Christian Brix, DC
Sitting and Poor Health- the New Epidemic
The amount of time we spend in the seated position is staggering. In North America, adults over 20 years old spend an average of 6.5 hours per day in the seated position. Teenagers 12-19 years old spend an average of 8.2 hours per day! Both of those numbers come from a JAMA study from 2016, and because each of those numbers had increased by one hour since the previous study in 2007, one could imagine that it is even higher today.
It has been observed in multiple anthropologic studies that human evolution was not meant to take us in the direction of sitting. Studies show that early hunter-gatherer populations and even the ones that still exist today incorporated almost ZERO time in the seated position. The earliest and most primitive humans displayed as much non-sleep “down time” as humans of today, but those periods of rest were spent in the squatting, standing or in kneeling positions. They wouldn’t sit on a log by the fire…they would squat!
So why do we care? What is so bad about sitting?
The truth is that
It is shocking how many of our processes and systems are hindered or altered because of long hours spent sitting. Let’s start with the obvious effects on our spine and the subsequent posture that comes with it.
The human spine has three curves: two lordotic curves for the neck and the lower back, and a kyphotic curve for the middle/upper back. These curves serve many purposes, but primarily they are there to provide shock absorption, protection for the spinal cord, and range of motion for the whole spine. With gravity pulling down on the spine and the ground sending forces up through the bones and discs, there can be a lot of stress. If there were no curves and the spine was just straight, all of those stresses from each end would go right through the actual bones and discs…they would wear out and degenerate much more quickly. Because we have the curves, we can literally absorb most of those stressful forces in the curve, and they have very little impact on the bones and the discs.
When we sit down, however, we immediately change the entire structure of our spine. The first thing that happens is the lower back curve pretty much disappears. Even with some lumbar support in our chair, the stress coming up from the chair and down from gravity goes into the discs and bones. The second most common postural change when we sit down comes with the neck. It is very common for us to slouch our shoulders and our head comes forward. That eliminates the curve in the neck as well. To add insult to injury, in an effort to still be able to see our screen, we hyper-extend our neck in the very top section and that puts significant stress in there as well. Research has shown that for every inch our head comes forward in front of our shoulders, we add 10 pounds of pressure to our neck. The average person at a computer comes forward 3.5 inches! Essentially, when we sit down, we are taking away the protective aspects of the spinal curves, and we leave our spines vulnerable to the forces that lead to degeneration and other health issues.
What are the other health issues?
Researchers have been exploring the connections between sitting and some of our most common health complaints. The results continue to show a significant correlation between holding those poor seated postures and issues. Here are only the most researched ones:
Upper back “hump”
So are we suggesting you squat at your desk or when you’re about to start your newest Netflix binge?? Of course not, but we will get to that.
One of the biggest challenges for health care practitioners is that often times people don’t have a lot of symptoms until degeneration or some of these other issues have become much worse than we want to see. Often, by the time symptoms arrive, we have been on that path for a very long time. As many of you know, most of us grew up believing that “well I don’t have any symptoms, so I must be healthy.” Of course, the guy that has a heart attack often “felt” perfectly fine the day before, and the person who ruptures a disc often had very little pain the day before he bent over to tie his shoe and set it off! The truth is, when it comes to our health, it isn’t always about how our bodies feel as much as it is about how they function. To make it even harder on us, we were also raised to believe that once we had an issue come up with our health, we could just treat the symptoms, and we would be good to go! When we have high blood pressure, we take a drug to lower it. We do the same for cholesterol. When we have pain, we take a pain killer to numb the pain signals that go to our brain. We haven’t actually looked at WHY our blood pressure is elevated (no it isn’t just the salt shaker you have on the dinner table), or the reason our back is in pain. Symptom gone…problem gone.
As we all know at least intellectually, we haven’t fixed anything. We have only covered it up. So when you are sitting in your chair all day, sitting to drive home, sitting to eat dinner, sitting on the toilet, and then sitting to read or watch this week’s episode of the Bachelor, you are putting tremendous stress on your spine, and you are moving towards the health concerns we listed before.
