neck retraction exercises improved neck tension demonstrating posture’s roll in developing neck pain (Spine 1995 Jun 1;20(11):1245-50).

Posture is an acquired habit. We are what we do all day, and if that is sitting and working, our heads and bodies begin to follow the direction of our eyes towards the screen resulting in a forward leaning position. It is a pattern that sticks with you even when you stand up and begin a different activity. Pretty soon, you could notice that you are positioning that same way even when you are standing, walking, or exercising. Our brains love patterns and will return to a pattern automatically if we repeat it frequently. This is actually how we learn to crawl, walk, ride a bike, or swing a golf club. It’s what you might call “motor memory”.

These patterns can work for us: like being able to perform tasks or play sports. They can also work against us causing body distortions that lead to imbalance and undue stress on our bodies. Envision the body as being made of regions of blocks. There is a block for your head/neck, torso, pelvis, and legs. If those blocks aren’t stacked and balanced on top of each other, then the body has to work harder to keep it upright against gravity. A simple demonstration can prove the point. Hold a broomstick upright in your hand. If the broom is balanced straight, then it is easier to hold. As you begin to tilt the broomstick at an angle, you can feel the muscles in your wrist/forearm having to work harder to keep it from falling over towards the ground.

Take the forward head position for example. As you move your head forward of your shoulders, it makes the muscles in the back of the neck and shoulder blades work harder to keep the head level. Even after a few minutes, those neck muscles become tense and fatigued. Over longer periods it causes a considerable amount of stress. You may notice achy pain in the neck and upper back. You may notice knots developing. If left unchecked, damage to the joints could lead to arthritis, or pinching of nerves.

The neck & upper back isn’t the only place we can develop problems from sitting. It can also happen in your mid & low back or even your hips. Sitting in a flexed forward position rounds the back and causes tight hip flexors. It’s another pattern that tends to stick. We’ve all seen that person at the grocery store who is stooped forward, takes short steps, moves slow, and just seems like they are in pain. That is essentially the result of a longstanding postural distortion and it’s effects on that person’s body. When the body is not well balanced, the muscles of the body have to work harder. Tight hip flexors and rounded back can prevent you from standing up straight and pitch the torso forward (remember the broomstick). That will cause the low back muscles to be strained, the discs to be under greater pressure, and increase the impact on joints. This leads to damage and early degenerative changes just like the neck situation above.

Sitting is linked to muscle weakness, postural changes and pain. An interesting study found a link between low back pain and errors in postural control due to impaired processing of sensory information (Exp Brain Res 2017 Mar 177(3), 411-418). A June 2014 Study published in the Manual Therapy Journal found that patients with low back pain did not activate their core during sitting and standing. Your posture affects how you move and your ability to balance, and this in turn makes you vulnerable to injury. A 1977 study published in the Journal of American Geriatrics Society found that adults who where not able to balance on one leg for more than 5 seconds were 2.1x more likely to suffer an injury from falling in the next year.  

Maybe the most surprising effects of poor posture is it’s association with increased risk of death. A 2004 study published in the Journal of American Geriatrics found that females 65 and older with forward head carriage had a 1.44x increased risk of dying in the next 4 years. The study defined the forward head position by patients who could not lay flat on their backs and touch their head to the table. A publication from S. Goya Wannamethee out of UCL Med School in London reports on effects of posture…”Resulting height loss can affect the normal functioning of the respiratory and GI systems, which in turn may lead to early satiety, poor nutritional status, and weight loss. Height Loss (from postural distortion) of more than 3cm in older men is linked to risk for all-cause mortality and heart disease (Arch Intern Med. 2006;166(22):2546-2552).

So, at this point, I’m sure you’re wondering what can be done to avoid static sitting. Here are some tips.

1. Microbreaking: For every minute of sitting, take one second to stand up and move around. For example, sit for 30 minutes, then get up and stretch/move for 30 seconds. You can also do 1hr/60min increments. Set your watch or phone to chime if you need. You can do neck retraction exercises, spinal extension exercises, hip flexor stretches, and other things to break up that postural habit developed during sitting.
2. Standing Desks: This has really been taking off in popularity as of late. Though, standing static might produce problems also. That’s why the treadmill desk has been invented. An easier thing to do is simply to switch between seated and standing work with an adjustable desk. This can be an expensive investment and impractical for some jobs.
3. Yoga Ball: This is one of my favorites. It is cheap, it is effective. It allows you to be mobile and shift positions, and best of all… you can use it to do rehab when microbreaking as described above.
4. Ergonomics: Improving the ergonomics of your work station can do wonders for your posture. Monitor height, keyboard height, seat height, and distance from the station to your body are all important factors to balance out. The monitor should be placed at a height level to the eyes or just slightly above. Your keyboard/mouse should be reached with a comfortable bend of the arm. An arm pad can be added to take stress off the wrists. Seat height should be accommodated to be able to place the feet on the ground while maintaining eye level monitor height. Distance from your body should be set to allow easy reach to your keyboard and mouse.
5. Get adjusted. Getting your spine aligned and moving properly again is one of the best ways to combat bad postural habits. Most patients can tell a difference immediately. It’s also a great opportunity to ask your Chiropractor about exercises and ergonomics.

For more advice or to begin the process of correcting postural distortions, please contact our clinic at (918) 600-2969. Alternatively, you can set up a free consult at ReactivateTherapy.com. We’re here to help!