Sit Better, Live Better: Can Active Sitting Improve Your Back Health With Dr Osler
Welcome to the Back Pain Solutions Podcast – Sit Better, Live Better: Can Active Sitting Improve Your Back Health With Dr Osler
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Episode Introduction
We sit to eat, watch TV, work at a desk and so much more……most daily activities involve sitting! In the US, on average people sit for around 10 hours per day and 80% of them suffer from sitting induced back pain. But that is just the tip of the iceberg as a more alarming consequence is that it increases the risk of heart disease, diabetes, obesity, and even cancer! ‘Sitting disease’ is now known to increase all-cause mortality and shorten lives, a public health emergency that’s just now coming into focus. The problem is now so urgent that sitting has been dubbed ‘the new smoking’.
Today we interview Dr Osler who after 30 years as a surgeon at the University of Vermont’s trauma centre left to begin a career as a research epidemiologist. This switch required hours of sitting at a computer, and despite trying a dozen different chairs, sitting all day caused him unrelenting back pain. Dr Oslers search for a better chair soon became a quest to fight an epidemic. Dr Osler couldn’t stop people from sitting, so he needed a way to let them sit better. Fortunately, available research suggested a way forward. It wasn’t sitting that was the problem but sitting still. The question became: Could sitting somehow be made active?
In this episode we discuss the negative impact of passive sitting and how Dr Osler partnered with his son to invent a solution himself. We discuss the journey of invention and how ‘active sitting’ has created a movement movement! We discuss the commitment that active sitting requires and the best way to introduce active sitting to your daily routine.
Some of the things you’ll discover…
- The negative impact of passive sitting
- How lumbar supports have not prevented a rise in the rates of global back pain
- How ergonomic chairs make it nearly impossible to adopt a natural posture, because they prohibit movement and postural adjustments
- The wider implications of passive sitting
- How Dr Osler created the QOR360 active chair to combat passive sitting
- How active sitting can improve your posture, ease and prevent back pain, strengthen your core and improve whole-body health
Episode Highlights
Everyday people are sitting for prolonged periods which they assume is normal, and certainly not unhealthy. However, research clearly demonstrates that this is not the case. Not only does sitting increase your risk of back pain but it has a negative impact on many areas of your health. DO NOT underestimate the impact that your desk work, TV watching, or time spent driving, can have on your health!
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Episode Transcription
Ben James 0:00
When we’re young, we move with freedom and confidence with a great resilience to injury. But somewhere along the line we develop poor habits and become more vulnerable to back pain, back pain solutions features evidence based and practical advice to help you take back control of your health and get back to the activities you love. This is your guide to better back health through movement. So join us as we demystify some of the commonly held beliefs about back pain and build your confidence to a stronger back the smartway.
So Dr. Osler, welcome to the back pain solutions podcast. Thank you for joining me this afternoon. I’m excited to talk about all things active chairs and and your background. So tell us tell us a little bit about you, a little bit about your background and where you’re up to now and why and why active cheairs?
Dr Osler 1:00
Oh yeah, no. So, you know, it’s, it’s, it’s, it’s surprising, really, and no one is, no one is more surprised than me, except perhaps my wife or maybe my son. You know, I was like your standard mild mannered trauma surgeon, you know, sewing up gunshot wounds and car wrecks in the middle of the night for 25 years, you know, at the University of New Mexico and then now at the University of Vermont. And, but it’s, it’s, you know, staying up all night, I could, it was okay, but the next day was getting harder and harder for me as I was getting older. So they’re younger people who want to be in the game of trauma surgery. So I got a grant from the NIH for a few million dollars and a master’s degree in bio stats and I started studying modelling outcomes for trauma centres, trying to figure out which trauma centres were doing a better job in which trauma centres were not doing not having results that were as good with an eye toward, you know, bringing the laggards up to standard and trying to learn from the best. So I found myself doing epidemiology and statistical modelling and sitting most of the day, you know, six 810 hours a day like everybody else. So I traded in the peripatetic life of a trauma surgeon, you know, er, or clinic, ICU back to the ER up to the or kind of stuff for just like sitting all day, and my back started to bother me. What’s up with that? You know, I’ve been fine for you know, my whole life. And now this it didn’t seem right, you know, so. Yeah, incised. Yeah. But basically every chair that was supposed to help, and not all of them were terrible, they, some of them and made things worse, the baylands kneeling chair though yoga ball and into the whole litany because, you know, just ruthlessly trying out, I thought, surely someone had worked this out. But turns out they haven’t. And so as a surgeon, you kind of get used to the idea that if you’re in the car, you have to solve the problem because they nobody going to rescue you. Okay, and it’s a, you know, it’s, it’s, it’s an act of hubris, really, you know, you walk in the car with water dripping off your elbows, and you say, I know what’s wrong, but I’m sure I can fix it. You know, and you have to be a crazy person to say that. But if you can’t say, you can’t do the job, so it’s anyway, that’s the space I lived in for a long time. I thought, Okay, well, fine. I’ll just work this out. And I took a deep dive into back pain and, and just exactly how it happens. And it’s