The Perils of Desk Work

August 09, 2018

By Daniel Nalborczyk - Tyack Health Chiropractor

At first glance, it almost seems counterintuitive that desk workers have a high incidence of musculoskeletal complaints and injuries.  After all, sitting in front of a computer is hardly cross-fit right?  However, statistics show that sedentary work can elevate your risk of suffering from a wide variety of musculoskeletal and general health disorders in many cases more than physical work. In the following series of articles, I would like to address the top 5 most common complaints that require treatment. 

First and foremost, we need to discuss a concept that underpins the development of pain and injury. Strangely enough, it is also critical to recovery. So let’s talk about adaptation.  Simply stated, the tissues and organs in your body do their best to adapt to the demands which you subject them to - within reason. Increased workload causes muscles, bones and connective tissue to become stronger and more resilient. This concept is sometimes known as the SAID principle: Specific Adaptation to Imposed Demands. If you challenge your body to perform a particular task, or movement, your strength and endurance will improve just enough to meet the challenge you apply. Conversely decreased workload causes your musculoskeletal system to weaken.  Think of this as your body’s attempt at conservation. If you don’t use it, you lose it. Simple as that.  

Now let’s apply this to a seated posture. Sitting allows certain muscles to rest and avoid working to support you against gravity.  In small doses this is fine, but as sitting time increases, your body adapts.  Muscle and bone mass decrease.  Certain muscles which are kept in a shortened position for extended periods will become short and tight, other muscles will become overstretched, weak and painful. These adaptations affect your posture in predictable ways. We have all seen the typical computer user with rounded shoulders, forward head position and increased curve in the mid back. If left uncorrected, permanent injury can occur to the spine, intervertebral discs and supporting tissues.

In the early, to mid-20th century, as the modern office and typing pools grew, the above posture became commonplace. The term Upper Crossed Syndrome was coined by Czech physical medicine specialists who described this condition in detail.  

Prolonged sitting with arms in front of the body on a keyboard and mouse causes the pectoral muscles to shorten. They are significantly bigger and stronger than the counterbalancing muscle group between the shoulder blades. So they win the proverbial tug-of-war and pull the shoulders forward and cause the overstretched and overmatched mid back muscles to become tired and sore. 

Simultaneously, mid back muscles weaken causing the head to drift forward which results in further demand on the small muscles of the neck and upper back. Many of you are already familiar with the end results: 

  • Tightness across the tops of the shoulders which radiates down the shoulder blades.
  • A stiff neck which can result in headaches below the skull or around the eyes.
  • Greatly increased occurrence of a shoulder injury

There are other consequences, but we will save them for future articles.

So what can be done?  Will a new chair help? What about a standing desk? Is there a cream or pill that I can take?  What about exercise? Chiro? Physio? Massage? Personal Trainer? All good questions.  Ironically, the simple answer is … it’s complicated. While each of these interventions can help, most people will require more than one of them. First and foremost, find a health care provider with experience in the evaluation and management of posture related pain to guide your treatment. This is much more important than what discipline of health care they are licensed in. Over my years in private practice, and working as a workplace injury management consultant I have found that the best outcomes are achieved when patients commit to a focussed exercise program and targeted manual therapy. In certain cases, pain medications and ergonomic considerations are also necessary.