Our bodies were designed to be upright. When we sit down the pressure on our discs increases by 40% compared to standing, and when we sit and slouch the pressure increases by 85%. As a physical therapist, I see the negative effects of sitting on the musculoskeletal system all the time when people complain of lower back pain (LBP), tight hip flexors causing hip and LBP, rounded shoulders causing mid-scapular pain, forward head posture causing neck pain and headaches, weak postural muscles which are needed to support the spine, and decreased gluteal muscle firing which stabilizes the pelvis and supports the back. But sitting not only wreaks havoc on the musculoskeletal system but the cardiovascular, endocrine, vascular, neurological, digestive systems, etc, as well.
So how much time do you spend sitting each day? Think about how our lives are designed around sitting. We wake up and (if we’re lucky) sit down for breakfast, then we sit in the car as we drive to work or school, 85% of us spend the day at a desk, we sit down to have lunch, after work we get back in the car and sit to drive home, finally we get home and sit down on the couch to relax, watch tv, and have dinner. On the weekend maybe you go to a movie where you sit for several hours or spend time on the computer playing games, facebook stocking, or surfing the web. If you’re really good maybe you set aside time to work out each day and you feel good about yourself knowing you did something good for your body and your health! We used to think that getting daily exercise would help fight obesity and disease and keep us strong and healthy. Unfortunately, what the research has been showing for the last few years does not support that theory.
There are two categories we need to talk about: Exercise and Physical Activity. The terms can not be used interchangeably and it’s important that we get both. Physical activity includes the daily activities that use our bodies and require movement- i.e. household chores, gardening, mowing the lawn, grocery shopping, etc. The way we objectively measure physical activity is daily steps. You should get 10,000+ steps per day to be considered “active”, less than 5,000 steps and you are considered “sedentary”. Strap on a pedometer (about ~$20) and see how many steps you are actually getting. We often give ourselves too much credit for steps that were never taken and exercise that was not done. Exercise is continuous (whole) body movement without interruption causing an increase in heart rate. The recommendation for exercise from the American Heart Association and the American College of Sports Medicine is 150 mins per week of moderate intensity exercise, typically recommended as 30 mins x 5 days/week. Based on the research, this is the best way to reach those 150 mins, as opposed to exercising 50mins 3x/week. I teach my patients now that for the maximum health benefits and disease prevention they need to reach 10,000 steps each day and at least 30 mins of moderate intensity exercise 5x/week. On those two exercise “off days”, you still have to get 10,000 steps! Phewf! The problem is that most of us spend the majority of the day sitting and think we’re doing a good job if we find the time a few days a week (or even daily!) for exercise. Unfortunately, we now know that adding in daily exercise has little benefit to our health if we spend the rest of the day sitting.
SO how bad is it? The Center for Disease Control said, “chronic disease is the number 1 contributor to public health” and “sitting is the number 1 contributor to chronic disease.” Therefore, sitting is the number contributor to public health! They found that if you can move your body every hour you will reduce the risk of breast cancer by 21%, colon CA by 25%, stroke by 27%, type 2 diabetes by 30%, and hypertension by 50%. Being sedentary poses as great a risk to your health as obesity and smoking. An australian research study of over 222,000 people over 3 years found that sitting 11+ hours per day increased the risk of dying in the next 3 years by 40% compared to people who sat <4 hours per day. Now you may be thinking, ‘that’s ok I only sit 8-10 hours per day’. But sitting between 8-11 hours per day still increases your risk by 15%. Remember, this isn’t just the time sitting at work but throughout the entire day. The worst part is that moderate intensity exercise had little impact on health when the amount of sedentary time spent each day was elevated. So I encourage you to start recording the amount of time you spend each day sitting to assess your relative risk.
Ok so sitting is detrimental to our health, even if we are exercising daily, so what can we do to get that important physical activity component?? Here a some of my favorite tips for where you can find those extra steps each day.
Park at the very back of the parking lot. I had a patient recently tell me that he started parking in the very last spot everywhere he went- the grocery store, work, the mall, Home Depot, the hospital, etc and it made a HUGE difference in his daily step count. Chances are you’ll actually save time too since you won’t be driving around in circles waiting for a closer spot to open up.
Do household chores at a faster pace. Move quicker when you’re taking out the trash, grabbing the laundry, putting away dog toys, etc.
Do exercises standing in place while on the phone or at the stove cooking. Do some slow and controlled calf raises, leg lifts, squats, marches, and single leg balance exercises.
Take the stairs!!Whenever, wherever, just do it!
Take an extra lap around before you leave. When you go to the grocery store, the book store, the mall, etc. take one big lap around before you leave.
Remember, exercise is vital to our health and you should give yourself kudos for finding the time in your busy schedule to move your body, but it must be coupled with daily physical activity for it’s impact to have true meaning on your overall health and wellbeing! My best tip is to first be honest with yourself. Get a pedometer to record your steps and keep a record of how often and for how long you exercise. Once you have a realistic idea of how well (or not well) you’re doing you can then set some specific and achievable goals towards a longer and, more importantly, healthier life!
To your health and to 10,000 daily steps!
Sabine Gempel, DPT, PT