There's a reason why sinking into a low runner’s lunge always makes you sigh “ahhh” with relief. Our hips and backs are feeling tighter than ever, thanks to our largely sedentary work lives. You may already know that prolonged sitting—aka “the new smoking”—is linked to a higher risk of cardiovascular disease, diabetes, and cancer. Yet increasingly, health experts are pointing out another harmful consequence that’s been hiding in plain sight as we type and teleconference the day away: the serious havoc sitting wreaks on the spine and the chain of muscles that supports it. Lower-back pain is now the leading cause of disability worldwide, per a report published this past March in the British journal The Lancet. It affects 540 million people in the world at any given time. In the U.S., where we spend about 10 hours a day seated on average, 80 percent of us will experience it at least once in our lives—and being desk- (or car-, or sofa-) bound is a key risk factor.
Long-term parking, so to speak, causes lower-back pain by upsetting the normal, healthy function of a few major muscle groups. The main problem is poor posture: We tend to slouch while we sit, and cashew-curling the upper body strains back, neck, and shoulder muscles. (The weight of the head, 10 to 12 pounds, drooping down toward our phones and computer screens exacerbates this further.) Sitting too much also causes our abdominal and gluteal muscles—vital to bracing the back and powering a wide, strong stride, respectively—to grow weak with disuse, so that when we do bend down to lift a box or tie a shoelace, or hop up to grab a book, undue tension gets transferred to our spine, increasing the risk of disk injury and muscle spasms. Finally, chronic immobility shortens our stability-controlling hip-flexor muscles, including the psoas majors (we have two, one on each side), which run over the pelvis, connecting our thighs to our spine. Short, tight psoas muscles tug painfully on the lower back, and the resulting backache triggers more psoas tightness. And a vicious cycle ensues. The bottom line? “When many of us sit for too long, that cumulative stress can become a perfect storm,” says Stuart McGill, Ph.D., a professor emeritus of spine biomechanics at the University of Waterloo, in Ontario, and author of "Back Mechanic" (Backfitpro Inc., 2015).
Respect Your S-Curve
Many of us were taught that good posture, whether we’re standing or sitting, means tucking our pelvis under to make the lower back perfectly flat. But this clenched position pushes the lumbar spine too far back and out of alignment, leading to shoulder rounding and lower-back pain. A healthy spine has two gentle inward curves—one behind the neck, the other right below the waist—to keep its vertebrae stacked naturally and the upper body’s weight distributed evenly along its length, says Joan Vernikos, Ph.D., a former director of NASA Space Life Sciences and author of "Sitting Kills, Moving Heals" (Quill Driver Books, 2011).
To maintain this silhouette, you need to sit correctly: with your chin neutral and level, ears over shoulders, shoulders over hips, chest slightly lifted, and feet flat on the floor. Typing on a keyboard? Be sure that your arms are bent at a 90-degree angle, your wrists are supported, and the center of your computer screen is positioned just below eye level. (If you use a laptop, put it on a stack of books, and type on a separate keyboard. Many neck-cricked people practically weep with happiness after making this quick and simple modification.)
Then pay attention to times when your natural support system might need reinforcements. For many of us, that means the afternoon. Spinal disks absorb fluid when we lie flat to sleep, increasing the space between them. But gravity gradually squeezes that fluid back out of the disks and into the bloodstream over the course of the day, potentially causing pressure and pain—and tempting us to slouch. A smart way to check in on your sitting posture is to picture three lines across your pelvis, waist, and shoulders, suggests Nancy Whitman, a certified licensed massage therapist at the Kripalu Center for Yoga & Health, in Stockbridge, Massachusetts. When you find that those lines are no longer parallel to one another (one may have shifted forward because you’ve leaned over to read, or gone lopsided when you crossed your legs), make an adjustment to correct that. Adding a bolster—like a lumbar pillow, a rolled-up sweater, or even a partially inflated beach ball—behind your lower back, whether you’re at work or in the car, can help you maintain your alignment and relieve stress by supporting your spine’s natural contours.
