Managing an acute injury

Knowing how to immediately look after an injury for the first few days can speed up its recovery. In this blog we look at a more up to date protocol on how to help you manage it.

Many of us are well versed on the R.I.C.E acronym (Rest, Ice, Compression, Elevation). Which eventually was upgraded to P.R.I.C.E (P = Protect). Over the last few decades the advice on the management of acute injuries has rarely been contested. However, with growing research there has been a change in the way clinicians deliver advice on acute injuries to patients. With more recent research there is a new acronym called P.O.L.I.C.E. Standing for Protect Optimal Loading Ice Compression Elevation.

What’s changed?

The term REST can be completely misinterpreted. While it’s important to have a balance of rest AND loading. Too much rest can lead to
deconditioning of tissues, stiffness and weakness. By OPTIMALLY LOADING tissue it provides the right levels of stress to encourage tissue healing, while assisting with the drainage of swelling.

What is the right amount of load?

Firstly, you must listen to the pain and not try to push through it. But if in doubt seek advice from a health professional, whether it be a Dr or Physio. Assessing the injury will help clear any serious problems, like fractures or ruptures. After having the serious issues cleared, you can be guided on the appropriate movements or weight bearing exercises to perform.

If in doubt seek advice from a Health professional

Additionally, to help provide the right loading you may require a moon boot, crutches, brace or strapping for support. Before being gradually weaned off.

Ice

I’ve previously questioned the value of applying ice for reducing swelling. There is growing evidence that shows that we need some swelling to aid in the healing process and  by using ice to minimise swelling, we could be slowing down the rate of tissue healing. 

See: hold the ice in RICE

But using the ice instead to reduce pain, by limiting nerve conduction and lowering tissue temperature. This can be effective within 5-10 minutes of application. Doing this every hour will bring pain levels down allowing you to move or load the tissue as tolerated.

Side note: Make sure you regularly check tissue quality while icing to avoid frost bite.

Compression and Elevation

These two are the least controversial in their benefit of recovery from acute injuries. Having compression helps maintain swelling to a manageable level and the area can still move normally. Making sure the compression is tight but not causing pain or numbness. You can use crape bandaging or a tubigrip.

Elevation, particularly for the lower limb helps again at minimising excessive swelling. While elevated it helps to be gently moving the
area, which also assists with tissue healing and swelling.

Anytime you’re dealing with a new injury it’s important follow the most up to date advice to help you recover as quickly and safely as possible. By seeking physio, we can offer you that guidance and support as you progress. At Fundamental Physio Newmarket, you’ll be thoroughly assessed to identify the extent of your injury, then put on the right treatment plan to help you return to normal activity. 


References

Bleakley et al 2012 PRICE needs updating, should we call the POLICE? Br J Sports Med 

Algafly et al. 2007. The effect of cryotherapy on nerve conduction velocity, pain threshold and pain tolerance. Br J Sports Med

Malanga et al 2015. Mechanisms and efficacy of heat and cold therapies for musculoskeletal injury. Postgrad Med

Neck Pain – Wry Neck

Managing sudden neck pain on your own can be difficult. Whether you’ve had an injury or just woke up with it, physio can provide the right type treatment.

Have you ever just woke up with neck pain? Well you’re not alone. Up to 75% of the general population suffer with an episode of neck pain once in their lives.

Usually it comes on suddenly, from some non-traumatic event causing severe pain and stiffness of the neck. Which can be quite debilitating. Often occurring when waking up, if the head has been held in a prolonged position or turning the head quickly in a particular direction.

This can be particularly concerning when not being able function with your neck the normal way. The reassuring news is that it can be treated with physio and resolved using the right type of treatment, in a short period of time.

Wry Neck Symptoms

  • Neck stiffness – Your range of movement becomes severely limited. Usually locked up away from the site of pain.
  • Pain – Extreme pain localised to the centre or side of the affected area. Often radiates into the shoulder.
  • Muscle spasm – The injury usually leads to muscle spasm of the surrounding neck muscles and causes further restriction in neck movement.

Causes of Wry Neck

There are several theories of what causes a wry neck. The most common one being the small facet joints (two on each side of the vertebra) become irritated or injured when held in a prolonged position or moved quickly. This causes the increased pain, movement restrictions and muscle guarding.

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The other cause of a wry neck is an injury to the disc. Whether it be a bulge or strain of the disc wall, it can cause inflammation and place pressure on nerves that branch out of the neck. This may result in pain that radiates down the arm or cause altered sensation. If you experience this altered sensation it is important to seek professional advice. Discogenic neck pain might take longer to recover than a facet, but still responds well to physiotherapy.

