You have probably read over the years about the fact that sitting is so bad for us and how we should be standing at work.
This naturally led to an explosion of “standing desks” or “walking desks” whereby you swapped sitting all day for standing all day or walking like a hamster on a treadmill all day – whilst at the same time working at your computer – all the time thinking that you were being so much more healthy by doing so!
However, like all these new marvellous ideas, they have their limitations that the manufacturers fail to mention in their attempt to sell their new equipment.
Specific guidelines were brought out in 2015 showed us what we should be doing at work and that created newspaper headlines that included phrases such as
“Abandon your chair for four hours to stay healthy” and
“Stand up at your desk for at least two hours a day”
These guidelines were published in the British Journal of Medicine in 2015 and were designed to get desk workers to stand and move around more often.
The recommendations said that workers should aim to initially progress towards accumulating 2 hours of standing and light walking during working hours, progressing to 4 hours per day of standing.
They did say that longer term intervention studies were required and they were right! Many media reports did not mention that the guidelines were based on limited evidence and that they were also co-authored by someone with commercial links to sit-stand desks (desks you raise and lower to work at standing or sitting), a fact which was not declared when the guidelines were first published in the journal.
The hype generated caused many people to panic and they started standing all day at work, thinking that sitting was going to lead them to an early grave.
Sitting for long periods is of course linked to health issues like heart disease, back pain, cancer progression, headaches, neck pain, stress etc. and we should be getting up and moving more – but we should not be standing all day or walking all day – we need to change what we do regularly – a bit like eating – everything in moderation is the most sensible way to work. In fact studies have shown that standing all day can lead to cardiovascular problems too!
The Cochrane report of March 2016 investigated the research up until then and found twenty studies with a total of 2174 participants from high income nations. Nine studies evaluated physical changes in the workplace, four evaluated changes in workplace policy, seven studies evaluated information and counselling interventions and one study evaluated both physical workplace changes and information and counselling components.
Effect of sit-stand desks
Sit-stand desks alone decreased workplace sitting with about half an hour to two hours per day. When combined with information and counselling sit-stand desks reduced sitting at work in the same range. Sit-stand desks also reduced total sitting time (both at work and outside work) and the duration of sitting episodes that last 30 minutes or longer.
Effect of active workstations
Treadmill desks combined with counselling reduced sitting time at work. Pedalling workstations combined with information did not reduce sitting at work compared to information alone.
Effect of walking during breaks
The introduction of walking during breaks in two studies with 443 participants did not change sitting time.
Effect of information and counselling
In two studies counselling decreased sitting time with 28 minutes and in another study mindfulness training did not have any effect on sitting at work. There was no considerable increase in work engagement with counselling.
Computer prompting software did not reduce sitting time in two studies. In another study computer prompts reduced sitting time with 55 minutes compared to no intervention. One study found that prompts to stand reduced sitting 14 minutes more than prompts to step. Computer prompts did not change the number of sitting episodes that last 30 minutes or longer.
Interventions from multiple categories
When multiple categories of interventions were combined to decrease sitting, there was reduction in workplace sitting time at 12 weeks’ and six months’ follow-up but there was no considerable difference at 12 months’ follow-up.
To date there is very low to low quality evidence that sit-stand desks may decrease workplace sitting between thirty minutes to two hours per day without having adverse effects at the short or medium term. There is no evidence on the effects in the long term. There were no considerable or inconsistent effects of other interventions such as changing work organisation or information and counselling.
The most sensible way to break up your sedentary day is as follows:
- Regularly break up sitting work with standing work – go to the photocopier, get a coffee, stand and talk to a colleague rather than phoning them and talking sitting down. Stand when you are talking on the phone.
- Avoid long periods of standing still, which may be as harmful as long periods sitting
- Change posture regularly while sitting to alleviate possible musculoskeletal pain and fatigue or use a ‘sit fit’ which is a small rubber cushion that is about 2” thick and full of air so that you can sit and move from cheek to cheek or rock forwards and backwards while you are sitting. However, you can obviously also do this without a cushion – you just need to remember – maybe set an alarm on your phone every half hour so you do some movement regularly.
This advice seems more ‘doable’ and studies that have looked at how to motivate workers to sit less and move more have apparently only managed to reduce the time spent sitting by 77 minutes in an 8 hour day. This is better than nothing but not great.
In fact an Australian study states that the evidence does not point to a specific amount of sitting time at which harm begins.
Given the evolving research field and the vested interests, although we DO need to pay attention to sitting time, standing, and physical activity levels but any banner headlines in newspapers need to be treated with caution and we should not allow ourselves to think they are based on concrete evidence. They are food for thought and we should pay attention and keep returning to the evidence.
Studies and research often conclude by recommending that further research is undertaken and the headlines fail to report that.
Meanwhile at the Avenue Clinic, we will always advise you to keep moving as much as you can and to think regularly about what you are doing with your body while you are concentrating on your work – whatever it is. We will show you exercises to do for your particular problem, having relieved the pain you are in already – then you can go back to work and not keep getting problems!
I can feel my jaw tight as I type this; my left leg is tingling a bit; my back is aching a lot; my neck feels tight and when I do rock my pelvis back and forwards I can feel it relieves that low back irritation and when I make my jaw relax and drop my shoulders, I can feel less tension in my upper back.
These are the things we should be doing while we sit – and regularly and of course we need to get up and move as often as we can!