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Published on : January 15, 2014

Sitting Disease: A Blueprint for Averting Crisis

Sitting Disease: A Blueprint for Averting Crisis

It is not a coincidence that 2013 was the year we began to take seriously the risks associated with prolonged sitting. The problems and issues faced by sedentary workers have been growing and compounding over the last 20 years, until they finally came to head this year in headlines like “Sitting is the New Smoking” and “Your OfficeChair is Out to Get You.”

These headlines were shocking, and as a result, we have more people than ever before aware of how dangerous sedentary work really is. But as a physician on the front lines of treating those affected by desk jobs, I want to make sure that the conversation continues. While education and awareness are good first steps,we have many more to take if we’re going to address what is the greatest health risk to the modern workforce.

In this article,let’s take a step back from the sensationalism. What we need now is a clear understanding of how sitting impacts our bodies, some good solutions that will work for corporate America, a plan to implement them, and a sense of urgency that allows us to solve this crisis quickly. Unlike smoking or a poor diet, prolonged sitting is a condition of the workplace, not an individual behavior. It is something that can, and should, be addressed at the corporate level, but you need a good blueprint. So, here it is.

Why Now?

In the 1960s, 80% of the jobs in America were considered “active” jobs. Today,that number has dropped to only 20%. Deindustrialization and the rise of technology have led to an economic shift in this country, where the majority of people are now working in information technology positions—sitting at desks. Slowly, over the last 20 years, these kinds of jobs have become increasingly sedentary. Whereas we once had to get up from our desk to go to a meeting or the fax machine, everything now can be done from the comfort of your own workstation.

Some of the physical consequences of desk jobs can be felt right away. Things like energy loss and a lack of focus can appear after spending just one hour in front of the screen. But a majority of these consequences take weeks, months, and even years to be fully realized. Now, 20 years after the proliferation of the Internet and 15 years after the growth of cell phones, people are starting to feel the impact of all that sitting.

What Exactly are the Consequences?

Sitting affects the body in a myriad of ways, but the results will always look the same for your company: higher workers’ compensation and disability claims, increased health care costs, and lower productivity. (For an idea of exactly what inactivity is costing your corporation, you can use one of the inactivity calculators developed in the last few years. I always recommend East Carolina University’sInactivity Calculator which can be found atwww.ecu.edu/picostcalc/costcalculator/coi.asp.) But what exactly are these high costs to companies attributed to?

Corporations have been aware of repetitive strain and motion injuries for decades now, but my position as a chiropractor allows me a unique insight into how these injuries typically play out. First and foremost, know that these injuries are the number one musculoskeletal injury affecting our population today, as well as the fastest growing class of worker injury. That’s a particularly scary statement when seen in the same paragraph as this one: the great majority of people suffering from an RSI do not know they have one. So while we already have many employees making workers’ compensation and disability claims for sitting related strains and sprains, we haven’t seen anything yet.

Usually, by the time I’ve diagnosed someone with an RSI, they have already been to see another physician. They’ve had expensive and unnecessary diagnostic testing and have been prescribed heavy duty medications (in fact, oxycodone is now prescribed even more than Penicillin). These employees are often misdiagnosed with tendonitis, bursitis, or arthritis, and each of these diagnoses are a burden to worker productivity. These are chronic untreatable conditions, as opposed to a repetitive strain injury,which can be rehabilitated.

Misdiagnosis and mistreatment lead to more expensive medical bills and huge losses in productivity from days lost of work or working inefficiently while in pain. I always tell employers not to base their musculoskeletal interventions on their number of workers’ compensation and disability cases because this number just doesn’t accurately reflect how many people in your office could be helped by better workstations and better work styles.

The take away:If you are in a business setting where people sit for a living, treat repetitive strain injuries as a risk associated with that job. Do everything you can to prevent these costly injuries from occurring. If you assume that the majority of your employees will develop a sitting related injury, you will be correct and way ahead of the inaccurate data.

After addressing the risks associated with repetitive strain and motion injuries, you’re not finished yet. In only the last 4 or 5 years a new type of worker injury has been emerging—one that no one is talking about yet. So pay attention, because you’ll hear it here first. When the body sits for 30, 40, 50 hours a week, the muscles, ligaments and joints do not get the necessary usage they need to stay strong and healthy. The result is a body that is drastically out of shape. And this doesn’t have to be a physical unfitness that you can see. I’m talking about the small muscle groups of the body that support the spine, muscle groups we don’t work out at the gym, but that play a very important role in keeping our body functioning.

When these muscles, ligaments, and joints become weak, stiff, and out of place,you become much more likely to injure yourself doing something you’ve always done with relative ease. Activities like gardening or shoveling snow, even playing with your kids or riding your bike, can now lead to injury. More and more of my patients are coming in shocked that they hurt themselves doing a minimally strenuous activity.

