Is Sitting the New Smoking? - Greenwood Physical Therapy

Is Sitting the New Smoking?
“Sitting is the new smoking”.
You may have heard this saying and wondered if it is true.
As a Physical Therapist this conversation often leads to the following questions:
Is sitting detrimental?
Am I sitting correctly?
Can I injure myself by sitting too much?
Does my hip/back/shoulder hurt because of sitting all day at work?
I have to sit, I have a desk job! I can’t quit my job, so what can I do?
The short answer is:
Sitting is not the enemy,
but lack of physical movement is hazardous to your health.
There are several strategies that you can use to increase the amount of body movement during your work day. There are also techniques to reduce your risk of injury when sitting is unavoidable or needed.
How can you minimize prolonged sitting throughout your work day?
One of the most important ways to avoid work related postural pain with desk jobs is to reduce the amount of time you are continuously in the same position. A good goal is that periods of being sedentary (whether static sitting or standing) are only 30-60 minutes in duration. That means trying to do some active movement for 1-5 minutes at least once an hour. Setting a timer to remind you to move can help. Many activity trackers have settings that will remind you to move at this frequency. There are also apps you can download on your phone to give reminders. This break from sitting can be as simple as going to the restroom or getting a drink of water. It’s even better if you can take a longer walking lap around your office or climbing up and down the stairs. Brainstorm about whether there are work tasks that can be accomplished while moving. Using talk-to-text apps you can dictate emails while on a walk and often can participate in conference calls as well. If you can, take a longer walking or stretching break during lunch. Even briskly walking for 20-30 minutes each day during your lunch break can be very beneficial for your health. It is also essential if you have a job that requires sitting or being sedentary for most of your day to ensure that when you are outside of work you are minimizing your time spent being sedentary.
Having a walking meeting can be a way to sneak more movement into your day
If sitting is the problem, is a standing desk the answer?
Many of my patients get a standing desk, thinking this will fix all of their work-related pain. While standing does require increased muscular work and increased energy expenditure compared to sitting, it is still a static, (i.e. sedentary) position. Standing without moving for prolonged periods can create similar problems to sitting without moving. A sit-to-stand desk can be a great option to switch your position throughout the day. I suggest my patients change from a sitting to standing position every one to two hours if possible. You obviously cannot and should not eliminate sitting or standing entirely. The problem arises from being sedentary for the majority of the day. Many people sit for eight or more hours per day at work, sit for meals before and after work, and then sit to relax until they go to bed for the night. It is estimated that the average American sits for 10-12 hours per day! Even if you are squeezing 30 minutes of exercise into your busy day, this may not be enough to counteract the other 10-12 hours of being awake that you are stagnant. This article from the Mayo Clinic discusses how as a society we are spending more time being sedentary compared to previous generations. There is research that indicates detrimental health effects of a sedentary life style. It is recommended that most adults should be performing 150-300 minutes of moderate intensity exercise per week. This is 20-70 minutes per day. There are also additional health benefits from being closer to the higher end of that range. It is suggested that an individual should spend more time exercising if they are required to be sedentary for a long portion of their day. Another recommendation for physical activity is to walk 10,000 steps per day. It is estimated the average American is only taking 3,000 – 4,000 steps per day, which likely relates to the amount of time per day that is spent sitting. In summary: the more time you are required to be sedentary (sitting or standing in one position) throughout the day, the more time you should spend counteracting this time with physical activity.
What can I do if my job does not allow for breaks to leave my work station?
There will likely be days that getting away from your desk for even a few minutes may be a challenge. Even on those days, there are strategies to introduce movement and reduce the time you are being completely sedentary. As mentioned, a sit-to-stand desk can be beneficial to change your positioning throughout the day. Performing stretches while standing at your work station or while sitting in your chair can also be helpful. Marching in place (sitting or standing), lightly rotating your trunk, pumping your feet up and down, bending and straightening your knees, rolling your shoulders forward and backward, and stretching your neck are a few ideas of easy movements you can do without leaving your seat. You can often participate in these exercises without discontinuation of your work activities. Ask your Physical Therapist or Physician if these exercises are safe for you.
Even small stretches at your desk count as active movement during the work day
Can I get injured from sitting too much?
Yes, there are many injuries that can be due to sitting for too long or too often. I often see patients with injuries that are caused or exacerbated by sitting for prolonged periods. Some of the most common areas of pain and injuries of this type are:
Usually these symptoms don’t occur when people sit for for short amounts of time to eat dinner or write an email. They are more likely to occur with sitting at work for 6-8 hours, or sitting to watch television for 2-3 hours.
In studies looking at amount of pressure on the discs of the lower back in different positions, sitting positions exert more pounds of pressure per square inch on the lowest disc in the spine then any other positions. (static standing ranks next).
These are the most common sitting injuries and areas of pain that I treat as a Physical Therapist. It is also important to note that a sedentary lifestyle can contribute to many other diseases and health conditions. Being sedentary can increase your risk of conditions such as: obesity, increased blood pressure, high blood sugar, and abnormal cholesterol levels.
What is “good” sitting posture?
While you want to minimize prolonged periods spent sitting, it is unreasonable to remove sitting from your day entirely. Therefore, you want to ensure when you are sitting, you are doing so in the best posture possible. There are few general guidelines I give to patients regarding ergonomics and ideal sitting posture. If you are having pain with sitting (or standing) at work, see a Physical Therapist or other health care professional. Every person’s muscular and skeletal structure is individual to them, and a Physical Therapist can give you personalized changes for the ideal postures for your body. There is no “perfect” posture, but there are ideal postures given your individual anatomical structure! Below are guidelines to get you started on a general good posture with sitting:
Hips and knees at 90 degrees
Requires optimal chair height and/or foot support as needed
Most of the thigh being supported by your chair without pressure all the way to your knee.
Requires correct positioning in your chair
Elbows at 90 degrees, arms close in to your sides
Requires correct position of your keyboard and sitting the correct distance away from your work station
Spine in a “neutral” position: not too “arched”, but not “slumped”
May require bringing a pillow or towel to conform to your spine: often even “ergonomic” chairs are not perfectly shaped for your individual spine
Head stacked in line with your torso, not pulled forward toward your screen
Requires correct screen height
These are very general guidelines. There are many more intricacies to adjusting/changing work equipment (chairs, desks, mouses, monitors) that I help my patient’s optimize to improve posture and reduce pain.
Is sitting the new smoking?
Sitting too much can be bad for your health. However, the problem is being sedentary, not the actual position of sitting. You should aim to reduce the number of hours you spend per day being sedentary, whether this is sitting, lying down, or standing. The more time you are required to be sedentary, the more you should counteract this with physical activity. Changing positions throughout the day and building in frequent breaks from sedentary positions are beneficial. Sitting in a good posture is helpful to reduce excessive stress on your tissues. Overall, movement and physical activity are the best tools to reduce your risk of health risks associated with sitting!
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