How to stay healthy and injury free at work

As you probably know and have experienced by now, having a daily 9-5 desk-bound job is not guaranteed to exclude you from the group of people that suffer from chronic pains, types of people working heavy jobs like construction, agriculture… you name it!

            That being said, what makes having to work in an office so difficult and so dangerous to our health?

            First of all, the long hours spent sitting at the desk in combination with our lifestyle have to be considered. Our bodies are designed to be active, to move freely and be engaged in a certain dynamic that ensures better vascularization, movement that would keep us alert and ready to react.

            Another major factor that is vastly underestimated and maybe one of the most important components involved in remaining pain free is proper posture.  

Posture is defined as being the position of a person’s body or body parts, it’s the position in which the body is found before starting every movement and the position to which the body returns when completing set movement. [1]

            Imagine your trunk, your core, as a tower comprised out of many floors represented by the vertebrae. We’re anatomically built in such a way that every one of these floors perfectly align with each other, thus providing stability. Such a build is also meant to conserve energy, muscles being found in their most optimal condition, at normal tension and length, with the body lacking the need for exerting extra effort for correcting imbalances.

Stripping the body of its given integrity by not maintaining the proper alignment results in muscle pain, joint pain and varicose veins.

Why, you may ask?

The answer is simple! The body as we know it should always be approached through a holistic manner. Let me further explain…

Like in physics, where “every reaction has an equal and opposite action”, our bodies function following the same principle. An occurrence of muscle imbalance is always described through analysis of the agonist muscles, on one side, and the antagonist muscles, on the other side. Shortening of one muscle group on one side will most certainly be followed by lengthening of the opposite muscle through reciprocal inhibition. This, in turn, will lead to poor joint stability which is a factor for pain and in worst case scenarios, actual injury.

            Most unprepared, unknowledgeable individuals suffering from muscle imbalances are unable to identify the problem or even recognize its existence. Several imbalances could occur between your abdominals and upper hamstrings, between your lower back and your hip flexors. Essentially, to be a fully balanced person, these four muscle groups have to work together synergistically, each providing the same amount of effort in order to produce movement.

Whenever one of these muscle groups are either too tonic or too relaxed, problems will gradually start to arise, continuously progressing  until the diagnostic for the such called Lower-Crossed Syndrome could be established.

Lower-Crossed Syndrome is defined as tightness of the thoracolumbar extensors crosses with tightness of the extensor muscles of the legs. Weakness of the deep abdominal muscles crosses with weakness of the hip muscles. This pattern of imbalance creates joint dysfunction, particularly at the inferior segment of the vertebrae and hip joint. Specific postural changes seen in LCS include anterior pelvic tilt, increased lumbar lordosis, lateral lumbar shift, lateral leg rotation, knee hyperextension. [2]

Although, as previously explained, the body should be looked at as whole, for didactical purposes, here are the two most common types of conditions encountered when either one of these muscle groups are predominant. For an easier comprehension of the problem at hand and  because of the lack of complex anatomical knowledge of majority of the population, I have resorted, for better visualization power, to the well-known cartoon characters, Donald Duck and The Pink Panther.

The Donald Duck syndrome

  • Hyper-lordosis
  • Anterior pelvic tilt
  • Inhibited / Weak: Abdominal muscles, Upper Hamstrings
  • Facilitated / Tight: Thoraco-lumbar erectors, Hip Flexors

In simpler terms, to correct hyper-lordosis you need to BOTH lengthen the overly tight muscles (with massage, myofascial release and stretching) and strengthen the overly long/weak muscles (especially the glutes and abdomen)!

 

The Pink Panther syndrome

  • Hypo-lordosis
  • Posterior pelvic tilt
  • Inhibited / Weak: Thoraco-lumbar erectors, Hip flexors
  • Facilitated / Tight: Abdominal muscles, Upper Hamstrings

In simpler terms, to correct hypo-lordosis you need to BOTH lengthen the overly tight muscles (with massage, myofascial release and stretching) and strengthen the overly long/weak muscles (especially the hip flexors)!