Get Up, Stand Up
Every little bit helps. Vernikos has found that doing so just once every half hour is enough to prevent muscle-wasting spinal-disk compression and other harmful effects of being stuck in one spot. Getting off your duff—if only for a few seconds—also recalibrates the balance-controlling system in your inner ears, helping you maintain healthy posture and coordination. (This is beneficial for us no matter how old we are, but it can become increasingly vital as we age in helping to reduce the risk of falls and other injuries.) “It’s an extremely important system and needs to be constantly tuned,” says Vernikos. Ideally, you should aim for a total of two hours of off-chair time every workday to start, and gradually build up to four, per the 2015 recommendation of British researchers who analyzed a wide body of research on the health impacts of sedentary behavior. To accomplish this, they suggest standing-based work (consider nonseated meetings); adjustable sit-stand desks that let you alternate positions as needed (every Apple employee now has one); and active breaks.
While you’re up and walking, take big, strong strides to relieve the pressure that sitting causes. When you move at a decent clip, with arms swinging—like you “mean business,” McGill says—muscles kick in to keep your pelvis stable and act elastically, “unloading” weight from your spine. To help get sleepy glutes firing so they can power your legs properly, think of scraping gum off the bottom of your shoe as you lift your back leg, advises Julie Erickson, owner of Endurance Pilates and Yoga, in Boston: “Glutes are super-lazy, but when we consciously activate them like that, they’re very good at lifting and extending the hip.”
Exercise with Intent
It’s time to let go of the “no pain, no gain” philosophy. There’s no need to heap on weight plates or push yourself to exhaustion at the gym. “Quality over quantity” is a much better mantra when you’re working out to relieve or prevent back pain. If you’re already achy, or have had issues in the past, first get the green light from a doctor or physical therapist. Then start conservatively, with basic core-strength-building exercises that work your glutes, quads, and abdominal muscles symmetrically, says Jill Thein-Nissenbaum, an associate professor of physical therapy at the University of Wisconsin–Madison. Think squats, bridges, planks, and wall sits. Distributing weight and movement evenly across your core, as these activities do, helps ensure that your back never takes on a heavier load than it can handle, or twists in a way that could tweak it. Begin by doing a number of sets that leave you feeling challenged but in control. When your last set feels as easy as your first, you’ll know you’re ready to add more sets or weight, or to try something more challenging.
Attention to technique really pays off, too. McGill’s research shows that when people practice exercises with flawless form, rather than just grunting through them, they learn to move and maintain better posture during all of their daily activities, including sitting, which reduces their risk of back injury. That’s because their spinal-cord neurons encode healthy firing patterns in their muscles with every rep, creating indelible muscle memories. In other words, eventually your body will remember how to sit, stand, and move around without triggering back pain on its own. The sooner you start training it, the better.
Get to the Core
Never loved sit-ups? Hallelujah—you can skip them: The University of Waterloo’s Stuart McGill has found that the repeated flexing motion can cause spinal disks to bulge and press painfully on nerves. He suggests these three safe, easy exercises instead. One rep equals one 10-second hold.
1. THE CURL-UP
Lie on the floor, with one knee bent and the other extended. Nestle your palms beneath your lower back. Brace your abs, then lift your head, neck, and shoulders slightly off the ground (about an inch). Do five reps, then three, then one on each side, resting in between.
2. THE SIDE BRIDGE
Lie on your left side, with your left elbow under you and your knees bent. Slowly lift up into a modified plank pose. Do up to six reps per side, then four, then two, then one, resting between sides. For a challenge, move into a full side plank with the top foot in front (not stacked) and your arm and legs extended.
3. THE BIRD DOG
Get on all fours. Raise one arm and the opposite leg. Do four reps per side, then three, two, and one. For a challenge, draw squares: Move your raised hand and foot away from the midline, down toward the floor, back to the midline, then back up.