By: Dr. Alfredo Petrone
Amongst all the change the last week, many of us have been shifted into working from home. In an attempt to #flattenthecurve, we are practicing lots of social isolation and have seen a dramatic increase in online teleconferences, meetings etc. One thing I’ve noticed is lots of this:
Since we don’t know how long these measures will be in place, I’ve decided to create a guide to help with spinal health while we adapt to a new work environment.
As with most things in our health, the more consistently and frequently we add these recommendations the better the results will be. I have simplified things as much as I can while still providing valuable content to help you understand why each of the recommendations are so important.
Following this guide should lead to better overall spinal health, a reduction of pain and stiffness and better productivity for you and your fellow co-workers.
1. KEEP MOVING
This is probably one of the most important. It is easy for us to get stuck on long conference calls or meetings for hours on end. It may feel comfortable sitting on the couch or your home office desk chair but I guarantee it is not healthy for your spine. There is a phenomena called “creep” that happens in our bodies. Essentially, over time which stagnant or prolonged sitting, the ligaments and connective tissues in our spine start to get damaged. You DO NOT feel this happening and usually only become aware once catastrophic damage has been done and you “throw out your back” or in worst case scenario herniate a disc.
My Recommendation: Set a timer and get up and walk around your apartment every 20-30mins.
Especially now, we tend to forget to drink water when we are in our own home. Hydration is essential for our bodies for many things but in particular to help our immune system flush away toxins etc. Water is an essential requirement for health. Remember that coffee is a diuretic so if you’re drinking lots of coffee (guilty) you’ll have to drink more water to counter balance.
My Recommendation: Drink at least a litre of water during your work day. Start your morning with one glass of water right away (before your coffee). This will help rehydrate your kidneys which have been working hard all night! Try using smaller glasses that you have to refill often (good excuse to move) and it will also make you have to use the washroom more frequently - also a good reason to move.
3. GET OUTSIDE
Even if you can just get out for a quick 10-15min walk outside it will be worth it. Schedule yourself some time and just turn off all of your work thoughts and commitments. Listen to your favourite music or just enjoy the beautiful cherry blossoms and sunlight. Getting a break from screen time is going to be critical for your mental and emotional health but also your physical health.
My Recommendation: Do this daily in the morning and in the evening. Even if it's raining it will help you to take a second to refresh and get back to being productive indoors.
4. HOME OFFICE ERGONOMICS
CHANGE POSITION OFTEN
That spot on the couch that seems super comfortable with your lap top propped on your lap is not going to be as comfortable for your spine for long. Try starting a the kitchen table, standing position on the counter, sitting on the bed, sitting on the couch changing chairs, sitting on the floor etc.
ADD A ROLLED TOWEL FOR LUMBAR SUPPORT
If you are being forced to sit for long periods of time for calls and meetings, try adding a role up towel to the small of your low back to help support it. Nothing will beat strengthening your spine and moving often but this could help relieve some of the pressure on the sensitives structures in your low back.
PUT YOUR FEET UP AND ELEVATE YOUR LAPTOP
Putting your feet up can help with circulation and blood flow. Ideally your hips and thighs should be at 90 degree angles when you sit. Having a chair that reclines is even better to take some of the stress off your low back.
Elevating your laptop in these positions will take the strain off your neck. Remember that laptops are never going to be ergonomically perfect because either the screen will be too low or the keyboard will be too high. Try and have the monitor at eye level by putting some pillows underneath it. This may be uncomfortable for typing but it will save your neck and spine when typing is minimal.
If you do get to work at a desk ideally , your hips and elbows should be at about 90 degrees when seated, the top of the monitor should align just above your eyes (when your spine and neck are neutral), and the wrists should also sit at a neutral position. See the diagram below:
If you are planing on buying a chair, you should look for one with adjustable features so that it can properly fit you and is adaptable to change when you want to change positions. Wheels are always useful to help you move the appropriate distance from your monitor but also to help you move around without twisting through your spine.
5. NUTRITION AND DIET
I can go into lots of details about nutrition and diet but I just wanted to highlight my main beliefs around nutrition and some of the challenges you will face when working from home.
To begin let me describe the beliefs I have around food and nutrition:
Food FUELS every single cell in my body, every nutrient in my diet is fulfilling a requirement my body has to operate and function normally.
