vsrfrontdesk July 3, 2014

Sitting Kills, But Can a Standing Desk Really Save You?

Sitting has taken a lot of flak in recent years with some health researchers going so far as to dub it ‘the new smoking.’ While sitting isn’t likely to ravage your lungs as severely as a pack of smokes, it does carry significant health risks. Extended periods of sitting have been linked to increased rates of colon cancer, endometrial cancer, lung cancer, diabetes, heart disease, and a slew of musculoskeletal issues (Diabetes Res. Clin. Pract., Sept. 2012; Am J Epidemiol., Mar. 2013; JNCI, Jun. 2014) Sitting for extended periods has also been shown to lower life expectancy regardless of cause of death (JAMA, Mar. 2012).

Initially, the thought was that these risks were due to low overall physical activity levels in people who spend a large portion of their day sitting. However, recent research has shown that sitting carries the same risks even if you exercise regularly. The problem is not a lack of physical activity, but rather the time spent sitting itself. Clearly we need to address our sedentary lifestyles head on. An increasing number of people are doing this by moving to a standing desk. But is this the right move for you?

Nurses and assembly line workers can attest that standing all day comes with its own set of issues, especially if your body is conditioned for 8+ hours a day of sitting. Moving to a standing desk adds load to the feet, legs, and core which many seasoned desk jockeys are just not ready for. Multiple studies have also linked prolonged periods of standing with its own set of health risks (WORK, Jan. 2002). But don’t give up hope just yet. There is an answer and a surprisingly simple one. Mix it up. That’s right, don’t limit yourself to one working posture; sit some, stand some, walk some, heck if you can figure out how to be productive lying down go ahead and add that in too. The key here is avoiding extended periods in one posture.

Some employers have fully embraced this concept with modular work environments where employees have the ability to switch from sitting, to standing, to walking at a treadmill desk. But even if you are stuck in a traditional office or cube there are many ways to get up and stay healthy. The simplest solution is to take regular breaks throughout the day. I recommend using a timer on your phone or desktop to remind you to take a short 30 second break every 20 minutes. Each break should include getting up out of your chair and performing a few quick stretches like the ones below from Bob Anderson’s book Stretching in the Office:

A quick round of stretches like this takes less than a minute and can have a major positive impact on your health.

A quick stretch break takes less than a minute and can have a major positive impact on your health.

It is also good to work in a few longer breaks where you can take a walk around the office. Break up your day with trips to the water cooler, coffee machine or a coworker’s desk. Forgoing an email to deliver a message personally will get you out of the chair while fostering good relationships with your coworkers.

If you do decide to go the standing desk route, make sure that you also have the option to alternate between both sitting and standing. An adjustable monitor and/or keyboard stand, a stool with a foot rest or a stack of books can all be used to make a function workstation for either standing or sitting. When standing, try going barefoot on a cushioned mat to ease the strain on your feet. Prop one foot up on a box or foot rest to vary your posture and relieve strain caused by locking out your knees.

The key thing to keep in mind with whatever workstation you use is to move as much as possible and avoid staying in any one posture for over 20 minutes without a break. If you are having discomfort when attempting the switch to a standing desk don’t give up. Start with short periods of standing and return to sitting when you become fatigued. Low back pain while standing is a sign of a common muscular imbalance that develops from years of excessive sitting. Talk to a health professional who can help you develop an individualized strategy for correcting the muscle imbalance. It’s never too late to make a healthy change in your work environment so why not start today.

Try the following links for help getting started with a standing desk:

http://lifehacker.com/five-best-standing-desks-1528244287

http://www.ikeahackers.net/2011/01/wide-standing-desk.html

http://www.howtogeek.com/100748/15-ideas-to-buy-or-build-your-perfect-standing-desk/

vsrfrontdesk June 18, 2014

Shoulder Pain: How to manage it and 3 easy ways to avoid it

Shoulder pain is one of the most common musculoskeletal complaints and something we see frequently at Velo Sports Rehab. The pain is most often associated with repetitive shoulder motions, such as painting, throwing or playing golf, but we also see pain coming from a specific traumatic event such as a shoulder dislocation or a car accident. The shoulder is a structurally complex region with a close functional relationship to adjacent regions. Because of this, it takes longer for patients to receive a correct shoulder injury diagnosis than with most other musculoskeletal injuries. This trend underscores the importance of early consultation with an orthopedic or sports medicine specialist such as the one of the great doctors at Velo Sports Rehab.

Despite commonly being discussed as if it were a single joint, the shoulder is actually a group of three anatomical joints and a fourth physiological joint. The coordinated movement between all of these articulations give the shoulder its unparalleled range of motion. But this complexity comes with a price. In order for the shoulder to function properly all of these joints need to move together in a carefully choreographed sequence. Problems arise when this does not happen, as is the case following an injury to one of the rotator cuff muscles or an acquired muscular imbalance say from years of hunching over a computer. (Cue: sit up straight and roll your shoulders back). When one of the shoulder structures fails to perform its part correctly, movement becomes less fluid with other structures being forced to cover for the failing structure. The body has a phenomenal ability to compensate and can often keep an acceptable level of function in spite of focal deficiencies. Over time however, if the issue being compensated for is not addressed, the compensatory mechanisms lead to inappropriate loading and eventually tissue damage.

This pattern can take a variety of forms and once things start to break down, it is best to talk to a qualified medical professional who can help identify the issue and develop a corrective strategy. Luckily, most shoulder cases respond well to conservative treatment and do not require surgery. Nevertheless, it’s important to remember that every case is unique. Any symptoms lasting longer than 2 weeks, causing severe pain or loss of function warrant a consultation with a qualified medical provider. That said, the easiest way to manage shoulder pain is to avoid getting it in the first place. Below I have included my top 3 tips for keeping shoulder pain at bay.

