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Shoulder and Scapular Mobility
Posted on January 27, 2011 by admin
People often come to see me as a chiropractor for neck pain. It turns out that for many, the real problem stems from the shoulders, shoulder blades, and upper back every bit as much as it comes from the neck itself.
This post is directed to the patients I have told need to work on shoulder, shoulder blade (aka scapular region), and upper back mobility. The exercises that follow, when done consistently, can go a long way towards improving the way this area of the body moves, which can in turn improve upon neck pain, upper back pain, and shoulder and arm pain. It can even help people who have symptoms down the arm and into the hands, and for those that have been diagnosed with carpal tunnel syndrome. I will have discussed why in the office, so I won’t go into that in this post.
NOTE: If you have pain in a specific area of feel like you cannot perform some of these exercises due to tightness, pinching, or restriction, discuss with me on your next visit. We may have to use muscle work and/or manipulation to correct issues that are preventing your body from moving properly.
The first exercise is very basic, yet very effective. It is a great warm-up prior to any of the other exercises. I just picked up this one recently, so it may be unfamiliar to those of you that I’ve worked with in the past. It is called the “tea-cup” exercise and is shown in the video below.
Next we have an exercise that I teach in the office quite often, called scapular wall slides. This is great for working on posture from your core up. As covered in the office, make sure to maintain contact with the wall with your low back, the bottom of your shoulder blades, back of the shoulder, head, back of the elbows, and back of the hands. There are other videos that show this exercise, but in my opinion, this is the only one with the proper form. This guy makes it look easy, but as you know if you’ve done this, it’s not!
These next two exercises are similar, and both can be very difficult to perform correctly. For some people it takes quite a bit of practice before they can do it like the guy in these videos. The key is keeping the elbows locked out and moving the body, not the shoulders or arms. This is a great exercise to both improve the strength of the scapular stabilizers while helping with mobility. You should feel some of the muscles burn a little after you do 15-20 repetitions.
NOTE:
The exercise below can also be performed on all fours vs. the legs being straight.
The next few exercises are aimed more at thoracic or upper back mobility vs. the shoulder and shoulder.
NOTE:The exercise below can also be done standing.
This next exercise is great if you have a foam roller. She makes it look easy, but for most people (myself included), it can be a killer. Start with a half round if the full round is too much.
This next exercise uses a kettle bell, but you can probably use a plate or dumbbell as well.
And last but not least, Pavel here is going to show you a great exercise using a kettle bell to help stretch this area to the max. You can also use a dumbbell to do the same thing. Start with a very light weight or no weight until you learn the correct motion. This is my second favorite exercise next to the scapular wall slide.
Thanks for checking out this post. These exercises/stretches work very well when performed on a regular basis. Along with muscle work and joint manipulation in the office, these can help normalize your posture and body mechanics. Just be aware that as you make (good) changes to your body, you will be sore. If you have any concerns or any pain that seems excessive, stop the exercises and bring this to my attention during your next appointment.
Regards,
Kevin Fielden, D.C.
Chiropractor, Johnson City, Washington County
Chiropractic care costs less for Back Pain than Medical Care
Posted on December 14, 2010 by admin
Back pain is one of the most common reasons for a visit to a healthcare practitioner. Cost effective solutions for back pain should be recognized in shaping future health care policy. I recently came across the blog of San Mateo chiropractor, Reza Abusaidi, DC, San Mateo Chiropractic 16 41st Ave., San Mateo, CA 94403 (650) 345-7010, that reminded me of this. In the study mentioned on his blog, chiropractic care for low back pain had a significantly less cost than medical care for low back pain. This is one of many studies which have came to the same conclusion. Just this past year, in major study performed by Tennessee Blue Cross Blue Shield insurance company found that if the care of low back pain was handled completely by a chiropractor it was about 40% less expensive than low back pain handled completely by a medical doctor. As we struggle more and more with the increasing costs of health care it would be prudent for those who shape policy to create programs that include chiropractic care and encourage its utilization.
Dr. Kevin Fielden, D.C.
