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While you are reading this,  you will most probably be in front of a computer, on your laptop, iPad or even using your phone….now just spend a minute thinking about your posture: how are you sitting? Is your back straight or twisted to one side? Are you on a chair or slumping on a sofa with the laptop on your lap? How close are you to the screen? Are your hands on a keyboard or a mouse? How comfortable do you feel? You would probably have heard a lot about keeping a ‘good’ posture when using your computer. So what is ‘good’ posture? Well this is the usual advice: The picture below summarises  some of the ‘key points of the less straining posture for your back:

• Keep the natural curves of your back, so avoid bending forward too much or ‘slumping’ on your chair. Your lower back should be in contact with the back rest of the chair, and keep your hip and pelvis on a 90-120 degree angle. So yes, it’s better to recline backwards slightly, ‘opening’ your hips.
• Knees should be around 90-100 degrees, making sure you can fit 2/3 fingers between the end of the chair and knees.
• Feet should be on the ground or on a foot rest, but never ‘dangling’.
• Elbows 90-120 degrees.
• Monitor should be arm’s length away.
• Keyboard should be fairly close to you on the table, so you can keep elbows at the right angles. The mouse should be as close to you and at the side.

What if you’re working from a Laptop?

Laptops are designed to be portable, not to be ergonomically comfortable.

If you are working with a laptop the ideal is to raise the laptop on a stand, so the screen is about eyesight level, but you only would do that if you have an additional keyboard that you can connect to it, so the keyboard remains on the table.

Avoid leaning forward!

If you don’t have a stand but you have another keyboard, just raise the laptop on some books and use the spare keyboard to type.

If you don’t have an additional keyboard maybe find something that allows you to tilt the the laptop slightly, such a ring folder. This will raise the screen and tilting the keyboard should make it a bit more comfortable to use

… and I don’t have my nice office chair now…

Some of you may be currently sitting on a dining room chair or working on your kitchen table (maybe even the sofa).

First have a look at the advice I gave at the beginning and see how much you can make your current set up to mimic that as much as possible. Can you use cushions to support your lower back or to raise yourself on the chair? How can you make sure that your shoulders are not raised and your elbows relaxed? How can you avoid leaning forward?

If I had to give you two simple guidelines those would be:

• Even if  you have the best chair, the most important advice is to make sure you are getting up  every 20-30 mins and moving around. Setting an alarm would be ideal. Kelly Starrett in his book Deskbound, advices at least 2 mins of movement for every 30 mins of a sitting position.
• Equally you should change your posture throughout the day, maybe sitting in a different chair or working on a different table, so you make it varied, but again, no more than 20 mins. 

BUT IF I SIT WITH A GOOD POSTURE, IS THAT OK?

Bad news, unfortunately, sitting is already quite a ‘straining‘ activity for our backs. In your back you have vertebrae (the bones), and discs (the softer bits in between the vertebraes that allow movement in our back and they also work as shock absorbers). Discs change shape to accommodate movement in the spine. The diagram below shows what positions put the most load on your L3 disc (the vertebrae in the middle of your lumbar spine):

So, compared with a standing posture, when you are sitting your discs are under an increased strain, and depending on how you sit, you will be putting more or less strain onto your back. It is not only the discs. Somebody who spends too long sitting, in the same posture, has more chance of straining the back and neck postural muscles, and as a result weakening the spine.

GOOD POSTURE IS A VARIABLE ONE!

Even with the best sitting posture, prolonged sitting is really the problem, so the answer is really to keep changing posture, and not to get stuck in the same one for hours: “an ideal sitting posture is a variable one!!!” (McGill 1990)

… and what else can I do to reduce pains from sitting?

One of the advantages of being at home is that you can keep doing different stretches, without raising a few eyebrows in the office.

Maybe pick up a different  stretch throughout your day, every time you break after 20-30 mins.

One of my favourite stretches is simply ‘child’s pose’ from yoga. This helps you stretch you the whole of your back and the shoulders.