I recently met an HR executive at the Corporate Wellness Conference who was sure that sitting wasn’t impacting her workers’ injury levels, because she wasn’t seeing a lot of people out with repetitive strain injuries. When I guessed correctly that what she did have was a bunch of people who “threw their back out” or had low back pain from doing something small like getting out of bed or bending over to pick up a pen, her jaw dropped.

The take away: Just because you are protecting people from RSIs doesn’t mean they aren’t feeling the effects of prolonged sitting.

“Sitting Disease” will be used here to represent the numerous chronic conditions that result from prolonged sitting. This last year alone studies found that diabetes, obesity, heart disease, and even cancer are all consequences of an inactive work style. However, it’s going to be difficult to parse out the costs of sitting related chronic disease and chronic disease that results from other factors such as diet, leisure time, exercise or lack thereof, and/or smoking.

One efficient way to figure out these numbers would be to simply stop your employees from incurring the costs associated with inactivity—break that chain right away. Chronic disease costs, whether in the form of medical bills or lost productivity, are a huge burden on employers. In fact, they are the entire reason we started wellness programs in the first place. The discovery that sitting is contributing to these costs should have led employers and wellness providers to stand up and say “Woo-hoo! It has been such a struggle to change our employees’ unhealthy behaviors. But you’re telling me that by simply addressing prolonged sitting, we can lower our costs? We can do that!”

Simply put: Prolonged sitting is a condition of the workplace, and therefore something companies have complete and total control over. Make people’s jobs a little more active (we’ll get to that in a minute),and let’s put a huge dent in the burden of chronic disease.

The take away: Think of sitting disease as an opportunity to create a healthier, more active and productive workplace and workforce.

  1. The True Costs of Repetitive Strain Injuries
  2. The Costs of Deconditioning Syndrome
  3. The Costs of Sitting Disease

Choosing a Solution

Right now, the most common way people are tackling prolonged sitting is through ergonomic devices that address injuries, or activity trackers that prevent chronic disease. While these are great efforts, a more effective and efficient way to address prolonged sitting is to find a solution that covers all of your bases.

To prevent both chronic disease and injury, the best thing for the body is to move 1-2 minutes for every hour it spends sitting. This prevents the biochemical processes like circulation or metabolism from breaking down and allows blood and oxygen to flow through the muscles preventing pain and injury.


During the 1-2 minutes that you’re moving to prevent chronic disease and injury, focus on targeted motions that engage the parts of the body that are most at risk for sitting related injuries. Of course, when sitting or standing for the other 58 minutes of the hour, be sure to use proper posture.

Right now, the best results I’ve seen occur when my patients use a wellness program that I’ve created that leads them through easy to follow stretch and strengthening exercises for two minutes every hour. In addition, I suggest they use my program along with a product such as LumoBack, which helps to train the body to sit with proper posture. In fact, that’s the exact protocol that I use when at my desk.

Implementing Solutions

When I first started specializing in inactivity related conditions in my private practice, I opened a second office that focused solely on introducing people to various programs and products that would help them avoid the negative consequences of prolonged sitting. Because my patients cover a huge range demographically, and all work in different companies with different rules, mores, and cultures, it was a challenge to find a solution that worked for everyone. After a lot of trials andtribulations, I learned some things along the way, and now have a pretty comprehensive list of features you need to consider when choosing how your office will combat sitting.

  1. Education and Awareness: Make your employees aware of why you are offering or implementing a new program or product. Make it personal for them.
  2. Ease of Use: People are busy, stressed, and focused on their own individual problems. Asking them to go out of their way or make something a priority that isn’t already is the surest way to fail.
  3. Accessibility: Getting healthy scares people. For so many years, we’ve tried to push diets or exercise routines on people that are intimidating and overwhelming. Whatever program you chose should be accessible to both the physically fit and to the most at risk employees of your population.
  4. Make it the Norm: If everyone in the office is expected to sit up straight or take stretch breaks, it becomes much harder NOT to engage in those healthy behaviors. Implement programs company-wide, use them yourself, let people see you using them, and make the unhealthy behaviors the things that stand out.
  5. Keep it Fun: We are social beings, and we respond to things that are attractive, pleasurable, and part of the social dynamic. More than ever before, our workspace has become the primary place we do our socializing. Capitalize on that by utilizingprograms that use competition and gamification to keep people motivated.

Whatever you decide to use, start now, start today. Don’t wait for this crisis to progress. You have the opportunity to make real and lasting change in your office by doing something as simple as getting people moving a little more all day long. The results will speak for themselves.

About the Author

Dr. Gregory Soltanoff is the CEO and co-founder of Voom.