Take a Stand

Have patients stand up for their health.
By Michael Vacon, PT
As physical therapists, most of us spend a great deal of time talking with patients about the negative impact prolonged sitting can have on the body. We have all had the conversation about the proper ergonomic setup of desks and the importance of changing postures throughout the day, and we have received the feedback from patients about just how long they are actually sitting each day.
If you think about the average United States worker and the habits that most of them have, the amount of sitting that is done is enormous. If you take an average daily commute of 30 to 45 minutes each way to work, an eight-hour day of mostly sitting at a desk and working at a keyboard, sitting during a lunch (if they take a lunch), sitting during dinner at home, and then unwinding in front of a television, tablet, or other device to end the day, you are looking at well over 10 to 12 hours of sitting. That is such a dramatic increase in sitting time from past generations. The health risks associated with all this prolonged sitting are just starting to be evaluated, but as physical therapists, we are seeing the shortening of hamstrings, hip flexors, pectoral muscles, and scalenes as well as the weakening of leg, trunk, and postural stabilization muscles.
Technology is making us soft. People do not have to get up any more. You can do everything from your desktop or tablet and the days of taking an hour lunch to run some errands or even exercise are long gone.
As I continue to encounter these people as patients, the one thing I keep reminding them is to get up every 30 to 45 minutes and do some simple stretches, maybe walk a flight of stairs or two—move it or lose it. Despite reminders and home programs for them to try at work, very few follow through with the advice. Then a few years ago I stumbled on a review in the “Apptitude Test” section of the Boston Globe. In this segment, they were reviewing an iPhone app called “StandApp”1 and after reading it, I knew it was exactly what some of my tech-savvy, desk-sitting patients needed.
StandApp (standapp.biz) does exactly what I cannot do as a physical therapist: remind my patients every 15, 30, 45 or so minutes to get up out of their chair and do some stretches. The app itself is very simple to use. You set a timer (15, 30, 45, 60, 90 minutes) for when you want to be reminded to stand up out of your chair. When the timer goes off you get an alert to stand up and then it gives you a few simple exercises or stretches to do to get you moving. Whether or not you choose to actually do the recommended stretches, it starts another five-minute timer and suggests that you at least just stand up for 5 minutes. If you do not like the stretch or exercise it selects for you, you can choose your own out of a video library of 30 exercises that are all appropriate to perform in the workplace. Initially just for iPhone and iPad, it is now an Android app as well as an entire desktop application that would allow a company to install this for all their employees to help remind them to stand up for their health!
The patients that I have recommended it to generally have good feedback about the program for no other reason than it gets them up from their desks a few times of day and moving around, something they might not have done without it.
Will it solve the epidemic of too much sitting? Probably not, but it just may help a few people realize how much time they spend sitting and start to think about it more.