Have a "Movement Snack" During Your Work Day

Is sitting too much the new smoking? Probably not, but sitting too much is not doing you any favors. In a study done by the CDC, prolonged sitting was associated with increases obesity in both men and women, which in turn raised the risk factors for other health issues. They also reported that the median sitting time for the average american adult was 6.5-8 hours, which corresponds with the typical duration of a work shift... Coincidence? Again, probably not. Odds are, you're not about to stop working, so how can you make changes while sitting at your desk? This is where adding little "movement snacks" (a stretch, a mobility exercise, even a change of position, anything can be a "movement snack") can help you. Try some of the following.

Diaphragmatic Breathing
  • Sit up tall so that your rib cage is "stacked" over your pelvis. Place hands on your bottom ribs on either side. Take a relaxed breath in trying to let your ribs expand into your hands. Hold then easily let the breath out.
  • Some tweaks to try are:
    • Breathe out for twice as long as you breathe in
    • Only breathe through your nose
    • Hold for 5 seconds
  • Even 2-3 breaths is enough to make a change and mobilize your ribs, diaphragm, pelvic floor, and thoracic spine

Seated Cat-Cow

  • From a position similar to the starting position for diaphragmatic breathing slouch down and let your chin touch your chest as you exhale. Inhale and stick your chest up and out as you try to look towards the ceiling. That is one rep.

  • Try 2-3 reps while you're waiting for that meeting to end

Seated Trunk Rotation

  • Sit up tall and with arms across your chest, slowly turn your chest and head all the way to on side. If you have armrests you can gently pull into the stretch further for 2-3s. Now do it the other way. That is one rep.

  • Try 4-5 reps after you put your conference call on speakerphone.

Seated Hamstring Stretch

  • Sit up tall at the edge of your chair. Straighten one leg in front of you with a "soft" knee (no need to "lock it out"). Lean forward with your chest while keeping spine straight. Hold for 30-60 seconds.

  • Try one rep on each side while your waiting for the microwave in the breakroom.

Seated Piriformis Stretch

  • Sit up tall at the edge of your chair. Cross one leg in front of you, placing ankle on opposite knee. Lean forward with your chest while keeping spine straight. Hold for 30-60 seconds

  • Try one rep on each side when your computer is not working properly

Upper Trapezius Stretch

  • Sit up tall and place one hand behind your low back/ hips. Bend your neck away from the hand behind your back. Gently direct your eyes toward the ceiling. Hold for 30-60 seconds.

  • Do one rep after hanging up the phone (especially if you were holding between your ear and shoulder).

Levator Scapula Stretch

  • Sit up tall and turn your head all the way to one side. Gently tilt your chin towards your collar bone. For an extra stretch you can grasp the wrist on the side you are stretching and gently pull down between the legs. Hold for 30-60 seconds.

  • Do one rep on each side after sending five emails
Sitting has been linked to increased rates of metabolic syndrome, type 2 diabetes, obesity, and cardiovascular disease. One study even showed that prolonged sitting correlated with decreased thoracic spine mobility which in turn correlates with increased neck and low back pain. The awesome thing is that taking breaks from sitting can help alleviate these negative effects, so if you have to sit a lot for work try some of the movements/ stretches above every 20-30 minutes and be sure to get up and go for a walk after 90-120 minutes.

These are just ideas to get you started. You know your workflow and your body best. Find what works for you and have fun "snacking!" If you have any questions, reach out to the physical therapists at Comprehensive Therapy Services to get some more ideas for "snacks" that may be right for you.
Barlow CE, Shuval K, Balasubramanian BA, Kendzor DE, Radford NB, DeFina LF, et al. Association Between Sitting Time and Cardiometabolic Risk Factors After Adjustment for Cardiorespiratory Fitness, Cooper Center Longitudinal Study, 2010-2013. Prev Chronic Dis 2016;13:160263
Heneghan NR, Baker G, Thomas K, et al What is the effect of prolonged sitting and physical activity on thoracic spine mobility? An observational study of young adults in a UK university setting BMJ Open 2018;8:e019371. doi: 10.1136/bmjopen-2017-019371
Hamilton MT, Hamilton DG, Zderic TW. Role of low energy expenditure and sitting in obesity, metabolic syndrome, type 2 diabetes, and cardiovascular disease. Diabetes. 2007;56(11):2655-67.
Healy GN, Dunstan DW, Salmon J, et al. Breaks in sedentary time: beneficial associations with metabolic risk. Diabetes Care. 2008;31(4):661-6.
Milan H. Patel, PT, DPT

Urinary Incontinence and Fall Risk

Falling is particularly dangerous, and unfortunately quite common, for people 65 years and older. According to the National Institute on Aging, more than one in three people in this age group fall each year. Falls could result in broken bones or other serious injuries that could keep someone off their feet for an extended period of time. In order to maintain musculoskeletal (bones, joints, muscles) and cardiovascular (heart, arteries, veins, lungs) health, we all need to be physically active. Unfortunately, recovery from fall injuries can be slow and other health complications could arise as a direct result of decreased activity. Luckily, there are many ways to decrease risk of falling. The list at the bottom of this article is a good place to start, but please talk to your doctor or physical therapist if you have any concerns or questions.

