Wednesday, September 12, 2012

Sitting Vs. Standing in the Workplace

Sitting vs. Standing in the Workplace
“The Fallacy of Standing Stations - Know the Facts"
 “Those who sit the most during the day have larger waists and worse profiles of blood pressure and blood sugar than those who sit less.”

“The average person can burn an extra 60 calories per hour just by standing.  Just avoid the chair is the simple recommendation, as much as you can!”

Standing while you work improves concentration by increasing blood flow to the brain. This results in clearer thinking and the ability to focus on problems more intensely for a longer period of time”

The statements above and recent media coverage indicates that standing is healthier, but knowing your options and the “pros and cons” are important in deciding if a standing station is right for you. 

Before we all get rid of our office chairs, we may want to understand the health consequences associated with prolonged standing, which include: work-related musculoskeletal disorders in the legs, knees, and lower back; varicose veins; joint damage; foot problems; stroke; heart and circulatory problems; and pregnancy difficulties.

Equally as frightening are the well documented health consequences associated with prolonged sitting including: higher rates of cardiovascular disease; obesity; higher body mass index; metabolic syndromes; Type 2 diabetes; deep venous thrombosis; and low-back disorders.

Research shows that both prolonged sitting and prolonged standing are a concern. It is not an "either-or" situation. A more responsible approach is to recommend a combination of sitting and standing activities throughout the work day to minimize the potential for adverse health consequences associated with both postures.


1) The best workstation allows for the change in position from sit to stand each hour.   In doing so, the station needs adjustability to allow the elbows to be at 90 degrees when typing.  Only a small percentage of the workforce has the same hand height (hands at elbow height) when typing in standing and in sitting.  For most employees the typing height for standing is much higher than the proper height for typing when they sit in the tall pedestal chairs.  As a result, most of the workstations require the worker to have the desk at a height that is optimal for standing or sitting and when they lose the ability to sit or stand without working in an awkward position.  Very rarely does the sit/stand workstation work without having height adjustability of the keyboard typically by having a keyboard tray installed on the desk.  These run between $200 and $400 for a decent one.  If you cannot afford the cost of a tall chair ($500+), the keyboard tray ($200+) and the cost of raising the desk- then the sit stand option is not a cost effective option.  The employer and employee are better off rotating job tasks that force an employee to get out of their chair for at least 5 minutes each hour.

2) When we (clinicians) walk around the office we commonly observe at least 75% of the workers in standing workstations sitting most of the time.  We find that most employees need to sit when they are focused and being productive.  The downside of this is that the tall pedestal chairs (used in a standing station) have no adjustability and offer little postural support as compared to the chairs used for the seating workstation.  The lack of adjustability in the tall pedestal chair is for safety so no one leaves a tilt level unlocked and falls.  Therefore, the majority of time is still spent sitting in a poor position leading to greater complaints of discomfort. 

3) The standing workstation has clearly become a fad.  Most people think it is a great idea, but once they are in this station are disillusioned.  Some of the issues include less privacy, more distractions, and an inability to focus and think while standing.  When we meet with workers who are interested in having a standing station and discuss the pros vs. cons of actually working at the standing workstation, more times than not, when educated, they chose to remain in a sitting workstation. 

4)  People are more likely to move around and walk when working in the standing position, which burns more calories, but also improves concentration, focus and productivity. Standing increases blood flow to the brain, which results in clearer thinking and less “zoning out” periods


1) Think about your work tasks and how well you think on your feet.  Before making a costly change, try just standing each time you meet with someone or get a phone call.  If you have difficulty doing so, a standing station is not for you.  Instead, rotate your tasks so you are out of your chair at least every hour when not using the computer.  You can also try using another person’s standing station for an hour.

2) Employers can set up demo standing stations that employees can use each hour.  If an employee can stand for 4 hours of their day for a month, they can be granted a standing work station.

3) When sitting, take standing breaks every 30mins to walk to another area, perform stretches, perform a task requiring higher force, or to improve your shoulder position, etc.

4) Walk around your office (inside or out) during your breaks

5) Park further away to increase your walking distance into work and take the long way to the cafeteria.

6) Be sure to participate in your daily STANDING stretch breaks!