really sort of a surprising story. And it turns out, in other countries where people still sit in traditional ways, they they squat or they sit stays, or they, they kneel, or they sit cross legged, back pain is pretty much unknown. It’s just in the Western world where we’ve got ergonomic chairs helping us out that 80% of Americans and most of the Western world seek the health of some healthcare professional sometime in their life for back pain, which is just crazy. When you think about it in the human spine is a perfectly evolved thing. I mean, billions of years worth of prototyping if you count all the vertebrates and, and then 3 million years in daily use as hunter gatherers errors that we set a lot. And the chairs that we sit on are terrible for us, they’re bad for our posture. They’re bad for our core strength. And it turns out, they’re very bad for biochemistry. We have been hunter gatherers for the last 3 million years. And you know, walking 10 or even 15 miles a day. So our biochemistry or milia interior, the mix of hormones, and enzymes and lipids, and all that stuff in our bloodstream relies on the fact that we get a lot of exercise. This isn’t true for our closest neighbours, you know, the bonobos and the chimps and the orangutans and gorillas, they’re all fine sitting around all day at the zoo, you know, they keep a low body mass their blood chemistry is good, because they’re gatherers you know, they they’re just accustomed to sitting around all day cracking knots in their their system expects that humans uniquely are hunter gatherers and their their machinery is expecting miles of walking a day. And when it doesn’t happen that way, when we slumped in front of our computer all day and just walk from the house, to the car, the car to the office, the office to the car and the card to your PC at home, are we’re really abusing our biochemistry. And so our bad cholesterol goes up, good cholesterol goes down. Our insulin goes up and our all cause mortality goes up. epidemiologists calculate with some precision that we lose on average to life years, from just sitting in front of our computers, and going to the gym doesn’t fix it that’s on like a completely different account. It’s just the act of sitting static all day long is terrible for people. So, you know, I thought well, how hard can this be to fix. And here’s where my my training and Epidemiology was, was kind of leptin I, I trained with Dr. Sue Baker, Susan Baker at the Bloomberg School of Public Health at Johns Hopkins here in the United States. And Sue taught all of her students, you know, you can’t harangue or shame or blame people into better behaviour, you have to redesign their environment, so that they can’t behave badly. You know, because otherwise, it’s, you just got to be yelling into the void for your whole life. So right so airbags are a great example. You know, you put an airbag in every car, and now you don’t have to yell at people they’re gonna, their face is gonna land in an airbag if they drive drunk or drunk or have bad luck or whatever. Unless obviously things like divided highways, you know, if you just put a divider of metal, or some kind of barrier down the middle of your highway, people can’t hit each other head on at 70 miles an hour anymore, they can only hit people from behind. And those accidents are way less fatal. I know this stuff. I’ve done a field for a long time. So by redesigning the environment, you can make it safe for people. So the idea for us was okay, how do we redesign a chair so that it’s safe for people to sit on. So that’s perhaps even helpful. And, and it turns out that, you know, the problem is sitting still. So you need a chair that encourages people to move. It’s just, you know, it seems obvious in retrospect, but it took quite a while to tumble to it. And then our project just became a design project, how do you make a chair that keeps people in motion, the whole time they’re sitting. And it turns out that we’re not the first people to actually have this idea. If you dive in, you can find the active chairs on the web. But, you know, our take was a little different. As an epidemiologist, I want to make these things so inexpensive, and everybody could have one, because as an epidemiologist, you know, if you’re selling a chair for 1000 bucks or more, you know, you’re not solving the problem for most people, because most people don’t have $1,000, to spend on a chair for crying out loud. So it became a design problem. And I, again, it’s just hubris, I got no business designing anything, I wasted the last, you know, 25 years in the operating room, I didn’t get out much. But I was lucky to fall into a group of very talented designers here in a makerspace in Burlington, Vermont, who could see that I had a good idea. And they could also tell that I was hopeless. And so they took me and said, well, Doctor, let us help you. And really, within a year, we had pretty good prototypes that we were, you know, firing out over the web, selling over the web, to people to get feedback to see how this was working out. And, you know, now a few years on, we’ve sold over 5000 chairs. And we tell people, if you don’t like it, send it back, we’ll pay the postage both ways. 4% of our chairs come back, people welcome. And the idea is drop dead simple. You just make a chair that all wobbles when you sit on it. And you think, Oh, well, you just need a hemisphere that led to get it to wobble smoothly and not have a bump in the middle. And it wasn’t so easy. But you know, after more prototypes than I care to think about, you know, we hit upon a, you know, this shape, you know, it’s, it’s, um, it’s the volume of intersection of two cylinders at right angles with non coincident axes, and possibly different radio. I mentioned, one of my interest is math. But But anyway, so if you take this this shape, and put it on a surface, yeah, rocks. And if you take this surface and put it on it, it rocks and because they’re 90 degrees opposed, you get rocking in all directions. So if you just slip this thing under the seat pan of a chair, now you you’re able to rock in all directions. And it’s very subtle motion. I mean, you have to constantly be rebalancing, because there’s