If you have a foam roller at home I would use it from time to time on your upper back throughout the day. Make sure that you are supporting your neck and it does not get strained.

Stretch your chest with this simple routine using a wall or a door frame

If you feel discomfort in the neck you can try decompressing on a wall or if it feels right for you, you can try using a towel or a strength band (the guy in the video claims that it may help you to look younger, I would question that.

Sitting also will make your legs get tight. Try this simple stretch for the front of the leg . Also use this  mobilisation for your hip to decompress it and ease your lower back.

For the back of you leg, you can stretch your hamstrings using a door frame.

So there’s a few ideas to encourage you and help you while working from home.

Enjoy and stay safe!

According to the World Health Organisation (WHO), physical inactivity is now identified as the fourth leading risk factor for global mortality causing 6% of deaths worldwide. Only high blood pressure, tobacco, and high blood sugar kill more people. Since moving to Lancaster my own regime of fitness has fallen by the wayside and I’m putting on weight, not loads but enough to make me stop and take notice.

Does this matter? In short, YES. Below explains why.

Physical inactivity is linked to cardiovascular disease, diabetes and cancer and their risk factors such as raised blood pressure, raised blood sugar and increased weight. Physical inactivity is estimated as being the principal cause for approximately 21–25% of breast and colon cancer burden, 27% of diabetes and approximately 30% of ischaemic heart disease burden. These diseases are classed as non-communicable diseases (NCDs) which now account for nearly half of the overall global burden of disease. It is estimated currently that of every 10 deaths, 6 are attributable to noncommunicable conditions. This means these diseases are influenced, at least in part, by our environment and our lifestyle choices.

Exercise isn’t just good for our heart health and to maintain a sensible weight. It stresses and strengthens our bones, gives us a boost of endorphins which counters depression, and according to the WHO, reduces the risks of colon cancer and breast cancer. Maintaining physical activity into older age helps to maintain good balance and reduces the risks of falls. If exercise was a pill, we’d all want to be taking it.

So how much should we be doing? It depends on your age and health; pregnant, postpartum or people who have had cardiac events have different needs and are recommended to seek medical advice before trying to meet the levels advised for adults aged 18-64. Let’s define the parameters. According to the most recent guidelines for healthy adults ages 18-64 we should be doing at least 150 minutes of moderate-intensity aerobic physical activity throughout the week or do at least 75 minutes of vigorous-intensity aerobic physical activity throughout the week or an equivalent combination of moderate- and vigorous-intensity activity. So if you were to exercise 3-5 times a week you need to be working for between 50-30 minutes at a time. In addition to that, muscle-strengthening activities should be done involving major muscle groups on 2 or more days a week.

This may seem like a lot but the benefits are worthwhile. Physically active people have higher levels of health-related fitness, a lower risk profile for developing a number of disabling medical conditions, and lower rates of various chronic noncommunicable diseases such as coronary heart disease, cardiovascular disease, stroke and hypertension; diabetes and obesity; osteoporosis; breast and colon cancer and depression compared to people who are inactive.

What about for people aged over 65? To my surprise they have the same recommended activity levels as those under 65. In some cases the evidence of health benefits is strongest in older adults because the outcomes related to inactivity are more common in this age group. This results in an increased ability of observational studies to detect the protective effect of physical activity in the over 65’s. Overall, conclusive evidence shows that adults aged 65 years and above should do at least 150 minutes of moderate-intensity aerobic physical activity throughout the week or do at least 75 minutes of vigorous-intensity aerobic physical activity throughout the week or an equivalent combination of moderate- and vigorous intensity activity.

In addition to this, those with poor mobility, should perform physical activity to enhance balance and prevent falls on 3 or more days per week and muscle-strengthening activities should be done involving major muscle groups, on 2 or more days a week. When adults of this age group cannot do the recommended amounts of physical activity due to health conditions, they should be as physically active as their abilities and conditions allow.

How many of us are reaching these targets? Especially those in the upper age group? I certainly wasn’t and I was feeling all the worse for it. I’ve decided to get up early in the mornings to get my recommended daily amounts of exercise in and I feel more informed for my patients to help encourage them to live healthier, more active lifestyles.