Almost everything is fine in balance - not in moderation. For example, having a can of pop everyday may be considered in moderation to someone who used to drink 5 cans a day. To put it in perspective: 1 can of pop/day for a year (45g of sugar/can) is over 36lbs of sugar!!!
First and for most, STOP SNACKING. Being just steps from the kitchen, in sweats and navigating through meetings and phone calls, it can be really easy to get caught up in snacking. In this scenario we are more likely to be snacking on foods that are unhealthy and have poor nutritional value. When eating something I always ask myself - in what way is this providing my body with a requirement it needs.
Secondly, most of our energy requirements are probably less than normal life as we are more sedentary at home then in the office. With lots of gyms temporarily closed, our level of fitness has probably decreased. In light of this, you should reduce to amount of food you eat to match the new level of energy output.
TIPS FOR DIETING AT HOME
Start by adding real/whole foods. Most of your diet should revolve around real and whole foods (i.e. foods without a label). Meats, vegetables, eggs, nuts, fruits etc.
Avoid Sugar - there are so many negatives to sugar that I can be talking about it all day. In short, sugar disrupts your body’s hormones, will make you more irritable, will lead to weight gain and is linked to many diseases like cancer, diabetes, cardiovascular disease etc. Don’t use sugar as a coping mechanism for being isolated as it is a slippery slop. Remember it is alright in balance.
Increase your Quality Fat Intake. This is a lengthy subject so I will simply leave it at this: add good fats, rich in omega 3 (avocado, coconut oil, grass fed butter, fish, eggs, nut butters etc.) as these rich fats are essential for our immune system, nerve conduction, hormone activity, enzyme control, metabolism etc.
6. HOW TO ENGAGE YOUR CORE PROPERLY
Bellow I will demonstrate the proper way to engage your core and spinal stabilizing muscles. Remember that your “core” does not mean your rectus abdominis muscle (aka your “6-pack”). It is referring to the barrel of muscles that surround the area between your rib cage and your pelvic bones. It also includes your diaphragm muscle and the muscles that line the floor of your pelvis - think of your core as more of a tube or can.
To properly engage this group of muscles I use the following trick (photos below description)
Standing upright with a neutral spine and chin tucked, straighten your fingers on both hands and stick them into the soft part of your sides between your ribs and pelvis in towards the midline.
Bare down and push your stomach out to the sides in order to push your fingers out of your midsection.
This is how to properly engage your core and should be used in ALL strengthening exercises.
7. STRETCHES AND MOBILITY - DAILY
The following stretches are going to be the biggest bang for your buck in terms of spinal health. Each will have a description of how to perform the exercise, as well as the recommended number of times you should preform each movement (repetitions). Do not move fast through these movements. It should always be slow and in control.
If you know me - this is my go to mobility exercise for the spine. Good form includes the integration of the neck, mid back and low back. All three sections of the spine should move together.
Step 1: Start on your hands and knees with your shoulders aligned over your wrists and hips over your knees.
Step 2: With a big breath in, extend your neck and look up while simultaneously dropping your belly to the ground and sticking your butt backwards to extend your low back.
Step 3: Next, slowly begin to bend your neck and tucking your chin into your chest. At the same time, begin to arch your mid back and drop your shoulder blades by lifting your spine through the upper back.
Repetitions: 10 times in each direction
STANDING THORACIC (MIDBACK) ROTATION
Step 1: Start in a bent over position, while maintaining a neutral spine (see picture below) let your arms drop down in front of you.
Step 2: Squeeze your shoulder blades back and down as though you were trying to put them into your back pocket. Squeeze your butt cheeks to keep your hips neutral and pointing down toward the ground throughout the entire movement.
Step 3: Engage your core and start to rotate your right arm up toward the ceiling while at the same time turning your neck in the same direction. The rotation should only happen through your mid back meaning that your low back and hips stay in the same starting position throughout the movement.
Step4: Slowly and controlled, bring your arm back to to the starting position and repeat on the left.
Repetitions: 6-8 times in each direction
Step 1: Start with laying with your stomach on the ground and face looking to achieve a neutral spine. Bring your hands close to your chest right beside your rib cage.
Step 2: Slowly start to push down through tour hands and squeeze your glutes and low back to create an arch while gently extending your neck to look up towards the ceiling. Hold at the top for 15-20 seconds gently rotating your head from the left to the right.
