Health hazards of standing apparent

Much attention has been directed of late to the consequences of prolonged sitting. Those avocations requiring long periods of inactivity in a seated position are now considered harmful to your health. Apparently, the human body requires movement, and when our work time is spent being inactive, ie sitting for most of our workday, there is a significantly increased risk of obesity, increased blood pressure, even a greater risk of developing diabetes. The conclusion is clear: a lot of sitting is bad.

What about the position considered the opposite of sitting? Standing is a natural human posture. By itself, standing poses no specific health hazard. But in nature, too much of anything is a bad thing, and this dictum applies to standing as well. Can working in a standing position cause health problems? If it’s the primary position you are in at work, it actually is recognized to be a cause of sore feet, swelling of the legs, varicose veins, general muscular fatigue, even low back pain, stiffness, and other health problems. In fact, several new studies have made another connection with standing occupations. They found people who primarily stand on the job are twice as likely to develop heart disease as people who primarily sit.

Some very good studies have revealed this surprising consequence of prolonged standing; damage to our cardio-vascular system. It doubles the risk of heart disease. In fact, the incidence of heart problems for those that stand a lot at work is similar to workers who smoked on a daily basis or those who were obese.

Some of the dangers of standing all day are, in effect, evolutionary. We evolved from quadripeds, ie four legged animals, to our upright posture. This vertical positioning places a great demand on our vascular system, especially the venous component (veins), which has to work against gravity to return blood to the heart. This frequently results in blood pooling in the legs and increased venous pressures, which results in poor oxygenation of the tissues of the lower leg and feet.

Many consequences to the health of our cardio-vascular system result from excessive standing. This includes all the many arteries, veins, capillaries, along with the heart. Prolonged standing causes blood to pool in the ankles and feet. When standing occurs continually over prolonged periods, it can result in inflammation of the veins. This inflammation may progress over time to chronic and painful varicose veins, or even venous ulcers, large, open, draining sores that develop on the lower leg.

Some of the hazards of prolonged standing are structural or, put another way, biomechanical. Certain parts of our bodies allow us to move, especially joint-related structures such as bone, tendon and muscle, and must work together; they are intimately connected. But our body can handle only so much strain in one position. The manner in which we stand is important, though few think about the particulars. Most assume a relaxed stance position, with the arch of your foot relaxed, the foot rolled in slightly. This causes the leg to rotate inward, potentially leading to pain in the foot, ankle and lower back.

Standing takes work, muscular work, the expenditure of energy. Standing results in a reduced blood supply to the loaded muscles, which consequently accelerates the onset of fatigue, and even sometimes pain, in various muscle groups, especially of the legs, back and neck. These are the primary muscles used by the human body to maintain an upright position.

One successful although difficult strategy is to maintain a more “active” stance. This can help to distribute body weight more evenly, and keep the involved joints better aligned. To do this, engage the leg and foot muscles while standing and, without picking up your feet, rotating your kneecaps outward slightly, which will cause the arches to lift slightly. This technique requires steady focus, which, some would argue, improves mindfulness, meaning that someone is more “in the moment”, and more aware of their body.

Another very different approach involves workplace wellness programs that focus on reducing prolonged standing at work, just as they have targeted smoking and unhealthy diet habits, as a means of curbing cardiovascular disease. But the physical workplace arrangement can contribute to increased immobility, and therefore ill health. A person’s body is affected by the arrangement of the work area and by the tasks that he or she does while standing. The layout of the workstation, such as keypads and controls will, as a rule, limit the body positions that the worker assumes while standing. As a result, the worker assumes fewer body positions, meaning they are moving less.

But the evidence is clear; our bodies were made to move.

Entire systems of medicine exist which are based on motion or, at least, improving it. For example, the Alexander Technique, which was developed decades ago, is a method that works to change ingrained motion patterns, those performed countless times in our everyday activities. It is a relatively simple philosophy geared toward improving our movement, our balance, our coordination. The technique teaches a person to use the appropriate amount of effort for a particular activity, the idea being this will give you more energy for all your other activities. Surprisingly, this is not simply exercises, but rather an attempt to reeducate the mind, and consequently, the body.

The human body is much better adapted for motion than for stillness. Most of us don’t take advantage of the benefits of being bipedal, ie standing on two legs. But standing implies stillness, a lack of motion. It seems now obvious prolonged standing, usually at work, without opportunities to sit, will increase the risk of various medical conditions, only some of which have been mentioned.

Strategies to combat inactivity should be part of every workplace. Unfortunately, many corporate executives do not pay sufficient attention to working conditions, especially ergonomic ones. In contrast, people who have the freedom and the ability to sit when they feel tired will suffer fewer repercussions. They will have fewer of the problems which accompany a sedentary lifestyle. The conclusion? Move to be healthy, whether it’s a walk to the mailbox or use of the stairs rather than the elevator. Motion begets wellness. Especially when accompanied by a healthy dose of good nutrition.

Editor’s note: Dr. Conway McLean is a physician practicing foot and ankle medicine in the Upper Peninsula, with a move of his Marquette office to the downtown area. McLean has lectured internationally on wound care and surgery, being double board certified in surgery, and also in wound care. He has a sub-specialty in foot-ankle orthotics. Dr. McLean welcomes questions or comments atdrcmclean@outlook.com.