3043 Boones Creek Rd, Suite 107
Johnson City, TN 37615
(423)929-2225
www.929-back.com
Shin Splints
Posted on December 14, 2010 by admin
In my practice I see a lot of people who enjoy running for exercise. One of the most common conditions I see these people for is shin splints. Since reading a blog post by Middlebelt chiropractor Dr. Kevin Venerus of Advanced Back Solutions Chiropractic, a Middlebelt Chiropractic office at 10988 Middlebelt Livonia, Michigan 48150, it reminded me of some things we can do to help prevent shin splints. First off, you need to make sure that you have a good pair of running shoes that offers adequate arch support. Every time your foot strikes the ground the arch in your foot flatens and causes the ankle to rotate inwards. Excessive twisting repetitively of the ankle this way can cause irritation to the muscles in the shin leading to shin splints. Sometimes the shoe support is not adequate and custom-made orthotics are required to provide the necessary stability. Secondly, warming up with some basic stretches before you begin running can help the shin muscles prepare for the increased demand. Stretches should address the calf and the front of the leg muscles as well as the quadriceps and hamstrings and hip. Often times I see patients whose shin splints are less of a problem in the shin itself but instead with the hip and surrounding muscles which are causing the foot to hit the ground at a slightly uneven angle and causing increase stress on the muscles of the shin. What is important is to realize that the action of running is a complicated biomechanical chain which requires joints and muscles to work together in perfect synchronicity. Alignment problems anywhere in the ankle, knee, hip, and lower back can cause shin splints to develop. If you have shin splints and would like to know how to alleviate them give our office a call.
Dr. Kevin Fielden, D.C.
3043 Boones Creek Rd, Suite 107
Johnson City, TN 37615
(423)929-2225
Accountability for your health
Posted on December 14, 2010 by admin
Recently I read a blog post by a fellow colleague of mine, Freehold chiropractor Dr. Russell Brokstein, that perked my interest in his subject matter. Dr. Brokstein practices at Hometown Family Wellness Center, a Freehold Chiropractic office at, 9 Broadway, Freehold, NJ 07728, 732-780-0044. In his blog post, entitled “accountability, if you think BP should be responsible for the Gulf of spill, who should be responsible for your health”, he makes several good points regarding how we should think about our health. It seems that we as a society are quick to place blame or accountability on a third-party, yet when it comes to our own health, we shirk responsibility. I hear all too often the saying “it’s in my genes” or a condition was “inherited from my parents”. While some diseases have shown that they are a direct result of a defect in one’s genes, the vast majority of diseases are bought on by poor choices in our lifestyle. Diets that are full of processed foods, lack of exercise, not getting enough sleep, and poor stress management are the main culprits behind the majority of afflictions that affect our society. We may have genetic predisposition that increases the likelihood of some disorders, but our lifestyle choices are usually the things that dictate whether or not we actually develop that disorder. We all must take accountability for our health, for it is truly under our own control.
Chiropractic for extremity joints
Posted on December 13, 2010 by admin
When reviewing the blog post from Omaha chiropractor Tyler Bray, D.C. it reminded me how often patients only think of chiropractic treatment for low back pain. While chiropractic care has a long and successful history of treating low back problems, chiropractors are also trained to treat all the joints and muscles of the human body. One of the things that my patients are often surprised to find out is that these joints and muscles are so tightly interconnected that, for instance, problems in your low back can even affect your shoulders. When have problems in one joint/muscle complex our body compensates and changes the way it moves to allow for the least pain-free motion at that problem area. This often leads us to perform movements which are not mechanically correct for other areas of the body and they begin at have problems as well. Here Advanced Care Chiropractic Rehab we have good success in treating problems like shoulder, elbow, and wrist pain and carpal tunnel syndrome as well as plantar fasciitis and knee pain.
Dr. Kevin Fielden, D.C.
3043 Boones Creek Road Suite 107
Johnson City Tennessee
(423) 929-2225
If you are in Omaha and need a Chiropractor, Dr Bray can be found at Active Motion Chiropractic, an Omaha chiropractic office, at 13027 Arbor Street,(402) 334-2244.
