Putting the spring back in your spine

Everything you need to unlearn about sitting down and leaning back in your chair

    

 

Photo: Pradeep Gaur/Mint

Almost half our lives are spent sitting. A poor sitting posture can put more strain on your spine than lifting heavy weights. It is, therefore, important to understand the right way to sit, especially if you are required to sit for long.

Sitting for a long period can strain your neck and back, and increase the risk of intervertebral disc bulges. Our backbone, or the vertebral column, is made up of alternating bones and a soft jelly-like structure called discs. When they bulge, they can compress the spinal cord/nerve that they are supposed to protect.

The spine is like a chassis for the whole body. If the spine is not held in a good posture, there will be too much pressure on the discs.

Good posture is not about the spine being straight. The spine actually has curves—convex in the neck and low back but concave in the thoracic (upper-back) region. Too straight or too curved compromises the springiness of the spine, effectively risking too much pressure on low-back discs. Good posture would be one where the spine is held tall, maintaining the curves mentioned above, but just.

While sitting does, in fact, compress the spine, sitting in a good posture reduces the compression. For that reason, the spine needs to be lengthened at all times.

You need to reclaim your spine’s springiness and be light. When your spine is lengthened, your head will be well balanced on the top of your spine. This balancing is a dynamic act, not a forced static one. Your arms and legs move freely from a supporting back. It’s almost like trying to balance a cue on your fingertip. Initially, it’ll be a struggle and your “good posture” won’t last very long. There will be discomfort and pain too. But soon enough, it’ll become second nature to you.

Sitting straight or completely tall is not correct either, the spine needs to be held at an approximate 5-degree slant.

The spine needs to be very dynamic, not stiff at all times. If you let go of the spine, it helps hold your upper (arms) and lower limbs (legs) very comfortably. If you make the spine rigid, the arms and legs are held stiff as well. This adds to tension in the shoulders and lower back, which will then lead to neck and upper-back pain along with low-back pain.

Everyone keeps talking about good posture, but it’s not sustainable if the muscles that are supposed to hold that good posture don’t have the right balance of strength and flexibility.

There is first a need to correct that imperfection by doing exercises with the correct techniques under supervision. Easier said than done. I struggle with helping people with this one all the time because fitness trainers just don’t pay enough attention to this.

Also, we all like to blame our tools, in this case our office chairs, for our incorrect posture without knowing how to use our bodies optimally. In the popular illustration showing our evolution from being a chimpanzee to a hunter to a farmer to a man sitting in front of the computer, the one big change is that we have finally lost contact with the ground. Most of us sit on chairs that have wheels all day long. I like to call them wheel-chairs as they make sure you’ll need one soon. Many of these chairs are also sold as ergonomically designed, which is often not the case.

But the chairs alone are not to be blamed. It is how you sit on the chair that also affects your posture. Here are some tips that will train you to sit better, independently, without using the backrest at all.

u Look for a chair with a seat which is parallel or slightly leaning forward to the ground, such that your hips are either at the same level as the knees or very slightly higher. Your hips should never be lower than the knees as that forces you to sink in the chair and does not allow you to take control of your posture even if you want to.

u You should be sitting in the middle of the seat.

u Now think of an equilateral triangle, with your sitting bones forming one tip of the triangle. The base of both your feet form the other two tips of the triangle. The gap between your feet should be as much as the length of your thigh.

u The angles between your torso and thighs should be 90 degrees or slightly more.

u The angle beneath your knee joint should be 90 degrees, so that your feet are right under your respective knee joints.

u Sit tall like a puppet: Imagine there’s a string attached to the top of your head pulling you up. It is not really forcing you up, the imaginary string keeps you tall, but your head isn’t stiff and the shoulders are relaxed.

u Relax your neck and shoulders while you’re thinking of growing taller all the time.

u Imagine that the strings on your shoulders are cut so that your shoulders are not raised any more. Instead, they are relaxed and fall freely. Now just to test the freedom of your neck, move your head the way the Noddy dog in the car would, i.e., bend your skull backward and forward as if it’s on a pole. Keeping your back tall, imagine that pull of the string is at a 5-degree angle, such that you are tilting forward, without slouching, such that your centre of gravity lies between the equilateral triangle.

You’ll be surprised to find that you can keep this position for a very long time. This will make your backrest redundant. It will also help you get rid of your expensive sofas and get back to sitting on Swiss balls.