Step 3: Gently lower yourself back down to the ground and repeat.
Repetitions: 10 holding for 15-20 seconds at the top
8. STRENGTHENING EXERCISES - 3-5x/week
Strengthening exercises focus on making the muscles that support your spine and pelvis stronger. There are a wide variety of exercises you can do for this but I have kept it simple with the 3 exercises I feel will benefit the “at home” worker the best. Ideally the goal would be to perform these exercises 3-5x/week and they are a great way to take a break from work.
Step 1: On the ground you are going to prop yourself up on your feet and elbows.
Step 2: From here you are going to squeeze your butt cheeks together to raise your hips slightly into a neutral position. Imagine someone put a glass of water on your low back. You want to maintain a neutral spinal position so that this glass of water does not fall. Keep your hips down but your core engaged but pushing out through your sides (see above). Hold this for 30 seconds (if you can) working on adding time to hold up to a minute. Repeat 3 times.
Repetitions: Hold for 30 seconds and work up to 1 minute.
Step 1: Start standing with your feet shoulder width apart and your toes slightly pointing outward. Your body weight should be focused toward the back of your foot and heel.
Step 2: While maintaining an upright torso, start to descend back and down (as if you are going to sit into a chair) until your hips reach parallel to the ground or just slightly below.
Step 3: From here pushing your knees out and squeeze your butt cheeks together to rise back up to standing.
Repetitions: 10 times
Many people lack the proper mobility for this movement so only go as far as your body will allow you to without doing the following:
DO NOT round at all through the low back - the second your chest starts to come down stop your movement there and stand up.
DO NOT let your knees fall into the midline or go forward past your toes
If need be squat to a target like your couch but keep your core engaged the entire time.
Step 1: Begin on your hands and knees with your shoulders on top of your wrists and your knees underneath your hips. Remember that with a neutral alignment there will be a slight arch in your low back.
Step 2: Without allowing any movement to occur at the low back, move one of your legs backwards while simultaneously raising the opposite side arm until both extremities are fully straightened . A helpful cue is to think of kicking your heel straight back so that you do not over arch through the low back. Hold for 10 seconds.
Step 3: Slow and controlled, return the leg and arm simultaneously to the starting position and repeat with the opposite extremities.
Make sure to keep your hips pointing down toward the ground and do not let your leg and hip flare out as seen below:
9. PRACTICE HAPPINESS
I used the term “practice” on purpose here. This is a difficult time for all of us and it is so easy to get caught up in the stressed of “what ifs” and unknowns. Trust me I am in the trenches with you. It is not easy! But finding and practicing happiness never really is.
One of the biggest keys to happiness is figuring out how to love yourself. The following are action steps that I use to make sure that I am taking time for myself daily and able to make decisions that are in line with what I believe, value and will ultimately lead to my happiness.
IDENTIFY WHAT YOUR VALUES ARE: What matters most to you? How can you pursue what you want if you don’t know what matters to you? Sit down and write out all the values that are important to you and then narrow it down to the top 3. From now on, start making decisions that align with these top 3 values even if they make you feel anxious or uneasy at first.
BE MINDFUL: Recognize your feelings, emotions and thoughts in any given moment. Be present with the people you are with and give to them the generosity of who you truly are not just who or how you want to be perceived. Pay attention to how your emotions are impacting situations in your life.
BE ABSOLUTELY IMPECCABLE WITH YOUR WORD: Only give your word if it is something you deep down wish to follow through on. Set boundaries for yourself and allow yourself to set limits and say no to work, love or activities that are going to deplete you.
PROTECT YOURSELF: Bring into your life and surround yourself with people who lift you up. There is not enough time in this life to waste on people that don’t make you feel the way that you want to feel.
FORGIVE YOURSELF: You’re not always going to be right and you will make mistakes. Use these situations to learn and grow from. Accept your humanness and the fact that you are not perfect. Some of the biggest eye opening moments for me are from mistakes that I never thought I could manage or handle but low and be hold I survived and in most case thrived.
Dr. Alfredo is an health enthusiast who’s goal is to help people and families live healthier, happier lives. My philosophy on health is simple - our body’s have the amazing ability and potential to self-adapt, self-regulate and THRIVE in this world.