7) Workstation should still be adjusted so you are working at elbow height and your feet are supported when seated at a standing station.


Tuesday, December 27, 2011

Ergonomic Chairs

When choosing a chair for your desk the task can seem daunting with all the conflicting information found on the internet. There are basic chairs out there that fit only one size and there are others that fit the small to the tall. There are chairs that are made for a standing station, there are fads such as a ball to sit on, or there are chairs that mimic a horse saddle. Some chairs only go up and down and others that do much more than that. There are so many different chairs with so many different features how do you know what you need or whether your choice will fit you?

First and foremost you must ask yourself, “How much time will I spend in my chair?” If it is more than 4 hours, you need a chair that is durable and has more adjustable features.

There are many different aspects that you may want to consider when selecting a chair. Let’s start at the feet. When sitting in a chair your feet and knees should make a right angle. To create this 90o angle you have to adjust the height of the chair. Most chairs have the basic function of going up or down which will accommodate you getting into your right angles. When you get your feet and knees at 90o, your hips should also be at a right angle, which will put your back at a neutral position (this can be adjusted up or down 1-2” for comfort).

Next, let’s look at seat pan depth. The seat pan is the part you sit on. When selecting a chair you want a seat pan that will give you good support and not be too short or too long. The length should allow you to put 2-4” between the pan and the back of your legs. Too short will put excess pressure on the back side of the thigh because a lot of your own weight will be resting there which can press on the sciatic nerve and give you leg pain. Too long and the seat pan could jam in the back of your knees and cut off blood supply to the lower leg causing numbness and the potential for blood clots if you sit too long. Shorter people with seat pans that are too long may not be able to sit back far enough to reach the back rest, which provides lumbar support.

Last let’s take a look at the lumbar support. Some chairs have great lumbar support; others do not. The lumbar support on some chairs move, but some don’t. When adjusting a lumbar support you want it in the small of your back. It should prevent you from slouching and support your back. To adjust it correctly put the support in the part of your low back where it curves towards the front of your body. It should fit nicely and not put pressure on your hips. Too high or too low and it will be counter productive.

Here is an example of how a chair should be set up:

There are other chairs out there as well. A standing station chair has all the same concepts as listed above. The only difference is that with a standing station chair you will need a foot rest to put your feet on to create that right angle at your feet and knees.

Many people use a ball as a chair. This is fine for those who use a chair intermittently, less than 4 hours of the day. A ball cannot be adjusted to your workstation and can cause awkward postures of the neck and arms. You don’t want the ball to be too small or you risk shoulder and neck problems because you have to shrug your shoulder to reach the top of the desk to do your work. Second, when sitting on the ball you are statically engaging your core for the entire time you sit on it. It is not recommended to sit on it all day. It is taxing on your core muscles to be sitting in an unstable position all day. Have your regular chair around so you can switch back and forth. It is recommended that you use the ball about 20-30% of the day and your chair the rest of the day.

A saddle chair is a new concept in office chairs. It is shaped like the saddle for a horse. The idea behind it is to create an upright posture. The chair forces you to sit up straight without back support. The concept is ok but like the ball it also has its drawbacks. Sitting up like that all day puts a lot of stress on your low back and core (like the Swiss ball). So have your regular chair around to switch back and forth.

When selecting a chair you want it to support you in the correct areas. The lumbar support should be in the small of your back not on your hips. The chair should be at a height where your ankles, knees, and hips are at a right angle. The seat pan should not be digging into the back of your knees or not too short and ending at the middle of your thigh. There are chairs out that that are less common and could be used part of the time, but make sure that you keep your current chair around so you can switch back and fourth.

Friday, June 10, 2011

Sneaker Selection

When purchasing shoes one should consider the amount of arch support, curvature of the shoe, size of the toe box, and need for inserts. If you are someone with lower arches or "flatter feet" you should look for a "stability" shoe or a "motion control" shoe if completely flat (these are the people with very soft, non-calloused feet)! These shoes will have arch support built into them to assist in maintaining the arch while walking or running. This will help to minimize the wear and tear on the plantar fascia, ligaments and muscles that have to work harder to support the arch because the low-arched foot is usually very flexible and mobile. These "motion control and stability" shoes will usually have a darker coloring around the arch area (gray color often) and have a firm structure to the shoe. When you squeeze these shoes at the heel and arch there should be some resistance felt. When looking at the bottom of the shoe you should be able to draw a straight line from the center heel to the point of the shoe. You always want to make sure there is enough room in the toe box to allow your toes to spread out and move without hitting the very edge of your shoe.

