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Sit StandThe cure might be more painful than the disease.

A rebellion is in place at the modern workstation and workers are increasingly being presented with alternatives to conventional workstation seating design. One can group these alternatives into three broad groups:  Standing Only, Sit/Stand and Treadmill.  Each of these approaches is being touted as “healthier” than sitting, which is being mercilessly pounded across Internetlandia as the “new smoking”. But rebellions are not always synonymous with solutions and while one applauds any effort to reexamine methods of sitting at a desk proponents of these methods are not being entirely honest or realistic in the way these alternatives are being presented.

Those proponents seem to be shaping a message uniquely targeted at the young and healthy. Worse, they seem to think these are the only people inhabiting the planet and that they are impervious to illness and ageing. “Yeah, I work out a lot, yeah my diet is superb, did all of the Colorado 14ers last year, never been sick, just turned 24…  and this workstation is just so cool.  Been doing it six months and it is GREAT….” But the American workforce is vast and diverse, and the fact is that far more people who try the standing idea give up on it than those who persevere.  They just don’t blog about it. (Actually, some do… Why I killed my standing desk  by Mikael Cho )

Degenerative disease does not2

The mechanism as to WHY seating seems to be so unhealthy is not completely understood.  There are many people who sit at workstations who are NOT unhealthy. This leads one to surmise that there may be other lifestyle and genetic factors at play, a fact researchers are constantly seeking to remind us.  But the medical community seems unanimous in condemning the static postures of both the 90 degree sitting paradigm and extended standing as a contributing factor in a variety of diseases including those of the extremities with which they must deal on a daily basis. Proponents of standing workstations are conveniently omitting this fact from their advocacy.  And the studies we have are incomplete. No one has ever taken a look at a hybrid workstation that enables true variable posture such as the one advocated by Renegade Space, and doing so might give us a stronger basis for comparison. Such workstations do not, of course, exist as of this writing.

And one has to keep our time frames in mind. Sitting is a marathon. 40 hours a work week is 2000 a year, 10,000 in five.  If you were to travel in your car at 55 miles per hour for 2000 hours you would go 110,000 miles in a single year.  Many workers are doing more. These are serious numbers and there is no place for Saturday night religion in the search for workplace solutions.

With the exception of treadmill desks, which are a relatively new phenomenon, there is nothing new about standing at a workstation.  Let’s take a look at all three approaches individually.

1. Treadmills. The following video is courtesy of Business Insider…

Sorry, but we simply see treadmills as a non-starter.  Others say they’ve already come and gone.  It’s an (admirable) attempt to introduce movement into the process of standing, and it comes out all wrong.  You are forced into continuous multi tasking and for most people it just doesn’t work.  You are also burning a lot of energy that isn’t available for mental functions. People tire out on these things, unnecessarily so. 40 hours a week? As always, there are those who are happy with the system. Watch for these designs to attempt to incorporate a seat into the already substantial apparatus to offset their obvious deficiencies and give the user a break from standing, but it’s probably too late.

If you’re really set on giving one of these things a go I suggest you check out Craig’s List or the thrift stores, where a good supply seems to be building.  That should be all the information you need on this one.

2. Standing ONLY. 

There is nothing new about standing at a workstation. Workers had to stand at workstations in past ages (probably since the beginning of time) because there was no concept of workstation design until the last hundred years. They were NOT doing it because it was “healthy”.  It was, in fact, entirely mindless.  No one put any serious effort into building an alternative. In the late 19th and early 20th centuries we see engravings and photos of men standing at desks wearing boots with leather soles, pointed toes and hard wooden heels; the women, as always, had it worse. The pain over days, weeks, months must have been unspeakable. Diseases of the extremities were rampant. Even sitting on a stool was a great relief. The situation spawned terms such as “slavery on the west end” and “cruelty to women” by U.K. physicians who dealt with the negative physical consequences of a standing workforce.

A rather scathing look at standing in the workplace both in the past and today can be found at hazards.org; this page notes that 100 years ago doctors in the UK were sounding alarms about the extreme suffering being caused by extended workplace standing and were pushing for mandates to require the availability of seating as an offset. Hazards bills itself as a “union-friendly” magazine with a strong bent toward health and safety in the workplace.  They are very tough on mandated workplace standing.

But even requiring seating was hardly a panacea for these poor Victorian devils. If you think your chair is bad today go back and look at the designs of yesteryear. No adjustments, no arm rests, bone and muscle crushing hard surfaces, excruciatingly uncomfortable. Lowering the surface of the desk and building a chair with padded surfaces was a significant liberation from the insensate designs of those days, but the transition was never completed and left us with a whole new set of problems.

Today legions of food, health care and other service workers and retail employees spend extended time in standing positions and find nothing remotely healthy or entertaining in what some see as a glorified yuppie movement toward standing workstations; hazards.org lists some 60 occupations it deems as at health risk from extended standing.

Still, I want to stand because it’s healthier than sitting.

