Standing desks

The bottom line

If your joints can handle it, a standing desk could be the best lifestyle change you make this year. The main reason is that it encourages microbreaks and varied activity, and that is key to avoid repetitive stress injury. Many other treatments, whether supplements or medications, can’t have as broad nor reliable of an effect on the whole body. Those who sit for 10 hours a day have a roughly 34% greater risk of early death. Sitting for many hours uninterrupted is bad news.

If you stand then you might also want to get something softer to stand on, like an anti-fatigue mat, as well as maybe something to rest one of your feet one (like a bar on a chair). Don’t stand in uncomfortable shoes (especially not high heels!), and if you’re allowed to, consider standing barefoot at times.

And don’t ditch your desk and get an expensive desk right away, if you don’t have standing experience. You sometimes learn lessons from standing more over time, using a makeshift desk. Like how much table space do you really need? Should you start by getting a different keyboard or mouse? If standing ends up helping your pain or energy levels, then it’s time to invest.

Does the science make sense?

Staying in any one position for long periods can cause pain. Sitting is uniquely bad for certain body parts when it’s prolonged and/or you’re slumped.

Sometimes you get hurt while playing sports. Or getting in an accident. Or getting punched in the face. But much of the time, people accumulate injuries due to the repetitive (and soul-sucking) nature of modern life: sit in the car/train to go to work, sit at a desk, hopefully take a nice lunch break, then sit back down.

Our bodies weren’t made to sit in a chair all day. The more you sit, the more certain joints get tight and certain muscle get weak. Here are a few specific impacts:

Microbreaks

The most important thing to take from this article: even if you don’t stand when typing, take several short “microbreaks”. Just getting up to drink water, say hi to someone, or walk up and down the hall is enough. You could even take a couple flights of stairs (or if no one’s looking, do some simple bodyweight movements). Microbreaks can substantially reduce muscular discomfort, and you’re more likely to do them if you’re not glued to a chair all the time.

Low-back and abdominals

Slumping is terrible for back pain, and part of the reason is because of its effect on stabilizing muscles. One study showed a substantial reduction in activity for a variety of stabilizer muscles when sitting slumped or standing in a swayed posture.

Sitting at work often involved prolonged time at the same posture, and that posture is one of reduced lumbar lordosis (meaning: rounding the lower back and slumping your butt forward in the chair). Back pain patients may be more likely to have exaggerated slumpy-butt when sitting.

Perhaps most importantly, sitting for too long is bad for the transverse abdominus. This is the muscle under your six pack (you have a six pack, right??) that is a main protector of your lower back muscles and spine. One study showed that slouching while seated results in a less thick transverse abdominus, which is bad for spinal stability.

Shoulder
Sitting for long periods is associated with greater shoulder pain, with almost half of office workerstypically reporting shoulder pain. And sitting erect instead of slouched may be beneficial for shoulder range of motion. Basically, sitting for long periods slumped over isn’t in line with the elegant ball-and-socket design of the shoulder, which has a wide range of motion and otherwise experiences regular motion when doing non-computer tasks.

Head/neck
The Jerry McGuire kid wants to tell you that the human head weighs eight pounds, which is pretty close the more typical 9-10 pounds. In any case, it’s heavy. And if you sit for long periods with no other muscles moving, the head is bound to start moving more and more forward. This can over-activatemuscles in your neck, which could make you more predisposed to migraines.

What do trial results show?

Most people stick with standing desks after starting. Pain conditions haven’t been studied, but even low levels of standing help discomfort.

Do workers actually stand at their standing desks?

Pretty much yes. One study showed that when given a choice, workers stand at height-adjustable workstations for between 20-30% of their day. Workers in another study chose a sitting:standing ratio of 3:1. Some studies show lower usage after a few months, which is to be expected. What does this mean for you? Don’t feel like you need to stand all day … variation is not only okay, but better than too much standing.

Do standing desks reduce pain/discomfort?
Again, pretty much yes. But they are much better at reducing discomfort if you get trained first. In a company setting, that would be like “see-do-practice”: you watch a demo, try it out, and get reminded to change postures. This also applies at home, but you just have to find legit advice yourself on the web.

How much do you have to stand to get benefits? Not much! Standing only around 8 minutes per hour has decreased musculoskeletal discomfort by around 27%. If you stand more, like equal parts standing and sitting, then legs and feet have been shown to hurt a bit more while the upper body hurts less. But the devil is in the details: what postures are used, and what your body is like. More important than an immediate pain reduction is the prevention of built-up pain over time from relying on static postures.

Decreased fatigue

One study showed standing desks to [reduce fatigue](http://www.ncbi.nlm.nih.gov/pubmed/24968210), but only after a week of adjustment. During the first week, fatigue in the lower back and legs/feet were common. This means you might have to hang in there for a bit. But fatigue is highly correlated with increased pain and worse perception of pain, so it may be worth it.

Not all bad when it comes to feet?
We’ll get to some possible lower-body drawbacks below, but a study has actually shown about 40% lower foot swelling with sit-stand adjustable desks. As always, the key is to switch up your positions.

Migraine
We’ve already seen that having a screwed up neck can predispose you to migraines. Trigger points are also common in the necks of migraine patients. That same study showed that migraine sufferers more often have forward head posture. So what’s one way to reduce forward head posture? Stand up! It’s much easier to ignore the alignment of your neck when you’re sitting in the same posture as you have for years.

Potential drawbacks

Spine/back issues

While standing can help back issues, it can also make them worse in some cases. One study in nurses tested 20-minute standing breaks versus sitting breaks. Spinal shrinkage was predictably greater during standing breaks, and the higher spinal load of standing could be a particular issue for certain back issues. Be very careful and slow in adopting standing if you have back problems, especially if you already stand a lot at work (like nurses) or home (like moms with tons of kids). Jobs involving much standing have higher rates of back pain, so paying attention to time spent standing is crucial.

Varicose veins
Research is clear on the relationship between standing too much and getting more varicose veins: it’s a major, major factor. If you stand or walk for more than 75% of the day, you have a 70-80% greater risk of varicose veins. Not to beat a dead horse, but standing desks don’t mean you have to stand literally the whole time. Also, if you have any circulation issues, you also need to be very careful when incorporating standing.

Makeshift standing desks cons

If you stack some boxes for a makeshift standing desk, you may create some other ergonomic problems. Your keyboard and mouse should not be super high-up, near the monitor. Nor should they be super low-down, near the normal desk. Both are bad for certain upper joints, such as the wrist.