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Chronic Sitting Disorder

November 6, 2017

Do you find that your back aches, your hips hurt or your legs feel tight after a day of work?

You’re not alone.  Studies have shown that sitting for a prolonged period of time increases these symptoms, as well as the risk of obesity, diabetes, impaired cognitive function and many other chronic diseases. The long term study of the effects of non-exercise activity thermogenesis (NEAT) and harm associated with sedentariness has been the focus of research by Dr. James Levine at the National Institute of Health (NIH).

Non-exercise activity thermogenesis includes all of our daily fidgeting and tasks, such as folding laundry, walking up or down stairs, running to catch the bus, or getting the morning paper. The more our body uses this NEAT energy, the more calories we burn. To increase the amount of NEAT energy that we spend each day, studies show that it is better for your health to pace rather than stand still, and fidget rather than sit still.

Prior to the industrial revolution, most people were working in an agricultural community, which required standing and walking around to complete the tasks of their daily jobs.  People sat for an average of 300 minutes per day. In today’s world, we are often bound to office settings and office workers sit up to 900 minutes per day. We are also confronted with environmental cues to sit.  For example, drive thru banks or drive thru restaurants are the norm when running errands, and  the invitation to sit down when entering a meeting or  visiting someone’s home is considered the polite thing to do. All of this increased sitting decreases our NEAT.

This sedentary behavior leads to detrimental changes in our body.

Obesity, Diabetes, Heart Disease and Cancer: It is reported that obese individuals sit 2.5 hours longer per day on average than non-obese individuals. This prolonged sitting causes decreased blood flow, and decreased muscle activity. Prolonged sitting can also increase insulin resistance. Increased insulin may promote cell growth, which could be a reason that increased sitting has been linked to different types of cancer.  But studies show that interrupting sitting time with light or moderate bouts of activity can improve glucose metabolism and prevent the increased risk of diabetes, cardiovascular disease, and cancer.

Muscular Limitations: Sitting leads to weakened core muscles and extremity musculature since muscles don’t have to activate while slumped down in a chair.  Postural deficits include forward head posture and abnormal spine postures. In addition, as we increase our sitting time, we lose mobility in the hips. Decreased hip mobility and tight hip flexors lead to decreased stride length with walking and can increase the risk of falling in older adults.

How Do We Change Our Sitting Habits?

In recent years, we have seen a surge in efforts to increase physical activity among individuals.  More and more people are investing in fitness trackers, standing/treadmill desks and health club memberships, but there is more we can do to work towards a healthy, non-sedentary routine.

Following are some tips to improve NEAT, decrease chronic diseases that are caused by lack of energy expenditure, and promote a healthier lifestyle:

  • Stand while waiting for the metro or bus
  • Stretch your hip flexors
  • March in place during tv commercials
  • Try a standing desk
  • Take the stairs whenever possible
  • Take short walks after meals
  • Purchase a pedometer or activity tracker. Most modern activity trackers can alert you to meet a step goal or signal you to stand after a prolonged period of sitting.
  • Park at the back of the parking lot so you are forced to walk a few extra steps.
  • Sit on a core/exercise ball. Sitting on an unstable surface requires your abdominal muscles to engage to stabilize your body.
  • Stand at the sink and wash your dishes by hand, rather than using the dishwasher
  • If you do have to sit, encourage good sitting posture with relaxed shoulders and feet supported, but make sure to take standing or walking breaks every 30 – 60 minutes.

The more you move, the healthier you’ll be!


Koepp GA, Moore GK, Levine JA. Chair-based fidgeting and energy expenditure. BMJ Open Sport & Exercise Medicine 2016;2:e000152. doi: 10.1136/bmjsem-2016-000152 

Levine, J. A. (2002). Non-exercise activity thermogenesis (NEAT). Best Pract. Res. Clin. Endocrinol. Metab. 16, 679–702. doi: 10.1053/beem.2002.0227  

Levine JA. Sick of sitting. Diabetologia (2015) 58(8):1751–8.10.1007/s00125-015-3624-6 

McCrady SK, Levine JA. Sedentariness at work: how much do we really sit? Obesity. 2009;17(11):2103–2105. doi: 10.1038/oby.2009.117 

Thyfault JP, Du M, Kraus WE, Levine JA, Booth FW. Physiology of sedentary behavior and its relationship to health outcomes. Med Sci Sports Exerc. 2015;47(6):1301–1305