Help me stand at a standing desk properly for long periods of time

March 27, 2020 3:27 AM

Using a standing desk for other ergonomic reasons, am getting some back pain, want to figure out why. Alternately, have some weird chairs I'm trying, but all have no backs and sitting at them...also gives me back pain. Details within!

First off: I've spent a lot of time investigating ergonomic options. I welcome suggestions, but please don't just say "don't stand." I'll explain my reasons below, but I am not making these decisions for arbitrary or fad-based reason.

I'm a programmer (well, currently on a long sabbatical, but...). I'm currently 33. When I was 25, I came down with some pretty serious RSI in my elbows and wrists. After lots of existential despair and experimenting, I found that the RSI was controllable as long as I used this keyboard in a specific way...my arm above the elbow parallel to my body, then a 90-100% degree angle, then the keyboard. Using the keyboard this way, I didn't have issues. But! Due to my body proportions, it is impossible for me to sit at a normal desk and get the proportions -- it would put the keyboard into my legs! So, I stood. For about 5 years, it was fine. I could use a desk quite a lot...if I didn't stand with my keyboard at the angle etc, I'd get RSI pain. If I did, though, no issue at all. There was a little adjustment at the beginning, but there was never back pain -- until I hit 30 or so (lol). At that point I started getting lower back pain...I went to a physical therapist, but we really never got to the bottom of it. Then, I quit my job and radically changed my lifestyle in a way that allowed me not to have to use a computer much at all.

Fast forward to now: I'm 33, and I want to be able to use computers a lot again. I'd like to gear up to go back to work, get into programming again, etc. So I bought a standing desk and got everything set up (NOTE: I have my screen at the right height, a proper distance, etc). But I've found that I get back pain...sort of in the center of my back?

Here's how I'm standing: slightly wider than shoulder width. Knees slightly bent. I try to engage the muscle around my stomach a bit to support my back. I try to stay straight. I try to bring my head/chin back over my spine, and keep my shoulders back (eg not slouch forward). Like I said: for most of the 5 years I used a standing desk, I had 0 back issues. Then I got back issues that went unsolved. Standing in the way I just described it is...ok. But I can still "feel it," and over the day it definitely builds. I try to take regular breaks, and do some stretches (I'd welcome advice on exercises or stretches!), but while that helps a little, it hasn't gotten to the core of the problem. Today I've been trying to make sure my whole body is straight, sort of, not letting my torso be more forward...I *think* that is helping a bit? But it's hard to tell. It's like whack a mole. You change your position to help one area and it moves a bit.

So I'd definitely appreciate any advice that you think can help me get to the core of the problem.

I have been trying to find chairs that work...but given the requirement that essentially my legs not be at a 90 degree or so angle, it's been hard to find. I live in China and while it's very easy to buy most things online, finding weird ergonomic chairs has been hard. I tried a couple and haven't had success -- they've all left my back hurting. So...maybe I also need to know how to sit properly? My guess is that whatever the core postural/physical issue is, it is probably similar. I'm going to keep trying chairs, but again, I'm not super hopeful that I can find anything while I'm still in China. I am open to suggestions about alternative ergonomic setups, chairs that you think might fit my requirements (there's always life after china or hey i might be able to even find it here).

A physical therapist who knows anything about this is probably out of the question. First off: coronavirus (boooo almost finished this post without mentioning it). But even beyond that, I live in a small city in China and am doubtful that there is anyone who knows.

I welcome your advice! This is really important. Right now I'm not relying on computer work to make money, but I will be in the next year or so, so I need to be able to work normally!

posted by wooh to Health & Fitness (15 answers total)

Where is the back pain?

If it is lumbar, look into your pelvic tilt.

I recommend posture exercises against a wall until you know how to straighten your spine more than you ever thought possible.

Also try balance exercises that work your body core muscles to recover. An example of the type of balance exercise that would potentially help is to stand on one leg with the other one raised and lean and flap and tilt by turns at 360* until you are off balance in as many different directions in succession as you can, recovering so you don't fall down by tightening those core muscles to tilt you back again. It looks silly. Switch feet and do it with each. Anyone who does not regularly walk on uneven ground and only walks on floors or leveled ground would benefit from this, even if they walk on slopes.

This will help you find and use the various small torso muscles and stretch them at different angles. It's not that you need washboard abs, it's that you are probably not doing any leaning and stretching because you don't have to, and when you do it's almost certainly always forward, or at a certain angle only that you use when you are sitting at your desk and lean over to grab something from the stand on one side.

