Back Pain Expert Dr. Sean Wheeler Discusses Making the Move to Standing at Work

The POSTURE Series, No. 5

By Sean M. Wheeler, M.D.

IMG 6003Chronic Back Pain Specialist Dr. Sean WheelerOur spines aren't designed to live as we today do. 

Our early ancestors sprinted barefoot across the savanna, spear in hand, the picture of perfect ergonomic position. In contrast, today we sit much of the work day at a desk, hunched over computers and phones. 

However, the evidence is clear: standing longer, when in correct posture, is better for us than sitting.  

Standing in this way reduces risk of obesity, diabetes, cardiovascular disease, cancer and lowers long-term mortality. In contrast, extended sitting causes us to slouch, tightens our hip flexors, rounds our shoulders forward and causes pooling of blood in our legs and feet. 

Standing strengthens our feet, calves and gluteus and puts us in a better posture.

The standing vs. sitting choice sounds obvious I gave it a try. I found boxes and outdated medical books on which to prop my computer screen and mouse. Ten minutes in I was feeling good. By 30 minutes I knew something was wrong and sat down. I was not ready for all-day standing, and in all likelihood neither are you.  

Recent studies, including a medical review published in the Cochrane Library, show that people don’t stand much longer with a standing desk and the standing they do is marked by bad posture. This outcome has much to do with bracing muscle® function.

Bracing muscles in the buttocks stabilizing the hip provide endurance for stabilization during standing, and under-utilized bracing muscles have to be built-up by standing with proper posture over progressively longer periods of time. Running or working out will build strength in the action muscles of the buttocks that move you, but not the endurance needed for stabilization during standing.

If you think you can suddenly just stand all day, you may end up as the above study suggests: sitting.

You can test your readiness for a stand-up desk at work while otherwise waiting in a long line that doesn't seem to move, or after you've arrived late at a function and all the chairs are taken.

Stand.

Stand with equal weight on both feet without locking the knees and without leaning forward. For a more complicated task, draw your tummy in, bringing your pelvis under you. Then keep track of how long it takes until you lean into one hip. This period of time is how much endurance you have in the bracing muscles of your gluteus.  Typically this period of time is not long. Once you begin to lean, the foot, knee and hip on that side get sore. This is not what you want. In fact, the leaning is actually worse for you than the sitting.

To achieve the ultimate goal of all-day standing at work, and the health benefits that come with it, budget your standing time as you build the necessary endurance. Stand until leaning, then sit. Time this out daily, slowly adding more and more non-leaning time until the day is filled with proper standing. By the way, propping yourself up, bent over the desk, doesn't count. 

Using this better posture you will soon be standing significantly longer. Expect the entire process to take up to six months, as that is the period endurance muscles require to rebuild blood flow for all-day endurance. 

Think of it like this: you have to climb the mountain before you can stand triumphantly atop it.

 

Sean Wheeler, M.D. is board certified in both Pain Management and Sports Medicine. He is a leading expert on back pain. His recently released book, UPRISE, is changing the way the world thinks of back pain causation and its treatment. With a new vocabulary in aid of understanding the cause of back pain, and new medical approach focused on increasing the endurance of your bracing muscles, Dr. Wheeler puts patients back in charge of their health to achieve liberation from chronic back pain. 

Jul 07 2016
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