Treatment Options

The good news is that a wry neck can be treated conservatively with physiotherapy treatment techniques and exercise. Physiotherapy can offer manual therapy techniques to loosen the stiff joints and soft tissue release for the muscle spasm. Dry needling may also help with reducing the muscle spasm and strapping can help during the acute pain.

Once the pain has gone and movement has returned, it will be important to consider prevention in the future. Strengthening and postural correction exercises for the neck, along with advice on ergonomics for your work environment may be needed.

Ideally seek treatment within the first 24 hours to start with the right advice for dealing with this injury. After a thorough assessment you will receive the best treatment and appropriate exercises to help you recover from your neck pain.

For an appointment, call on 095290990 

Upper Crossed Syndrome – A foundation for failure

Are you aware of upper crossed syndrome? Does this postural shape look familiar to you? If yes, then you take a look at the corrective exercises I’ve included in the blog.

Posture follows movement like a shadow

Are you being double crossed by your posture? There is a chronic condition called Upper Crossed Syndrome (USC) which is expressed by the rounding of shoulders, forward chin poke of the head.  Mostly seen with elderly, but with an accelerated escalation of sedentary lifestyles and work environments, it has become a common sight for all ages.

Upper Crossed Syndrome Anatomy

The position of your head and shoulder is orchestrated by various opposing forces. These muscle balance forces vary depending on the positions we regularly find ourselves in. With UCS there is usually a weakness of the deep neck flexors and overactive/tightness of the upper traps and levator scapulae. This causes a forward head position with a hinge point at the lower cervical spine.

Lower down with weakness of rhomboids and lower traps, matched with overactive/tight pectoralis major and minor causes a rounding of the shoulders.Posture

The muscle imbalance can affect multiple joint levels of the spine, the glenohumeral joint, the acromioclavicular joint and scapulothoracic joint. These might all lead to dysfunctions and result in injury.

How does this impact me?

Well that depends on how you live your life. This is a chronic condition that affects multiple joints and progressively over years they become stiff or weak. This closes the window on living an active lifestyle and increases risk of injury.

With less mobility and stability, comes greater risk to injury. 

This is typical with most office workers, students or driver’s. Their neuromuscular system has adapted to the UCS shape for years. But the injury risk increases when activity and movement levels are pushed higher than normal, for example overhead lifting, throwing sports or freestyle swimming that requires a wider overhead range of movement and ends up putting undue stress on the upper body.

Have you got the following?

  • Chin Poke: Is your head sticking so far out it’s at risk of falling off! Next time you stop at traffic lights take a look at the other drivers posture, it’s common to see the drivers head stuck at least 12 inches from the head rest.
  • Rounding of the Shoulders: Due to a weakness of scapula retractors, the lower traps and rhomboids, the super tight Pec muscles draw the shoulders forwards. Look at overly developed bodybuilders for a great example of rounded shoulders.
  • Winging scapula: When the scapula lifts away from the wall of the rib cage, it’s usually the result of a muscle imbalance. This might take a friend to spot this one for you.
  • Creasing in the neck: It’s the last places you want to see a crease. At the base of the neck and accompanied by the start of a hump in the thoracic spine.

Change starts now – How do I get there?

Expecting to do an overhead squat or chest to bar pull up straight away might be unrealistic if you’ve spent years holding a UCS posture. But there are ways of getting there…

  • Scaling the new movement that your practicing and working within the ranges that your body allows. Giving the joints time to adapt, without risking injury.
  • Working on individual muscles that developed the weakness and tightness over the years. This requires specific strengthening and stretching exercises.
  • Muscle tightness in your neck and chest may benefit from soft tissue work to release the muscle, like massage or dry needling.
  • Correcting form, sometimes we don’t have the body awareness to identify poor technique. Having the coach or physio look at your movement to correct where it’s needed.
  • Change can only be enforced through repetition and habit. The positions you’re in most of the day dictate your posture. At work, in the car, or at home, try to change your posture regularly.

Below are some basic examples of exercises to get you started with organising the shoulder and head. Try following them regularly to give your body the opportunity to change.

Continue reading “Upper Crossed Syndrome – A foundation for failure”

Study: When is bending too much?

This recent study looked at sustained bending and the time it takes before our postural muscles give in and we begin to rely on our passive structures for support.

