Better Sitting for Better Knees - Part 4
by Sharon Duffey, PT,FCP
JACK’S STORY
Part 1 recap: A star football player in his youth, 64-year old Jack has become less active because of knee discomfort. His doctor says it’s only a matter of time until both knees need replacement. Jack’s leg strength check-up shows he has real leg weakness contributing to knee arthritis. Jack begins by strengthening his leg muscles with an exercise done while sitting. Learn this high value exercise and discover the benefits for yourself!
Part 2 recap: Jack must use his hands to get up/down from a chair. This is an obvious sign of leg weakness. Jack’s body movements for sitting and standing is less than ideal. This is true for many people. Discover the steps to hone this daily movement to reverse further wear & tear and accelerate the leg strength needed to protect your knees.
Part 3 Recap: Jack is no longer able to walk the distances he wants due to arthritic knees. The discomfort from arthritis actually changes how Jack walks. Instead of focusing on improving his gait, there is a more important step to do first. Like many people, when Jack stands he has a habit of tilting slightly forward, which limits his walking. Like jack, you can learn how to “de-tilt” using four essential rules for a healthier standing posture.
THE NEXT CHALLENGE
When Jack stands now, his weight is back toward his heels. He is upright and no longer tilted forward, giving his knee joints greater longevity.
Yet, Jack has one blind spot. He is unaware he holds his upper torso tight, unable to relax when he stands. This tightness adds tension throughout his entire upper body and spine causing him to walk more stiffly.
In normal walking, the pelvis and torso move in a relaxed reciprocal and rotational pattern. This bio-mechanical motion reduces the impact of your body weight and better disperses the forces among your weight bearing joints, especially on your hips and knees.
Jack is missing this natural trunk motion. As a result, his walking style puts too much stress on his already arthritic knees.
With Jack’s recent improvements in leg strength, he no longer has knee stiffness when walking shorter distances. However, longer distances are still problematic, preventing him from getting back to a full 18 holes on the golf course. Jack is ready to start the next lesson, developing a more relaxed upper torso.
In Jack’s case, the quickest way to do this is by fine-tuning how he sits; a habit that not only influences walking but also has an impact on overall health.
The price of poor sitting
The average person spends 13-15 hours every day sitting. That is 80% of your waking day! No big surprise, then, that in 2014 the American Medical Association issued a statement identifying “sitting as a disease” because of the consequences of long stretches of sitting on overall health.
This cumulative sitting time wreaks havoc on our spines, especially when it’s not healthy. Poor sitting habits accelerate common degenerative conditions such as osteoporosis, arthritis, spinal stenosis, sciatica and DJD to name a few.
How we sit often predicts our standing health too, which was the problem for Jack.
YOUR POOR SITTING HABIT CAN LIMIT YOUR WALKING
When Jack is sitting, he keeps himself upright. This can look like good posture. But as he sits and moves by bending, turning or reaching, I can see his upper torso remains relatively fixed, like a robot might move. This is not normal.
As we talk, Jack learns his upper torso has many parts that are supposed to move together--24 ribs, shoulders, shoulder girdle, even the sternum. When we move while sitting, all those parts are supposed to move easily in a synchronous way. Prior surgeries, injuries, pain, even stress or anxiety can cause these body parts to become more fixed and guarded.
Leaning back in a recliner or on a couch for hours at a time also contributes to the loss of easy flexible movements. That loss of movement is what contributes to the loss of natural agility to walking we all once had.
For Jack, he just didn’t see why it mattered how he sits. He doesn’t have any back issues. Jack is familiar, however, with the power of his pelvis moving when he hits a long drive on the golf course. It never occurred to him that the pelvis also is the driver for easily moving the spine while sitting, standing, and walking. The pelvis is a catalyst for reducing muscle tension in the spine too.
After Jack sees for himself how he walks after observing a short video, Jack becomes more motivated and used these next steps to develop a better sitting posture. Try them for yourself and see the benefits.
KEEP GOING
EXERCISE TO DEVELOP HEALTHIER SITTING
1. Pick a firm chair so when you sit, your hips are slightly higher than your knees.
2. Identify your sitting bones; place your hand deep under your buttocks and gently sit on your hand to feel a hard round bone. You have two; one under each buttock. These are your sitting bones.
3. Sit with your weight centered on your sitting bones and your feet flat on the floor, directly under your knees. In this position your spine is in proper alignment.
4. Rock your pelvis back behind your sitting bones; let your spine & back relax to bend and feel your chest sink downward. Envision your whole spine from pelvis to neck becoming round like the letter “C”.
5. Now, Rock your pelvis forward so you are squarely on your sitting bones, allowing your spine and head to straighten. If you feel ANY strain or discomfort, make the movements slower and much smaller.
6. Place your hands on your thighs. Let your pelvis rock back behind your sitting bones. Allow your knees to move apart. Encourage that motion with your hands. Now straighten and feel your knees move toward each other. This relaxes your hips to move automatically.
7. Do 5-7 repetitions. Each time reduce the effort it takes to move. Move slowly as you start and make movements smaller if you feel any tension or pain.
8. Finish by staying on your sitting bones while relaxing your back muscles. Let your spine remain straight to support your upper body weight; this should allow for easy belly breathing. NOTE: When you anticipate sitting for longer periods i.e., in your office chair or watching TV, a pillow or cushion help maintain healthy spine alignment on your sitting bones.
EXERCISE TIPS
TO REDUCE UNNECESSARY STRAIN
· Place one hand place against your clavicles and sternum, when your spine rounds, encourage downward and inward motion with your hand.
· As long as there is no strain or discomfort, allow yourself time to relax fully when your spine is rounded, feeling the tension release. Let go of tension layers as you breathe out, for several breaths.
· Gently, push your belly outward, as your rock your pelvis behind your sitting bones. Do this for a few reps. Sometimes stick your belly out when your rock your pelvis forward. Both this movements help reduce stomach tension that would inhibit easier motion of the back.
Practice until it becomes a habit
Practice this exercise until it becomes a habit—something you do without thinking. You might want to do it 2-3x every hour of sitting time. Until it becomes more routine, consider setting your watch or computer to remind you to move or do this exercise. Remember the purpose is not just for spine health but to develop your ability of comfortably maintaining relaxed sitting posture for long periods of time.
Jack began practicing this sitting skill on chairs a little higher than recommended until he felt comfortable doing it on any seated surface. While Jack may not appreciate it now, he will see the long term benefit of a better sitting habit leading to a healthier spine. Applying this sitting skill is an important safeguard against the acceleration of common degenerative problems, DJD, spinal stenosis, sciatica, disc bulge/herniation, arthritis. For now, Jack is satisfied and can feel the subtle difference in his walking. Overall, it feels easier.
See the final step to Jack’s improved walking that will make a direct and long term difference in the effects of future arthritis and improvement of his overall physical health!
DON'T FORGET
Be patient with your own body while learning these steps. The idea of reducing effort while moving is a novel concept for most of us. It takes time to feel these subtle differences. Don’t worry about getting it perfect. Give it a little time. If you don’t feel any positive differences after following these steps, you might want to consider taking a group class and working one-on-one with a SmartBody Coach.
Any improvement in your sitting habit is beneficial to both your spine and your health. And don’t forget to congratulate yourself for taking time to learn and practice habits to take better care of yourself!
Sharon Duffey PT, FCP, is a Physical Improvement & Pain Relief Expert, founder of SmartBody. [www.smartbody50.com]
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