Osteopaths are interested in your overall health and well-being when you come for treatment. I hope this blog helps those of you who read it too.

We all have times in our life when our mental health is not good. This might include feelings, thoughts, reactions and emotions that prevent you from feeling well. Triggers might include environmental, social, financial, physiological, relationship, work or emotional stressors (perhaps more than one thing on this list has/is happening to you on this list.) You are not alone. According to fundamental facts about mental health, every week, 1 in 6 adults experiences a common mental health problem such as anxiety or depression.(https://www.mentalhealth.org.uk/publications/fundamental-facts-about-mental-health-2016)

Normal feelings of being low or anxious might become a ‘mental health problem’ when it starts to impact on your ability to live your life fully, when the issues don’t go away after a couple of weeks, or they come back over and over. (https://www.mind.org.uk/information-support/types-of-mental-health-problems/ )

So what does this have to do with being an osteopath or osteopathy? Well for starters osteopaths claim to work with the body as a unit, which includes the mind, the body and the spirit. This is similar to the ‘Biopsychosocial model’ of approaching health care which is a model that is used to understand the combined biological, psychological and social factors that determine our health and well-being; a person’s illness or pain should not be viewed in isolation from their psychological or social factors.

Osteopaths take the time over a case history to hear about the reason you’ve come to see us and also hear about your overall health. That includes common problems like high blood pressure but also common problems like depression and anxiety. This links in with the below statistics taken from Q lab which inspired this post. (https://qlabessays.health.org.uk/essay/mental-health-and-persistent-pain-an-introduction/ .)

Osteopaths want to hear about your mental health as well as your physical health because the two are inextricably linked. Especially when it comes to pain. The ‘pain cycle’ below explains how factors such as family, social and work concerns may connect and reinforce each other affecting joint pain like neck and back pain.

As well as physical strains your body is under, osteopaths want to hear about the mental strain you are under. Stress can impact on your body’s health. Chronic stress negatively affects your body’s immune system and can progress dysfunction and disease within the body. Poor sleeping habits associated with chronic stress increase levels of pro-inflammatory cells in the blood stream and negatively affect mood. All of this affects your body’s balance and homeostatic mechanisms which brings us to another tenant of osteopathic treatment. The body is self-healing, self-modulating living organism and when given the right conditions will heal itself.

Osteopaths treat patients with self-healing in mind so if you are stressed out, not sleeping, low and anxious then a certain amount of energy is being used to keep you going that we cannot access to heal your injury or pains. Your state of health; mental, physical, spiritual dictates how much treatment and what kind of treatment is offered.

In a few weeks I’ll be going on a course to learn how to treat patients suffering from chronic stress so more on this then. I’m looking forward to it already!

Osteopaths treat more than you think. In a profile of osteopathic care in private practices in the United Kingdom (Fawkes et al., 2014) osteopaths were consulted most commonly for low back pain (36.0%), followed by the neck (15.0%) and then the pelvic region(11.0%); the other sites all scored less than 10% and included; the leg, the shoulder, the mid-back, head/facial area, the arm and the abdomen.

Did you know…?

Osteopaths can treat the jaw or temporomandibular joint (TMJ). If you have ever had a facial trauma or grind your teeth you may find treatment of your jaw helpful.

Some headaches are called cervicogenic meaning ‘comes from the neck’. This can be when muscular tension at the base of your skull can impact on nerves and blood vessels that innervate your scalp.

Osteopaths can treat your diaphragm which as well as being a key muscle for breathing is a lymph pump, aids venous return and acts as an emotional reservoir. Some people find they get an emotional release when the diaphragm is treated.

Interested in what an osteopath can do for you? Get in touch via the link below.

Fawkes, C. A., Leach, C. M. J., Mathias, S. and Moore, A. P. (2014) ‘A profile of osteopathic care in private practices in the United Kingdom: A national pilot using standardised data collection’, Manual Therapy. Churchill Livingstone, 19(2), pp. 125–130.