GPPC Blog

According to Dr. Emily N. Ussery et al., a quarter of adults sit for 8 hours a day in the US. Therefore, any job that requires prolonged sitting, be it taxi drivers or office clerks, are susceptible to chronic pain and joint problems in the neck, shoulders, back, hips, knees, and arms. The medical professionals at General Physician understand the issues associated with prolonged sitting and can help you take preventative measures to maintain healthy joints. 

Lower Back

Prolonged sitting’s primary victim is the disks between the vertebrae in your lumbar spine. Dr. Loubert Suddaby, MD, says your disks are like a jelly donut, with the inner part, or nucleus pulposus, consisting of high water content and layers of cartilage forming the outer part, or annulus. The disks act as shock absorbers for your vertebrae and give you the mobility to bend and twist.

Too much pressure on these disks causes problems. Dr. Suddaby states, “The intradiscal pressure is highest when you sit. It is lower when you stand and, of course, it’s lowest when you lay down.” This pressure is exacerbated when you slouch. “When people get tired, they tend to lean forward and put pressure on their spine, front-loading the discs and causing more damage.” The damage leads to degenerative disk disorder, which causes chronic pain and loss of flexibility.

Dr. Suddaby recommends keeping an upright posture to distribute pressure more evenly along your spine to lower the risk of damage. Maintaining a slight arch in your lumbar spine is especially important when driving, as bumps in the road can cause additional trauma to the disks. Dr. Suddaby suggests using a pillow or rolled-up towel as support or a specially designed Obusforme for your desk chair or car seat.

Dr. Suddaby also suggests taking breaks from sitting every 30 minutes and performing preventative isometric exercises. He states, “The best exercises are not Isokinetic exercises like you would get from sports, jogging, or running. They’re isometric exercises. They involve toning the core muscles that support the spine, neck, and lumbar by tensioning the muscles without moving the spine.” Isometric exercises need to be performed habitually to get the full effect, like brushing your teeth.

Hamstrings & Knees

Prolonged sitting also has an orthopedic impact on your hamstrings, knees, back, and core. Todd Sweeney, OTR/L, CHT, explains what happens when seated: “Your hamstrings and hip flexors shorten, impacting your back. In addition, core muscles get weak due to slouching and poor posture.” Mr. Sweeney uses the term “kinetic chain” to describe how deficiencies in one area can create a chain reaction. When one link in the chain is weakened, like your hamstrings, it can lead to back problems, knee and calf problems, and then onwards in both directions.

Another critical factor is synovial fluid. Dr. Sweeney states, “Our bodies produce synovial fluid, which occupies our joints. Regular movement, weight-bearing, and exercise help the body to produce extra synovial fluid which encourages strong muscles, flexible tendons, and healthy cartilage.” 

Mr. Sweeney says that isotonic exercises are beneficial for your joints, similar to isometric exercises. Think of lifting weights like dumbbells, resistance bands, or your bodyweight. Any controlled resistance movement will strengthen the muscles around the joint and add dynamic movement to the joint.

Mr. Sweeney, like Dr. Suddaby, also stresses the importance of good posture and taking regular breaks to get up and move around. He states, "The optimal position is to have your knees, hips, and ankles sitting at 90 degrees each." This position will maintain the integrity of the kinetic chain in your lower body and prevent pressure from building in your joints during the day. 

Wrists & Shoulders

Prolonged sitting causes problems in your upper body, too. Slouching forward causes your shoulders to slope, leading to increased pressure and grinding on your rotator cuff. Dr. Paterson, MD, an upper extremity surgeon, often sees wrist and elbow injuries. “Typing with your arms tucked in close to your body all day can cause a pinched ulnar nerve in your elbow. I work on carpal tunnels daily, which are caused by overuse and poor wrist positioning during work.” These injuries will cause shooting pains through your forearm and into your fingertips. The pain can get severe enough to disturb sleep at night, too.

Dr. Paterson states that movement is as essential for healthy joints as correct posture. He states, “While it’s always important to maintain good posture at work, whether sitting or standing, regularly getting up and moving is just as important. Movement provides blood flow to all of your soft tissues, which keeps them soft and compliant. But, unfortunately, it’s something people can neglect when trying to avoid overuse injuries associated with their occupation.” 

Dr. Paterson recommends taking breaks every 30 minutes to do mobility exercises like shoulder and neck rolls. You may also purchase a lightweight dumbbell to do wrist flexor/extensor exercises. Ergonomic keyboards can also help prevent carpal tunnel and pinched ulnar nerves. 

Take Care

No matter the work, prolonged sitting can lead to deficiencies and injuries throughout your body. So be sure to monitor how long you sit and take appropriate breaks to stand and move around. And remember, if you are experiencing symptoms or injuries related to prolonged sitting, contact General Physicians PC to schedule an appointment with one of our medical experts.

Colonoscopies aren’t something a lot of people really want to talk about, but they are one of the most important preventative health screenings men and women can get. They’re so important that the month of March is dedicated to the topic—it’s Colorectal Cancer Awareness Month! 

The role of a colonoscopy is to detect precancerous polyps in the colon, which doctors can remove before they turn into cancer. The screening test can also detect early-stage cancer, increasing the chance of successful treatment and survival. We sat down with Dr. Ahmad Kadhim, gastroenterologist at General Physician, PC, to ask three important questions that help shed some light on why this screening is absolutely worth discussing with your doctor.