When reviewing the blog post from Omaha chiropractor Tyler Bray, D.C. it reminded me how often patients only think of chiropractic treatment for low back pain. While chiropractic care has a long and successful history of treating low back problems, chiropractors are also trained to treat all the joints and muscles of the human body. One of the things that my patients are often surprised to find out is that these joints and muscles are so tightly interconnected that, for instance, problems in your low back can even affect your shoulders. When have problems in one joint/muscle complex our body compensates and changes the way it moves to allow for the least pain-free motion at that problem area. This often leads us to perform movements which are not mechanically correct for other areas of the body and they begin at have problems as well. Here Advanced Care Chiropractic Rehab we have good success in treating problems like shoulder, elbow, and wrist pain and carpal tunnel syndrome as well as plantar fasciitis and knee pain.
Dr. Kevin Fielden, D.C.
3043 Boones Creek Road Suite 107
Johnson City Tennessee
(423) 929-2225
If you are in Omaha and need a Chiropractor, Dr Bray can be found at Active Motion Chiropractic, an Omaha chiropractic office, at 13027 Arbor Street,(402) 334-2244.
Proper Breathing
Posted on December 13, 2010 by admin
While reading a blog post from a Orem chiropractor, Dr. Ned McArthur, whose Orem chiropractic office can be found at
560 S. State #C2 Orem, UT 84058
801-225-1311
it reminded me of something very important that we try to reinforce with our patients-proper breathing technique. You see one of the most important functions of your body is proper breathing since every cell requires oxygen. Improper breathing technique, also called stress breathing, causes certain muscles that assist in breathing to work too hard and pull on the joints and muscles of the back and neck often irritating or causing pain. Proper breathing technique involves utilizing the diaphragm, which is a muscle that separates your thoracic cavity into two spaces, one for the lungs and one for the other organs. With proper breathing technique the diaphragm contracts and increases the space that the lungs occupied thereby drawing oxygen in. With this type breathing the abdomen will bulge outward. With improper technique we end up not letting the abdomen bulge outward and instead utilize the muscles in the ribs and the lower neck to raise and widen the ribs and thoracic cavity to draw the air in. A good way to practice proper breathing technique is to lay onto your back in place a hand on your chest and a hand on your belly button. Take a deep breath in and with proper technique you should notice that the hand on your belly button is the one to rise and the hand on your chest stays stationary until the last portion of the breath where it begins to rise also. Practice this daily for several minutes and throughout the day try to pay attention to when you are breathing that this is the pattern you use. Abdominal breathing in this manner tends to have a calming effect on the nervous system whereas chest breathing tends to have an excitatory effect on your nervous system. It really can have a profound effect on your pain and your health.
Dr. Kevin Fielden D.C.
Advanced Care Chiropractic and Rehab
3043 Boones Creek Rd, Suite 107
Johnson City TN 37615
Symptoms vs Cause
Posted on December 8, 2010 by admin
As I get time I like to read other chiropractor’s blogs. I recently came across an interesting blog post by Mission Viejo chiropractor, Edward Harriott D.C. regarding the frustrations of making patients understand symptoms vs. true causes. Dr Harriott is located at
Mission Viejo Chiropractic
24896 Chrisanta Dr. #120
Mission Viejo, CA 92691
(949)360-1112
Here at Advanced Care Chiropractic and Rehab we share similar concerns with Mission Viejo Chiropratic regarding educating our patients on the causes of problems, not just their symptoms. For instance, I often get patients that are diagnosed with “bursitis”. These are conditions where a bursa, which is a small fluid filled sac that acts as a cushion between 2 structures that often rub together, gets inflamed and is painful. The patient will accept this “diagnosis” and proceed to take anti-inflammatories that are prescribed for the problem. The question no one usually asks is “why is the bursa inflamed in the first place?” Most of the time the true “cause” of the problem is mechanical, meaning that something in the musculoskeletal structure is not moving properly or out of alignment and is resulting in extra pressure or rubbing of the bursa that produces the inflammation. The only way to truly treat the problem is with mechanical treatments aimed at reducing the movement and alignment problem that is present and not just masking the symptoms. Don’t get me wrong here. There is a place for judicious use of antiinflammatories with bursitis, but they should be used to make a patient more comfortable while they are receiving the needed treatment that addresses the real source of the problem, not as the “cure” for the problem. To look at it another way, if your oil light comes on in your car, do you change the oil (the true cause of the light coming on), or do you pull out the wire to the light to make it go off (the equivalent to masking the symptom)? Unfortunately, the overall mindset of society seems to be centered around symptom suppression. It is understandable though since from our earliest years we are taught to take this pill for this and that pill for that. Virtually every commercial break we are inundated with pharmaceutical commercials that are extremely slick in their marketing and convince us that happiness and feeling good is as simple as taking a pill. Medications are good when used at the right time for the right problem with the understanding of their limitations and what should be done to best correct the source of the problem.
