The Sitting Down Disease
Updated: Dec 30, 2019
How many of us earn a living from sitting on our backsides all day but pay a huge price with our health and well being?
Despite the medical community not currently recognising 'Sitting Disease' as a diagnosable disease, there are no doubts as to it being a metabolic syndrome and the knock-on ill effects of an overly sedentary lifestyle. Combine this with a poor diet and I'm sure that in future years this era will be looked back upon as a blip in Homo Sapiens development (which is ironic considering homo sapien is Latin for "wise man"!). The human body was designed for hunting and travelling long distances efficiently - we can outrun almost any animal - not sitting in a hunched position for 40+ hours a week. However, that is how the vast proportion of us exist and make a living, with manual labour and jobs 'on your feet' being the exception not the rule. Even if you are working as a manual labourer, how many tradesman do you know that have bad backs?
If you sit for six hours a day or more, your risk of dying early jumps 19 percent, compared with people who sit fewer than three hours according to an American Cancer Society study. Unfortunately that is what the vast proportion of us are asked to do as a paid employee, or even if you're running your own business for that matter. Whether you're in a traditional office job or driving a vehicle for long periods of time you are inadvertently shortening your hip flexors (the muscles in front of your hips) and over-stretching your glutes (the muscles in your butt). If you spend the majority of your time sat down, initially you'll just end up with stiff muscles that don't work as well when you stand up, but over time it will shorten your stride and make it difficult to walk/run comfortably and efficiently. And this is if you are sat correctly - which most of us are not. The spine is designed to support pressure head-on i.e. hold the weight of your head against gravity. As soon as this becomes mis-aligned, there are stresses and torsional forces being applied to your back that it hasn't signed up for. The human body is an incredibly resilient and robust machine and can cope with most pressures initially but apply over a long period and something has to give.
The 2 main issues that arise from a long-term sedentary, sitting down lifestyle are:
Lower back pain (LBP)
Lower back pain
Before we talk about the debilitating nature of lower back pain let's have a look at a few statistics:
540 million people affected globally: main cause of disability worldwide
1/3 of all adults suffering at any one time with almost everyone experiencing LBP at some point
In last 20yrs, 12% increase in UK of experiencing disability as a result of LBP
LBP most common medical reason for sick leave and for early retirement (31 million work days lost in UK in 2016 due to musculoskeletal problems)
Costs attributable to LBP in UK estimated at £12.3bn/year
(Figures courtesy of Office for National Statistics and featured in The Lancet)
There's no doubt - it's a huge problem! One of the biggest health issues of our time, and certainly one of the costliest.
But aside from grabbing a few headlines, these figures are so huge that they're largely irrelevant to the individual. You either want to know how to prevent yourself from getting lower back pain, or what to do about it if you already have it.
The answer to both these questions is pretty much the same - get moving!
Very easy for me to say, but not so easy to do (particularly if you've already got LBP).
Gone are the days, where you would go to your local GP with back pain and he would say rest it. In most cases, you need to be getting out of bed, stretching and moving around. To prevent and cure LBP we need to be working on our flexibility, functional movement and core strength.
Core strength is a key to this. If our internal abdominals and stabilizers (the muscles below the 'superficial' six-pack) are firing and active we can get them to support our bodies and movement and take on the role that most of us rely on our backs to do all the time. Much like a disgruntled, overworked employee as soon as you give that back some downtime, 'Hey Presto!' it quits complaining and threatening to go on strike all the time.
I know you're reading this and thinking "Sure, common sense really, but I don't have the time". My wife and I hear this in our studio every day. Firstly. it's about priorities - if your back doesn't work - you don't work. Secondly, you do have the time. You can do a thorough back stretch and get your core engaged in less than 5 minutes. This can all be done on 2 metres square of floor space in front of the TV, in your bedroom/hotel room/office, anywhere really.
Right up until back pain started affecting the quality of my life, I made the same excuses. Blamed lack of time, space, equipment, genetics - everything but me.
In actual fact all I had to do was take 5 minutes out of my time and build it in to my daily routine and within a few months I felt like I had been given a new body to work with again. One that allowed me to play with the kids, and sit at a desk for more than half an hour without needing a shoehorn to prise me off...
What I have found is that just doing this for a few minutes each day (I do it immediately after getting out of bed) it resets my body after a night's sleep and gets me engaging the correct core muscles for the rest of the day. A bit like rebooting your computer each day, so that the previous day's work is no longer slowing it down and it can operate efficiently.
The 5 minute daily routine that I use can be seen in the video below.
Give it a try - whether you're trying to prevent LBP or you've already got it.
