Don’t Sit Yourself to Death: Part 2 of our “Skills You Might Suck At” Series

Sitting.

You’re doing it right now. And chances are you sat for awhile today. Or yesterday. And the bad news is that all that sitting we’re doing? It’s killing us in more ways than one.¹ Sitting all day for work and all night for fun means you’re more likely to have lung or colon cancer.² The risk of depression is higher.³ You’re more likely to have blood sugar issues,^4,5 to be diabetic, to have cardiovascular disease, and to die.¹ Gallstones and mental disorders⁶ are likelier when you’re sitting more, even if you’re exercising. Not to mention the increased amounts of neck and back pain that plague those who sit more frequently. The kicker is that some of these associations are true even if you are exercising regularly! Meaning exercise has benefits, but it doesn’t erase the effects of sitting all the time. 

But let’s be honest.

At this point, it’s probably not new information that sitting all day is bad for you. Sitting is killing us and our quality of life slowly but surely, but what the heck are we supposed to do about it?

There are two parts to getting rid of the negative impacts sitting has on us. The first is recognizing how to sit better so when we do sit it’s not causing so much damage. This doesn’t eliminate the impact of sitting on cardiovascular disease. It does help increase your joint range of motion and decrease the pain associated with sitting. It means that when we get up to move, our sitting time doesn’t have such a negative impact on our movement patterns. (Think old people getting weaker over time, to the point that they can’t even go on a walk around the block. That happens more than you think and faster than you’d expect.) The second is figuring out how to sit less. This means increasing the low-intensity movement throughout our day rather than doing a high intensity “cardio sesh” and diving back toward our desks. 

So part one of that is:

1. Sitting Better: How to sit better

Sitting in and of itself isn’t an evil position. At some point we have to rest, and it would get old standing and eating dinner every night. That said, a lot of us spend our time sitting in one position. This creates tension in our muscles (hello calves, hamstrings and hip flexors!) and doesn’t let us use our various body parts the way they were intended. On top of that, we think posture is using willpower and back muscles to straighten ourselves up and stay there. For example, if you sit up right now, there’s a decent chance the muscles you feel pulling you there are on your back half and that you feel nothing in the front. If that’s the case, you’re not sitting the right way.

I’m not a big believer in the willpower theory of posture. For one thing, I’d like to use my brain for other things besides remembering to sit up. 

So we should be able to sit some, and we should sit a little better than we do now.

But we tend to fixate on the idea of one solution for one problem. In sitting we do this when we buy chairs that fix us in one position. (Think the perfect hips-and-knees-at-90-degrees position, the holy grail of ergonomics complete with angels singing in the background) As part of this idea, we assume that when we find the perfect set-up that it will prevent us from having pain anytime we sit. In theory, sitting in the perfect 90° position that doesn’t strain our joints results in the least damage. In reality though, never pushing our joints out of their most neutral positions means we lose range of motion and strength. Eventually we’re stuck doing the only thing we’ve practiced for years–sitting on our bums with our knees and hips bent to about ninety degrees.

What we really need is a little more variety in our positioning. Studies show that joints that don’t move as often are more prone to osteoarthritis. This seems contrary to what we would think but is a result of the fact that our body reinforces the areas that have more force placed on them.^7,8,9,10 High impact activities and injury can increase arthritis, but being sedentary can also make us more prone to arthritis. That’s right–not moving much can do the same thing to your joints that putting tons of force through them can. This is not your grandma’s china collection we’re talking about…joints need use to stay healthy.

So we need to move more, but we need to move–and sit–in a way that helps us keep our full hip and knee ranges of motion and helps support proper biomechanics. That’s right, sitting doesn’t have to be bad. And most people understand that poor posture can create pain. That said, a lot of ‘good posture’ I see is misguided. Most of us start to have issues with sitting because we don’t know how to sit. 

And here’s the big secret of good posture: Maintaining good posture relies primarily on your butt and your belly and doesn’t have much to do with your back muscles. 

Now it’s true that you can use your back muscles (like your erector spinae and your quadratus lumborum) to pull you up into a more upright position, but doing that isn’t good biomechanics and isn’t really sustainable. It usually just makes you tired, or you end up over-arching your back (like pictured). Instead, there’s two things to think about as you sit–what you’re sitting on and where the pressure is. 