Look into your shoes. Shoes cause a certain angle of pelvic tilt which is different depending on the varying thickness of the sole. You may want to switch out to a different brand of shoe with a different heel width, work barefoot or in socks, or try standing with a small box in front of you, with one foot on that, switching feet from time to time. If working barefoot or using the box causes an immediate increase in problems it will be useful diagnostic.

Another exercise that could help is stretching the ligaments and muscles in the back of your body. Those stretches where you fold yourself forward are the right ones to do - remember all exercises are more effective if you vary the direction of the stretch a bit as you do it. Don't just touch your toes, but work from touching just to the right of your foot, the right foot, the floor between your feet, the left foot and the floor to the left of your foot. Try holding the pose a bit longer.

If you can't actually touch your feet or the floor don't be discouraged. I mentioned the floor for clarity. A lot of healthy and flexible people haven't a hope of touching their feet without bending the knees. I was describing the direction not the actual goal.

Make sure that the chairs you usually sit in do not have a tilt in the seat, especially a forward tilt. This also could have thrown your structure out in a small but hidden way.

Triple check that your work surface is not actually causing you to round your back when you are concentrating. Again it doesn't take much of a lean forward to shorten those ligaments and tendons and muscles.

Hydrate well, and make sure you are not constipated. Believe it or not that could also contribute to back pain.

Use a timer while working to ensure that every few minutes you move around and stretch your back. You don't even have to stop working. You can type while doing shoulder rolls and pelvic tilts.
posted by Jane the Brown at 3:58 AM on March 27, 2020 [2 favorites]

I have similar issues so I'll be reading with interest. My guess is that core strengthening would help, but that's a random internet suggestion.

On the chair front, have you tried kneeling chairs or saddle-type chairs?
posted by trig at 3:59 AM on March 27, 2020

Research getting a physiotherapist consult over the phone.
posted by Jane the Brown at 4:00 AM on March 27, 2020

Weird thought but are you wearing good, supportive shoes? And if you're wearing shoes without enough cushioning, have you tried standing on an anti-fatigue mat?
posted by needs more cowbell at 5:00 AM on March 27, 2020 [2 favorites]

Seconding the anti-fatigue mat, it is essential.
posted by mhoye at 5:02 AM on March 27, 2020

I had a pair of shoes that gave me lower back pain every time I wore, nothing special about them, pretty flat heels. They did something that just threw my back off by a millimeter or 5 and it was enough to cause lower back pain. So, try wearing different shoes and see if that helps.

I've also noticed that a couple of friends' kitchen sinks are also at a height that messes up my back when I wash dishes there. Can you raise or lower your desk just a tiny bit and see if that helps, or stand on something.
posted by mareli at 6:11 AM on March 27, 2020

I stand all day to work (programmer as well) and have found a Pono board keeps me more comfortable. It does raise my height quite a bit so everything at my work station has to be higher than if I were standing on the ground.
posted by hilaryjade at 6:14 AM on March 27, 2020

So a big chunk of this is often posture, as you suspect - if you don't already know how to do a real core workout, it may make a big difference in how you carry yourself. And good news! Unlike getting your biceps jacked, you can do a ton of core exercises just using the weight of your torso. Crunches, situps, and a couple different types of leg lifts, every day, for say 10-15 minutes, made a marked difference in my posture.

The other thing is - desks were invented for a reason. Standing for a long time is actually quite fatiguing. I am relatively long of leg and short of torso, and I've always found stools and and tall chairs to be exactly wrong for my build. Rather than trying to find fancy standing desk chairs, you could find a comfortable chair that you can sit in, and spend the money on a desk that can maintain several different positions - I switch 4-6 times a day.
posted by aspersioncast at 7:21 AM on March 27, 2020

Response by poster: I use an ad-hoc non fatigue mat -- an exercise mat folded in half Not sure if that is inadequate? My shoes are not particularly supportive. Will try out various things there.

I got an adjustable height desk so messing around with boxes and stands is totally doable.

Definitely should do more core strengthening. I also should practice straightening. How straight should I be going? Straight as a wall? I guess I should say, should my goal when standing be to be as straight as if I was against a wall? Should I just...move my desk next to a wall and stand against it while I work?

Back pain is not quite power back, it's more like the center.

Asperioncast, I wish I could just find a normal chair and then buy a nice desk to work around that. Lamentably, a normal chair won't work because the ergonomic dimensions my keyboard/arms demand would but the keyboard directly in my thighs :/

Trig, I'm trying to find good ones but the pickings is slim here. But that's the direction I'd like to go. I got one that I couldn't use with the back rest (bc it was all too tight with it) and using it without the backrest was killer. Certainly a posture issue on my part. Got another sort of angled chair and also have back issues without a backrest. I have a saddle chair in the mail and am hopeful BUT I fear that without proper posture, I'm going to hurt.

