By Max Prokopy
Exam season is here and summer internships are just around the corner. For many of us, that necessitates a major increase in the time we spend hunched over a keyboard. Although it seems harmless enough, sitting for a long time can be costly to our bodies. This article will review some of the damaging forces at work and offer some tips to help offset the physiological price of a cram session or office job.
Approximately 80% of U.S. adults experience low back pain1. This pain is the second most common reason an adult will seek out his or her primary care physician, and recurrence is common1. It’s also the number one cause of worker disability for those under the age of 452. Long-term compression of the spinal discs is a major reason for the alarming injury rate. The photo below simplifies the anatomy of intervertebral discs. Compressing them by flexing or extending the lumbar spine for prolonged periods can “squeeze” the disc out of alignment. As the nerve-rich spinal cord is right next door, this anatomical change can irritate nerves, be painful, and impair optimal movement.
Excessive compression used to be a problem relegated to plumbers or other high-repetition occupations. However, desk jockeys and cubicle dwellers, who barely move at all throughout the day, now experience the same high rate of back pain. Sitting with the posture noted in the figure below places approximately twice as much compressive load on the lumbar discs as standing does3.
Sitting Can Give you the Creeps
Discs, ligaments, and other back tissues have some resilience. While the amount of resilience varies from one person to the next, long durations in the same position takes a toll on everyone. A major source of the damage is called creep. Sitting for a long time slowly pulls on the ligaments and joint capsules of the spine. This reduces the oxygen and nutrient supply to these tissues, along with impairing the signaling of the spinal nerves4. The end result of creep is poor tissue resilience; poor elasticity (the ability to rebound from a stress); and impaired proprioception (how your brain perceives the location of a joint). Not only do the tissues lose vital nutrients but they lose their sensory relationship with the brain and other joints. Joints that don’t communicate with one another lead to poor function and possibly pain. Often times, people get out of a chair and struggle with their posture or the first few walking steps. This is a perfect example of creep impairing an important functional task. Hours and years of creep are an important part of how mobility decreases with age.
Getting Crossed Up
As the cartoon below indicates, the standard sitting position puts the body in several poor anatomical positions:
- Hip flexors and hamstrings are shortened
- The glutes are lengthened and weakened
- The diaphragm (breathing) is restricted
- The ears are well in front of the shoulders, and
- The hips are tucked underneath the spine.
Famed Czech therapist Vladimir Janda coined the term “lower crossed syndrome” for people who have relatively short hamstrings, weak glutes, and tight hip flexors. The lower-crossed posture increases compression on the lumbar spine as well as hindering optimal movement patterns. This postural pattern also deteriorates the alignment of the neck and shoulders.
Try to Breathe Easy
Do you have knots in your shoulders and neck? Do they get painful or increase with stress? This is extremely common in people who sit a lot and don’t take regular breaks. Try this quick experiment:
- Sit down, hunch your shoulders, and round your spine, just like you would at a desk.
- Inhale and exhale as fully as possible. Next,
- stand tall with your back, shoulder blades, and head flat against a wall.
- Again take a big inhale and exhale.
There is going to be a noticeable difference in the amount of air you exchange as well as what muscles do the work. In sitting, the diaphragm is restricted so the auxiliary respiratory muscles of the shoulders must come to help. These are the muscles that get all those knots! Why? Because helping the diaphragm 8 hours a day has over-worked them. In contrast, standing straight and open will allow the diaphragm to work correctly. It removes the burden of the shoulders to help with breathing, allowing them to do their regular jobs correctly.
Okay, So What Can I Do?
Sitting is here to stay, but you can counteract things like disc compression, creep, poor posture and restricted breathing. If you devote 8-12 hours a day to sitting, you need to keep up with this regularly.
1. Reduce disc compression. Sitting with a small lumbar support, pelvic wedge or kneeling chair (pictured below) puts the lower spine in better alignment. It also improves upper body posture and reduces creep because the ligaments don’t stretch as much.
Important note: Sitting on a gym ball does not improve the effects of sitting. In fact, it’s worse. Evidence from world-renowned back expert Dr. Stuart McGill shows the increased muscle contraction from the unsupported gym ball increases compression on the lumbar discs5.
2. Kill the creep. Creep sets in at about 20 minutes of a single posture. All you have to do is remind yourself to stand up, take a few steps around, or a do a couple quick stretches that look like the opposite of sitting (pictured below). Take deep belly breaths to restore full movement of the diaphragm. Set an alarm, put a sticky note on your monitor, whatever it takes to get up and moving for just a few seconds.
3. Re-invigorate the tissue. I am loathe to recommend a single brand product but The Wedge, developed by back expert Dr. Jeff Anderson, is the best product I’ve come across to restore nutrient exchange and preserve the elasticity of the lumbar tissues. It’s portable, durable, and you can safely do a number of core exercises on it. Disclosure note: I receive no incentives, financial or otherwise, in recommending this product.
4. Raise your monitor to eye level. Keeping the ears in line with the shoulders helps the overall posture of sitting, illustrated below.
5. When you exercise, don’t replicate sitting. Exercise is always a good idea but desk jockeys doing sit-ups and riding a bike are relatively poor choices. In fact, the two movements instigate massive lumbar compression. They reinforce the very postures we’d like to like to limit. Think about working on the movements that oppose sitting: deadlifts or kettlebell swings; glute bridges; rows or pull-ups; and stretching the hip flexors. If you’re completely opposed to any type of resistance training, try walking on a treadmill at a 15-25 degree incline. You’ll get all the benefits of biking without the back stress.
If sitting is a daily, task, so should be your efforts to counteract it. Regular breaks, some ergonomic changes to your cubicle, and a few minutes a day of strengthening the backside will reduce your chance of falling into office-related pain.
*Sources available upon request.
Max Prokopy is a first-year Biochemical and Molecular Nutrition PhD student who has certifications and experience with training prep, collegiate and professional athletes with a particular focus on ice hockey.