Q: It used to be that age 50 was considered a good time to start getting regular colonoscopies, but now more doctors are saying to start at 45. Why?  

A: Over the past 10 years the rates of colorectal cancer in young people throughout the United States have risen—so much so that the American Cancer Society and United States Preventative Task Force (USPSTF) recently lowered the recommended age to begin screening for colon cancer from age 50 to age 45.

No one really knows other causes for colorectal cancer development besides strong family history and unfortunate genetic inheritance. There are other theories which include environmental factors and unhealthy habits.

Q: Are there other things beside family history that increase a person’s risk of colon cancer?

A: Yes, and the common risk factors for colon cancer are similar to risk factors for many other serious health concerns. They include obesity, not getting enough exercise, poor dietary habits, excessive alcohol, smoking, increased red meats, and not eating enough fruits and vegetables. 

Q. What about the in-home colon cancer screening kits that are available at drug stores—are those a reasonable substitute for a colonoscopy?

A: There is a limited role for them especially for individuals who do not want to consume bowel preparation or undergo a colonoscopy. They should be offered to average-risk individuals (with no family history of colon cancer) and no alarm-like symptoms such as abnormal weight loss or blood in the stool. It is important to keep in mind that this test is NOT a replacement for a colonoscopy in the sense that it does not detect early polyps or lesions like a colonoscopy. With colon cancer DNA-detection kits, the cancer is often diagnosed in late stages which can limit treatment success at times. It is also important to remember that at-home stool kit tests may result in false positive and negative results, which might lead to performing a colonoscopy anyways.

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While February might be American Heart Month, cardiovascular health is an important cornerstone of overall health that’s worth celebrating and maintaining 365 days a year. For some everyday tips to keep hearts going strong, we spoke with Dr. Vijay Iyer, Medical Director of Cardiology at Great Lakes Cardiovascular and Chief of Cardiology at Buffalo General Medical Center and Gates Vascular Institute.

1. Know your family health history.

“Knowing your family history and whether anyone developed heart disease at an early age helps you understand your preexisting risk,” says Dr. Iyer. “If you’re at high risk because of family history and you have other risk factors like diabetes, high blood pressure, and so on, it’s important to get more aggressive with prevention and work with a cardiologist and come up with a plan.”

2. Exercise for at least 15 minutes a day.

“It’s important to do the little things to move more,” says Dr. Iyer. Even simply walking briskly for 15 minutes is a great start and is a short enough timeframe to fit into even the busiest schedules. 

3. Quit smoking.

“Absolutely refrain from smoking,” says Dr. Iyer. “It’s the worst thing you can do for your heart.” 

While quitting can be challenging, it’s always worth it. Finding the right smoking cessation program and having a support network are crucial. Your doctor—and friends who have successfully kicked the habit—are great resources to find a strategy that fits your personality, habits, and budget. And if one method doesn’t work for you, try another. 

4. Improve what’s on your plate.

Keto? Paleo? Mediterranean? Juice? There’s no shortage of diets and food trends claiming to be the healthy way to eat. And while many of them do have valid heart benefits, going from a daily burger to a life of quinoa and kale overnight isn’t realistic or sustainable—but finding healthier replacements for certain red-flag foods whenever possible is a no-brainer.

“There’s so much info out there about healthy eating that it’s daunting,” says Dr. Iyer. “But we know the basics: cut back on fried foods, red meats, and saturated fats. A little bit in moderation is fine, but don’t overdo it.”

5. Start young. 

“Heart health starts in your 20s; you can’t wait to think about it until you’re in your 50s,” says Dr. Iyer. “Cardiovascular issues generally don’t develop in two years—it takes a long time for heart disease to progress, so it takes a sustained effort to prevent it, too. You should know your family history and cholesterol profile by age 25. And if you never start bad habits in your early years, you never have to quit them later.”

6. Don’t wait for a crisis.

“Prevention is hard,” admits Dr. Iyer. “We don’t change if nothing has happened yet. Most of the time we say we need to have a wake-up call to change, but that’s a heart attack or stroke in this case. We want to avoid that. It’s hard to be motivated if you haven’t had an event yourself or had friend or family member experience a heart attack or stroke. The reasons behind not adopting healthy habits aren’t that people are unaware, but it’s more of an ‘it hasn’t happened to me yet’ phenomenon.”

7. Get heart healthy together.

There are few things that sabotage a diet faster than a well-meaning spouse or best friend showing up with a pizza or a box of donuts. Whether you’re trying to eat better, be more active, or give up cigarettes, one of the surest ways to success is to share your journey with those around you. 

“Life is busy—it’s hard to make changes and sustain them, but it’s easier with support,” says Dr. Iyer. “Lifestyle improvements are often decisions to make as a family or as a couple, not as an individual. For example, if you’re a couple, both people need to commit to stop smoking. It’s not going to work if one person is trying and the other is not.”

 

Dr. Vijay Iyer is an interventional cardiologist specializing in structural heart interventions. His clinical practice includes general cardiology, interventional cardiology, and complex valvular heart diseases. He directs the complex valve clinic at Buffalo General Medical Center, as well as structural heart interventions at the Gates Vascular Institute and Buffalo General Medical Center. https://www.greatlakescardiovascular.com/physicians/interventional/vijay-iyer-md-phd