I said that last part because most people don’t necessarily feel the detrimental effects of sitting on a daily basis. “I work out, I eat clean, I walk at lunch, and I actually don’t really notice any of those issues.” The reality is that I have had the fortune of being in practice for over 20 years, and in that time, I think I have almost seen everything. When we are young, more fit or take better care of ourselves, we won’t notice these issues for a longer time. When we are more sedentary and getting a bit up there in “experience,” these challenges can come up sooner and perhaps more dramatically. I cannot count the number of times in practice where patients felt perfectly fine, took care of themselves, and then one day they go to pick up a pen off the floor or get out of the car and their back “goes out.” These are the cases where the body was under stress from the issues related to posture, and the muscles finally were not able to hang on or compensate any longer. Of course, the process is much more complicated, but it is essentially just that. The body was too stressed for too long, and it finally rebelled!
So why is a Chiropractor having this conversation?
Many people are aware of ergonomics and the ways we can minimize the stress and damage that come with ignoring it. Should this not just be as easy as having HR set you up with an ergonomic chair, get your keyboard right, and you should be good to go? Those things are important and will certainly help, but they are, unfortunately, not enough. Below is a list of all the tools and tricks to make sure you can optimize your sitting and lifestyle to reduce the damage, but there is a part that may require an intervention…hence why you’re hearing from me!
After falls from your bike as a kid, car accidents, small bumps over the years, your time in the circus, many years spent sitting, and all the other things that put stress on our bodies, it is almost always the case that it can change the alignment and function of the bones in our spine and pelvis. The problem with these joints not moving in their full range of motion or being out of place is that it is much harder for us to tell than in other parts of our body. If your shoulder is only moving in one direction 50% of the way, you will know it right away! But the numerous tiny joint in between our 24 vertebrae, and the joints that make up our pelvis can be pretty stuck or even locked, and we likely won’t notice it at all. There are so many of them, and they all move so little already that we often don’t notice the loss of movement, and we go on about our day. Those are the joints that cause ALL the problems for us as we age and degenerate. Those tiny little joints can bring a 280 pound rugby player to his knees when they get to the point of degeneration or decreased function they are capable of when not addressed early enough.
That is where we come in. A Chiropractor will evaluate your spine at the segmental level to find the joints that are locked or “sticky” and get those joints moving and aligned again. Research has shown that joints that are not moving in their full range of motion will degenerate significantly faster than joints that are moving well. Very quick anatomy: Every joint in our body is surrounded by a membrane capsule, and inside it is the nutritional bath for that joint called synovial fluid. When joints don’t move, that fluid becomes stagnant and deprived of nutrients, and the joint immediately starts to break down. When someone receives a Chiropractic adjustment, the joint is moved, the fluid is replenished, and it is essentially the exact same thing as an oil change for your car! Once that joint is moving and replenished, it can go back to doing everything it is supposed to be doing without moving down that road toward osteoarthritis.
So what can you do now or between visits to your Chiropractor? Below are some great guides, exercises and tips to get you started. While it may seem overwhelming to start this process, I can assure you that once it becomes a routine, it will get very easy…all you have to do is start! This will help us all make sure we are healthy by choice…not by chance!
Raise or lower your seat so your thighs are parallel to the floor and your feet are flat on the floor or a footrest.
Adjust the depth of your seat so you have at least 2” of clearance between the back of your knees and the front of the seat.
Adjust the height of your backrest so it fits comfortably on the small of your back.
Adjust your chair’s recline tension—if necessary—to support varying degrees of recline. Avoid using recline locks.
Lean back and relax in your chair to allow the backrest to provide full support for your upper body.
Position your keyboard support 1 – 1.5” above your thighs and angle the keyboard so it slopes slightly away from your body. Be sure to keep your wrists in a straight, neutral posture while typing, and rest the heels of your palms—not your wrists—on a palm support.
Position your mouse close to the keyboard—preferably on a mousing platform—to minimize reaching. Avoid anchoring your wrist on the desk. Instead, glide the heel of your palm over the mousing surface and use your entire arm to mouse.
Position your monitor at least an arm’s length away with the top line of text at or just below eye level. Tilt the monitor away from you slightly, so your line of sight is perpendicular to the monitor.
Position your task light to the side opposite your writing hand. Shine it on paper documents but away from your monitor to reduce glare.
ALIGNMENT OF DESK ITEMS
Align your monitor and the spacebar of your keyboard with the midline of your body.
Arrange frequently used work materials within easy reach to minimize twisting and reaching.
Take two or three 30- to 60-second breaks each hour to allow your body to recover from periods of repetitive stress.