It's a combination of yoga and pilates, and if you've got any stretches that work for you, incorporate them as well. After all, we're all built differently, and unfortunately there isn't one blueprint that fits all. The key points are:
Do something (something is always better than nothing)
Keep it simple (otherwise you won't do it)
Do it regularly (ideally, make it part of your daily routine)
If you spend most of the day sat at a desk you are not expending a great deal of calories. Basic, I know - but sometimes it needs to be said. If you are also consuming a lot of calories in the form of coffees, snacks, unhealthy lunches etc this is going to magnify the issue. The tangible result of which is, you are going to get fat.
Even if you are fortunate enough to have a high metabolic rate so as to not get fat on the outside, the chances are you will be getting fatter on the inside (high cholesterol, with visceral fat around the middle and vital organs). Being a numbers man, and in the interest of fairness let's have a look at a few obesity stats:
In the UK more than two-thirds of the adult population are overweight or obese
World Health Organisation (WHO) estimates that that more than 200 million men and 300 million women are obese worldwide
It is the fifth-leading risk for all deaths globally
One in ten people over 40 has type 2 diabetes, driven by the obesity epidemic
Obesity is obviously a huge issue and will no doubt be one of the major problems faced by an ageing population in the 21st Century. Many factors are involved but
the two primary contributors we are looking at here are, simply:
Greater calories going in
Less calories being expended
Unfortunately, if you're sat at a desk all day you are more than likely consuming considerably more calories than you're expending.
There is no simple answer to turn this equation around without applying self-control, discipline and making good choices.
The problem is quite often if we're sat in the same place for a long time, we're often bored and in some cases depressed. The first thing most people do to alleviate these issues is reach for the snacks - get that sugar rush (and the subsequent crash!).
So what can we do to avoid this vicious circle and their long-term consequences?
Improving our situation
As I said, there is no one simple solution to alleviate the above problems associated with spending a lot of our time resting on our asses. We all know that life isn't that simple.
But like the British Olympic Cycling team we can apply our theory of marginal gains and make small improvements, which cumulatively will add up to make big differences to us over the long-term. It's all about making it routine, so we don't even have to think about them - they just become second nature.
1) Get up and move
Very simple, and yet almost no one does it.
There's no getting round it - if you sit in the same position for hour after hour you are going to have problems. It may not be today or tomorrow, but it's coming. If you're a twenty-something reading this and thinking "What's he on about - my body can handle it - it's only sitting", I promise you 10, 15, 20 years down the road of concentrated sitting on your ass you won't need those blue pills to get stiff ...
So get up and move around.
Ideally you don't want to be sat in the same position for more than an hour.
However you want to break it up, take a walk around and have a stretch even if it's only for a few minutes. Not only will you get the physical benefits but it will clear your head as well and probably make you more productive on your return.
Set your alarm to remind you if you need to.
Or as I did, take in a small bottle of water.
This gives you plenty of opportunities to regularly take a walk to the kitchen or water dispenser to fill it up. I used 75cl rather than a big 1.5 litre bottle so that it needs re-filling regularly. It also helps deal with the issue of dehydration (which most of us are, and will be spoken about in future blogs). People often mistake being dehydrated for feeling hungry - so reach for the snacks. Vicious circle built around vicious circle.
So, by the simple act of taking in a small re-fillable water bottle you are:
Moving and walking regularly to fill it up
Hydrated, so less likely to feel hungry and boredom eat
Have a quantifiable measure of how much water you are drinking each day
Probably drinking less tea and coffee. Saving you money and your health.
One small change that won't feel like it's changed much. But applied over a working career, it will make a huge difference to your long-term well being.
2) Learn how to sit correctly
Sitting - like standing - is one of the most technically challenging things we do, yet most of us have no idea how to sit well.
Every time you sit down you are effectively performing a box squat.
Position your heels a few inches in front of the chair.
Screw your feet in to the floor to create torque.
Keeping shins vertical, back flat, sit hamstrings back and hinge at the hip.
Lower butt, and press lower back in to back of seat.
Nice straight back pressed against back of seat (you are not limited to sitting perfectly upright - you can also lean forwards or backwards whilst maintaining a braced neutral spine. This is effectively keeping everything in alignment with your core supporting the load).
Once seated, abdominal muscles need to be engaged at least 20 per cent to maintain correct posture - this is very challenging and therefore a good static position can only be held realistically for 20 minutes.
In order to apply in the real world, I would suggest practicing your proper sitting down technique 5 or 6 times. Now that you are thinking about it, this will become your new 'norm'. It is almost impossible to correct yourself from a sitting down position, so every half an hour find a reason to stand up and wander around, or just 'reset' yourself from a standing position. View every time you sit down or stand up as an opportunity to squat and have a stretch.
Sitting is a toxic position, so all you can effectively do is reduce the damage caused by extended periods of sitting. It is no accident that you feel like a broken-down bag of rubbish after stepping off a 9 hour flight - try not to effectively do this every day!
3) Avoid sitting down all together
Most companies are slowly becoming aware of the destructive nature prolonged sitting can have on their employees health. Certainly the larger companies will quite often have someone you can contact through human resources that will come and check your desk set-up from an ergonomic perspective. Ideally, they may even provide stand-up desks so you can avoid sitting down at all for large chunks of time.