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CHAIR FACTS

What to avoid in a chair and why

uA chair with wheels doesn’t let you rest your feet flat on the ground. Even if it does, your chair is not stable, hence you are not really in control.

OPT FOR: A chair without wheels, which is stable and sturdy. The good old benches in schools or straight-back dining chairs do a good job. The so-called ergonomic chairs make your chairs more mobile, when it is you who should be more mobile.

uThe seat on a chair should not be slanting back. This will make your hips lower than your knees and force you to slouch.

OPT FOR:The seat should be flat or just very slightly slanting forward. Your thighs need to be either parallel to the ground or very slightly slanting down.

uThe length of the seat you sit on should not be too long, so that the backrest is too far away: No matter how important it is for you not to use the backrest all the time, once in a while we all want to rest our backs. If the backrest is too far away, it will again make you slouch.

OPT FOR:The length of the seat should be such that you are able to shuffle your buttocks all the way back, so that the backrest then gives ample support to your back.

uThe angle of the backrest should not be leaning too far back. Chairs with this kind of backrest are useless as they don’t encourage you to sit tall.

OPT FOR:A chair with a slight lean, if at all. Good old dining chairs work very well.

uThe backrest of a chair should not be too flexible, because your back will not get enough support. It will make you lean back even when you want to sit tall.

OPT FOR:A chair with a backrest that is firm and does not give too much. This will give better support to your back.

uThe chair should not be too high. If it is, you will not be able to let your feet rest flat on the ground. This will reduce your chances of sitting up tall. Also, if it happens to be too low, the angle at your knee joint will be too acute, and won’t provide enough support for your lower back. This will force you to slouch your back, no matter how much you want to sit tall.

OPT FOR:The height of the chair should be such that your feet are flat on the ground and the angle at your knee joints is 90 degrees or slightly more. It will give you a better opportunity to sit tall.

Rajat Chauhan is an ultra marathon runner and a doctor specializing in sports and exercise medicine and musculoskeletal medicine, and founder of Back 2 Fitness. He is also associate editor, British Journal of Sports Medicine.

This piece is primarily based on the original work of F. M. Alexander (Alexander Technique), modified by Dr Wilfred Barlow, and introduced into London College of Osteopathic Medicine (LCOM) by Dr John Lester. Dr Chauhan was introduced to them in 2004 by Dr Roderic MacDonald, Principal, LCOM.

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Mimicking siesta at work

It’s tough to take a nap at work. But here is a technique that will help you relax

Take out 5-7 minutes while in office to carry out six steps to help release tension in the body. Photo: Pradeep Gaur/Mint

Most of us spend one-third to one-fourth of our lives sleeping. Adequate sleep is the means to recover from a hectic day and it helps recap and digest what all happened during the day, both physically and mentally.

Siesta refers to a short nap taken in the early afternoon, often after midday meal and it can help you feel refreshed too. I suggest that everyone, those who stay at home and those who go to work, should make an effort to take a siesta daily. An afternoon nap is not about sleeping in the true sense: it intends to do what a full night’s sleep does, but on a smaller scale. A 2007 study, Siesta in Healthy Adults and Coronary Mortality in the General Population, published in the Archives of Internal Medicine, found that regular 30-minute afternoon naps reduced deaths due to heart diseases by 37% over a six-year period compared to those who never napped. This study was done on 23,000 Greek adults by Dimitrios Trichopoulos, the senior author of the study and a professor of cancer prevention at the Harvard School of Public Health in the US.

If you want to take a seista break at work, here are a few positions that will not put you to sleep, but by mimicking the sleep postures, they will do what sleep is meant to do: Help you to unwind and release tension in the body.

For this you will need to keep a yoga mat in the office. Take off your shoes and lie down on the mat on the floor near your desk, or wherever space is available. While relaxing don’t hold your breath.

Take the posture:

Lie on your back, with knees bent at a comfortable angle, with your feet flat on the ground. Have your feet shoulder-width apart. Place your hands on your abdomen as shown (on the right), with elbows completely relaxed. Use a few books to support your head. Keep in mind that your head should not be bent forwards or backwards; it should be flat facing upwards. If possible, have your neck supported as well. If you have a small towel, put it under your neck for support. This is meant to support the curve in the neck area. Your posture should be such that you feel comfortable with the thought of elongating the spine and also doesn’t tense your neck, shoulders or upper back. After each step, count backwards from 100 to zero.

