As a massage therapist, you have likely encountered many clients whose jobs involved eight-plus hours a day of sitting at an office desk—and you’ve no doubt used your skills to address their aching shoulders, necks and lower backs.
Recent research into the negative health consequences of sitting all day has fueled the popularity of sit-stand desks, which allow employees to alternate between sitting and standing—and which might provide new challenges to massage therapists.
If office workers spend more time standing, will those aches and pains become a thing of the past? Not likely, said massage therapist Caylon Ellis, owner of Caylon Ellis Therapeutics in Carlsbad, California.
The idea that standing is a good way to counter the effects of sitting so much “is a fallacy in logic,” Ellis said. “I don’t think that is sound logic, to assume that the opposite of something that’s bad is good. It depends on a lot of factors.”
Highly Personalized
One such factor is the height of the desk while standing, as well as the positioning of the computer. Standing at a poorly adjusted desk, said Ellis, can put as much stress on the body as sitting all day. She recommends choosing a sit-stand desk that allows adjustments to the height of the computer monitor and keyboard separately, so office workers can find exactly the right position to avoid problems like carpal tunnel syndrome and forward head posture.
Office Workers and Back Pain
Another factor is a person’s back. Ellis explained that the lumbar spine has a natural curve, shaped like a backward C.
“A lot of people have too much of that curve, and … that puts a lot of pressure on your discs between the lumbar vertebrae,” she said.
Ellis cited as an example one client, an engineer, who switched to a sit-stand desk after seeking massage therapy for the pain she experienced from sitting too much. The new desk helped—but then a new problem arose.
“Part of the issue is her lumbar spine is excessively curved,” she said. After the switch to standing, “her low back started to bother her a little bit more.”
Even if a person’s lumbar spine curvature is normal, low-back pain can develop if the knees aren’t kept slightly bent and neutral when standing. Locking the knees throws the pelvis forward and increases the curvature, which can lead to pain.
Other spinal issues, such as degenerative disc disease or stenosis, can worsen if an office worker stands too much, Ellis added. So, office workers and back pain might show up in a massage therapist’s practice, even among clients who use a sit-stand desk.
Office Workers’ Posture
Bad ergonomics practiced for long periods of time, while sitting or standing, can lead to pain because, in order to relieve fatigue or create stability, the body compensates by activating muscles that would ideally remain at rest.
“I find that people who stand all day have a tendency to lean on one leg or hip,” said Eric Steibl, D.C., who practices in the Manhattan area of New York, New York, and sees many office workers. “[This] can cause a pelvic rotation and put more torque on the lumbar spine, causing compensations up the back and into the neck.”
Steibl, a massage therapist and chiropractor, specializes in Muscle Activation Techniques, Active Release Techniques and Neuromuscular Therapy, and is also a Certified Advanced Rolfer™; he has found Muscle Activation Techniques and Rolfing® to be most useful for addressing office-related pain and dysfunction.
One modality Ellis practices, Neurokinetic Therapy, focuses on identifying compensations that lead to pain, then correcting the underlying cause by retraining that area of the body so the compensation is no longer needed.
“If people sit too much or stand too much, their abdominal muscles have no activation and no ability to stabilize,” Ellis said. “So their low back is working, working, working all the time to help stabilize them.”
The result: low-back pain and problems with office workers’ posture.
Foot-Friendly
Another potential problem that could arise from standing too much is plantar fasciitis, an inflammation of the band of tissue that runs along the bottom of the foot, connecting the toes to the heel. Ellis recommends standing on a cushioned foam mat for support while working at a standing desk.
Women who wear high-heeled shoes to the office may be better off reconsidering either the standing desk or their choice of footwear. “If [you’re] standing all day and wearing heels,” Ellis said, “that’s actually going to cause more stress and require more compensation than if [you’re] sitting in a really good, ergonomic position wearing heels.”
Movement Is Key
Whether workers sit or stand, being mindful of proper desk positioning and posture can help prevent pain. So can movement, said Steibl.
“Set a timer on [your] computer and move around every 15 minutes,” he said. “And take a few steps away from your desk.”
Is Standing Worth It?
While many office workers love their sit-stand desks, science has not yet borne out their potential health benefits. A 2016 systematic research review in Cochrane Review concluded that sit-stand desks did decrease sitting time, but that more research is needed to determine whether the desks have a major positive effect on health.
“At present, there is not enough high-quality evidence available to determine whether spending more time standing at work can repair the harms of a sedentary lifestyle,” said one of the study’s authors, Jos Verbeek, in a press release. “Standing instead of sitting hardly increases energy expenditure.”
About the Author
Allison Payne is online & associate editor of MASSAGE Magazine and managing editor of futureLMT.com, MASSAGE’s publication for student and beginning massage therapists. She wrote “Massage Therapists Play Starring Role in Disney Spa Magic” for massagemag.com.