Take a Stand for Health

Women jumping

Take a Stand for Health

By now you may have heard the phrase “sitting is the new smoking.” Beyond being clever, the catchphrase, coined by Mayo Clinic-Arizona State University Obesity Solutions Initiative director Dr. James Levine, underscores a disturbing fact. According to Levine, we lose two hours of our lives for every hour we spend sitting. In fact, in an interview with the LA Times, Levine makes a further comparison: “Sitting is more dangerous than smoking, kills more people than HIV and is more treacherous than parachuting. We are sitting ourselves to death.”1 With the CDC’s National Health and Nutrition Examination Surveys showing that 50-70 percent of Americans sit for six or more hours each day, sitting has truly become an epidemic2.

The sitting epidemic is fueled by contemporary culture and lifestyle, particularly in the U.S. Our bodies and brains developed in response to particular environmental pressures and an active lifestyle. These days, most of us are not exposed to life-threatening scenarios on a regular basis. We exert little energy in our daily efforts to survive. Even our schools and workplaces promote the sedentary lifestyle: children are expected to sit still for hours upon end, and our workplaces have us sitting at desks, often typing away at keyboards for most of the day. Even our recreational habits have become less active: video games, instant access to movies and television shows, and virtual social environments tempt us to sit more and stand less.

The physical effects of this cultural shift are daunting. Excessive sitting has been linked to hormonal changes, increased inflammation, cardiovascular disease, diabetes, obesity, and cancer.3 From a chiropractic standpoint, sitting can distort the natural curvature of the spine, cause undue stress on nerves and ligaments, overstress muscle tissue, and compress the vertebral discs and spinal joints. As we age, too much sitting leads to disability. According to an NPR report, research out of Northwestern University found that, “For people 60 and older, each additional hour a day spent sitting increases the risk of becoming physically disabled by about 50 percent — no matter how much exercise they get.” With U.S. Census data revealing that nearly half of the population over age 65 have a disability, the impact on our aging population, their families, and their communities is significant.4

The science behind the sitting epidemic revolves around a neat acronym: NEAT. NEAT stands for non-exercise activity thermogenesis. Along with exercise activity thermogenesis, NEAT is the third component of human energy expenditure—calories burned during daily activity (basal metabolic rate, which is the energy required for basic body functions, and the energy needed to process food are the other two.) Some people have a “NEAT switch” that gets them up and moving after over-eating, while other people do not, which can lead to obesity. Surprisingly, the simple act of standing burns more calories than sitting, as noted in the table below.

Occupational Non-exercise Activity Thermogenesis (NEAT)*
Occupation type NEAT, cal/d
Chair-bound 300
Seated work (no option of moving) 700
Seated work (discretion and requirement to move) 1000
Standing work (eg, homemaker, cashier) 1400
Strenuous work (eg, farming) 2300
*Data based on a basal metabolic rate of 1,600 cal/d. Adapted from Black AE, Coward WA, Cole TJ, Prentice AM. Human energy expenditure in affluent societies: an analysis of 574 doubly-labelled water measurements. Eur J Clin Nutr. 1996;50:72-925

So what can we do about this national health crisis? Unlike with anti-smoking campaigns, we can’t tax chairs and benches, people can’t be banned from sitting in public spaces, and we can’t enact a legal sitting age. We can, however, actively participate in our own health. As shown above, just standing makes a difference. Some workplaces and even schools are using sit-to-stand desks, which allow the user to set their workspace at a different height in order to stand. If your boss is not quite there yet, or if you’re retired, here are some simple things to do to reduce the effects of sitting.

  • Stand. It seems obvious, but, as shown above, standing burns more calories. Instead of just sitting during a lunch break, try standing for a bit, or even doing some simple stretches like bending forward and reaching for your toes to get the blood flowing. Standing a little more each day not only increases your metabolism, it also helps tone muscles, burns calories, and increases blood flow.6
  • Walk. Directly related to standing, of course, is walking. You should get up and walk around every 20-30 minutes.
  • Stretch at your desk. Shrug your shoulders up to your ears and hold that position for several seconds before releasing. Gently stretch your fingers, hands, wrists and arms by bending at the joints. Straighten your legs and point and flex your toes. These simple stretches are great for multitasking: the person on the other end of the phone will never know!
  • Do eye yoga or eye palming to stretch and moisten your eyes. Try moving your eyes in circles of varying sizes, or doing a figure eight with them. Or you can stare at the tip of your nose—and no, your face won’t freeze like that. Eye palming is simply cupping your hands over your eyes and breathing. As well as giving your eyes a break, this can make your vision clearer and reduce headaches.7
  • Use good posture. Your mother was never more correct. Good posture goes a long way to preserving the overall health of your spine and reducing stress on the nervous tissue of the spinal cord (which provides nerve input to all your muscles and internal organs.) Maintaining and supporting the natural curves of the spine is paramount to spinal health. While sitting at your desk/computer, use a lumbar and/or a thoracolumbar support cushion height along with proper workstation ergonomics (correct workstation, chair, and monitor height, proper keyboard placement, etc.).
  • Exercise, exercise, exercise. With summer coming, it’s easier to jog, swim, or hike, and there’s always the treadmill or elliptical machines at the gym. While, by definition, exercising doesn’t affect your NEAT, it does help your overall metabolism and health.