Step 1: Think about your whole spine, starting from the base of the skull to your lower back. Focus on elongating and releasing your spine, not so much straightening your spine. This is to be done by not forcing but letting go.

Step 2: Relax your neck. Think as if you are losing control of your neck and let go of the tension as your skull and tail bone go their separate ways.

Step 3: Let your shoulders relax and let go from rest of the torso. Let the shoulders fall to the ground. It’s not a forced activity. Just let gravity take over.

Step 4: Let your elbows go in the opposite direction to that of the shoulders, in effect, lengthening your upper arms. Now think of letting your forearms lengthen as well by elbows going in the opposite direction to that of the wrists. Relax your wrists.

Step 5: Focus on your legs. Now think of letting the front and back of your thighs relax. Follow this by doing the same with the calves. Let your feet expand by letting your toes and heel move in opposite directions. Let your feet widen as well.

Step 6 : Imagine your knees are moving up towards the sky. But at all times, your feet and buttocks are being pulled down by gravity.

Releasing the posture:

All the six steps should take about 5-7 minutes. Get up slowly by rolling to your side. Once you have become comfortable with letting go, start to focus on your breathing. Take a long breath in, hold for a second or two and then breathe out.

Rajat Chauhan is an ultra marathon runner and a doctor specializing in sports and exercise medicine and musculoskeletal medicine, and founder of Back 2 Fitness. He is also associate editor, British Journal of Sports Medicine.

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Stay mobile through the day

Physical activity throughout the day is far more important than a short concentrated workout.

Stand up every 30 minutes for 1-3 minutes and take a walk.

Over the last decade, there has been an explosion of information about how beneficial exercise and physical activity is for everyone—young or old, sick or healthy.

Companies like Google, Apple and Samsung, whose core business had nothing to do with fitness or healthcare, are now betting heavily on this sector—the next big thing. Fitness bands across brands have been flying off the shelves and the reason perhaps is that people are realizing that physical activity throughout the day is far more important than a short concentrated workout.

We know today that 68% of premature deaths are because of non-communicable and lifestyle-related diseases such as cancer, diabetes and heart problems, according to the World Health Organization (WHO). Half of these premature deaths have been shown to be preventable if people are physically more active.

This evidence led to a general consensus among all the authorities in public health and sports medicine, like WHO, American College of Sports Medicine, etc., that 150 minutes of moderate-intensity physical activity and exercise, spread over the week, is recommended for everyone. New research, however, indicates that the 150-minute recommendation is not realistic. Studies, like one published in the Annals Of Internal Medicine, show that sitting down for as much as 8-9 hours a day increases the risk of early death; even exercising regularly cannot counter this. In fact, exercising for half an hour or an hour every day will not undo the effects of sitting or lying down for the remaining 23 hours.

Of course, if you are not exercising regularly and are very sedentary, the risk of early death almost doubles. Some studies, like a 2012 study published in the International Journal Of Behavioral Nutrition And Physical Activity, have gone to the extent of calling sitting the new smoking.

In our fight against physical inactivity and better health, we shouldn’t lose track of our primary objectives. We need to be mindful that the person who spends long hours sitting, has poor dietary habits, including eating processed food and drinking aerated drinks, doesn’t sleep well, is overworked and stressed, and doesn’t end up being physically active or doing enough exercises, is at risk. It is not one or the other issue that affects health—all these problems contribute to the larger issue.

Besides, being physically inactive affects academic achievement, cognitive abilities, brain structure and brain function and limits personal, social and emotional development too.

Here is what you can do to remain physically active through the day:

u Stand up every 30 minutes for 1-3 minutes and take a walk.

u Don’t let water, tea, coffee, juice or any such thing be served at your workstation. Get up and fetch it.

u Use standing workstations—standing uses double the amount of energy than sitting down. Organize meetings where everyone gets to stand.

u High heels and uncomfortable shoes should be avoided as far as possible. Wear comfortable shoes like sneakers and sports shoes.

u Limit intake of processed food, sugar and fizzy drinks. Your dinner should be 2-3 hours before you sleep.

u Sleep 7-8 hours every day. Your sleep is supposed to reboot the system. So you need to get up fresh rather than all stressed out.

u Go for a brisk walk, cycle or jog for 30-45 minutes every day. This can be done in bouts of 10 minutes, like a 10-minute walk post meals, or taking the stairs instead of the elevator, or parking the car a little further away from home or office.

u Strength-train two-three times a week and work the legs, hips, back, abdomen, chest, shoulders and arms. You can do this at the gym or at home.

