White-collar problems: In defense of traditional sitting

Sitting is bad

I'm sure this is not the first time that you have heard about the danger under your bottom. Sitting Disease is a term coined by James Lavine, a medical doctor who has spent most of his career studying sitting at the Mayo Clinic in Rochester, Minnesota. Estimates on exactly how much we sit vary. But it's hard to deny that many white-collar workers are plagued with this diagnosis.

Consider the human behavior that we call sitting. Notice what's going on all around you. Sitting has been implicated in numerous orthopedic problems like headaches and disc herniations. You do not have to earn a PhD in biomechanics to confirm all the protruding heads, C-shaped spines, and extremities that have adapted to the chair position.

A recent study by the American Heart Association found that whether or not you exercise, long sedentary periods raise your risk of developing heart disease, diabetes, cancer, and obesity. In other words, a lunch time jog does not make up for a typical day of sitting at work or class, and in the car, and while eating and reading and watching TV.  In 2010, British experts linked prolonged periods of sitting to a greater likelihood of disease, and Australian researchers reported that each hour spent watching TV is associated with an 18% increase in the risk of dying from cardiovascular disease.

The chair's fault

In the United States, the science of ergonomics is generally considered to have originated during World War II. Since then, both the medical community and furniture companies have attempted to design safe chairs, desks, and anything else needed to perform repetitive sedentary work. 

Numerous ball-shaped chairs, kneeling chairs, and ultra adjustable chairs have been proposed. These are definite improvements with some degree of scientific and plenty of anecdotal evidence for effectiveness. Yet many ergonomic solutions spare one part of the body at the expense of another, don't fit properly at common table heights, or have an odd appearance that is unacceptable for a professional workplace. Other ergonomic chairs simply don't accomplished what most people still want: enabling us to sit still and comfortably accomplish work.

It is my opinion that we are asking far too much from our chairs. The research seems to indicate that a healthy chair is an oxymoron. We may as well be talking about designing a low-impact hammer or the best Oreo for weight loss.

At this point, the conversation on Sitting Disease warrants some perspective. 

Lesser of evils

I imagine ages past when people hoped for a time when less strenuous work would allow them or their children to lead happy and healthy lives. These days, we are far less optimistic about that idea. Only recently have we began to understand some of the risks of white-collar work.

Sitting is not the only thing that is taxing on the body. The far majority of humans throughout history have had to perform more or less repetitive physical labor, rarely by choice. In modern times, blue-collar workers of all ages are in worse health than white-collar workers, even after controlling for socioeconomic variables. Blue collar workers are more likely to suffer from arthritis and report 3.4 more musculoskeletal injuries per one hundred workers. At age 65, blue-collar men score a mortality rate 42 percent higher than white-collar men.


When the daily grind involves repetitive lifting, carrying, pushing, pulling, kneeling, and operating heavy machinery, a good sit is legitimately therapeutic.Who among us hasn't been there after even one Saturday afternoon of yard work?

"Ahhh. The chair."

Keep in mind that many of us have such things as gardens and yards to tend to outside of our employment. We all sprint through seasons of time-crunched mayhem, some of it self-induced. But overall, Americans have far more leisure time than ever. We have the time and freedom to choose whether or not we want to watch TV, exercise, or otherwise fight back against what ails us.

The problems

The problem isn't simply the chair or desk or sitting or being classified primarily as a blue- or white-collar worker. The real problem, of course, is that too much of anything is bad for us. Some of the studies listed above and many others like them have found that physical inactivity, and not necessarily just sitting, is the crime we commit against ourselves.


Sedentary living is undeniably linked with sitting, and white-collar work demands siting long and often. But the fact of the matter is that our bodies gradually break down and fail us. If not from sitting, we would likely suffer repercussions from months and years of farming, hanging drywall, sorting packages, standing on cement, or some other task.

Some occupational risks are less obvious than others. Despite a growing body of evidence, white-collar employees remain less aware of their risks. A national workplace survey sponsored by The Hartford Financial Services Group Inc. found that while the average blue-collar worker expects to suffer overuse and traumatic injuries on the job, far fewer of their white-collar peers recognize that possibility.

Some not-quite solutions

Be aware of the realities of sitting for the majority of the day. Do not take the threat of sitting down...sitting down. By all means get your work done. But fidget, stand, kneel, walk and move as if your life depended on it, because it does. Search some of the evidence on NEAT (Non-exercise activity thermogenesis). Fascinating evidence is emerging that every small movement does count.

If many of your waking hours involve sitting, for heaven's sake, don't sit during the time you allocate to exercise. For example, the seated leg extension machine, the bicep curl machine, and the recumbent bike are not your smartest choices at the gym. Don't let me catch you on these unless you have a specific disability or other good reason for using them. I'm an advocate of exercises like squat and lunge variations, step-ups, shoulder presses, and pretty much anything where you must practice good posture, balance, and control the movement of multiple body segments against gravity.

Yes, you should schedule breaks from sitting, stretch, and take the requisite time and effort to create an environment that enables you to work efficiently over the long haul. Remind employers that an ounce of prevention is indeed worth a pound of cure.

As a physical therapist it is my duty and obligation to lecture you about posture. If only you could see my hypocritical posture as I type this! Why is it so difficult not to slouch? Gravity, our ancient friend and foe, is relentless. Stretching, strength training, "adjustments" and ergonomic chairs all only provide the potential to sit and stand with good posture. In the end, the only way to actually achieve good posture is relentless attention to sitting and standing with good posture. 

Don't stay in any one positions for too long, and don't give up. Variety, the spice of life, is also good medicine!

Given this problem with no easy or complete solutions, one of the most powerful things we have is gratitude. If only we can choose to be thankful for the privileged time and place in which we live. We can at least envision a narrow road that lies between the broad paths of sedentary living and backbreaking manual labor. With the perspective and time we have been granted to learn and engage in activities that do not involve chairs, maybe we can even be thankful for our place to sit.

 - - - - -

Long duration of inactivity raises risk despite exercise habits: http://circ.ahajournals.org/content/107/1/e2.full

Long duration sitting linked to various disease: http://bjsm.bmj.com/content/43/2/81.extract

Television viewing time and mortality:  http://circ.ahajournals.org/content/121/3/384.long

There is no one correct posture, chair, or correct way to sit: http://www.knoll.com/media/477/936/wp_future_ergonomic_seating.pdf

Blue-collar workers of all ages are in worse health than white-collar:
 http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3154222/

Blue collar workers 3.4 more musculoskeletal injuries per one hundred workers:
http://www.ncbi.nlm.nih.gov/pubmed/17314467

Mortality of blue-collar and white-collar men at age 65: http://jech.bmj.com/content/57/5/373.full

Americans have more leisure time than previous generations: 
http://www.bls.gov/news.release/atus.nr0.htm

Sedentary lifestyle, but not siting, linked to health-related costs: 
http://www.ncbi.nlm.nih.gov/pubmed/24512865

Every small movement counts: http://www.ncbi.nlm.nih.gov/pubmed/16439708

Cost effectiveness of occupational health intervention: http://www.ncbi.nlm.nih.gov/pubmed/16299706