Moving around during the workday not only benefits individuals, but companies and schools as well. Research shows that productivity and focus improve if employees and students have the ability to stand or move during the day.8 According to Dr. Levine, “This is about hard-core productivity. You will make money if your workforce gets up and gets moving. Your kids will get better grades if they get up and get moving.”9 Like ergonomic keyboards, standing desks are becoming a workplace necessity.

With summer coming, we’re likely to be more active outside of work. Warm weather tends to get us out-of-doors on the weekends and inspires us to exercise more overall. But after spending the weekend on the trail, don’t forget your body during the weekday grind. Take a stand for your health by taking a stand at work.

1MacVean, Mary. “‘Get Up!’ or Lose Hours of Your Life Every Day, Scientist Says.” Los Angeles Times, July 31, 2014. http://www.latimes.com/science/sciencenow/la-sci-sn-get-up-20140731-story.html.

2“Questionnaires, Datasets, and Related Documentation.” Accessed May 11, 2017. https://wwwn.cdc.gov/nchs/nhanes/Default.aspx.

3“Sitting Disease: The New Health Epidemic.” The Chopra Center, August 14, 2014. http://www.chopra.com/articles/sitting-disease-the-new-health-epidemic.

4“Sit More, And You’re More Likely To Be Disabled After Age 60.” NPR.org. Accessed May 4, 2017. http://www.npr.org/sections/health-shots/2014/02/19/279460759/sit-more-and-youre-more-likely-to-be-disabled-after-age-60.

5Ibid.

6Just Stand “Burn Calories at Work.” http://www.juststand.org/Portals/3/literature/Burn_Calories_at_Work_Flyer.pdf Accessed May 11, 2017.

7 “Sitting Disease: The New Health Epidemic.” The Chopra Center, August 14, 2014. http://www.chopra.com/articles/sitting-disease-the-new-health-epidemic.

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What is the Temporomandibular joint?

TMJ is an acronym for “Temporo-Mandibular joint” and refers to the joint that hinges the mandible (the lower jaw) to the temporal bone of the skull in front of the ear on each side of the head. We use this joint every time we talk, bite, chew, or yawn. It is one of the most frequently used joints of the body. The temporo-mandibular joints are complex and composed of muscles, tendons, and bones. Each component contributes to smooth movement allowing the upper jaw to close on the lower jaw. This joint is a typical sliding “ball and socket” that has a disc sandwiched between it. When this joint becomes displaced or when the muscles or ligaments surrounding the joint become stretched or damaged, simple movements become painful. TMJ joint

We can locate the TMJ by putting a finger on the triangular structure in front of the ear. The finger is moved just slightly forward and pressed firmly while opening the jaw. The motion felt is from the TMJ. We can also feel the joint motion if we put a little finger against the inside front part of the ear canal. These maneuvers can cause considerable discomfort to a person who is experiencing TMJ difficulty.

What are TMJ disorders, and what are causes of TMJ disorders?

TMJ disorders are a group of complex problems of the jaw joint. This is also sometimes referred to as myofascial pain dysfunction because muscles and joints work together, a problem with either one can lead to stiffness, headaches, ear pain, bite problems (malocclusion), clicking sounds, or locked jaws. The following are behaviors or conditions that can lead to TMJ disorders.

• Teeth grinding and teeth clenching (bruxism) increase the wear on the cartilage lining of the TMJ. Those who grind or clench their teeth may be unaware of this behavior unless they are told by someone observing this pattern while sleeping or by a dental professional noticing telltale signs of wear and tear on the teeth. Many patients awaken in the morning with jaw or ear pain.
• Habitual gum chewing or fingernail biting can lead to TMJ pain.
• Dental problems and misalignment of the teeth (malocclusion). Patients may complain that it is difficult to find a comfortable bite or that the way their teeth fit together has changed. Chewing on only one side of the jaw can lead to or be a result of TMJ problems.
• Trauma to the jaws: Previous fractures in the jaw or facial bones can lead to TMJ disorders.
• Stress frequently leads to unreleased nervous energy. It is very common for people under stress to release this nervous energy by either, consciously or unconsciously grinding and clenching their teeth.
• Occupational tasks or habits such as holding the telephone between the head and shoulder may contribute to TMJ disorders.

How do we do to treat TMJ disorders?

Many TMJ related problems can often be successfully treated without surgery. Our treatment plans generally focus on calming the surrounding muscles and ligaments, relieving the pain and reducing the pressure on the joint. This can be achieved by performing chiropractic adjustments on the temporomandibular joint using a spring-loaded instrument called an Activator. We also reduce tightness in the muscles of the jaw (masseter) and neck using myofascial release muscle work.