• Base of support: If you think about what you’re resting on as you sit, most of the pressure should be on your sit bones (i.e. ischial tuberosities, aka the hard bumps in your bum), not your tailbone. If you rock your pelvis back so that most of your bum is smashed flat against the seat, you’re putting extra pressure on your tailbone and pelvic floor. This decreases your ability to use your core as you sit. When you’re sitting with more pressure on your tailbone, most of the work of holding your upper half up is done by the back muscles or by resting on the mechanical limits of the joints (not good). Sitting like this is equivalent to expecting your house to stay upright with a corroding foundation. Instead, sitting on the sit bones lets your upper half stack up on your lower half with much less strain. 
• Areas of Pressure: So if your pelvis isn’t rocked back, you create more space for your belly to do it’s thing. Using what’s called intra-abdominal pressure (the pressure created between your core muscles, diaphragm, and pelvic floor), you give your upper body a wider base of support to rest on. You stop relying entirely on your spine and the muscles right next to it. Instead, you can use the bigger column of support that comes from your core muscles and the intra-abdominal pressure they create. This intra-abdominal pressure is the same pressure that is created when you’re breathing correctly (if you haven’t read about breathing basics, click here). It involves having slight activation of the core muscles while you’re sitting to provide pressure to keep your rib cage up, but not so much pressure that it changes your ability to breath in a relaxed way. 
• Caution: Sitting on your sit bones doesn’t mean arching your low back as you sit. Arching typically means you’re on your sit bones but using your lumbar muscles to hold yourself there, not your core. Sitting really shouldn’t feel like it takes effort from your back muscles. Excessive arching usually leads to more tension in your upper back and neck because you don’t have the intra-abdominal pressure to rest them on. 

Passing Good Things Forward

The good news is that as you start to change your resting pelvic position, the position of your head and shoulders changes too. When your lumbar is rolled backward from slouching, your head and shoulders come forward to keep your center of gravity in the same place. When you bring your hips forward, your head and shoulders come backward (in the same way that when one gear turns forward, the gear next to it turns backward). This means the tension in the backside of your neck and shoulders gets less, simply by moving your bum.

Once you make a habit of your new base of support and transfer pressure onto your core, you can think about dropping your shoulders and sliding your chin backward (like giving yourself a double chin, but a little less dramatic). Biomechanist Katy Bowman refers to this as head ramping, others call it chin retraction–really it’s just putting your head where it belongs over your body with your ears lined up with your shoulders. In the car this feels like pushing the base of your head into the headrest. When sitting without anything behind you it may feel like a stretch, and ideally it doesn’t feel like much of anything at all because that’s just your head’s resting position. That said, trying this before you change your base of support means you’ll have to try too hard. 

“In Conclusion…”: Boiled Down Sitting

• Breathe: Thinking about your breath is a helpful tool in figuring out how to sit. If you’re slouched forward, you don’t allow your diaphragm and core muscles space to move. Because they’re scrunched, they can’t create additional support for the upper half of your body. This means that instead of a column of support (the intra-abdominal pressure), you are relying on a stick of support (only your spine and the muscles next to it). In consequence, the muscles along your spine get really tight to keep you from falling face first toward your computer. Ever wondered why they get so tight? That’s part of the reason. Start by making sure your pelvis isn’t rocked backwards, then work on your belly breathing. You’re essentially creating a balloon of pressure to support the weight of your upper half. 
• Slide forward: As you start working on sitting, scoot to the edge of your chair and get your knees below your hips. This helps because many people have poor hip flexibility. The higher their knees are, the more their pelvis has to rock back to account for hip joint and muscle stiffness. 
• Force your pelvis into Neutral: Put a soft-back book or another semi-firm item behind your tailbone (not lumbar) to prevent it from rocking backwards. As you get better at using your intra-abdominal pressure while you sit, you should notice you can ditch the support and bring your knees up without the extra tension in your lower back. Sitting on an exercise ball or a balance air pad is another way to keep your pelvis in neutral. If you’re in a car all the time, shove a rolled up towel in the back half of your seat so your pelvis doesn’t tilt back so much. You can also look at getting something like a BackJoy seat prop.
• Slide Your Head Back: Mostly feels like giving yourself a double chin, then easing up an inch or so. Because you’ve already changed your base of support, having a biomechanically sound upper half should be way easier. Translation? It should be easier to not have your head and neck in the turtle position.
• Go Slow and Steady: Just like you wouldn’t expect yourself to run 10 miles well without working up to it, sitting well for a while takes muscle you may not have. Be patient and persistent. Ideally we want to utilize a lot of varied sitting positions, all using proper biomechanics involving intra-abdominal pressure. Start with working on not rocking your pelvis back and belly breathing as you sit. Then, increase the number of sitting positions you can use regularly by increasing hip and knee mobility. 
  • Being in different positions for a while means you can increase your flexibility without having to actively stretch. It lets you work on your hip mobility (how far you can bring your knee to the side or to your chest without rocking your pelvis backward). The easiest way is crossing your ankle over your opposite knee while you work. If you’ve lost hip mobility to the point where you can’t even cross one leg over the other, drop your knees further down and make this a number one goal.
  • The best way (in my opinion) to improve and maintain hip mobility is to get yourself to the point where you can sit on the floor and then sit there regularly. If you can’t get all the way to the floor, get yourself a little closer to the floor (a stool, a lower chair) and then keep your pelvis neutral and breathe with your belly as you sit. You can progress from a low chair to a stool to a cushion to the floor.