Alessa 2017

How long is too long, to be in a forward, bent posture? Many of us spend hours doing house chores; weeding, DIY, working on the car etc. Not to mention the time spent leaning over a computer desk or looking down at your phone.

Back pain

Your muscles play an amazing role of suspending us in these positions, but just like with exercise our muscles will reach a point of fatigue. When the postural muscles aren’t able to provide the support we then rely on “passive” structures like ligaments and fascia, which is not their primary role, eventually leading stress and increased risk of injury.

This study looked at 2 angles of the spine leaning forwards and found that within 40 seconds the participants transitioned from the support of postural muscles to the passive structures. While this was found to be a natural transition the prolonged strain on the passive structures has been shown to increase the risk of lower back pain as suggested in another study.

As mentioned in a previous blog, these positions are not “wrong” but it’s better for the overall health of the spine to regularly change position and break from sustained load on an individual structure to provide balance.

Abstract

Static trunk bending is an occupational risk factor for lower back pain (LBP). When assessing relative short duration trunk bending tasks, existing studies mostly assumed unchanged spine biomechanical responses during task performance. The purpose of the current study was to assess the biomechanical changes of lumbar spine during the performance of relatively short duration, sustained trunk bending tasks. Fifteen participants performed 40-s static trunk bending tasks in two different trunk angles (30° or 60°) with two different hand load levels (0 or 6.8 kg). Results of the current study revealed significantly increased lumbar flexion and lumbar passive moment during the 40 s of trunk bending. Significantly reduced lumbar and abdominal muscle activities were also observed in most conditions. These findings suggest that, during the performance of short duration, static trunk bending tasks, a shift of loading from lumbar active tissues to passive tissues occurs naturally. This mechanism is beneficial in reducing the accumulation of lumbar muscle fatigue; however, lumbar passive tissue creep could be introduced due to prolonged or repetitive exposure.

 

Alessaa F. et al (2017) Changes of lumbar posture and tissue loading during static trunk bending. Human Movement Science

Continue reading “Study: When is bending too much?”

Top 5 Posts of 2017

Entering the new year here’s a look back at last years 5 most popular blogs.

Happy New Year – 2018 is already under way. Hope you all had a great break.

Last year was a busy year with the blogs. Here are the top 5 posts from last year in case you missed them.

5. The Office WOD

  • How many of us at work get stuck in the same position and forget to move?
  • This post was offering some general strengthening and postural awareness exercises to follow regularly at work.
  • Try getting into a routine with these types of exercises. It should help prepare you better for training.

4. Trigger Points – what are they?

  • Those knots felt in your traps after a busy day at work are more than likely trigger points.
  • This blog goes into explaining what they are, how they’re caused and how they’re treated.

3. Recovering from DOMS

  • This was a popular topic as we all love a bit of DOMS.
  • Understanding how to manage your recovery and training while in the DOMS phase will make it more tolerable.
  • Also knowing the difference of pain between DOMS and an injury will help avoid making anything worse.

2. Improving front rack position

  • After doing many mobility assessments, the front rack shape is what most people struggled to hold passively without a bar.
  • This was one of a 4 part series of shoulder shapes we should be achieving to help make movement more efficient.
  • It offered a range of mobility exercises to open the shoulder into the front rack.

1. Anterior knee pain in CrossFit

  • One of the most common injuries in sports and top 3 with CrossFit athletes is a knee injury.
  • This blog looked at anterior knee pain and the common causes. It offers some basic suggestions to self managing the injury.

The purpose of these blogs has been to provide a wider understanding of your body and give you more control of it. Wishing you all an injury free 2018 and keep checking for the new blogs.

What’s causing my muscle tightness?

Muscular tightness is one of the disruptions to normal movement and if not managed well can lead to possible injury. Identifying your tightness and using specific strategies will help relieve tension.

One of the main issues patients struggle with is muscular tightness. They get a feeling of pain or tightness and an inability to relax the muscle.

What is tightness?

When looking at patients I need to find out if they have mechanical stiffness or the “feeling” of tightness or a combination of both, as this would direct my treatment plan.

Is the range of movement limited? does it have a soft or hard end feel? Are movements a struggle at end range, feeling heavy? What’s the rest feeling like, is it a constant tightness?

While we can have mechanical tightness of a joint or muscle, there are also the “feelings” of tightness. You might get your hands to the floor with your legs straight and feel the hamstrings tightening. While another person could do the same, get to their knees and not have tightness.

What causes the feeling of tightness?