If you are in the correct shoe you should not need additional inserts. If you have a lower arch and unsupportive sneakers, or are in need of support for your dress shoes, then you may want to consider inserts. Over-the-counter inserts are a good place to start. I would recommend starting with “Super Feet”. These inserts would take the place of the inserts that came with your shoes.

On the other hand, if you are someone with a high arch, you'll want to look for "cushioned" sneakers. Shoes that absorb shock to minimize forces going through your legs and back from the ground. These shoes will not have a rigid or high arch support; they will be softer with squeezing and have a slight curve to them when viewed from the bottom.

All shoes, if worn regularly, should be replaced every 6 to 8 months.

If you are having pain you should consult your physical therapist along with considering a shoe change!

Monday, May 23, 2011

IHMS Receives The Governor's Safety Award

IHMS is excited to announce that at the Vermont Safety Spring Conference on May19, 2011 we received the Governors Award for “Outstanding Commitment to the Protection of Health and Safety of the Vermont Business Community”.

For those of you who don’t know, Louise and Erica began IHMS on April 1, 2003, out of Louise’s basement. Our vision was to guide companies in management solutions for healthy and productive employees with a goal to become leaders in workplace injury prevention, health promotion and physical rehabilitation. Over the past 8 years we have grown to our Colchester, Vermont location now serving companies from up state New York to Southern Vermont.

We would like to take an opportunity to thank all of those who have supported us along the way and allowed us to continue to live that dream. We continue to be committed to helping companies and their workers promote health, and treat injuries quickly and efficiently to save valuable industry resources so they can meet their own company mission. A healthy workforce is a productive workforce.

We look forward to continuing to support our New York and Vermont Businesses in creating sustainable injury prevention programs and helping you meet your ergonomic and industrial rehabilitation needs in the years to come.

Wednesday, April 13, 2011

Computer Monitor Height

If you were to get into your friend’s car to take a quick ride down to the store what is the first thing you would do before departing? Most of us would adjust the driver’s seat to compensate for a difference in size or stature to provide us with a comfortable short commute. Interestingly, on the contrary when a worker inherits a new workstation many times I find that the worker will diligently sit down and begin productive work without making adjustments to their workspace.

Monitor position is often one area that gets overlooked. Ergonomic monitor position is considered to be centered in front of the worker, about 20-25” (arms length) away from the worker with the top of the monitor screen at eye level.

The monitor should be positioned directly in front of the worker to allow for a neutral head position. If the monitor is positioned to the left or the right it tightens all the muscles and compacts the joints on that side of the neck, leading to muscle soreness. I equate this to falling asleep on the couch watching football for an hour or two with your neck in an awkward position. You would waken to the realization of a sore neck. The same is true from rotating to the right or left to see you monitor but that is for 8 hours a day, 5 days a week.

To prevent neck and upper back fatigue it is vital that the monitor is positioned close enough to the worker to prevent them from straining their eyes. For most of us this is about an arms length away. In the 1990s and early 2000s most of our monitor were encased in a box that was anywhere from 12”-18” deep, therefore the constraints in the depth of our desk top often kept the screen of our monitor at the proper distance. With the more modern flat screens we now have a monitor that has only 2-4” of depth. As a result, we have the temptation to put the monitor toward the back of our desk space to open up much needed real-estate on the front of our desk to place our coffee, pens and work papers. The problem with this is that this puts our monitors greater than an arms reach away causing eye fatigue. Because of this fatigue, we tend to extend our necks forward and slouch at our upper back to make the monitor an arms length away from our eyes. The human head weighs about 10 pounds. The strain of this position is similar to holding a bowling ball at arms length. The leverage caused from long lever arm to the weight would strain the muscles in our arms and shoulders. The same is true with our heads. Forward head posture gives our head leverage over our body putting additional strain on our neck muscles causing them to shorten and fatigue.

