In this article, Naomi Dinneen, a Chartered Physiotherapist at Physio1to1 in Godalming discusses the risks of sitting, pain at the desk and how to sit well.

Firstly and most importantly, should you be sitting at all? 
Global studies show, on average, we sit for 7.7 hours a day at work, during our daily commute and at home. Apart from the plethora of musculoskeletal issues that arise from poor positioning, research suggests that sitting for extended periods slows your blood flow and metabolism. This leads to a higher risk of cancer, diabetes, heart disease, obesity and early death.

Unfortunately, counterbalancing sitting time with exercise is not sufficient. So if you’re a gym-goer or you cycle to work, well done and keep it up, but unfortunately this doesn’t make up for the 6-7 hours (or more) that you sit per day.

From a musculoskeletal point of view, sitting is a perfect storm. Hunching can create an extra 60lbs of force through the spine, leading to degeneration and disc problems. Whilst in the upper limb, rounded shoulder posture creates internal rotation at the shoulders linked with impingement symptoms and dysfunction of the rotator cuff (the muscles that stabilise the shoulder joint). At the mid spine, diaphragm function is compromised resulting in poor breathing patterns, decreased VO2 max (maximal rate of oxygen consumption) and increased stress breathing patterns which can lead to poor sleep. At the hip, the lengthened posterior structures can lead to what is kindly termed as ‘dormant butt syndrome’ or a weakening and lengthening of the gluteal muscles which is known to contribute to hip, knee and foot pain.

So fidgeting is good medicine, but how can we move more and meet our targets in a busy work day?

Current guidelines suggest we should not sit for longer than 20 minutes, however the amount of movement required at each 20 minute break hasn’t yet been determined. Try standing up for 10 seconds, stretching your arms to the ceiling, marching on the spot and turning your head from side to side whilst deciding on the next sentence you will write. Then sit down and write it… simple.

Try taking a walking meeting. OK, it’s not particularly viable in a big group or the drench of a Surrey or West Sussex downpour but alongside its physical benefits, meeting side by side tends to cut through hierarchy and sets people at ease. Creativity is also increased when you get ‘out of the box’, as your brain is more relaxed and susceptible to certain chemicals.

It’s only more recently that we started to meet sitting down, Philosophers and poets like Kant and Wordsworth triumphed the link between walking and deliberation. Just have the courtesy to notify your colleague in advance so they can bring an umbrella!

Consider a sit to stand desk, desk raiser or wall desk to create an environment in which you can easily stand to work. A study by the Centres for Disease Control and Prevention found these devices are effective in reducing sitting time, upper back and neck pain and improving mood states.

Standing tones muscles, improves posture, and increases blood flow and metabolism.

However it should be noted that just like sitting, standing for too long can lead to poor posture and fatigue. So the key here is to be able to move easily and frequently between the two different positions throughout the day.

Try using an app like ‘sitstandCOACH’ on your phone or download a programme like ‘eyesrelax’ to your computer to remind you to stand frequently. More simply, place your phone on the other side of the room with a 20 minute recurring alarm or only use small cups to collect water, forcing you to visit the water machine more frequently.

Set your ‘fit bit’ or other fitness device to record your hourly steps, not the daily total, to ensure you are moving regularly as well as burning calories.

If you don’t need to type whilst on the phone, stand up and move around. Ideally you should use a headset or headphones to prevent the urge to squeeze the phone between your ear and shoulder.

So how should we sit when we have to?

Here’s a lowdown of the most extreme postures I see and how to prevent them. Remember, none of these postures are wrong for a short period of time, only if they are sustained over longer periods.


1) The Slumper

Classically seen during laptop use.

To help correct, place the screen on a raised platform like a pile of books or even a formal laptop stand on a desk. The top third of your screen should be level with your eyes. To test if you are at the right distance from the screen, gently reach out in front of you, your screen should be at your fingertips. Take note though that you must be in good posture with your bottom at the back of your seat to do this test.

pic-22) The T-Rex

Most frequently caused by incorrect desk height.

If you can’t lower the desk, bring your chair up to have your elbows level with your hands and allow your wrists to maintain neutral. If your feet now don’t touch the ground you need to place a foot rest under them to keep your legs and therefore spine supported.

pic-33) Over-corrected

When we finally realise we have been slumping for the last hour this is the posture we all often adopt. Unfortunately, this can be just as hurtful as ‘the slumper’, with an increase in forces on the facet joints at the back of the spine. However to find the right posture, overcorrection is a helpful position. Bring yourself as upright as you can, then relax by 10%-20% and you should be just about right. The only areas you should feel working to hold you here are your tummy and the area between your shoulder blades. Your low back and neck muscles should feel comfortable and relaxed.

Perfect office desk setup is complicated and is dependant on your body shape, current injuries and work demands. There are some general rules you can follow but if you’re still getting pain at the desk it’s worth investing in a formal desk assessment carried out by a physiotherapist. This involves body measurement and task analysis to create a bespoke desk setup for your demands.

Naomi Dinneen is a Chartered Physiotherapist with a Workstation Ergonomics qualification from the ACPOHE (Physios for work and Health). Call Physio1to1 on 01483 424470 for more information.