Ergonomic chair alternatives to traditional office chairs
Posted on December 7, 2010 by admin
Ergonomic chair alternatives to traditional office chairs
As an alternative to the more traditional office chair, new styles of ergonomic chairs have been designed to try to create good support, comfort and promote good posture. These chairs may take a little getting used to, but typically become very comfortable over time. Use of these types of ergonomic chairs can be very beneficial for some people with lower back pain or discomfort.
Kneeling chair
The kneeling chair is an office chair that has no back, and places the user in a modified kneeling position. The design encourages good posture by sliding the hips forward and aligning the back, shoulder and neck. Primary support is from the seat of the chair, with additional support coming from the shins. This type of ergonomic chair distributes the weight between the pelvis and the knees, which reduces spinal compression, and therefore reduces the stress and tension in the lower back and leg muscles. This ergonomic chair has a forward slanting seat that leads to a more natural position for the spine. The result is an office chair that makes sitting in the proper position feel comfortable and effortless.
Saddle chair
The saddle chair is another ergonomic chair that can be used as a desk chair or computer chair. This type of office chair is in the shape of a horse’s saddle and puts the user in a position somewhere between sitting and standing, similar to the position used when riding a horse. This allows the legs to drop naturally, and widen, creating a healthy and stable position. This position is often useful for patients with lower back problems. With long term use it can even strengthen the back muscles. These chairs have an adjustable height to be appropriate for different users. The design is intended to eliminate some of the typical problems experienced with a traditional office chair such as circulation system problems and slouching forward.
Exercise ball chair
The exercise ball chair is another completely different type of ergonomic chair. As the name states, it is a ball, which is large enough to support the user in any long-term sitting usage, and works well as a desk chair or computer chair. The major advantage to this type of chair is that it encourages movement and active sitting. There is a slight bouncing involved that keeps the legs moving, which stimulates circulation and keeps muscles busy, reducing stress and fatigue. Sitting on the ball makes slouching difficult, and the positioning needed to stay on the ball will automatically improve posture. The ball comes in different sizes to find the appropriate height for individual users. Some of these chairs can be modified with a base frame with wheels for improved mobility, and can even have a backrest attached.
Recliner
For some people, sitting in a reclined position is most comfortable for their backs. For example, people with pain from lumbar spinal stenosis or degenerative disc disease often will feel most comfortable in a reclined position with feet propped up on a footrest. For these people, one option may be to use a recliner while working. Small tables are available that attach to the reclining chair and can swivel over the chair to allow one to work comfortably on a laptop or do paperwork.
No matter what type of office chair is used, short breaks should be taken throughout the day to improve circulation. Getting up from the chair from time to time will encourage stronger posture, relieve strain on the eyes, and reduce fatigue.
Headaches
Posted on December 7, 2010 by admin
Headaches are considered to be one of the most prevalent symptoms in the world. It is estimated that 9 out of 10 people in the USA experience headaches. The severity, frequency, and intensity of a headache episode are not similar. Some experience mild aches, while others feel intense stabbing pain, but most describe it as an intense throbbing pain. While some have an occasional headache perhaps a few times a month, there are many that have a headache on continual daily basis. Taking medications when you have headaches may be an effective short term fix; it is not a long term solution. Some people develop immunity to the medications after taking them a long time. There is a less expensive and more effective alternative for headache relief, and that is the treatment offered by a Johnson City TN chiropractor.
Chiropractic care utilizes spinal adjustments to effectively and safely rid tension headaches and pain coming from the neck area. Research on headaches was conducted in 2001 by the prestigious Duke University Evidence-Based Practice Center in Durham NC. The research report showed that spinal adjustments by a chiropractor enabled participants to experience immediate relief from headaches and had a major impact of the headaches that originated from tension in the neck. The treatment was found to have fewer side effects and resulted in greater efficacy then medications.