Tightness is a sensation like many others, including pain. What we understand from pain is that this is not always brought on physically, but also by the perception of threat.

pathway-of-a-pain-message-via-sensory-nerve-in-injured-muscle,2324600

So like pain, tightness is a protective mechanism from the central nervous system to avoid danger. On a number of levels it detects stressor’s that expose the whole body or specific region to threat.

Examples of this…..

  • Prolonged sitting, without movement we often notice tightness in certain areas, possibly through reduced oxygen supply and increased metabolic toxicity.
  • Stressful situations cause rising cortisol levels and increased activity of the Vagus nerve leading to muscular tightness.
  • Repetitive movement over a period of time causes increased tension.
  • Posture muscle tightnessInjury or pre-existing weakness can cause a guarding response from the nervous system.

Using tightness as a warning sign for these potential threats might allows us to acknowledge the situation and quickly act upon it.

What will help my tightness?

Like all movement patterns, we improve with practice. The same goes for muscle tightness. If we regularly bombard it with neural messages to remain tight we develop trigger points and chronic tightness through a process called central sensitisation. Which makes the tissues more sensitive to pain and tightness.

If we can regularly supply our nervous system with input that is non-threatening we can slowly help desensitise the muscle. But this takes time and regular repetition.

Stretching

Most people with tightness, especially after prolonged rest feel the need to stretch out. But depending on our intended goal there are different types of stretches.

  • Static stretches
  • Active stretches
  • Dynamic stretches
  • PNF (Contract-relax)

While these stretches will help, it might only be temporary without regular repetition and reinforcing the nervous system with good movement.

Strengthening

There is a misconception that resistance training causes our muscles to feel tighter. Mainly due to the effect of DOMS. That feeling of soreness you have the day after a hard workout. But some recent studies have shown that strengthening can be equally, if not more beneficial than stretching.

Improvements in flexibility coming from improved ability to handle higher levels of metabolic stress and lower levels of inflammation. By lowering the threat to the nervous system through increased strength, it allows you to work the muscle through a wider range, without getting a stretch reflex.

Massage and other soft tissue work

Another way to help desensitise these tight muscles is to apply pressure. This could be with the use of a foam roller/lacrosse ball or other manual therapy techniques like deep tissue massage, myofascial release, trigger point release, dry needling.

Relaxation techniques and breathing mechanics

Like in the previous blog, an overactive or dominant sympathetic nervous system can cause muscle tightness. Finding ways of breaking poor postures or shallow breathing using a range of methods like kapalbhati, wim-hof, meditation, yoga etc. Using these methods are just part of the process to lowering overall tightness.

Usually, just following one of these methods individually is not going to be as effective as combining them together. Try to deal with the tightness from all angles.

If guidance is required or manual therapy techniques feel free to call 09 5290990.

Study: Resistance training on neck pain

This study found positive results with strengthening exercises to reduce muscle tension and pain with office workers suffering with neck pain.

Lindegaard 2013

Working in the office you’re bound to suffer with neck pain at some stage. If poorly managed this can progressively become chronic. Not only can this impact your function, but interferes with your levels of concentration and performance at work. This then feeds into your mood and becomes a negative loop which is then difficult to break.

When treating a patient with chronic neck pain there’s a range of manual techniques that have strong evidence to support them. But in addition to hands-on therapy, exercises are provided to assist in the recovery. These could be in the form of stretches, postural setting or strengthening.

This study focused on strengthening exercises using a resistance band  (Theraband). Over a 10 week period they performed lateral raises with the resistance band once per day to the point of fatigue or up to 2 minutes. They found at the end of the 10 weeks through EMG testing the neck muscles were more relaxed and had reduced pain levels.

Original Abstract

Background: This study investigates the acute and longitudinal effects of resistance training on occupational muscle activity in office workers with chronic pain.

Methods: 30 female office workers with chronic neck and shoulder pain participated for 10 weeks in high-intensity elastic resistance training for 2 minutes per day (n = 15) or in control receiving weekly email-based information on general health (n = 15). Electromyography (EMG) from the splenius and upper trapezius was recorded during a normal workday.

Results: Adherence to training and control interventions were 86% and 89%, respectively. Comparedh with control, training increased isometric muscle strength 6% (P < 0.05) and decreased neck/shoulder pain intensity by 40% (P < 0.01). The frequency of periods with complete motor unit relaxation (EMG gaps) decreased acutely in the hours after training. By contrast, at 10-week follow-up, training increased average duration of EMG gaps by 71%, EMG gap frequency by 296% and percentage time below 0.5%, and 1.0% EMGmax by 578% and 242%, respectively, during the workday in m. splenius.

