Opinion piece – Stand up Australia – sitting is as bad as smoking

Last night, 60 minutes had a story on the devastating effects of sitting. Yes we absolutely need to get talking about how ridiculously sedentary our lives have become but I’m afraid this story failed to truly emphasise what we need to do about it.

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The story can be viewed at http://www.jump-in.com.au/show/60minutes/stories/2014/september/stand-up-australia/

The highlights were:

  • A reflection on the catastrophic effects of our sedentary jobs and we were told ‘the latest research says sitting is as bad as smoking’. Yikes! They said sitting can be linked with diabetes, cardiovascular disease and cancer.
  • Their case study, Donna, shed 20kg by doing some big changes around the office. This included getting up hourly to move around the office and standing at her desk.
  • You have a 40% higher risk of early death if you sit on a daily basis for 11 hours or more versus 4 hours
  • You can decrease your blood pressure and improve your energy levels if you stand or light walk around the office while you are working, versus sitting at the office.

Be warned that to loose weight and improve health, it won’t just come from standing at the desk and wandering around the office every now and then throughout the day. People who sit for the doomed 11 hours or more during the day are probably more likely to have sedentary behaviour with most other aspects of their life, don’t exercise and don’t give a hoot about their diet. And this is why the story was so misleading. There are too many variables to make the research they were talking about ‘high quality’. The diseases – cardiovascular disease, cancer and diabetes – aka lifestyle diseases have so many contributing factors and sitting is just one variable – absolutely an important variable but it is just one variable. A healthy lifestyle must also factor in regular exercise, a good diet, not smoking, not drinking and reducing your stress.

We still MUST do our 30 minutes of cardiovascular exercise and in addition, take on board some of these suggestions of how to keep active during the day. Suggestions include:

  • As per the story, I love the idea of doing a ‘walk and talk’ meeting rather than sitting in a board room (see story for full details).
  • Perhaps try a standing desk. If you do, don’t start off by standing all day because if you aren’t used to it, you’ll may end up with a sore back anyway.
  • Get up every 30-60mins and MOVE around the office. You could
    • walk around your floor
    • Do some calf raises (as this gets blood pumping in your legs)
    • Hold a stretch to prevent your joints from getting too stiff
  • Set your alarm to remind you to move every 30 mins because, lets face it, it is so easy to get engrossed in our work and forget about moving
  • Take the stairs not the lift or elevator

For a truly healthy lifestyle, yes we could all improve our incidental movement throughout the day, but don’t forget WE MUST also keep up our exercise and have a good diet!

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Is cycling really good for you? A must read for office workers and cyclists.

MAMIL aka middle aged men in lycra. We’ve all heard the phrase before and rightly so since cycling has become a hugely popular sport in recent years. We are seeing less of people going off to have a round of golf and instead people of all ages, shapes and sizes jumping on a bike and going for a ride.

Benefits to cycling

There are huge advantages to cycling especially the cardiovascular benefits. The heart works harder if more major muscle groups are worked during exercise. Therefore cycling is a fantastic cardio work out because the major leg muscles are involved. This makes the heart worker harder and pump more blood, giving you better cardio benefits for the workout.

The other advantage is that it is a form of non impact exercise, to give those creaky joints a break!

 What to watch out for

One issue to be aware of is the position you are in and the problems this contributes to for people with back pain and for office workers. As you are in a bent forward position on the bike, your hip flexor muscle is held in a very short position. This will make the hip flexor tighter.

As with sitting in a chair, your hip flexor muscle is held in a shortened position and again this will make the hip flexor tighter.

iliopsoas-cycling short mm

Anatomy review of the hip flexor

The hip flexor muscle runs from the front side of your lower back, passes through the pelvis and attaches onto the front part of your hip. See the pictures below, looking front on at the hip flexor. As you can imagine, when you sit at work or are on a bike this muscle is held in a shortened position, which over a period of time makes the muscle tight and overactive.

iliopsoas anatomy pic 2iliopsoas anatomy

The issue

The problem with your hip flexor being tight is that it can:

  • contribute to lower back and hip joint stiffness.
  • It will start to cause muscle imbalances. As your hip flexor becomes tighter and more overactive, surrounding muscles such as the buttock and deep core muscles get weaker and start to switch off. This can then place more load and start to cause pain in your hip joint and lower back.

Should you still cycle?

