In recent years the dangers of sitting to our health has attracted a great deal of attention as researchers have proven there is a link between lack of movement and injury/disease. All this attention has prompted many great improvements in the workplace to overcome the fact we have many jobs that require us to be seated and computer bound. From workplace exercise programs, to the amazing evolution of the stand-up desk which is one of the best things to be invented in recent times we are becoming much smarter and more aware of the need to move. However, there are many who remain oblivious to the danger this repetitive movement causes to your body and in particular the neck, lower back and knees. In this article I will explain exactly what this danger is and how it can very easily create a vicious cycle of ongoing pain if you do nothing to recognize the warnings early on.
When we develop back pain we tend to look at the last thing we were doing and blame that for the reason of our pain. Many are aware of the dangers to the spine from lifting things poorly but what is not common knowledge is the damage to our spine and discs from sitting. Compression of our discs is normal to some extent and happens all day due to Earth’s gravity.
Most of these forces and motions are handled pretty well by the spine, and usually causes us no trouble. The spine is a strong, durable and yet flexible structure designed not only to transmit force but also allow a whole heap of movements in all planes of motion.
However, when the amount of these forces exceed the spine’s capability to withstand being squashed by various postures we repetitively adopt, or the dysfunctional way that we move, you will find pain is not far away. Bulging disc injuries are extremely common and affect people of all ages.
Sustaining a slouching or forward bending of your spine leads to overstretching and weakness of the posterior fibrocartilage (or annulus) of the spinal discs. Over time, this leads to poor disc integrity and displacement of the disc nucleus fluid posteriorly. This places your spinal joints and nerves under pain-causing pressure.
Take a look at the picture below to see just how much pressure is placed on the lumbar discs in various positions.
This chart demonstrates the spinal pressure from various positions in comparison to standing. (Source of these figures are from Paul Chek’s Scientific Back Training Course)
Note the spinal disc pressures from sitting slouched are much greater than the spinal compression of bending with load otherwise known as a deadlift!
When we bend over to pick something up we do not stay in that position for hours at a time. It is more like a second or two before we pick the object up and stand up straight again. Yet when we sit we can easily be stuck in one position for hours at a time with no relief at all on the discs.
Imagine sitting in compression like this all day and then heading to the gym to do a quick workout that involves heavy deadlifts or squats. How well do you think your spine is going to take this workout? Maybe your solution is to train your core or do some Yoga to loosen you up.
Unfortunately, these exercise methods may be even worse for at least good form with a squat and deadlift maintains the spine in neutral. Many of the abdominal exercises, Yoga poses and stretches that adopt spinal flexion or excessive extension place massive amount of compression into the discs.
See picture below to see how many pounds of pressure are placed on the discs with many popular core exercises.
Note how much compression on the discs there is with the basic abdominal crunch or sit-up. Many of the core workouts work on the belief that if the abdominal muscles are stronger the back will be stronger and resistant to injury.
Not only is this false but many of these exercises may in fact be creating a back injury for you!
The core works best when it can funnel the load and compression away from the spine and outwards to the limbs of the arms and legs. If the load is concentrated into one area it will only serve to create more compression into the spine as all this energy has nowhere to go.
As the abdominal musculature become progressively shorter and tight, the following postural aberrations may be seen:
1.Short and tight upper abdominal musculature
2.Depressed sternum
3.Forward head posture which increases the chance of neck pain and a shoulder injury not to mention the poor breathing resulting from this position
4.Increased thoracic kyphosis, (a dowagers hump on the upper back)
Watch the video below for a detailed look at some of the common mistakes with abdominal training.
A great article to read with some great core alternatives that do not ruin your posture and spine is here – 7 anterior core exercises that are better than the plank
What Can You Do To Counter The Effects Of Sitting?
There is several very simple things you can do to prevent the onset of pain and damage to your discs.
It is not so much that sitting itself is bad, but more how you sit that is. This means you need to learn how to sit correctly.
There are many great therapists who teach how to do this and I highly recommend reading the book by Esther Gokhale – “8 Steps To A Pain Free Back” as she provides several great examples of sitting, lying and standing postures that are very effective and easy to learn.
The video below gives you a really basic look at how poor pelvic positions create spinal problems and a simple fix you can use to counter this.
I know pretty simple isn’t it?
But it is amazing how easily we can fall into the trap of slouching and as it becomes a habit we do not even realize what we are doing. The biggest mistake I see is where people fall into a POSTERIOR TILT of the pelvis where the butt rolls underneath and they round out their spine.
This leads to what is known as “BUTT GRIPPING” and can become a very serious chronic condition that can be very hard to get rid of.
The very first thing you need to do is move your butt back into the corner of the chair and slightly tilt your pelvis forward so you can maintain an optimal position of the spine and hip. Some people may find this very tiring as the muscles required to do this may be very weak. Using a lumbar roll to sit in the curve of your spine may be very useful here as well as taking breaks by standing up or even kneeling on the floor every 10 minutes to give your muscles a rest.
Get A Stand-up Desk
Getting a stand up desk would be a great starting point. A standing desk, also called a stand-up desk, is basically a desk that allows you to stand up comfortably while working. Many workplaces are implementing these now as they also see the value to their employees and reducing loss of work time due to back pain.
There are tons of versions available that are easily adjustable, so that you can change the height of the desk and alternate between sitting and standing. These are referred to as height-adjustable desks, or sit-stand desks.
There has been several studies have been completed as to the effectiveness on these desks with back pain.