Why would standing at a workstation be any healthier than sitting? Exactly the same criteria that one uses to criticize the 90 degree sitting posture can be applied to standing. Medically, the risk factors are identical. If anything, Standing Only is worse and possibly a LOT worse.  But we are getting a curiously sanitized view of the alleged health benefits of the Standing Only workstation from its proponents.  Fastco Design, a Fast Company site touts the benefits of standing in “Everything Science Knows Right Now About Standing Desks” (link), and yet the story (one example of many) conveniently omits any reference to the mass of science that we DO have about the hazards of extended sitting and standing, and that science is devastating. Here’s an example.

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The (clickable) image on the left is a variation of a condition known as “venous insufficiency“, a horrific problem that costs the medical system some $3 billion annually and affects a stunning 25-50% of the population to varying degrees. Now, no one is maintaining that a healthy 24 year old is in immediate danger of developing this condition at a standing workstation. But degenerative diseases of the extremities are varied and extremely common, and in every single case where the medical literature cites standing and sitting for extended periods as risk factors they are cited in the same sentence. There is no disconnect. And we are getting a disturbing number of critical posts from the field dealing with edema, varicose veins, pain in the knees and so forth. These are all potential precursors to venous insufficiency.  Now, these are complex issues requiring your own diligent research. But the bottom line remains that you do not want to light the fire of extremity disease, because when you do it will be permanent and it will ruin your life .


Here’s a more detailed explanation of the issue from the Cleveland Clinic:

What causes chronic venous insufficiency?

“Veins return blood to the heart from all the body’s organs. To reach the heart, the blood needs to flow upward from the veins in the legs. Calf muscles and the muscles in the feet need to contract with each step to squeeze the veins and push the blood upward. To keep the blood flowing up, and not back down, the veins contain one-way valves.

“Chronic venous insufficiency occurs when these valves become damaged, allowing the blood to leak backward. Valve damage may occur as the result of aging, extended sitting or standing or a combination of aging and reduced mobility. When the veins and valves are weakened to the point where it is difficult for the blood to flow up to the heart, blood pressure in the veins stays elevated for long periods of time, leading to CVI….”

To repeat, the risk factors are complex and diverse beyond simple immobility, but note that in addition to extended sitting and standing “aging” is listed as a key risk factor, as it is in all diseases of the extremities. Degenerative disease does not, by definition, develop overnight. In addressing the problems of workplace sitting we must keep a focus on the marathon aspect of the work life, and your happy 20 something with their brand new standing workstation may not be your best source of information.

Let’s break it down a little further.

To stand at a workstation you must commit to extended immobility in one position with the entire weight of the body focused on a VERY small footprint, that of the feet, and the feet are as far away gravity-wise from the blood pump as you can get them. This makes no rational sense and the medical literature is unanimous in condemning this very scenario. It has taken us years to understand the negative effects of circulatory issues associated with the static 90 degree posture, and there is no reason to not anticipate similar negative data from years of static standing;

Every joint in the body is being crushed by gravity. Again, the focus here must be the degenerative as opposed to the immediate. The need for decompression at the joints is not just common sense, it was shown in a 2006-07 study by Bashir that advocated a 135 degree angle as opposed to the 90 degree now in use.  The standing model is the exact opposite of decompression;

• More specifically, degenerative disk disease is a condition of aging in which the soft disks between the vertebrae degenerate. While not strictly a “disease” the condition, which is nearly universal, can lead to a variety of lower back and spinal problems over time.  Now, once again we are here seeking to understand and hopefully offset the long term consequences of degenerative progressions. While the condition affects everyone differently a rational person in the second or third trimester of life might want to seriously consider a position of decompression as a regime of offset, rather than the maximum load inflicted on the spine by extended standing.

The only offset to standing is movement. Standers maintain that their workstation model is one of movement, but it is difficult to see how this works. After all, you are locked in an upright position. Unless you are talking about pumping your legs or fidgeting, which would be useless, the only way you can move when standing is to walk away from the workstation… and go find a place to sit down, which you may in fact be doing anyway. See Sit-Stand below;

The position, as a real seating alternative, is getting little to no support from a medical community that has been familiar with the many ills of prolonged sitting and standing for years, and who would much prefer to see the legs elevated to be more in horizontal line with the heart and overall less pressure on the joints.

Do you seriously think that osteopaths are going to start recommending to their back trauma patients a standing workstation?  How about the diabetic with foot problems?  The 250 pound engineer with a cardio condition? Amputees? The 45 year old woman who’s been working in retail her entire life while on her feet and thinks you’re nuts?  Anyone with dozens of any health or circulatory problems? Even many among the young and healthy who understand their own mortality want a better solution.

Trying to blame all health problems on sitting alone has become the newest wasteland of the internet.  Stating that standing at a workstation is a way to avoid these health problems is simply living in denial of the very real problems the standing position can create on its own, particularly when seen in the long term of the marathon workplace. To repeat: many of the problems we are seeing from users who have abandoned their standing attempts arose AFTER they started using the posture, and at this point we are missing long term data.

How does all of this affect worker productivity?