Tips for Avoiding Shoulder Pain

1. Avoid Repetitive Overhead Activities.

Repetitive overhead activities such as baseball pitching, painting, and overhead lifting are strongly correlated with shoulder pain. The simplest advice here is to avoid doing them at all. However the realistic answer for most people is to minimize the negative impact from repetitive overhead activities. First make sure that you are using good form, a coach or trainer with experience in your sport will be able to help you with this. Be sure that you are taking adequate rest days; you are more vulnerable to injury when fatigued. Working through shoulder pain is rarely a good idea and should only be done under the direction of a qualified medical provider.

2. Keep Your Body in Balance

Most people tend to overwork the muscles involved in pushing and rounding the shoulders forward. Don’t forget to work pulling motions as well. Adding rows and reverse flys into your workout routine will help to strengthen the often neglected muscles that extend and externally rotate the shoulder. Start out with light resistance and focus on perfect form. There are plenty of other exercises that you can use to target the same muscles, the key here is to make sure that your workout routine is balanced. If you are uncertain about your routine a personal trainer is a great resource.

3. Work on Core Stability

Earlier in this article I referenced the close functional relationship that the shoulder has with adjacent areas of the body. The neck, thoracic spine and lumbar spine are all attached directly to your shoulder. These connections are made via muscles which use the spine as a stable base from which to move the shoulder. A deficit in core stability means that the base is not stable which in turn forces the shoulder to compensate. This compensation alters shoulder mechanics, leading to inappropriate tissue loading and eventually resulting in damage. Here is a link to a great blog post from Bret Contreras on using a foam roller to help develop core stability.

The shoulder is a complex structure that we rely on daily for everything from tying our shoes and putting on a shirt, to pitching a baseball or swinging a tennis racket. When things go wrong you’ll need the help of a skilled medical practitioner to get you moving well again. But as with most things, an ounce of prevention is worth a pound of cure and following the tips above will help keep your shoulders working smoothly for years to come.

Photo Credits: Shazam, University of Liverpool Faculty of Health & Life Sciences

Eric DeRoche DC March 21, 2014

3 Surprising (But Effective) Treatments for Your Achilles Tendinitis

Achilles tendinitis affects a wide variety of athletes but arguably is most troublesome for runners.

For runners there is no way to work around concentric or eccentric loading of the achilles tendon. This issue has derailed many a race. It certainly hampers training, as it limits volume and makes speed and interval work impossible.

Based on the research and my experience treating runners/triathletes of all levels, I have settled on 3 self-treatments that can improve the majority of tough cases of achilles tendinitis.

Those treatments are: [Read more…]

Eric DeRoche DC March 12, 2014

Overcoming Plantar Fasciitis

According to www.runnersworld.com, the 7 most common running injuries are the following:

Runner’s Knee
Achilles Tendinitis
Hamstring Strain
Plantar Fasciitis
Shin Splints
IT Band Syndrome (ITBS)
Stress Fracture

Plantar fasciitis is caused by repetitive strain of the plantar fascia (the thick connective tissue that runs from the calcaneus (heel bone) to each of the 5 metatarsals (the bones that connect toes to ankle bones). Plantar fasciitis is the most common cause of heel pain in runners. Although thought of as an inflammatory process, plantar fasciitis is a disorder of degenerative changes in the fascia, and may be more accurately termed plantar fasciosis. Plantar fasciitis is diagnosed on the basis of a history of pain on taking the first few steps in the morning, worsening pain with weightbearing, and pain and tenderness to palpation over the medial calcaneal tubercle (Capt. Danielle L. Scher, MD et al).

In my experience, most runners with plantar fasciitis have limited ankle dorsiflexion, tight calf muscles, tight achilles tendon, and dysfunctional hip mechanics. My approach to treating plantar fasciitis is as follows: [Read more…]

Eric DeRoche DC March 4, 2014

What Are ART Treatments Like?

Active Release Techniques or ART is the primary system I use to treat patients. I began training in ART in 2003 while still a chiropractic student. I began practice in 2004 and have always employed a functional movement approach that includes applying Active Release to tight, overused, and often pain causing soft-tissues. I have always been gratified at the positive feedback I have received from athletes in particular.

The definition of Active Release Techniques, according to the official ART website, www.activerelease.com, is as follows:

ART is a patented, state of the art soft tissue system/movement based massage technique that treats problems with muscles, tendons, ligaments, fascia and nerves. Headaches, back pain, carpal tunnel syndrome, shin splints, shoulder pain, sciatica, plantar fasciitis, knee problems, and tennis elbow are just a few of the many conditions that can be resolved quickly and permanently with ART. These conditions all have one important thing in common: they are often a result of overused muscles.

When patients ask me what ART treatments are like, I describe it as seeming to be a mix of deep tissue massage and stretching. For large muscles, such as hamstring, hip flexors, and quads, I use an assistant to guide the patient through the body movements. Always in ART there is patient body movement while the provider is placing tension on the targeted muscle. [Read more…]

Sitting Kills, But Can a Standing Desk Really Save You?

Shoulder Pain: How to manage it and 3 easy ways to avoid it

Tips for Avoiding Shoulder Pain

3 Surprising (But Effective) Treatments for Your Achilles Tendinitis

Overcoming Plantar Fasciitis

What Are ART Treatments Like?

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