The Journal of Manipulative and Physiological Therapeutics conducted a study in 1995 to determine the effects of chiropractic care on tension headaches. The study found that the relief from chiropractic care resulted in longer duration than medications used for headache relief. Participants reported having no headaches or side effects four weeks after ceasing chiropractic treatment.
Neck tension accounts for about 95% of all headaches. Neck stress is due to staying in one position for a long period of time, like using a phone, or blow drying your hair. This prolonged and repetitive usage can lead to irritation in joints, tension in neck, upper back and scalp pain leading to headaches.
When required to be in a position for a prolonged period of time like sitting, computer usage, sewing, or reading you should stop every 30 minutes and do some stretching exercises on your head and neck.
Chiropractic for Temporomandibular Joint Disorder
Temporomandibular joint (TMJ) is the term for the paired joints between the upper and lower jaws, as well as the term generally used to describe pain or other dysfunction of these same joints. Initial treatment for a temporomandibular joint disorder (TMD) can include applying heat or cold to the jaw area, eating mostly soft foods, taking anti-inflammatory drugs, or wearing a bite guard in the mouth at night. If these methods are unsuccessful, many patients resort to dental treatments to modify the bite or even surgery of the jaw. For those with TMJ symptoms, chiropractic is available as an alternative to those more invasive treatments.
How Can Chiropractic Help the Temporomandibular joint (TMJ)?
Chiropractic care for the temporomandibular joint (TMJ) can ease pain by correcting the misalignment between the spine and nervous system. Chiropractic can be effective at reducing the pain associated with TMJ, either when used alone or as a complement to other treatments. This is because, rather than change the diet or modify the teeth, it relaxes the muscles, adjusts the joint and uses specific trigger points to accurately re-position the jaw. When done successfully, this will not only relieve pain in the short run (as would medications or eating soft foods), but it will help prevent TMJ pain from returning.
Chiropractic treatment of the temporomandibular joint (TMJ) focuses on relieving tension in the muscles around the joints themselves—working both outside and inside the mouth, using massage and trigger point therapy. A trigger point is a very sensitive area made of muscle fibers. Trigger points feel like knots and may cause pain or even a twitching response when pressure is applied to them. A chiropractor can manipulate trigger points in such a way to alleviate the pain associated with them.
Trigger points common to TMJ include:
- Trapezius muscle, located at the base of the neck. Manipulating this trigger point can influence the areas behind the ear, at the temple and at the jaw bone.
- Sternocleidomastoid muscle, located along the neck from the collarbone to the ear. This trigger point can be used to relieve pain in the forehead, front of the jaw and around the eye socket.
- Masseter muscle, located at the back of the jaw. This refers to pain in the upper jaw, ear and above the eye.
- Medial Pterygoid muscle, located behind the molars on the jaw. This trigger point influences pain in the TMJ, as well as in the ear, nose, lower jaw, and the neck.
Adjustments to the joints can also be done by hand, using a technique that causes a tiny stretch inside the joint to release any fibrous attachments made by the body due to previous trauma. The chiropractor may also give the patient home exercises to help strengthen the joint and loosen the tight muscles.
In some cases, misalignment of the jaw that results from improper posture or a back problem can cause temporomandibular joint (TMJ) disorder. An approach to treating TMJ caused by misalignment in the neck and upper back is to perform chiropractic adjustments on the spinal joint in these areas. In addition, a chiropractor may use massage to relieve tight muscles in the back around the spine. This reduces the amount of stress put on the jaw so that other treatments to adjust the jaw will be more effective.
When these treatments are employed, motion of the jaw joint can improve and symptoms such as ear pain, jaw locking, headaches, and neck pain can be reduced.
Why use Chiropractic for Temporomandibular Joint Disorder?
While there are numerous ways to effectively treat temporomandibular joint (TMJ) disorder, scientific studies have shown that chiropractic was helpful in cases of TMJ. In a 2003 study, 15 participants were administered treatments with the Activator Method, which uses a tool that delivers high-frequency, low-impact adjustments. All participants showed improvements in the distance they could open their jaws and in pain measurements. Although this group was not compared to a group receiving traditional treatment, it shows that chiropractic treatments like the Activator Method show promise as an emerging treatment for temporomandibular joint disorder (TMD).
