Pelvic floor Mythbusters: Is Sitting the New Smoking?!


Fiona McMahon PT, DPT

Nowadays everywhere we turn we keep hearing the warnings about sitting. I’ve heard it on the radio, from fitness instructors, from colleagues. But is it?! Are we sitting our way closer and closer to the grave and disability? Should I fear my own chair?! Or is it like so many purported dangers of the past, caffeine, egg yolks, fat, carbs, and the like, an overblown threat? Let’s venture into the science and the common sense about sitting in our next installment of Pelvic Floor Mythbusters!

Is sitting the new smoking? When I ponder this question, there are so many other mini questions wrapped up in it. I want to break them down for us so we have a running chance at trying to answer the big overarching question: “is sitting really catapulting us faster towards our graves?”. Here are the questions contained within the larger question in my eyes.

  1. Is sitting just as bad as standing?
  2. Are we really sitting more as a society than our ancient ancestors did?
  3. If we have sedentary jobs, what can we do to counteract the ills of remaining sitting for too long?

… let’s dig in.

Is sitting just as bad as standing?

By now most of us know that a sedentary lifestyle can lead to a whole host of maladies including cardiovascular disease, obesity, amongst other conditions. In a study by Edwardson et al, office workers were cited to be the most sedentary out of all workers, spending 75-80% of their time sitting. Clearly being a sedentary person will increase your risk of serious health conditions and sitting certainly qualifies as being sedentary, but does a standing desk reverse all of the bad effects of sitting, or does it still qualify as being sedentary?

The truth is, the time spent standing at a desk versus sitting at your desk is not burning a ton more calories so one could infer that it won’t help much with improving the maladies I listed earlier. Sitting burns about 80 calories an hour, while standing burns 88. The difference is negligible. A standing desk will not get you out of going to the gym to get that 150 minutes of exercise recommended a week by the CDC.

Some studies have found that a standing desk can help in musculoskeletal complaints, especially neck and shoulder issues, which is certainly a boon for many and a reason to consider a standing desk. The studies did not find that standing desks increased baseline activities levels as measured by daily steps.

Are we really sitting more as a society than our ancient ancestors?

In a brilliant piece, (and inspiration for this blog post) on National Public Radio (NPR), by Michaeleen Doucleff about sitting, an anthropologist was interviewed about whether or not excessive sitting is a new epidemic. Anthropologist, David Raichlen studies modern hunter-gatherers call the Hadza. Using heart-rate monitors, he found out that their daily sitting times were actually pretty comparable to that of modern day Americans. The big difference between Americans and the Hadza is that the Hadza get approximately 75 minutes of exercise a day, where many of us Americans are not getting the 150 minutes weekly recommended by the CDC. He also surveyed back pain and found that the Hadza experience less back pain than Americans do with age. We will get into why in a bit. If you want to listen to this piece, click here it’s really worth the listen. If we can extrapolate and say that the Hadza lived their lives like our ancient ancestors, we can say sitting is not the new epidemic that has wrought so many chronic diseases upon us. It may be that we are more sedentary.

If we have sedentary jobs, what can we do to counteract the ills of remaining sitting for too long?

By this point in the blog, I think we have come down on the verdict that it is not necessarily the sitting that’s doing the harm it’s the inactivity. That being said, if sitting is painful, then the way you are sitting is doing harm to your body and action should be taken to make sitting more comfortable.

If you prefer to sit, or your workplace does not allow standing desks, there are a few things you can do to make sitting more comfortable. The most common “mistake” I see in sitting, is sitting with a rounded spine. In the NPR piece movement coach Jenn Sherer described the shape of a person sitting with a rounded spine as resembling the letter “C” or looking like a cashew. That prolonged posture can be super nasty on your spinal discs and cause back pain and disability over time. To undo the C shape, you should sit more forward on to your pelvis to reduce the C shape, rather than trying to straighten your back by starting at the top of your spine. In the radio piece. I cited earlier, Jenn Sherer recommended visualizing yourself like a dog. You want to sit so you would be able to wag your tail. I really like this visual. It helps me to remember the proper way to sit. Again I would recommend listening to the full piece cited above to get the most out of the story.

What if sitting hurts?

Many of our patients here at Beyond Basics Physical Therapy, find sitting to be painful even if they are in “the proper posture”. Pain with sitting can be caused by many different things including poor hip and back mechanics, muscle tightness in the back and pelvic floor, or poor work set up. If your job requires you to sit and it is painful, feel free reach out to us to learn how you can make your sitting situation more comfortable and to relieve any musculoskeletal dysfunction contributing to your pain.


This myth is busted! Sitting in itself will not hasten your demise, however; being sedentary certainly may. The real problem that we face as office workers, or workers, in general, is that our jobs often require us to be sedentary and often times we are not counteracting that outside of work. In order to make sure we are living our most healthy and happy lives, we should be participating in some type of exercise at least 150 minutes a week. This can be a challenge and it doesn’t all have to be done at once you can do it in small doses. If pain or dysfunction is holding you back from exercising, feel free to contact us.


Fiona treats at our midtown location


B Ee J, Parry S, Ir de Oliveira. Does a classroom standing desk intervention modify standing and sitting behavior and musculoskeletal symptoms during school time and physical activity during waking time? Internation Journal of Enviromental Research and Public Health; 2018; 2


Doucleff, M. To fix that pain in your back, you might have to change the way you sit/ Morning Edition. August 14, 2018


Edwardson C, Yates T, Biddle S, et al. Effectiveness of the stand more AT (SmArt) work intervention: cluster randomised controlled trial. BMJ.2018;363


Sperlich B, De Clerck I, Zinner C, et al. Prolonged sitting interrupted by 6-min of high-intensity exercise: circulatory, metabolic, hormonal, thermal, cognitive, and perceptual responses. Frontiers in Physiology. 2018; (9)



The truth behind standing desks
POSTED SEPTEMBER 23, 2016, 9:30 AM , UPDATED SEPTEMBER 27, 2016, 7:47 PM
Robert H. Shmerling, MDRobert H. Shmerling, MD
Faculty Editor, Harvard Health Publishing

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