Why You Shouldn't Just Sit There

New Hampshire Magazine - June 2017

Why You Shouldn't Just Sit There - Mounting research points to the hazards of sitting
By Karen A. Jamrog

If you had to take a guess, how many hours would you say that you spend seated? Thanks to the prevalence of desk jobs and technology, most Americans aren’t moving much these days. A typical day often consists of a sedentary commute to and from a sedentary job, a seated dinner and unwinding on the couch while watching TV before bed. All told, we can spend upward of 90 percent of our waking hours in a seated position, says Amy Harrison, MPT, a physical therapist at Southern New Hampshire Rehabilitation Center in Nashua.

Have we in effect become sitting ducks? Mounting research indicates that too much seat time can seriously sabotage health — and even ardent gym rats are not off the hook on this one.

“Numerous studies have shown that, even if you have adequate exercise, leading a sedentary lifestyle — that is, sitting for more than six to eight hours [per day] — will lead to poor circulation and cardiovascular risk,” says Syed Peeran, MD, a vascular surgeon at Appledore Medical Group-Coastal Cardiothoracic and Vascular Surgery, based out of Portsmouth Regional Hospital.

When we walk, Peeran explains, the leg muscles in our calves contract, helping to propel blood upward toward the heart. Doctors sometimes refer to this action as the “calf muscle pump.” When calf muscles are idle, such as when we sit or stand but remain still, that supportive boost from the calf muscles does not occur, making it more difficult for blood to work against gravity and circulate back to the heart. Prolonged sitting causes blood to stagnate and has been linked with a range of health problems that include varicose veins, leg swelling and pain, obesity, heart disease, diabetes, cancer and premature death.

While it isn’t always easy to avoid extended periods of sitting, there are ways that even 9-to-5 desk jockeys and cramped airline passengers can minimize the harmful effects of too much seat time. The key is to keep active as much as possible and to keep the calf muscles working. Peeran recommends the following:

• Take a break from sitting at least once every hour. “The more frequent, the better,” Peeran says. Try to notice and take advantage of opportunities to get up and move. If you need to communicate with a work colleague who is in a different part of the office, for example, rather than sending an email or text message, get up and walk to where the person is located.
• If you are preparing to embark on a long airline trip — one that is three hours or more in duration — then purchase compression stockings beforehand and slip them on the day of the flight. Both medical-grade and standard compression stockings work effectively to provide external support, Peeran says, and “are very helpful for long travel.”
• If you can’t easily move around due to travel, work or other circumstances, do toe lifts, calf raises and leg extensions (by straightening the leg at the knee) while seated, Peeran suggests. If you are on a plane and it’s OK to unbuckle, stand and walk up and down the aisle. Even Peeran himself walks the walk, you might say. “I wear over-the-counter compression stockings when I [perform] an operation because sometimes I’ll be operating for six straight hours, and I won’t be able to walk around,” he says. Peeran also does toe raises and heel lifts when possible during a long stint in surgery since, he points out, “I can’t really walk away.”
• If you can, use a treadmill desk. Despite the popularity of standing desks, they are not really an effective way to avoid most of the health hazards that come from prolonged sitting. In terms of vascular benefits, “standing up in one place is not helpful,” Peeran says, “because you still have the pooling of the blood.” You need to walk — and more than just a few steps. “You just have to keep your legs churning,” Peeran says, “and keep your muscles contracting.”
• Consider investing in a Fitbit or other activity tracking device, or downloading an app (some of which are free) to raise your awareness of how many — or how few — steps you take each day and to deliver a digital poke when it’s time to get up and move. “I think they’re wonderful,” Peeran says of such aids. “The patients’ level of awareness and their compliance with exercise and walking is enhanced by these things.” Additionally, he notes, tracking devices and apps provide valuable information to doctors about patients’ walking ability and exercise tolerance. “I am very much in favor of these devices,” Peeran says. There’s something about seeing a visible, running tally of activity-related data that can motivate even reluctant exercisers. “It’s a constant reminder” on your wrist, belt or screen to walk more, Peeran says, “and I think people enjoy that. I think they like that feedback.” Without it, he adds, “the day can just pass by and you won’t really notice how much you’ve walked or how much you’ve sat.”

Many people who do not have health restrictions aim for a minimum daily goal of taking 10,000 steps per day. Before beginning a walking program, however, talk to your primary care doctor, Peeran says. “Your primary care doctor knows about your health, knows about your limitations, and is probably the best person to talk to about your walking regimen or how much you’re sitting and if that’s a problem.”

Give Your Back a Break

Hours spent scouring Amazon for deals notwithstanding, “our main occupation as humans is not hunting and gathering anymore,” says Amy Harrison, MPT, a physical therapist at Southern New Hampshire Rehabilitation Center in Nashua. We spend altogether too much time sitting, placing ourselves at a higher risk of cardiovascular disease, diabetes, cancer and death. If those potential consequences perhaps seem too far off in the future to warrant your attention, know that sitting also does a number on your back.

Sitting pulls the back out of its natural position, creates abnormal forces on the spine, and is a common source of back discomfort, Harrison says. Even if you maintain good posture and avoid slumping while seated, “the effect of gravity is at least quadrupled when we’re sitting,” Harrison says, and creates compression within the spine, which does not make for a happy back.

To keep your back healthy, try to minimize the time that you spend seated — including while you are at work. “The best work station is an arrangement that you can break free of regularly,” Harrison says. Standing desks, unfortunately, don’t do much to negate most of the health risks that are associated with prolonged sitting, but using one can benefit your back. The load on the lower back is reduced by more than 50 percent when we stand compared to when we sit, Harrison says.

But don’t wait for back pain to cue you to stand (as many individuals do). Some people can sit for only 15 minutes before their back starts to hurt, Harrison says, “so I tell them to sit only five or 10 minutes [at a time]” until back tissue becomes healthy enough to tolerate longer periods of sitting.

Clearly, it’s best for all of us to spend less time parked in a chair, but standing motionless for hours each day is not a great idea. “The back craves movement,” Harrison says. “No position is good to stay in for long periods of time.” Compared to standing, she says, “sitting is just worse for the back.”

Tips for a Healthy Back

Courtesy of Amy Harrison, MPT

• Use a chair with good lumbar support.
• Raise the seat of the chair so that your hips are positioned higher than your knees. This will help your spine remain in a neutral position.
• Keep your shoulders pulled back and your chest lifted.
• Consider using a lumbar pillow or placing a 3-inch binder with a towel in it behind you in your seat, but do not rely on them to keep you upright in your chair. “They really should be used as more of a cue,” Harrison says. When you feel yourself press against the pillow or binder, think of it as a signal that you need to sit up straighter.
• Most importantly, take frequent breaks from sitting. Get into the habit of standing while taking a phone call and spreading other standing breaks throughout your day.