With the majority of the corporate workforce in Auckland (NZ) getting used to the norms of working from home, standing desks, sitting posture and screen time seem to be hot topics in physio clinics.
“should I get a standing desk?”
“I think my posture is not correct..”
People seem to be complaining more and more about feeling stiff, sore, and fatigued by the end of their work days. I’m sure most of you have read an article or watched a video about posture and have been told that 'you’re going to hurt yourself in that position'.
Now, although the research-based statistical associations between "bad postures" and pain are not strong, the effects of prolonged postures on flexibility and joint mobility are still valid. Let me explain.
The drawback of this sort of research is that it fails to attribute any individual lifestyle factor to have strong associations to musculoskeletal injury or pain. This is due to the multifactorial nature of injury and pain. The average human injury and pain presentation has been found to have many other contributing factors outside of “ouch, I must have lifted that wrong!” These factors have a lot to do with the various types of stresses (physical, physiological, psychological and social).
Despite this, during periods of reduced movement, muscle is still subject to a phenomenon called “thixotropy”.
Muscle thixotropy is the temporary movement restriction felt by a muscle or group of muscles that are subject to an extended period immobility. Most of you have probably felt this upon waking up in the morning or after sitting for hours on the couch before feeling the urge to groan and stretch to the floor or ceiling. This temporary stiffness is due to the thixotropic phenomena, and as you will have noticed it is temporary. The extent of this stiffness is dependent on the length of time of immobility, but also the position that you have adopted.
As well as muscle thixotropy, there is also ligaments and tendons within the musculoskeletal system. These are also subject to changes based on prolonged positions and load. During periods of prolonged positions, especially when in a sub-optimal stretched or awkward position, these structures are subject to creep. Yes, you read that right. This is the phenomenon whereby the collagen-forming network within the soft tissue (ligament, muscle, tendon, joint capsule) is disrupted due the prolonged stretch and changes in fluid balance within the tissue matrix. This causes some deformation to the musculoskeletal tissue and has been implicated in some injuries or pain presentations. This may be a component to the morning stiff neck or the back pain after slouching and falling asleep on the couch.
To summarise the science above:
When a joint or soft tissue is stretched past its “comfort zone” for prolonged periods, it can become temporarily sensitive. Cumulative strain on the same tissue over time has the potential to cause changes associated with pain.
Qu: Is that considered tissue damage?
Ans: NO. The research still doesn't support the notion that posture is the primary predictor of injury. Meanwhile the tissue can still become sensitive and stiff as a response to prolonged stretch.
Qu: Will improving your posture help with my injury?
Ans: The research may be a little more conclusive for this whereby a few recent studies have found that in adults, 'forward head posture" is more commonly seen in those with neck pain than those without. SO although we cant reliably predict those who are likely to develop neck pain from looking at their posture, this can be an important component of your care if you have a history of neck pain.
So, although the awkward or sub-optimal postures in the home-office aren’t necessarily going to cause injury, adopting these postures may cause temporary or cumulative changes to the affected joints, potentially leading to sub-optimal movement patterns and muscle or joint stiffness.
What I mean here is that it’s hard to get the most out of your body as an active runner, jumper, swimmer, or recreational hiker if you spent 8-10 hours sitting whole day. Your muscles aren’t built for a 40-minute burst of F45 and High-intensity-interval-training immediately after sitting slumped and inactive for 8-10 hours.
So, what are you trying to say??...
If there is anything that the evidence points strongly to, is that the body loves and responds well to MOVEMENT. Movement is medicine. Our body doesn’t like prolonged postures but preferers movement and postural variations.
Standing desks, adjustable workstations and kneeling setups all provide this opportunity but remember, it’s not the desk that introduces variability into your workday, it’s YOU.
So, finding ways to sit or stand in different manners or having zoom meetings in different settings throughout your day are good habits to get in to. Also, having screen lock-outs or scheduled break times throughout your day are good strategies to have to walk around, stretch or bust out a few squats or push-ups (rather than scrolling through social media).
A few sitting alternatives at desk:
- Lunge stretch at desk and alternating legs
- Kneeling at desk
- Standing desk
- Cross leg sitting on floor for work meeting (with stool for laptop height)
- Be creative..
A recent product I purchased for my home office was a "deskalator" which I find very convenient and easy to use. Ive attached a link to the one I purchased below.
Disclaimer - I dont receive any financial or promotional benefit from MightyApe. I've recently purchased the product and recommend it from a quality and value point of view.
Have a chat to your physiotherapist or workplace health and safety officer regarding some strategies to make this work for you. Optimising the home-office set up is still very important but then promoting some postural variability and scheduled break times will also be key. If you’re dealing with an injury, a physio can help with a clinical diagnosis and see if your posture is contributing to your pain or symptoms.
If you would like some individual input on your posture or injury, feel free to get in touch to book an appointment with me. I usually ask people to come along to their appointment with a photo of you sitting in your home office (side and back views) so I can help you with tailored suggestions. Any messages with questions, feedback or topic suggestions will be greatly appreciated.
References:
Lakie, M., & Campbell, K. S. (2019). Muscle thixotropy-where are we now?. Journal of applied physiology (Bethesda, Md. : 1985), 126(6), 1790–1799. https://doi.org/10.1152/japplphysiol.00788.2018
Mahmoud, N. F., Hassan, K. A., Abdelmajeed, S. F., Moustafa, I. M., & Silva, A. G. (2019). The relationship between forward head posture and neck pain: a systematic review and meta-analysis. Current reviews in musculoskeletal medicine, 12(4), 562-577.
Sbriccoli, P., Yousuf, K., Kupershtein, I., Solomonow, M., Zhou, B. H., Zhu, M. P., & Lu, Y. (2004). Static load repetition is a risk factor in the development of lumbar cumulative musculoskeletal disorder. Spine, 29(23), 2643-2653.
Wong, A. Y., Chan, T. P., Chau, A. W., Cheung, H. T., Kwan, K. C., Lam, A. K., ... & De Carvalho, D. (2019). Do different sitting postures affect spinal biomechanics of asymptomatic individuals?. Gait & posture, 67, 230-235.