Causes

  • Prolonged sitting, particularly with bad posture
  • Physical inactivity
  • Imbalanced strength training

Common signs and symptoms

  • Lower back pain
  • Anterior pelvic tilt (APT)
  • Increased lower back curve
  • Vicious knee position

These signs and symptoms, in combination with a screening that reveals stiff hip flexors, poor glute and abdominal strength are good indicators of LCS.

I’ve identified the problem, what do I do about it?

Lower back pain is subject to treatment through lifestyle combined with physical therapy which consists of strengthening the muscles that have been inhibited in your condition and stretching the opposite muscle group. Here’s a list of stretches and strengthening exercises that you might find useful in dealing with lower back pain.

1. A lack of flexibility can be a major factor in the appearance of lower back pain. Taking that into account, it is important to set aside the misconception that you either are/are not naturally flexible and work for yourself on opening up your body. All of these following stretches should be pain free so if you feel discomfort, stop what you are doing and come back to it when you feel ready.

  • Quadriceps stretch
  • Hip-flexor stretch
  • Adductor stretch
  • Hamstring stretch
  • Dynamic hamstring stretch
  • Side-lying hamstring stretch
  • Glute stretch
  • Prayer – cat – camel

2. Lumbar / Core strength and stability exercises

  • Supine abdominal draw in
  • Abdominal draw in with double knee to chest
  • Prone bridging on elbows
  • Side bridging on elbow
  • Press ups
  • Superman’s
  • Quadruped opposite arm/leg
  • Supine butt lift with arms at side
  • Prone bridging- “around the world” [3]

3. Lifestyle

  • Kneeling chairs

Such alternatives represent a real solution to our correcting our unhealthy way of sitting down.  The mechanism of these chairs is designed to divide the burden of one’s weight between the knees and the pelvis. Such benefits might be helpful to those experiencing lower back pain, reducing the discomfort and the fatigue usually associated with classic sitting positions.

                        Sitting for prolonged periods of time in such a dynamic chair results in less lumbar flexion and less back muscle activation compared to regular chairs, preventing slump sitting, thus favorizing a correct upright position. [4][5]

  • Smart Desk (Standing desk)

Ever since the standing desk was introduced to the masses in 2012, it has taken the world by storm, being marketed as the healthier alternative to working an office job. The main principle behind it is that it allows you to work while standing; the ones in higher price ranges also offer adjustable heights.

            Although it’s been shown to reduce back pain because of the more ergonomically correct position adopted while working for prolonged periods of time, some major flaws have been signaled like reduced productivity, in some cases, because of the concentration problems presented while standing up. That being said, the following recommendations must be taken into consideration while using such a desk:

  • Alternate between standing and sitting
  • Adjust your desk and screen
  • Use arm supporters
  • Take breaks every hour (a Fitbit watch might be useful)

4. Spinal manipulation by a Chiropractic

            Paying a visit to an experienced chiropractor might offer you surprising results. These are trained professionals specialized in relieving pain and in improving physical function by manipulation of several joints, including those of the lower back and pelvis.
The constant need of having your muscles massaged or stretched for relieving pain is not natural, it’s a temporary solution offering short term relief.

The chiropractic treatment is aimed towards having your posture properly verified, offering personalized advice on dealing with this issue, whether that being at home or at work. Such an alternative is aimed at solving the underlying problem!

References

  1. Paul Chek, “Effectively preparing clients for today’s functional exercise approaches
  2. Janda V. 1987. Muscles and motor control in low back pain: Assessment and management. In Twomey LT (Ed.) Physical therapy of the low back. Churchill Livingstone: New York. Pp. 253-278.
  3. https://uhs.princeton.edu/sites/uhs/files/documents/Lumbar.pdf
  4. O’Sullivan, Kieran, et al. “Lumbar posture and trunk muscle activation during a typing task when sitting on a novel dynamic ergonomic chair.” Ergonomics 55.12 (2012): 1586-1595.
  5. Suzuki, Tetsu, et al. “Comparison of Trunk Muscle Activities and Spinal Curvature when Sitting on a Kneeling Chair and Sitting on a Conventional Chair — Investigation of Two Sitting Postures.” Rigakuryoho Kagaku. 2011, Vol. 26 Issue 2, p263-267. 5p.

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