One should be deeply suspicious of short term studies and unsubstantiated claims of enhanced productivity arising from this position. CUErgo denies any benefit whatsoever. Again, it’s not what you do in the first hour or two of work, it’s what you do with 2000 in a year.  Both the 90 degree paradigm and the Stand Only position demand constant breaks from what should be short term positions, and in that respect it’s difficult to see how standing is an improvement. Failure to move, i.e., walk around, while standing breeds fidgeting. In the Sit-Stand model one can arise from a chair and stretch or stand for a bit while still at the workstation, but if you are already standing the only thing you can do is walk away. And the breaks always become longer and more frequent, the returns to work less efficient.  Fatigue increases and the anticipation of the next break is what increasingly preoccupies the worker’s mental disposition.

But it’s up to you.  If this is what you think you want and can make it work, go for it. Obviously, there are those who can and do.

3. Sit-Stand.  The variable posture approach.

Unlike the Standing Only crowd, Sit-Stand keeps a chair available and seeks to limit actual standing to what the body seems able to tolerate. There is some discussion that many Standers are actually Sit-Standers and the main focus of the movement is really in this group. There is nothing new about the Sit-Stand approach. Workstation exercises, wherein one rises periodically from a sitting position and does a series of stretches or similar maneuvers have been advocated by many for years. Standing for self-determined periods has been part of that advocacy. The approach, if truly applied, actually works, or at least a practitioner is better off than those who do nothing. But the key is, you have to do it, and self-discipline is here both critical and too often lacking. It goes without saying that the model would be greatly facilitated with a hybrid workstation like the one advocated by Renegade Space.

Sit-Stand, which incorporates variable posture, is really the best option in an imperfect world. It’s an approach that focuses on working with and listening to the body. With this model a user ignores studies and peer pressure and uses the dictates of internal forces to determine how much time to stand and how much to sit. And that, dear people, is the future of workplace seating.

Where does Renegade Space…

…stand in all of this? Renegade Space has as the core of its mission the delivery of comfort to a long term workstation user. We do this by building a device that enables true variable posture, i.e., we enable a worker to access the full possible range of seating positions that can be used at a workstation. We emphasize movement and fluidity in our model, and we enable moderate to full changes in the center of gravity. We recognize that there has long been a championing of periodic workplace movements or exercises from third parties and we readily embrace those efforts. “Standing”, or getting up and moving around is part of the variable posture concept and has been part of our model from day one. We have affinity with the sit/stand advocates who want to balance their sitting with standing and vice versa, listening to and allowing their bodies to decide what is best at any given moment.  This points to around two hours of standing a day, but individual use will obviously vary.

There is nothing wrong with the 90 degree posture and there is nothing wrong with standing, as long as they are seen as short term or “task” positions that are held for about 15 minutes and then corrected with a complete change in position, or when the body dictates a change.  It is when these models are postured as the sole means of occupying a workstation that the gates of workplace hell have been opened.

Can you be more specific about this health issue as it relates to sitting and standing?

The most important factor for anyone to think about when attempting to mate a human with a workstation is gravity.  Rather than taking it for granted you might want to reconsider your physical universe and contemplate it as a world tethered to the surface of the planet and shaped entirely by this mysterious force. We Are Dead Stars;

This is not accidental.  Gravity is at the very core of our existence. One can say that life itself is a fundamental force of the universe that, in the far distant past, saw gravity as an opportunity and took advantage of it to manifest, or if that is too much of a duality for you… work that one out as you wish;

Your entire body structure is an organism specifically evolved to work with the gravitational force on this particular planet.  If there were more gravity, or less gravity, we would look different.  If there were no gravity there would be no life as we know it.  Gravity is the designer and assembler of the physical universe, the force that makes life possible;

Gravity can have a deleterious effect on the human body.  But we are engineered in such a way that we can offset these negative forces for most of our 80 or 90 years on the planet, and our chief tool of offset is movement. Another is sleep. The body, in fact, is subconsciously continuously looking for ways to stay in harmony with gravity.  If we are paralyzed life can go on, but the body will atrophy from lack of movement.  We can, of course, enforce stillness for extended periods, such as a Zen monk, but that is a trained effort and is specifically always offset with plenty of vigorous movement;

The force of gravity at a workstation is translated into three key terms, or factors, which are variable constants: Load, weight bearing surface and footprint.  To this we must add angles of support, which is how we configure our weight bearing surfaces. The body is constantly seeking to keep these three factors in balance.  If one or more of the factors is unbalanced the body or organism interprets this as stress, and it seeks to mitigate that stress with movement until equilibrium among the factors is reestablished. Once the body begins reacting to stress you cannot stop the reaction until the imbalance is corrected. Messages from the body about unsatisfactory sitting positions come in the form of fidgeting, slumping, various pains and a sense of overall discomfort, among others. This is why little children often fidget in the abominations we call school desks: their bodies are subconsciously fighting for a better solution.  It is why a “break” is necessary every 30 minutes from the 90 degree sitting paradigm. The stress forces from the position have built up to the point where they are unbearable and need to be corrected with movement.

And so it is with static standing. We weren’t designed to hold a stationary position on our legs for vastly extended periods of time.  And when we do spend a significant period of time standing it is important to offset it with walking, dancing, playing sport… or sitting down.

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