Of course! The cardio benefits of this non impact exercise far outweigh the idea of a muscle getting tight. However, follow the tips below to get the most out of cycling without causing too much tightening of the hip flexor:

  • Stretch the hip flexor EVERYDAY, no matter whether you have cycled or not. As mentioned above, this muscle gets tight even while you are sitting. Stretch 3 times per day for 30-45 sec each side. And after a cycle stretch for longer. psoas-stretch1
  • Lean back! With sitting at work or being on a bike you are in a bent forwards position, so do some stretching EVERYDAY to take you into the opposite position and help iron you out. Do the below standing stretch (pictured on the left) for 30 seconds every 1-2 hours while you are sitting at your desk. Do the prone stretch (pictured on the right) every night for 1-2 minutes. Do either option as well for 1-2 mins immediately after you finish a ride.

extension_standing_exerciseback ext stretch prone

  • Keep strengthening your gluts and deep core to correct any muscle imbalances.
  • Vary your exercise. Don’t just use cycling as your only cardio exercise, but vary your routine so you can place your spine and body in different positions – this can be achieved with adding in some other exercise such as walking, running and swimming.

Happy cycling!

The power of the brain in dealing with pain

Have you ever wandered why after a bad nights’ sleep, you are in an irritated mood or feel more pain? As sports physios working with teams, why is it that when a team wins their game, players have less injuries and complaints versus when the team looses, players have more injuries?

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It used to be believed that when you injured a tissue, a message would travel up to your brain to say the tissue was damaged. The brain would register that information and then signals would be sent back to the tissue saying the area was in pain. But this didn’t explain phantom limb pain. So if someone had an amputated leg, how was it possible they could still feel pain or an itch in the leg that is no longer there?

Scientists and medical professionals have shown that the brain is the powerhouse for understanding your perception of pain and that pain is in fact related to many factors. It isn’t just to do with the amount of tissue damage you may have experienced. Instead, your perception of pain is to do with a huge range of factors. This includes:

  • Sleep – the more pain you have, the poorer your sleep pattern. Poorer quality sleep also makes you feel more pain.
  • Immune system – when you experience ongoing pain, this can weaken your immune system, making you more susceptible to things such as colds. When your immune system is down, you generally feel more achey.
  • Your mood, stress and your environment– the more stress, anxiety and worry you have about anything in your life, the more pain you will have. The more pain you have the more you are going to feel stressed and anxious.
    • For example, your pain may be worse if a relative has just died or you are moving house or you have work pressures.
  • Past experience and your thoughts can dictate your brain’s perception of pain. For example, if you have recurrent episodes of acute low back pain, you may experience either:
    • more pain because you know what is involved to get you better, you may become emotional, frustrated and fear the pain you have had in the past. All these factors can escalate the amount of pain you are experiencing.
    • less pain because you have had a good understanding of your pain in the past and you know what to expect.

pain-in-the-back

Chronic pain is a huge problem in Australia, where 1 in 5 people have it. The brain keeps producing pain even though the tissues are restored and out of danger and any other serious diagnosis have been ruled out.

Note the difference between acute and chronic pain.

  • Acute pain is defined as pain you may experience for less than 3 months. For example, if you sprain your ankle and you make a speedy recovery.
  • Chronic pain is pain that lasts for longer than 3 months and where the ongoing pain is to do less with the structural changes to your body and more to do with sensitivity of the nervous system. That is, the tissue damage is not the main issue.

What should you do about it?

We need to retrain the brain and nervous system. The brain is not fixed. It is PLASTIC. You may have heard the term before, neuroplasticity – where we can retrain your brain (for an interesting read, see Norman Doidge’s book The Brain That Changes Itself). These are the factors to work on:

  • Medical
    • Medication can help to get you going but should be tapered off and ceased as your symptoms settle.
    • Always get a second opinion, especially if you are told to get surgery and you have any doubts.
  • Keep your approach active
    • Learn ways to decrease your stress levels and wind down the nervous system. This can help with your emotional wellbeing and can reduce pain.
  • Diet and lifestyle
    • Our sedentary lifestyle and what we eat contributes to a sensitized nervous system. Take a good look at your diet and lifestyle and make appropriate changes to your drinking and smoking habits, diet and exercise.
  • Explore the deeper meaning of your pain by looking at what was going on in your life around the time the pain developed. Any worrying periods of life can make pain worse so think deeply to recognize your emotions.
  • Physical activity
    • Get moving at comfortable levels without fear. Slowly build back your normal activity levels.

If you want to learn more on this topic:

Pain comes from the brain. The brain can be re-trained. But to re-train the brain, you need to look at a broad perspective and all the factors contributing to your pain.