Many report relief and satisfaction with chiropractic care for temporomandibular joint (TMJ) disorder. In a survey of 192 members of a health maintenance organization published in 2003, nearly two-thirds reported using some form of complementary medicine to treat TMJ. Almost everyone surveyed used complementary approaches together with other traditional treatments, and the greatest satisfaction was reported for the hands-on alternative therapies, including chiropractic.
Chiropractic may be used alone or in conjunction with other treatment approaches. Medications can include anti-inflammatories, analgesics (pain killers) and muscle relaxants, as well as local injections of corticosteroids in severe cases. Application of hot and cold compresses also reduces inflammation. When teeth grinding or clenching is an issue, wearing a mouth night guard can help prevent these actions during sleep. Bite plates can help correct misalignment. Stress reduction, relaxation techniques, jaw-stretching exercises, and modifying chewing habits are all behavioral approaches that are proven effective.
More research into chiropractic methods used to treat temporomandibular joint (TMJ) disorder are needed; meanwhile, evidence from existing studies as well as patient testimony suggest that chiropractic therapies are helpful in relieving TMJ symptoms.
What is Chiropractic?
Chiropractic is an alternative healthcare practice that focuses on the relationship between the spine and nervous system. It is based on the principle that improper alignment of the vertebrae or other skeletal structures can cause symptoms related to neurological function at local or remote points in the body.
What Causes Temporomandibular Joint (TMJ) Disorder?
Temporomandibular joint (TMJ) symptoms can be the result of an injury to the joint, improper alignment of the jaw and teeth, overuse due to excessive or vigorous chewing, or the action of orthodontics. Habitual clenching or grinding of the teeth, especially while sleeping, can cause or aggravate symptoms. Besides pain and difficulty chewing, jaw symptoms can include decreased range of motion, locking, popping, clicking or sudden misalignment of the teeth. TMJ can lead to pain that radiates to the face, head, neck and shoulders. Some chronic sufferers experience headaches, dizziness, earaches and even difficulty hearing.
For individual experiencing symptoms of TMJ, receiving treatment from a qualified chiropractor can help.
References
Journal of Manipulative and Physiological Therapeutics 2003 Sep;26(7):421-5.
Journal of Orofacial Pain. 2003 Summer;17(3):224-36.
Reprinted from: http://www.altmd.com/Articles/Chiropractic-for-TMJ
Why your desk job is slowly killing you
Even if you exercise, the more hours a day you sit, the greater your risk of early death
Do you lead an active lifestyle or a sedentary one? The question is simple, but the answer may not be as obvious as you think. Let's say, for example, you're a busy guy who works 60 hours a week at a desk job but who still manages to find time for five 45-minute bouts of exercise. Most experts would label you as active. But Marc Hamilton, Ph.D., has another name for you: couch potato. Perhaps "exercising couch potato" would be more accurate, but Hamilton, a physiologist and professor at the Pennington Biomedical Research Center, in Baton Rouge, Louisiana, would still classify you as sedentary. "People tend to view physical activity on a single continuum," he says. "On the far side, you have a person who exercises a lot; on the other, a person who doesn't exercise at all. However, they're not necessarily polar opposites."
Hamilton's take, which is supported by a growing body of research, is that the amount of time you exercise and the amount of time you spend on your butt are completely separate factors for heart-disease risk. New evidence suggests, in fact, that the more hours a day you sit, the greater your likelihood of dying an earlier death regardless of how much you exercise or how lean you are. That's right: Even a sculpted six-pack can't protect you from your chair.
But it's not just your heart that's at risk from too much sitting; your hips, spine, and shoulders could also suffer. In fact, it's not a leap to say that a chair-potato lifestyle can ruin you from head to toe.
Statistically speaking, we're working out as much as we were 30 years ago. It's just that we're leading more sedentary lives overall. A 2006 University of Minnesota study found that from 1980 to 2000, the percentage of people who reported exercising regularly remained the same—but the amount of time people spent sitting rose by 8 percent.