For my last couple of years in an office environment, I used a swiss ball to sit on. This made a huge difference to me - by taking away the back support I was no longer able to slouch and forced in to using my core muscles instead for support. In order, to do this effectively though you do need reasonable core strength to begin with, otherwise you will very quickly find yourself in an uncomfortable sitting position on the ball.
Also don't sit near any sharp objects. I inadvertently rolled over something sharp, and the swiss ball exploded. One moment I was on 2 phones, speaking to someone across the desk. The next, I was lying on a small piece of plastic in the foetal position on the floor, stifling a scream. Not sure who was more shocked!
Alternatively, most larger companies will normally offer the option of a standing desk, if requested.
These work great and will make a big difference if used correctly. Don't go into it with the idea of standing for 8 hours of the day. Start off just using it for 1-2 hours a day and you'll be surprised how quickly you get used to it. Eventually sitting down is the one that feels strange. Most people don't try it due to peer pressure - nobody wants to be the first in the office. Well, I was - and received all the usual abuse / banter ... 'Chedgy's special needs desk', 'look at the old man in the corner'. But within a few months, half the trading floor were requesting them. In fact, a friend of mine who owns an IT company bought 3 standing up desks with walking machines attached for his coders. Now the problem is that everyone wants to se them!
When you can't avoid sitting down, help yourself to sit correctly by adjusting everything you use to force yourself to sit correctly - screen height, keyboard position, mouse etc. Hopefully there is someone at work to help you with this, but otherwise there's plenty of information online.
We also find ourselves seated for long periods of time when driving, whether it's part of your job or just getting from A to B. Most people don't help themselves, by having the seat, wing mirror and rear view mirror set up for their natural, slouching position.
Sit in a correct upright position with a nice straight back and then make your adjustments. That way, if you're halfway through your 2 hour drive and not able to even see through your rear view mirror, you know you've resorting to slouching down and can reset yourself. Whenever the mirror's appear to be in the wrong place, it will be a gentle reminder to sit correctly. It only takes a few reminder's before you'll find yourself sitting correctly naturally.
4) Healthy snacks
One of the real issues we need to develop a coping strategy for is boredom eating. Even if you are incredibly stimulated by your day-to-day job (lucky you!), just being sat in the same place for hours at a time can drive even the most disciplined person to eating crap. Sometimes your just looking for stimulus. It's all too easy to make a cup of tea and reach for the biscuit jar, or go for a walk to the vending machine for a packet of crisps.
As I mentioned earlier, sometimes you're not even hungry - just dehydrated. If we make sure we're drinking plenty of water, the next thing we need to do is have healthy snacks at hand to prevent bingeing on rubbish when blood sugar is low or we're just bored. I always found nuts or fruit (particularly bananas) the easiest and healthiest snack. Just make sure the nuts are in their natural form i.e. unsalted or flavoured, and don't eat too many of them. Two good sized handfuls a day is the maximum you should be getting through. Almonds are classed as a superfood because of their good fats and high protein content. If you have the odd snack, particularly mid-morning you're also less inclined to over-eat at lunch. How many of us refrain from eating all morning, plan to have a healthy lunch, and then buckle when a work colleague next to them orders a McDonalds because they're so hungry! If you don't let yourself get to that desperately hungry stage, it's normally a lot easier to keep your self-discipline.
5) Sit / stand correctly when texting
Although many of the physical stresses of a hunter / gatherer life have gone modern day life throws up many other issues that our body is not built to cope with. One of these is screen time and mobile phone usage. There's 10 blogs just on this subject alone, but the one I'm going to focus on here is the physical demands placed upon your body, or more precisely neck, when looking at a screen or texting. The average adult now spends nearly 4 hours a day on their mobile phone! With the majority of people bending over or straining their neck in order to do this, it's going to provide a future generation of health professionals with a job for life trying to fix 'text neck'.
Again, it's not a difficult problem to resolve - just a bad habit - just make that routine a good one, and sit or stand correctly when you're doing it.
Correct texting posture
So much of what we do is due to habit or routine. Whether it's exercise, unhealthy eating and drinking, sitting down for too long without moving, or texting - we do it, not because we're going out of our way to be unhealthy, but because we've self-programmed ourselves to make it it part of our daily (bad) routine and it feels normal. Unfortunately with life in general, the easier, less thought/effort required option is normally the unhealthy one. But it really does not require a whole lot of thought or effort to turn it around and get yourself in to healthy routines. Hopefully, after reading this blog, you will now notice where you've got yourself in to a bad routine and see that it's only a few relatively minor adjustments you need to make to get yourself on track again. If not, you've now got your ready-made answer for when any child asks what they should be studying for a future career. There's going to be a huge demand for physiotherapists and chiropractor's ...