One study participants have reported up to a 32% improvement in lower back pain after several weeks of using standing desks. Another study published by the CDC found that use of a sit-stand desk reduced upper back and neck pain by 54% after just 4 weeks. Additionally, removal of the sit-stand desks reversed some of those improvements within a 2-week period.
To decrease the effect of poor posture on your spine it is important to continually attempt to maintain a good posture or even better, regularly change your posture. If you do not have a stand up desk then setting up your workstation correctly will be a good start and regularly taking breaks to give your hips and spine a break will be another.
Use Exercises That Enhance Good Posture
We know exercise is great for our body and improving our stability and strength is a great way to build resilience to our discs and the back. If you work out with good form and are able to maintain neutral spine in every movement you will be fine. If your form suffers and you compromise the stability of the lumbar spine you will now place huge compressive forces into your discs.
A great way to learn how to maintain a neutral posture while you move is to use a stick! We use this extensively in the early stages of training with almost every client so they can begin to feel what the position of optimal alignment during movement. Such a simple tool but extremely effective.
Once you have mastered simple movements like push ups and forward ball rolls you need to learn how to incorporate this into the more complex exercises in a standing position that demand more stability, strength, and skill.
Squats, deadlifts and various movements that require spinal flexion and extension can be amazing ways to train incredible core strength and good stiffness into the spine to protect the discs. But they can also completely destroy you too!
Technique is everything. While I cannot give you a template to follow as each person is unique with their individual needs and imbalances you can get some good ideas for exercises to help improve posture in the video below.
It’s Not Just Your Back That Suffers This Is What Sitting Does to Your Knees
Your back is not the only problem with long periods of sitting as the damage to your knees is significant and sitting is often overlooked as a source of the problem with chronic knee injuries.
Without a doubt the biggest factor that can increase stress in the knee joint is tightness of the hips and quadriceps. Tight quads greatly limit your ability to flex the knee and create what is known as patellofemoral compressive issue.
The quadriceps muscle attaches directly to the knee cap and then the knee cap attaches directly to the tibia (shin bone) which forms a strap. As the knee flexes further and further when you bend your knee the strap tightens and compresses the patella into the trochlear groove causing compression within the patella femoral joint.
This is the reason why people with knee pain also have pain with prolonged sitting, especially if the tuck their legs underneath the chair.
They basically continue to place their body in a position which compresses the joint for a long period of time.
See picture below.
In nearly all cases of knee pain we find huge mobility problems at the hips and knee joint. Before any strengthening or stabilizing work can be applied we have to restore optimal mobility first.
From a mechanical perspective, a tight muscle will limit the range of movement through which its opposite muscle can move. This is known as muscle inhibition.
For instance, in the case of the gluteus maximus (your big butt muscle), a tight hip flexor muscle at the front of the hip mechanically will limit hip extension (backward leg movement) and neurologically will decrease the force of the nerve signal to the buttock. In other words, the tight muscle at the front of the hip will make the rear hip muscle less efficient and weak, which in turn will significantly affect the function of the kinetic chain, increasing strain on the lower leg.
So how do you restore this back to normal? Some of the best ways to do this are featured in the video below.
Failure to address mobility and release the knee from this constant grinding and tightening up of the hips/quads eventually leads to compensatory movements that will now expose other areas to pain. And usually the next joint to suffer is the spine!
It becomes a very vicious cycle of the tighter the hips and quads become the more painful the knee gets limiting your movement and forcing you to bend your spine into positions of danger. To have a rest from this you sit down to give you temporary relief which is really exacerbating your problem in the long term! As painful as it may be to exercise you must break this cycle or you will end up with severe osteoarthritis and a candidate for knee replacement!
You will find tons of information about addressing knee pain in this article – How to strengthen a weak VMO and get rid of knee pain
Do You Need More Help?
Obviously there are a lot more exercises and strategies you need to do if you already have back pain or knee pain which you will find great resources for this in the online shop.
If you would like to follow our Step by Step approach for assessing back pain and applying the lessons here and many others, make sure you get a copy of our Back Pain Secrets online program below by clicking here.
With over 90 minutes of video and a PDF instruction manual complete with over 60 exercises this is a great addition to the person looking to get rid of back pain for good.
Summary
I hope this article enlightens you to the potential dangers of sitting and gives you some great strategies of how to overcome this and avoid the nasty injuries that result. It is not as simple to tell someone not to sit as there are so many occupations that this is a necessity.
We have to become smarter with how we hold our body position and we MUST use exercise to combat the negative impact it places on us. If you can implement the things discussed in this article you will go a long way to living pain free and being able to sit for work without the pain and suffering.
About The Author
Nick Jack is owner of No Regrets Personal Training and has over 20 years’ experience as a qualified Personal Trainer, Level 2 Rehabilitation trainer, CHEK practitioner, and Level 2 Sports conditioning Coach. Based in Melbourne Australia he specializes in providing solutions to injury and health problems for people of all ages using the latest methods of assessing movement and corrective exercise.
References
•Gift Of Injury – By Stuart McGill
•Low Back Disorders – by Stuart McGill
•Back Pain Mechanic – by Stuart McGill
•Ultimate Back Pain Fitness – by Dr Stuart McGill
•Motor Learning and Performance – By Richard A Schmidt and Timothy D Lee
•Assessment & Treatment Of Muscle Imbalance – By Vladimir Janda
•Scientific Core Conditioning Correspondence Course – By Paul Chek
•Scientific Back Training – By Paul Chek