Monitor height is also crucial for good neck and upper back positioning. A monitor that is positioned above eye level forces the muscles that rotate your eyes upward to fatigue. As a result your eyes will return to a neutral position (looking straight ahead). To continue to see the monitor you will extend your neck compacting the joints and putting the neck extensors in a static contraction causing fatigue and eventual discomfort. A monitor that is too low will cause workers to look downward and often slouch at their shoulders, causing fatigue and discomfort. This rule gets thrown out for those of you who use bifocal or progressive glasses. With these types of glasses the line that allows you to focus is often in the lower portion of the glasses. Therefore, the position of your monitor should be below eye level, at a height where your neck is in a neutral position.

The key to ergonomics is to make the workspace fit the worker rather than the worker fit the workspace. Remember that our bodies will tend to deform into the position that we put them in most. Work posture outside of a neutral position will often cause a variety of aches and pains and in some cases injuries. For monitor positioning equipment has some great equipment.

Wednesday, March 16, 2011

Are My Old Yet?

I remember vividly when I was 4 asking my mother when I would get to be a grown up. Each stage of my early years was waiting to be old enough to do something; go to school, drive a car, get a job, have a family, etc. There was always a longing for the next milestone. I could trust in my body, felt strong and did not worry too much about “getting old”!

Then when I turned 40, I started to notice “aches and pains” that came out of no where. My skin was not as supple and my hair was getting gray. I work hard to stay healthy. I am careful what I eat, I exercise almost every day, I sleep about 7-9 hours, and I have a great support network and enjoy my life. These lifestyle choices and with my Irish genetics have so far helped me to age gracefully if I do say so myself. As I tell my friends, “I am like a fine wine and get better with age”.

So what can you do to age like a fine wine? First you need to understand the aging process. Aging is defined as the process of becoming older that is genetically determined, but environmentally modulated (think lifestyle choices). The first 25 to 30 years of your life (maximum potential) your body is growing and maturing to its maximum potential. You come with spare parts. Many of your lifestyle habits and behaviors are also being developed during this time that determines how many spare parts you will have at your disposal when you are older. So between the ages of 25 and 30 you will be at your strongest and personal best. The body is always in a state of breakdown and then repair. The breakdown depends upon the demands that your body encounters each day, and the repair happens most when you sleep at night.

After the age of “maximum potential” your body will start the aging process of deterioration. Now the body still has the capacity for healing itself, but it is not as efficient as when you are young. Some of the systems that are impacted are that your muscle strength declines, your flexibility decreases, which increases the stress on your joints, your body fat increases putting strain on your joints and heart, your skin wrinkles and loses elasticity, cardiovascular output decreases making you more tired, senses decrease impacting vision and hearing, and your temperature regulation may not be as good. The impact of disease on the body is also very evident. Your lifestyle choices now play a much bigger part on how you age because your choices directly impact how quickly the deterioration occurs. It is always amazing to me that you can have two 70 year old people, one will be riddled with disease and homebound and another just finish gardening, hiking, and still working and living a productive life. My Mom is a great example of this, and it is not just genetic, her mom died in her 60’s of a massive heart attack. I can see how her lifestyle choices slowed the aging process despite her genetics.

So what is the magic answer? You’re not going to get it in magic pills and concoctions they are selling online and infomercials. It takes effort. It’s not stopping the aging process because that is genetically determined. It is taking steps to have “healthy aging” which is solely determined by your daily lifestyle choices. It is living a longer healthier life!

Here is a list of the proven tips that I could find from reputable sources:

1. Get 7-9 hours of sleep- This is repair time.
a. You need deep uninterrupted sleep
b. Avoid caffeine and stimulants before bed
c. No TV in the bedroom
d. Keep the room dark

2. Move your body every day (My motto is “Move or Rot”)
a. Strengthening Activities
b. Flexibility Activities
c. Balance Activities
d. Endurance Activities

3. Healthy diet rich in anti-oxidants
a. Avoid packaged food, saturated fats, chemicals and man-made products
b. Colorful organic fruits and vegetables
c. Whole grains
d. Anti-inflammatory foods (
e. Fish
f. Other- Acai berry
g. Drink water- hydration improves your skin

4. Reduce the impact of stress in your life
a. Meditate
b. Exercise
c. Keep life in perspective
d. Get counseling

5. Maintain Your Ideal Weight
a. Too skinny makes your skin “saggy”
b. Too fat speeds the aging process
c. Ideal weight is where you feel the strongest and healthiest

6. Use Sunscreen

7. Have a strong Social Network (Why woman live longer)
a. Have Fun Every Day
b. Laugh
c. Enjoy Life
d. Live you’re Passion!!

