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After 20 years as a physical therapist working with thousands of patients, I've identified a new set of conditions I've informally dubbed "sedentary syndrome."
I coined this term after I realized that, while doctors evaluate internal measures like blood work to determine overall health, they often overlook obvious physical changes when someone struggles with things like pain and extra weight.
I see these and other physical manifestations in patients who've been sedentary, overweight, and in pain for years and even decades. Fortunately they are reversible.
For me to "officially" diagnose one of my patients with Sedentary Syndrome, they need to exhibit a minimum of three out of five key signs:
1. Central obesity
The more you weigh, the more you feel gravity's effects on your joints—especially weight-bearing joints like the ankles, knees, hips, and lower back—with the simplest of daily tasks. Every pound of excess weight exerts about 4 pounds of extra pressure on the knees. If you're 50 pounds overweight, that's 200 pounds of extra pressure on your knees! Consider all your daily movement, and you can understand why premature damage1 in weight-bearing joints occurs.
2. Spinal health
Your spine should have an S-shaped curve from the base of your skull down to your sacrum. This shape prevents overdue pressure on joints, intervertebral discs, and certain muscles. Sitting and being sedentary can reverse or alter these curves and invite pain. People in Third World countries, often more active and not as sedentary as Americans, overall have healthier spines. Compared with a chair, sitting cross-legged on the floor, and walking lend themselves to a healthier spine2.
3. Sarcopenia
Loss of lean muscle mass and strength affects about 45 percent of older Americans. Physically inactive folks can lose 3 to 5 percent of muscle mass per decade after 30, affecting everything from how you look to how you move. Even active people experience some muscle loss. You can prevent or reverse sarcopenia with adequate protein intake, consistent exercise, optimizing hormone levels (including DHEA, testosterone, and growth hormone), as well as reducing oxidative stress and inflammation. Simply put, diet, supplementation, and exercise go a long way here. https://www.ncbi.nlm.nih.gov/pubmed/259997043
4. Posture
Oxygen is an undervalued nutrient—yes, nutrient!—that generates energy and ultimately sustains life. You can live days without water, weeks without food, yet without oxygen, cell death occurs within three minutes. Your mitochondria—those little energy plants in your cells—use oxygen to produce energy. Insufficient oxygen results in poor muscle metabolism and creates pain. How you move and your posture dramatically affects oxygen levels4. One study found slumping (compared with normal seating and standing) produced the worst lung capacity and airflow. Normal sitting was better. While standing posture was best, you can have poor posture standing. Adopting upright postures and consistent movement will keep you well-oxygenated.
5. Joint failure
Most people develop joint failure from arthritis or arthritis-related conditions like osteoarthritis5, rheumatoid arthritis, gout, or lupus. Joint failure and arthritis are intimately connected, creating inflammation that leads to pain, aching, swelling, and stiffness. When my patients lose weight, they simultaneously reduce joint-related pain. Gut health6 also contributes: Leaky gut and other gut imbalances mean toxins, bacteria, and other foreign invaders slip through your gut wall and land in your joints, creating inflammation and pain.
Understanding and reversing risk factors for Sedentary Syndrome significantly affects movement and pain management. The first step means moving again. Once your overall mobility improves, you'll want to strengthen your body with a more formal exercise program and burn some serious fat with high-intensity interval training.
6 Sources
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4332294/
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3512264/
- https://www.ncbi.nlm.nih.gov/pubmed/25999704
- https://www.ncbi.nlm.nih.gov/pubmed/1938733
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1003922/pdf/annrheumd00433-0078.pdf
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4637104/
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