Recently, I saw a picture of my friend's dog, Sammy, in a ridiculous position (one of many at this point) and my first reaction was to laugh as usual and shake my head.  I'm pretty sure we've all seen something like this at one time or another.  Immediately my next reaction was "How is that comfortable?"  As you can see above, most of the time he is lounging on big fluffy pillows but it still looks like an awkward position.  But then it got me thinking, maybe it isn't so awkward after all.  Maybe this kind of variety is a good thing to do.  Clearly it doesn't seem to faze him as he's good to go after he gets up and stretches it out a little bit just like every other dog you've ever seen.  Maybe we can learn something here.  Granted, humans are not dogs and dogs are not humans (even though we treat them like that sometimes).  However, we are made of the same stuff like bone, muscle, nerves, ligaments, etc. so maybe it isn't such a bad comparison in this instance.

How many times are you told some position or posture is bad for you?  Doctors, physical therapists, chiropractors, yogis, the internet are constantly telling you what you should and shouldn't do.  There are obviously some basic guidelines that are worth practicing but they may not have to be so strict.  I will be the first to say that I am guilty of saying something similar to my clients over the years but more recently I've added a caveat and I think Sammy does a great job of illustrating my caveat.  It goes something like this: "Just don't do it 100% of the time."  None of Sammy's positions are the same so he is most definitely not doing the same thing 100% of the time.

In general, consistency, repetition and overuse are what tend to get people in trouble more than a specific position or posture itself.  They end up sitting the same, standing the same, laying on the same side to watch television often for prolonged periods of time.  As you can see above, Sammy doesn't subscribe to doing the same thing over and over again.  He's living the dream of variety in his life (at least in sleeping positions).  Maybe all of these different positions stimulate his nervous system (his brain) and the tissues of his body since nothing is ever the same.  Maybe it is important to take advantage of the full range of motion of each joint at some point during the day.  Maybe it is important to stretch muscles in a variety of positions throughout the day.  The living body, dog or human, is extremely adaptable and can handle all kinds of positions and postures.  Think break dancers and Cirque du Soleil performers.  They can do all types of "crazy" and "awkward" things with their bodies and they make it out alive just fine.  Just don't do the same thing 100% of the time.  Chances are your body welcomes the change and variety and will be better in the long run.

So don't beat yourself up if you find yourself in a "bad" position on a super soft sofa that was really comfortable.  Don't beat yourself up if you find yourself slouching as I just was until writing this sentence.  Just don't do it 100% of the time and you will be ok.  When you do catch yourself doing something all of the time, take some advice from Sammy: Change things up and add some variety to your life...or napping position at the very least.  Your body will thank you for it.

Sitting.  It didn't take long before I remembered why I don't like sitting for prolonged periods of time.  It is only recently that I have spent more time parked on my posterior between marketing, blogging, (I am currently standing for this one), and reviewing new research along with many other administrative items as owner of my practice.  Prior to my leap as a business owner, I was on my feet and moving more during the day as a staff physical therapist in several different clinics.  Sitting was something to be cherished when I had the chance.

Now under normal circumstances when you are sitting for a while, that soreness sensation, generally in your lower back/sacroiliac region, is the brain and body's gentle way of telling you to MOVE!  ANYWHERE!  JUST MOVE!  It's quite an ingenious alarm system because it works really well....as long as you listen to it.  Unfortunately I failed to listen to that initial alarm system recently and that soreness turned into a more constant and very annoying pain to the point where any static position was uncomfortable.  It was even a bit challenging to fall asleep and my sleep is not something to be messed with.  However, the solution was still an easy one....all I had to do was start moving more.  Walking, running, (even a 10 mile trail race), and changing positions all felt great so it is no surprise that my constant pain has decreased almost back to its baseline of normal soreness if I sit for too long.

With this experience in mind, I wanted to share some issues related to sitting beginning with a basic understanding of the biomechanics involved and soft tissue considerations.  There are different classifications of sitting but for the purpose of this discussion, I will focus on the very technical version that we all succumb to at some point during the day with or without knowing it: the slumped sitting position. 

Before going any further, it is important to have a reference point, which would be standing in this case.  In stance, the spine is naturally curved when looking at it from the side.  More specifically, the lumbar spine, roughly the bottom third of the spine, has a lordotic curve which changes when we sit.  Using the L1 vertebrae to the top of the sacrum, Lord et al measured the average decrease in lumbar lordosis angle from standing to an upright sitting position, (90 degree angle at the hips and knees).  It was 49 degrees in stance and decreased to 34 degrees in sitting. (1)  When the body gets lazy, gives in to gravity and slumps, this change is even more dramatic further decreasing the lordosis and sometimes eliminating it altogether.  This by itself is not a cause for concern as it happens normally with many activities like putting your socks on or bending over to tie your shoes.

Something else also happens as a result of this position: stretching of posterior structures and tissues of the lumbosacral region.  These can include muscles, tendons, ligaments, fascia, etc.  In order to accommodate the decrease in lordosis, tissues must lengthen and stretch compared to their length in stance, which is a more neutral position for the spine and pelvis.  It should be noted that this by itself is also not a cause for concern because tissues are stretched all of the time throughout the body as we move during the day.  Time, on the other hand, is the enemy.  When tissues are stretched, they trigger mechanoreceptors which are responding to the mechanical deformation of being lengthened.  Initially the messages sent from the mechanoreceptors to the brain are not enough to trigger any type of soreness or pain response but the longer the time being stretched, slumped sitting in this case, the more frequent and "louder" those messages become.  If it is long enough without a change, the brain processes the increasing messages and begins to perceive this as a potentially "dangerous" or "threatening" situation, and the output is sensations of soreness first followed by pain.  This is the ingenious alarm system mentioned above as the expectation is that you will move so those tissues are not being stretched, (or not in "danger"), anymore allowing the mechanoreceptors, (and your brain), to chill out.  This can obviously be overridden, as I did for too long and over several days, since most of the time you know that you are not actually in any danger, just uncomfortable.  As I described above, any kind of movement, especially if you get on your feet for a bit to return the normal lordotic curve to your lumbar spine, usually relieves this type of soreness and discomfort.  Unfortunately, many of us are stuck sitting, often slumping, for prolonged periods of time for work or in that super soft sofa you love.  So do the easy thing: listen to that alarm system, get up and move a little bit.  Your body, (and brain), will thank you for it.

Stay tuned for Part II as I discuss some of the metabolic issues associated with prolonged sitting.


References:

1. MJ Lord, JM Small, JM Dinsay, RG. Watkins. Lumbar lordosis. Effects of sitting and standing. Spine, 22 (1997), pp. 2571–2574.

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