If you haven’t worked on breath yet, go back to that article and work on that for a week. If you’ve already done that, this week you’re going to work on sitting differently. It can feel a little exhausting at first, but as you start to get the hang of sitting on your sit bones and using your core to stay upright (it’s less effort than it sounds) it gets to be second nature. It prevents tension from building up, and when you do feel tension you can go through your checklist and think about where your positioning fell apart. 

If these concepts seem a little tricky, check out this video or go more in-depth with Katy Bowman’s Move Your DNA. If you understand the concepts but have discomfort getting there, call your local movement professional. Some people need a little more intervention just to get themselves sitting like this because they’ve built up restriction in their muscles and joints.

Happy sitting! And as you get better at positioning, check out Part 2.5 of the “Skills You Might Suck At” Series.

Sources

1. Wilmot, E.G., Edwardson, C.L., Achana, F.A. et al. Diabetologia (2012) 55: 2895. https://doi.org/10.1007/s00125-012-2677-z
2. Schmid D, Leitzmann MF. Television viewing and time spent sedentary in relation to cancer risk: a meta-analysis. J Natl Cancer Inst 2014, 106.
3. Zhai L, Zhang Y, Zhang D Sedentary behaviour and the risk of depression: a meta-analysis British Journal of Sports Medicine 2015;49:705-709.
4. Brocklebank, L. A., Falconer, C. L., Page, A. S., Perry, R., & Cooper, A. R. (2015). Accelerometer-measured sedentary time and cardiometabolic biomarkers: a systematic review. Preventive medicine, 76, 92-102.
5. Edwardson, C. L., Gorely, T., Davies, M. J., Gray, L. J., Khunti, K., Wilmot, E. G., … & Biddle, S. J. (2012). Association of sedentary behaviour with metabolic syndrome: a meta-analysis. PloS one, 7(4), e34916.
6. Thorp, A. A., Owen, N., Neuhaus, M., & Dunstan, D. W. (2011). Sedentary behaviors and subsequent health outcomes in adults: a systematic review of longitudinal studies, 1996–2011. American journal of preventive medicine, 41(2), 207-215.
7. Allen, K. D., & Golightly, Y. M. (2015). Epidemiology of osteoarthritis: state of the evidence. Current opinion in rheumatology, 27(3), 276.
8. Hannan, M. T., Felson, D. T., Anderson, J. J., & Naimark, A. (1993). Habitual physical activity is not associated with knee osteoarthritis: the Framingham Study. The Journal of Rheumatology, 20(4), 704-709.
9. Palazzo, C., Nguyen, C., Lefevre-Colau, M. M., Rannou, F., & Poiraudeau, S. (2016). Risk factors and burden of osteoarthritis. Annals of physical and rehabilitation medicine, 59(3), 134-138.
10. Pal, C. P., Singh, P., Chaturvedi, S., Pruthi, K. K., & Vij, A. (2016). Epidemiology of knee osteoarthritis in India and related factors. Indian journal of orthopaedics, 50(5), 518.

On November 10, 2019   /   Aches, Pains, and Mechanical Problems, Body, Uncategorized   /   Leave a comment