Now consider how much we sit today compared with, say, 160 years ago. In a clever study, Dutch researchers created a sort of historical theme park and recruited actors to play 1850s Australian settlers for a week. The men did everything from chop wood to forage for food, and the scientists compared their activity levels with those of modern office workers. The result: The actors did the equivalent of walking 3 to 8 miles more a day than the deskbound men. That kind of activity is perhaps even more needed in today's fast-food nation than it was in the 1800s, but not just because it boosts calorie burn. A 2010 study in the Journal of Applied Physiology found that when healthy men limited their number of footsteps by 85 percent for 2 weeks, they experienced a 17 percent decrease in insulin sensitivity, raising their diabetes risk. "We've done a lot to keep people alive longer, but that doesn't mean we're healthier," says Hamilton.
Today's death rate is about 43 percent lower than it was in 1960, but back then, less than 1 percent of Americans had diabetes and only 13 percent were obese. Compare that with now, when 6 percent are diagnosed with diabetes and 35 percent are obese.
The definition of an active life
Make no mistake: "Regularly exercising is not the same as being active," says Peter Katzmarzyk, Ph.D., Hamilton's colleague at Pennington, the nation's leading obesity research center. Katzmarzyk is referring to the difference between official exercise activity, such as running, biking, or lifting weights, and so-called nonexercise activity, like walking to your car, mowing the lawn, or simply standing. "A person may hit the gym every day, but if he's sitting a good deal of the rest of the time, he's probably not leading an overall active life," says Katzmarzyk.
You might dismiss this as scientific semantics, but energy expenditure statistics support Katzmarzyk's notion. In a 2007 report, University of Missouri scientists said that people with the highest levels of nonexercise activity (but little to no actual "exercise") burned significantly more calories a week than those who ran 35 miles a week but accumulated only a moderate amount of nonexercise activity.
"It can be as simple as standing more," Katzmarzyk says. For instance, a "standing" worker—say, a sales clerk at a Banana Republic store—burns about 1,500 calories while on the job; a person behind a desk might expend roughly 1,000 calories. That goes a long way in explaining why people gain 16 pounds, on average, within 8 months of starting sedentary office work, according to a study from the University of North Carolina at Wilmington.
Why sitting too much is never a good thing
But calories aren't the only problem. In 2009, Katzmarzyk studied the lifestyle habits of more than 17,000 men and women and found that the people who sat for almost the entire day were 54 percent more likely to end up clutching their chests than those who sat for almost none of the time. That's no surprise, of course, except that it didn't matter how much the sitters weighed or how often they exercised. "The evidence that sitting is associated with heart disease is very strong," says Katzmarzyk. "We see it in people who smoke and people who don't. We see it in people who are regular exercisers and those who aren't. Sitting is an independent risk factor."
This isn't actually a new discovery. In a British study published in 1953, scientists examined two groups of workers: bus drivers and trolley conductors. At first glance, the two occupations appeared to be pretty similar. But while the bus drivers were more likely to sit down for their entire day, the trolley conductors were running up and down the stairs and aisles of the double-decker trolleys. As it turned out, the bus drivers were nearly twice as likely to die of heart disease as the conductors were.
A more recent interpretation of that study, published in 2004, found that none of the participants ever exercised. But the two groups did sit for different amounts of time. The analysis revealed that even after the scientists accounted for differences in waist size—an indicator of belly fat—the bus drivers were still more likely to die before the conductors did. So the bus drivers were at higher risk not simply because their sedentary jobs made them resemble Ralph Kramden, but also because all that sitting truly was making them unhealthy.
Hamilton came to call this area of science "inactivity physiology" while he was conducting studies to determine how exercise affects an enzyme called lipoprotein lipase (LPL). Found in humans as well as mice, LPL's main responsibility is to break down fat in the bloodstream to use as energy. If a mouse (or a man) doesn't have this enzyme, or if the enzyme doesn't work in their leg muscles, the fat is stored instead of burned as fuel.
Hamilton discovered that when the rodents were forced to lie down for most of their waking hours, LPL activity in their leg muscles plummeted. But when they simply stood around most of the time, the gene was 10 times more active. That's when he added an exercise session to the lab-rat routine and found that exercise had no effect on LPL. He believes the finding also applies to people.