So remember you are only as old as you feel. It is your choice and every day is a “do over”. How you feel tomorrow is dependent upon what you do today. Good Luck!

Tuesday, May 4, 2010

Brain Power

I just finished reading Jill Bolte Talylor's book, "My Stroke of Insight". Jill is a neuroanatomist who had a stroke that damaged her "left brain". She writes not only about how the stroke impacted her life, but also how the two sides of the brain impact what we do, how we behave and the peace or chaos we feel in our life. I learned in school what each side of the brain did from a physical standpoint, but his book outlines it from a psychological and personality standpoint. I highly recommend reading the book (because it is good for your brain!). My favorite chapters for those of you who don't want to read the whole thing are chapters 15-19. If you are really busy, you can also watch her story on YouTube at the following link:

I have always been fascinated about how the body and mind work so perfectly together. I have known that peace in the world begins one heart at a time and I can either add to peace or chaos. There are days I can access that peace and pass on healing to those who come to me in pain. There are other days, when I can barely shut off my busy self absorbed mind that chatters incessantly. On my journey for healing and peace in the world, this is what I learned from this story and want to teach you:

1) Our "Right Brain" controls the functioning of the left side of our body. Information from all of our senses comes into the brain and the right brain makes a master collage of what all the information looks like in "pictures". It is not concerned with the details, just how it all fits together. It creates a picture of the space around us and our relationship to that space. It is our creative mind. It helps us remember moments with clarity as to all the pictures, smell, and emotions that were felt. It gives us those warm feelings of being connected. No time exists except the present moment and it exist vibrant with sensation. It is what people mean when they say "I feel it in my heart or soul". In our right mind, the only moment is NOW! There are no rules or regulations or "right" way of doing things, therefore we can be creative. You have all felt it, it is when you are "in the groove" at whatever you are doing and you don't have to think about it. It is spontaneous, carefree and imaginative. We are all one when we can inhabit our "Right Brain". This is where our intuition and "gut feelings" arise.

2) Our "Left Brain" controls the right side of the body. It thrives on the details of the information coming in. It breaks present moment information into manageable bits of data. It categorized, list, compares, files, retrieves information to keep us organized and on task. It creates stories about the information to help us make sense. It creates edges, boundaries, rules to keep us safe and organized. It separates us as individuals different from those around us. It judges the information that is coming in. It is great a critical analysis of all information. It excels in academics and manifests a sense of authority over the details it masters. It allows you to process large amounts of information without overload. Our language center is found here and speaks to us constantly. It defines who we are. It reacts to protect us. Without the left brain you would lose track of your life and forget who you are and how you relate to those around you.

This was a "stroke of insight" because the author realized that prior to her stroke she functioned mostly with "Left Brain" dominance. We all have a dominance we use, some of us find it easier to be creative and have difficulty with facts and figures. We think in pictures and make decisions by the way "things feel" (that's me). (Right Brain) Others think in fact sand figures. They have great memorizing skills and easy recall. (Left Brain). But we all have the ability to tap into the "other side". The first 90 seconds of a response to incoming stimuli (sight, sound, etc..) is usually an automatic response. We were designed that way to protect ourselves from harm, because in a dire situation if you wait to think, you could be dead. But after the 90 second, we have a moment where we get to choose. In that moment you get to decide how each stimuli (stressor) is going to impact your day. You will first fall back on which side of the brain is dominant. I am proposing that you take the time to go to the "other side" and process the information before you make your choice. So for me (right brain dominant), I need to think about the fact, figures and outcome before I make my choice. I may have to give myself time. And if you are a "left brain" person, take the time to ask your right brain the best way to connect.

So the bottom line is use your amazing brain every day to learn new things. Figure out what hemisphere you are comfortable in, and then go and explore the other side. You will be amazed at how your life will change. I was. Louise Lynch