It’s very simple. You either take out time for yourself now and make some good decisions, or you’ll have ample time when a chronic diseases catches hold of you and you can’t move enough. The idea is to keep pushing a little harder.

Rajat Chauhan is an ultra marathon runner and a doctor specializing in sports and exercise medicine and musculoskeletal medicine, and founder of Back 2 Fitness. He is also associate editor, British Journal Of Sports Medicine.

rajat@b2f.in

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Is sugar the new tobacco?

Early exposure to a high sugar percentage in food can shape future taste. This bad habit should be nipped in the bud and children should be discouraged from having sugar.

Stay away from Sugar

  Obesity is a worldwide epidemic today, prevalent not just among the rich but also the poor. For the longest time obesity has been thought to develop when the total daily intake of dietary calories exceeds the total daily calorie expenditure. Insufficient physical activity and excessive food intake are considered major culprits.

So it has been thought the solution is simply to lose excess body weight by eating less and increasing physical activity. As Prof. Timothy Noakes highlighted in his book 

Challenging Beliefs: Memoirs of a Career, this model makes certain predictions that are universally accepted—that those who are obese are both lazy and greedy. So when doctors see an obese patient who then happens to have diabetes, knee or back pain, they end up blaming the victim. In some public healthcare sectors like the UK’s National Health Service, patients are even asked to lose weight before being operated on.

This thought process is an oversimplification for the biggest health problem our generation faces. It isn’t a problem that happens simply because of the number of calories consumed—it also depends on where that “energy” comes from.

It was in 1972 that English nutritional scientist John Yudkin, in his book Pure, White And Deadly—How Sugar Is Killing Us And What We Can Do To Stop It, noted that the exponential increase in the incidence of diabetes in the US and UK exactly matched the rise in sugar consumption.

A panel of experts at the World Health Organization (WHO) analysed about 9,000 studies before coming up with the new guidelines for food intake. It was found that when more than 10% of the total daily calories were from “free sugar”, it correlated with higher tooth decay, but there was complete absence of tooth decay when the calorie intake from sugar was reduced to 5%. Free sugar includes monosaccharides, the most basic units of carbohydrates; disaccharides, which are table sugar and milk sugar; and other sugars added by manufacturers, cooks and consumers to food, as well as sugars that are naturally present in honey, syrups, fruit juices and fruit concentrates. This does not include intrinsic sugars that are present in fruits and vegetables. The guidelines were released on 5 March on WHO’s website.

In recent years, experts have gone to the extent of calling sugar a “slow poison”. At a press conference this month, Francesco Branca, director of nutrition for health and development, WHO, recommended halving the earlier recommendation for daily calories as “free sugar” from 10% to 5%, i.e. from 50g to 25g of sugar a day.

So for an average body-weight adult, if the daily calorie intake is 2,000, 10% would be 200 calories and 5% would be 100 calories. Since each gram of sugar is four calories, it’ll be 50g for 100 calories and 25g for 50 calories.

An average-sized bowl of cereal is likely to have approximately 14g of sugar. A tablespoon of tomato ketchup has 7g of sugar and sweetened yogurt, 6g. A sweet beverage on an average contains 35g of sugar.

WHO appreciates that even though 5% would be ideal, it is wishful thinking. So it’s being termed a “conditional” recommendation; 25g of sugar daily would be very difficult in today’s world where sugar or its replacement, high-fructose corn syrup, are used in almost all foods and juices. The previous recommendation of 10% is more realistic, so it’s being termed a “strong” recommendation.

Just a day before the release of the WHO guidelines, the chief medical officer of England said sugar could be addictive and advised the British government to introduce a tax on it. There is no definite proof, but current medical literature suggests that early exposure to a high sugar percentage in food can shape future taste. The suggestion is that this bad habit should be nipped in the bud and children should be discouraged from having sugar.

It might be a good idea to replace vending machines in schools and office spaces that have sugary beverages with water fountains.

In India, during festivals or celebratory occasions, many people binge on sweets of various kinds. If you refuse sweets, your hosts could get offended. Maybe it’s time for us to show our hospitality and love in some other way.

Rajat Chauhan is an ultra marathon runner and a doctor specializing in sports and exercise medicine and musculoskeletal medicine, and founder of Back 2 Fitness. He is also associate editor, British Journal of Sports Medicine.

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