really no there’s really no effort involved until you get toward the extremes of rocking and then there’s some gradual onset by Hookes law of kind of keeping it from tipping too far. But the idea is that in order to stay sitting, you have to stay in a balanced posture. So this does a couple things. First of all, your spinal reflexes know what to do with gravity. They were programmed as you were a baby going from creeping to crawling to throttling to walking. So if you just free your spinal reflexes in Gravity, your spine will automatically orient itself in an optimal posture. I’ve done this experiment, maybe hundreds of times by taking our chairs out on the Walking Street in Burlington, Vermont. And just putting some chairs out on a sunny day and watching out, it’s always the same people come by and they, they give the seat a wiggle and, and they sit down on it for a moment, you know, they lose their balance, and then they find their balance. And then within a minute, or a minute and a half or two minutes, you know, their sternum comes up, their head comes back and balances on that Atlas and axis, the first two cervical vertebra, the shoulders come down, and really they’re sitting with basically perfect posture within a couple of minutes, just by responding to gravity, and having to organise their posture, really millisecond to millisecond, because the the chair requires that they keep rebalancing. So they get to try many different postures in a very short period of time. And they don’t move to the next postural choice unless it feels better. And so they very quickly find their way to basically perfect posture. And, and these experiments, were really an eye opener for me, cuz one day, we had like a bunch of chairs out and some like 13, or 14 year old girl just sat down at the periphery on one of our chairs. And she was just sitting in the Sanyo kind of blissing out, you know, kind of rocking and playing with our chair, you know, forward and back and around and making circles and so on. Two minutes, five minutes, 10 minutes, 15 minutes, 20 minutes, you know, and that’s he just got up and walked away. But she didn’t get about about 10 paces, when she turned around, she said, You know, I think it makes me walk better. Now, because she had recalibrated and readjusted the way she was using her spine. So that it was, you know, she was kind of optimally using her spine. And this, this doesn’t just apply to walking it applies to it doesn’t just apply to sitting applies to walking and everything you do so. So with kind of wordlessly, without an owner’s manual, or, or a trainer, or a video, you know, this chair, kind of lets people find their best posture. And so, you know, it’s very interesting to see, you know, what it does to people. But the real question for me as a physician was we have it as a do anybody any good. And, and here’s where, you know, you know, selling chairs of the web is extremely helpful, because when people buy a chair, we have their email, and I sent him an email, say, you know, how’s it going, blah, blah, blah. And I got these heartfelt emails that went on for ages about how to transform their lives, and you know, they were going to have to quit their job, their back pain was so bad, and now it’s fine. And, and as a researcher, and especially, you know, I’ve published over 300 peer reviewed papers and book chapters over my life, I review for a bunch of journals. I have a master’s in biostatistics that I know about research, and it makes me extremely uncomfortable when you start getting anecdotal reports that you want to believe because, you know, as as fine, then they got a Nobel Prize for quantum mechanics back in the 70s, or 80s. Anyway, he famously observed, First, you must not fool yourself. And unfortunately, you are the easiest person to fool No. So. So I’ve been I’ve been hyper alert that, you know, you know, I don’t want to I don’t want to drink my own Kool Aid. But I know, we’ve gotten so many emails from people that I’m actually starting to believe that this, this could be a very general solution for people with back pain.
Ben James 13:36
And other other studies out there for you mentioned there are other manufacturers, there are other active chairs other Is there any good quality research at this point, supporting the use of active chairs, rather, that you’re aware of? Is that something you’re looking at? Or?
Dr Osler 13:53
No, there’s no good research, you know, people have done stuff, like put accelerometers on people act of terrorists to see how much they move, they put real breathing masks on people to measure how much carbon dioxide they’re producing, to see, you know, to document that they go, the resting metabolism goes up by 20 or 30%, when they’re sitting on an active chair, because they’re using their core muscles rather, just going dark. So we know that people use these chairs, we know, we know that they have a metabolic impact, the business of studying back pain turns out to be a fraught thing because you need lots of subjects, questionnaires, and blinding people to whether their chair is active or not, is impossible. So what you need is a crossover design. And, you know, before you know it, you need a grad student and you need, you know, several $100,000 worth of funding and you need several years. And, you know, I’ve put in a, you know, a couple of proposals to the NIH, you know, hoping that you know, they would find such a study, but, you know, it’s, it’s, it’s this is just so outside the realm of
what what’s understood
Ben James 44:15
Yeah. So there you go. For those people listening, there’s your your licence to squirm and move in your chair or or certainly, if you’re telling your children off or they’re getting told off by their teachers, then they know better than you think. So Dr Osler thank you so much for joining us. It’s been really insightful. And we’ll certainly share those links so that people can take a look and find out more about the work that you do and the chairs that are an offer, and see if that can be a solution to to their back problems. Really appreciate the input.
Dr Osler 44:45
I’m delighted to be here. Thanks so much for having me on.
Transcribed by https://otter.ai