Conclusion: While resistance training acutely generates a more tense muscle activity pattern, the longitudinal changes are beneficial in terms of longer and more frequent periods of complete muscular relaxation and reduced pain.

Lidegaard M, et al. Effect of brief daily resistance training on occupational neck/shoulder muscle activity in office workers with chronic pain: randomized controlled trial. Biomed Res Int. 2013.

Neck Pain

In New Zealand neck pain is a growing problem due to a more sedentary lifestyle. They can be tricky injuries to recover from. Take a look at how physio can help.

Neck pain is a growing musculoskeletal problem with more of us sitting over longer periods of time. But also from doing heavy manual jobs or exercise.

This condition can cause various symptoms, including the following:

  • PainNeck pain Symptoms 1
  • Stiffness
  • Muscle spasm
  • Referred pain (face, arm, mid back)
  • Headaches
  • Altered sensation (ie numbness/tingling)
  • Nausea
  • Dizziness

These symptoms may be caused by strain to any of the structures around your spine. Structures such as the ligaments, muscles, joints, discs or nerves. Acute injuries are often brought on through excessive loading, this could be from an accident playing sport or in your vehicle.

Other more chronic forms of neck pain could have developed from an acute injury that was poorly managed. Or with an increasingly sedentary lifestyle, the sustained postures can overload tissue of the neck.

Preventing Neck Pain

Your next posture is your best posture

Our body is designed to handle multiple positions. Set regular intervals every 20-30 minutes to change your sitting position. Try alternating between sitting and standing. See my other blog Sitting Posture how important is it really”

Lifting correctly

We’re not all Olympic lifters, but understanding the basic principles of lifting are important to preventing neck pain. Also understanding your limits to lifting. If it’s too heavy be honest with yourself and ask for help.

Keeping calm and dealing with stress

Stress can have a significant impact with pain and ignoring stressful situations can lead to the development of neck pain. Dealing with these gremlins will be great for you in so many ways. See my other blog on “Coping with stress”.

How can Physio help my neck pain?

Identifying the source of your injury is our primary goal with a detailed assessment. Once the root cause of your neck pain has been identified you will receive an effective evidence based treatment. Treatment may consist of the following.

The aim of the your rehab is to fully recover with the confidence to use your neck normally, without fear. Also to leave with a greater understanding of your neck to prevent any injuries in the future.

For an appointment, call on 095290990

The Office WOD

Do your best when no one is looking. If you do that, then you can be successful at anything that you put your mind to.

Following up from last weeks piece about SITTING POSTURE. It’s not about holding the perfect posture. Whats more important is changing position regularly, adding variation. Holding postures long enough results in changes to the strength of a muscle and how quickly it activates.

Neuroplasticity

This refers to the brain constantly changing to its environment, trying to find more efficient neural connections.

Consider your memory at school, studying a particular subject and you ace the exams. Now think 10 years on and you’ve done nothing relating to the subject, you’ll likely struggle with the same exam paper. The neural connections changed, these memories were not regularly reinforced and were forgotten.

Look at the typical sitting posture above that we find most of us in. Multiple changes are happening from head to toe. This also happens on a neural level. The longer we hold this posture the more the change will be ingrained. When doing complex activities that require fast reactions or more strength the adapted structures will make the task more challenging.

The Office WOD

The office workout is focusing on the neglected muscles we forget to stretch or use throughout the working day. Following this routine, 10-15 minutes at Lunch or on a coffee break will help maintain healthy muscle activity and length.

**This does not substitute exercise that gets your heart rate elevated.

The Workout won’t draw too much attention to you in the office. I won’t have you doing planks off the office chair or dead lifting the photocopier.

1. Chin Tucks (1 minute)

2. Neck Extensor stretch (1 minute)

3. Thoracic Spine Stretch (2 minute)

4. Posterior Shoulder Strengthening (1 minute)

5. Forearm  Stretch (1 minute Each)

6. Glute Strengthening (1 minute)

7. Hip Flexor Stretch (1 minute each)

8. Hamstring Stretch (1 minute each)

9. Calf Stretch (1 minute each)

Try these exercises in your workplace to get muscles fired up again and working. Feel free to leave a comment about any of the exercises or any suggestions for changes.

Sitting Posture – How important is it really?

Sitting posture is something that get’s heavily criticised and over analysed. There could be more to it than simple ergonomics.