"Humans sit too much, so you have to treat the problem specifically," says Hamilton. "The cure for too much sitting isn't more exercise. Exercise is good, of course, but the average person could never do enough to counteract the effect of hours and hours of chair time."
"We know there's a gene in the body that causes heart disease, but it doesn't respond to exercise no matter how often or how hard you work out," he says. "And yet the activity of the gene becomes worse from sitting—or rather, the complete and utter lack of contractile activity in your muscles. So the more nonexercise activity you do, the more total time you spend on your feet and out of your chair. That's the real cure."
"Your body adapts to what you do most often," says Bill Hartman, P.T., C.S.C.S., a Men's Health advisor and physical therapist in Indianapolis, Indiana. "So if you sit in a chair all day, you'll essentially become better adapted to sitting in a chair." The trouble is, that makes you less adept at standing, walking, running, and jumping, all of which a truly healthy human should be able to do with proficiency. "Older folks have a harder time moving around than younger people do," says Hartman. "That's not simply because of age; it's because what you do consistently from day to day manifests itself over time, for both good and bad."
Inactivity affects more than the heart
Do you sit all day at a desk? You're courting muscle stiffness, poor balance and mobility, and lower-back, neck, and hip pain. But to understand why, you'll need a quick primer on fascia, a tough connective tissue that covers all your muscles. While fascia is pliable, it tends to "set" in the position your muscles are in most often. So if you sit most of the time, your fascia adapts to that specific position.
Now think about where your hips and thighs are in relation to your torso while you're sitting. They're bent, which causes the muscles on the front of your thighs, known as hip flexors, to contract slightly, or shorten. The more you sit, the more the fascia will keep your hip flexors shortened. "If you've ever seen a guy walk with a forward lean, it's often because of shortened hip flexors," says Hartman. "The muscles don't stretch as they naturally should. As a result, he's not walking tall and straight because his fascia has adapted more to sitting than standing."
This same effect can be seen in other areas of your body. For instance, if you spend a lot of time with your shoulders and upper back slumped over a keyboard, this eventually becomes your normal posture. "That's not just an issue in terms of how you look; it frequently leads to chronic neck and shoulder pain," says Hartman. Also, people who frequently cross their legs a certain way can experience hip imbalances. "This makes your entire lower body less stable, which decreases your agility and athletic performance and increases your risk for injuries," Hartman says. Add all this up, and a person who sits a lot is less efficient not only at exercising, but also at simply moving from, say, the couch to the refrigerator.
There's yet another problem with all that sitting. "If you spend too much time in a chair, your glute muscles will actually 'forget' how to fire," says Hartman. This phenomenon is aptly nicknamed "gluteal amnesia." A basic-anatomy reminder: Your glutes, or butt muscles, are your body's largest muscle group. So if they aren't functioning properly, you won't be able to squat or deadlift as much weight, and you won't burn as much fat. After all, muscles burn calories. And that makes your glutes a powerful furnace for fat—a furnace that's probably been switched off if you spend most of the day on your duff.
It gets worse. Weak glutes as well as tight hip flexors cause your pelvis to tilt forward. This puts stress on your lumbar spine, resulting in lower-back pain. It also pushes your belly out, which gives you a protruding gut even if you don't have an ounce of fat. "The changes to your muscles and posture from sitting are so small that you won't notice them at first. But as you reach your 30s, 40s, 50s, and beyond, they'll gradually become worse," says Hartman, "and a lot harder to fix."
So what's a desk jockey to do? Hamilton's advice: Think in terms of two spectrums of activity. One represents the activities you do that are considered regular exercise. But another denotes the amount of time you spend sitting versus the time you spend on your feet. "Then every day, make the small choices that will help move you in the right direction on that sitting-versus-standing spectrum," says Hamilton. "Stand while you're talking on the phone. It all adds up, and it all matters."
Of course, there's a problem with all of this: It kills all our lame excuses for not exercising (no time for the gym, fungus on the shower-room floor, a rerun of The Office you haven't seen). Now we have to redefine "workout" to include every waking moment of our days. But there's a big payoff: more of those days to enjoy in the future. So get up off your chair and start nonexercising.
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