When considering fall risk, people often think about muscle weakness, poor balance, blood pressure changes, confusion, shortness of breath, and vision impairments as primary concerns. Footwear, environmental hazards, and medication side effects are also important to consider.

You might be surprised to know that struggling with urinary incontinence, or leaking urine, can also put someone at higher risk of falls.

Men and women dealing with urinary incontinence might make lifestyle changes in order to stay close to a bathroom, or to have quick access to a change of clothes if an accident does occur. This could result in isolation and decreased daily physical activity. Individuals might also decrease their physical activity if prolonged jogging, walking, or other aerobic exercises causes urine to leak. These lifestyle changes as a result of urinary incontinence can lead to muscle weakness, poor cardiovascular endurance, and lower bone density which we know are important factors for fall risk. Individuals who have urge incontinence or feel like they cannot hold their urine when they get a sudden urge, may find themselves moving very quickly to the toilet without being on the lookout for tripping hazards. This also increases their risk of falling. Many people feel a frequent need to void, but do not actually leak. Some of these people wake up multiple times per night to use the restroom which means they are walking while in a groggy state in the dark.

Vision is a huge component of balance and when this is altered due to darkness, the risk of falling goes up significantly.

Many people think that urinary incontinence is a "normal" part of aging. Leaking urine is common, but it is not "normal" and there are ways to treat it. Now that we know that urinary incontinence can contribute to increased fall risk, it is more important than ever to get the word out that urinary incontinence can be treated by a pelvic health physical therapist. Incontinence is often the result of dysfunctional pelvic floor muscles. If this is the case, your physical therapist can teach you where these muscles are, what they are supposed to do, and give you a rehabilitation program tailored to your needs. The pelvic floor muscles are muscles, just like anywhere else in the body and they can be trained to function properly. You can expect to see some improvement in the first two weeks of training as you improve your coordination. Timeline for resolution of symptoms varies from person to person, but you can expect to build muscle strength and see even more improvement after 6 to 8 weeks of consistent training.

If you or someone you know is over 65 and is dealing with incontinence, please consider seeing a pelvic health physical therapist in order to decrease this burden and decrease the risk of falls.

Steps to Decrease Fall Risk According to the National Institute on Aging

1. Stay physically active
2. Have your eyes and hearing tested
3. Find out about the side effects of all the medications you take
4. Get enough sleep
5. Limit the amount of alcohol you drink
6. Stand up slowly and find your balance before you start walking
7. Use an assistive device for walking if you feel unsteady
8. Use caution when walking over wet surfaces or uneven surfaces
9. Make sure your house is well lit including nightlights to the bathroom if you wake up at night to urinate
10. Remove all tripping hazards including area rugs, cords, or other walkway obstructions that could be tripped over
11. Use the railing when going up and down stairs
12. Wear non-skid, rubber-soled shoes that fully support your feet even if you are just walking around the house

Again, please talk to your doctor or physical therapist if you have any questions or concerns about fall risk. And please let your healthcare provider know if you have fallen in the past year, even if you did not get hurt.
Allison LK, Painter JA, Emory A, Whitehurst P, Raby A. Participation restriction, not fear of falling, predicts actual balance and mobility abilities in rural community-dwelling older adults. J Geriatr Phys Ther. 2013;36(1):13-23.
Brown JS, Vittinghoff E, Wyman JF, et al. Urinary incontinence: does it increase risk for falls and fractures? Study of Osteoporotic Fractures Research Group. J Am Geriatr Soc. 2000;48(7):721-725.
Chiarelli PE, Mackenzie LA, Osmotherly PG. Urinary incontinence is associated with an increase in falls: a systematic review. Aust J Physiother. 2009;55(2):89-95.
Fisher, S., Stanich, S., Hong, I., Mcgaugh, J., Jang, H., Galloway, R., & Utsey, C. (2019). Fall Risk Reduction in the Elderly Through the Physical Therapy Management of Incontinence. Journal of Women╩╝s Health Physical Therapy, 43(1), 3-9.
Luo X, Chuang CC, Yang E, Zou KH, Araiza AL, Bhagnani T. Prevalence, management and outcomes of medically complex vulnerable elderly patients with urinary incontinence in the United States. Int J Clin Pract. 2015;69(12): 1517-1524.
National Association for Continence. www.nafc.org
Brittany Lombardi, SPT

Men's Pelvic Pain Support Group

Tuesday, June 18 at 6pm

1 in 12 men suffer from pelvic pain and most suffer in silence.

Let's gather together and share our experience and resources. Together we can heal & help others get on the road to recovery. For more information, contact Milan at milan@comprehensivetherapy.com or 858-457-8419.
Vulvodynia Support Group
Saturday, June 22 at 10am

Do you or someone you know: Suffer from chronic vulvar and/or vaginal pain? Have pain with intercourse? Been diagnosed with interstitial cystitis (IC)? Have pelvic floor dysfunction? If so, please join our support group! For more information or to RSVP, contact Cindy Furey - cindy@comprehensivetherapy.com or 858-457-8419.