The use of Cold Laser Therapy is also a very effective treatment we use to treat and manage temporo-mandibular joint pain. This is an FDA cleared non-thermal (non-heat producing) laser capable of penetrating deep into tissue. Laser therapy has been successfully used around the world for over 25 years, with no reported long-term or irreversible side effect. Many seek relief from TMJ jaw pain through this effective non-invasive form of therapy before resorting to surgery. We have had excellent results using the non-thermal laser to relieve pain and promote healing of this painful issue.

At times, it may be beneficial for your dentist to create a custom-fitted oral orthotic appliance. This is worn by the patient on either the upper or lower teeth and helps to relieve pressure and allows ligaments that have stretched to heal.

Stretching for Jaw Muscles and TMJ relief:

Resisted Close
1. Sit in a comfortable position with your head centered over your shoulders. Keep your chin neutral and parallel to the floor.
2. Keep your head stable, relax your jaw and let your mouth open naturally. Put your index finger against your bottom teeth.
3. Press down on your bottom teeth, gently, while trying to close your jaw. Hold for five seconds, release and repeat five times.

Resisted Open
1. Sit in a comfortable position with your head centered over your shoulders. Keep your chin neutral and parallel to the floor.
2. Keep your head stable, and rest your fist under your chin. If necessary, sit a table and rest your elbow on the table to keep your fist stable.
3. Press up, gently, with your fist while trying to open your jaw. Hold for five seconds, release and repeat five times.

Jaw Rotations
1. Sit in a comfortable position with your head centered over your shoulders. Keep your chin neutral and parallel to the floor.
2. Keep your head stable, relax your jaw and let your mouth open naturally. Slide your jaw forward and back five times. Relax then slide your jaw side to side five times.
3. Slide your jaw clockwise five times. Change direction and slide your jaw counter-clockwise five times.

Open Wide
1. Sit in a comfortable position with your head centered over your shoulders. Keep your chin neutral and parallel to the floor.
2. Keep your head stable and open your mouth as wide as comfortable and stick out your tongue as if doing a wide yawn. Hold for one second then release.
3. Repeat five times and relax.

References:
How to Exercise the Masseter Muscle, Oct 21, 2013, Max Whitmore, http://www.livestrong.com/article/454964-how-to-exercise-the-masseter-muscle
Chiropractic Treatment of Temporomandibular Disorders Using the Activator Adjusting Instrument and Protocol
November 11, 2005. James w. DeVocht, DC, PhD, James w. DeVocht, DC, PhD, Walter Schaeffer, DC, Dana J. Lawrence, DC Alternative Therapies in Health and Medicine, Volume 11, Number 6

http://www.gustrength.com/muscles:masseter-muscle-actions-and-trigger-points
http://en.wikipedia.org/wiki/Temporomandibular_joint_disorder

The importance of good posture

One of the ways you can alleviate back and neck pain is to develop good posture.  Our spine has three natural curves: a forward or lordotic curve in the lumbar region (low back), a backward or kyphotic curve in the thoracic area (midback) and another forward curve in the cervical area (neck). 

These curves allow for smooth articulation of the joints of the spine , called facet joints. If the facet joints are aligned properly, we will have biomechanically appropriate movement. When we sit with good posture, our weight is distributed through our spine rather than through our muscles and ligaments.  This allows our muscles to stay relaxed and the stress on the ligaments to be minimal.  When the spine moves the way it was meant to, it provides natural support to the discs, ensuring healthy discs throughout life.

When the curves are reduced or exaggerated due to the way we carry ourselves every day, many problems result. Unnecessary stress will be placed on muscles, resulting in chronic back or neck pain.  Pressure placed on the discs that cushion the spine might result in degenerated or herniated discs.  Some of the more typical postural deformities include standing with too much or not enough low back curve, accentuating the thoracic curve, leading to a stooped over posture,  or standing with the head forward from the body, creating strain on the neck muscles.

Standing postural exercise

Stand with your feet under your pelvis, and rock back and forth on your feet.  Find the center of the arch of your foot and place your weight there.  Rock your pelvis back and forth on your legs, and notice how the movements of the pelvis affect the curves of the low back. Find the center of your pelvis and hold it there.  Exhale and drop your ribs slightly, making sure your sternum is perpendicular with the floor.  Bring your shoulders slightly up towards your ears and rotate your arms out, bringing your shoulder blades on your back.  Relax your arms and shoulders.  Bring your ears  in line with your shoulders and relax your neck.

Seated postural exercise

Place both feet directly on the floor under your knees. Rock your pelvis forward and back on your chair, feeling for the “sit bones” of your pelvis.  First, place your weight on your sit bones (the bones you feel at the bottom of your buttocks). Lean slightly forward on the sit bones so that your weight rests on your pelvic floor. Exhale and drop your sternum and ribs slightly, making sure your sternum is perpendicular with the floor. Bring your shoulders slightly up towards your ears and rotate your arms out, bringing your shoulder blades on your back.  Relax your arms and shoulders.  Bring your ears so that they are in line with your shoulders and relax your neck.

While a more correct alignment may feel strange at first, over time it will become more natural, and healthier habits will be developed.  This will result in a healthier, pain free spine for years to come!