Your best posture is your next posture

In the last several years sitting posture has been classed as the “new smoking” or a dangerous position that will ruin your life. There are various arguments for and against sitting from different health experts and research. My opinion on this topic comes from my own clinical experience and taking value from all of the other respective parties.

First of all, sitting is not dangerous. But the longer we sit over a prolonged time is not healthy

Our body is dynamic and multi-functional, one of these functions is sitting. What’s up for debate is length of time and position. Recent studies have documented the following long term health risks from prolonged sitting.

diabetes-infographic

**These studies are predictors for potential health risks, but are also contributed by poor nutrition, sleep deprivation and lack of exercise.

What’s the physical problem with sitting?

In unsupported sitting (i.e. on the floor, perched sitting) we have some activity from core muscles that stabilise the spine. With no activity we would collapse into a heap.

Our central nervous system cleverly adapts to positions we hold most in the day. In supported sitting our body adjusts, slowly loosing flexibility in the thoracic spine, hips and hamstrings. The trunk muscles, “the core” reduce activity in sitting and loose their primary function of support when doing physical activities. Other muscles like the glutes, scapular stabilisers and posterior rotator cuff become short or weakened.

With the lack of support our body naturally falls into the path of least resistance and this is when changes in posture begin to happen. Essentially causing us to hang off the tension of ligaments and other soft tissue, instead of support from the tone and strength of stabilising muscles.

Chemical changes are brewing while sitting

The longer we sit without movement puts more stress and pressure specific tissues. Causing reduced blood flow to that area, meaning it gets less oxygen and less removal of metabolic bi-products. The muscle becomes increasingly toxic and acidic.

Luckily our tissues hold acidic sensing Ion channels that detect changes to PH levels. When in an acidic environment it sends our brain a signal and we get the feeling of discomfort.

Choosing to ignore the discomfort and stay in the same position causes an increase in toxicity and will result in the development of the trigger point phenomenon. Another phenomenon called central sensitisation may also happen. When pain signals constantly bombard the brain with pain signals it lowers your pain thresh-hold, making you more susceptible to pain in stressful environments.

Whats the answer to sitting?

Looking at the physical and chemical changes that happen in a sustained position you can see that any position for a prolonged time is not beneficial to us.

A posture that doesn’t move isn’t a postural problem, it’s a problem of movement.

“Neutral” spinal and postural alignment is all well and said. But even sitting in an ergonomically aligned position will feel uncomfortable if sat this way for 8 hours.

To counteract the negative effects of sustained sitting positions, here are some recommendations:

1. Position variation

Look at the postures below. Some of them were traditionally classed as “bad” postures. But these postures vary the tensions and stress’s applied to different tissue. By regularly changing these forces it will allow you to tolerate sitting for longer. Making a conscious effort to change position every 15-20 minutes (remember you can still work, just change position).

Sitting variation

2. Get up and move

Offload the stress and compression of your toxic butt! Giving a chance for tissue to oxygenate and flush unwanted toxins away. Also reducing eye strain, stress levels and fatigue. Not to mention all the other long term health benefits displayed above.

Studies have shown improvements in performance with intermittent breaks every 30 minutes (4). Consider standing when taking a phone call. Think about how many calls you get a day!

3. Sit-standing desks

Standing desks have taken off and are all the rage in open plan offices. Standing gives those stablising muscles a chance to work their magic. But even with standing you should consider regularly changing standing positions to offload pressures. Using a perching stool or foot stool to alternate step-standing.

4. Exercise

If this component is not included all of the above strategies will be wasted. Standing desks are not an exercise, it encourages a little more activity and is more sustainable. But your body needs to be challenged in other positions other than the one you hold most of the day. The long term health benefits are well documented for exercise.

Remember if you are just starting to exercise and coming from prolonged sitting over a number of years, ease into exercise gradually. Start off with regular power walks or exercycle. But as your fitness improves try to challenge it more, through other sources like pilates, yoga, resistance training or team sports.

Sitting isn’t the problem, it’s not moving enough. 

  1. Bell et al, (2014) Combined effect of physical activity and leisure time sitting on long-term risk of incident obesity and metabolic risk factor clustering. Diabetologia
  2. Schmid et al, (2014) Sedentary behavior increases the risk of certain cancers. J Natl Cancer Inst

  3. Katzmarzyk et al, (2012) Sedentary behaviour and life expectancy in the USA: a cause-deleted life table analysis. 
  4. Thorp et al (2014), Breaking up workplace sitting time with intermittent standing bouts improves fatigue and musculoskeletal discomfort in overweight/obese office workers. Occup Environ Med.