So I guess that's to say; what's proper posture for sitting in a chair with not back? Same as standing? Straight as if you were against a wall?
posted by wooh at 7:29 AM on March 27, 2020

Response by poster: "Also try balance exercises that work your body core muscles to recover. An example of the type of balance exercise that would potentially help is to stand on one leg with the other one raised and lean and flap and tilt by turns at 360* until you are off balance in as many different directions in succession as you can, recovering so you don't fall down by tightening those core muscles to tilt you back again. It looks silly. Switch feet and do it with each. Anyone who does not regularly walk on uneven ground and only walks on floors or leveled ground would benefit from this, even if they walk on slopes."

This sounds useful! But I don't have quite a clear picture of how it works. So, I sort of have my upper body doing 360 degree turns, and I sort of force myself to (in a wild but controlled manner?) go off balance, then use my core muscles to bring me back? Just making sure I get it.

"I recommend posture exercises against a wall until you know how to straighten your spine more than you ever thought possible."

I'm not familiar with such exercises, but again, happy to do them! Is the goal that my back is completely flat against the wall, or just that my lower back and upper back are? for the mid back to be against the wall I sort of have to point my pelvis up, if that makes sense. Is that correct?

Thank you, everyone
posted by wooh at 7:38 AM on March 27, 2020

I just got this chair for my standing desk. I don't really sit _on_ it like a chair, but take breaks by perching up against it. It helps to have a little step stool in front of me to put my feet up a little too.
posted by advicepig at 8:37 AM on March 27, 2020

Definitely the shoes. Look into a shoe with a good cork insole, like Allen Edmonds. It’ll add hours to your standing workday if your current shoes aren’t great or are merely good, and make it so you can deal with a hard bare floor (with good enough shoes, anything more than a thin, hard standing mat will make you uncomfortable because it messes with your posture.)

Other than that, getting sleep, avoiding leaning forward, keeping your shoulders relaxed (may need to lower the desk) and making sure your pants are not too tight are likely culprits.
posted by michaelh at 11:50 AM on March 27, 2020

You do seem to have the gist of the exercise where you balance on one foot.

Details like where your feet and arms are depend on how good your balance is to begin with. If your balance is good you can hold your other foot up with one of your hands, and keep your arms close to your body. If your balance is not as good you'll want your foot near the floor and to keep adjusting your arms to bring your balance back so you don't fall. When you overbalance you will over correct, so the trick is not to lean exactly opposite the direction you leaned but a few degrees from it. You can think of a clock face and lean towards 12 o'clock first and then correct it so that you are leaning too far towards 6 o'clock, and when you correct and put yourself off balance again, aim towards 1 o'clock and correct towards 7 o'clock. The thing to watch out for is if you are missing some portion of the clock face. If you always only ever correct towards three o'clock, no matter which direction you lean in, it won't strengthen the muscles on all the sides of your body core.



When you do posture exercises you do them against a wall to test that you are actually straightening your back. Start by straightening up as tall as you can when you are not by a wall and get a feel for the position your pelvis and shoulders and neck are in. Then try and do it with your back against the wall, tilting your pelvis, flattening your back, putting your shoulders back, and drawing back your head like a turtle trying to pull its head back into the shell. You'll probably be surprised at how much the wall helps as a guide to flattening your back and getting your head in the right position, because without the wall it will feel like you don't need to pull yourself backward that much. For many people this posture produces a double chin. You can try repositioning your head and neck while looking in a mirror to check if you are actually pulling your neck backwards or only tilting your head back while letting your neck still lean forward.

You can try and put your hand behind yourself to check if there is a gap at any point and then wriggle and rock to try to push back against your hand. For most people, especially computer users, the hardest thing is getting your neck upright. We are a society of people who stoop. It's quite remarkable.

One of the classic ways to improve your posture is to imagine that there is a string connected to the top of your head pulling you up, ever so slightly off the ground. Doing this will help you get your feet placement correct and gives most people at least a couple of millimetres of additional height. You'll want to transfer a bit more of your weight onto the balls of your feet from your heels. Make sure you are not lifting your shoulders when you straighten, you want your arms to drop as much as possible

When you have corrected your posture using the wall, walk away without relaxing and stroll around keeping your spine in that position. After a short while go back to the wall and test again to see if you have stopped putting your shoulders back or otherwise begun to slump or lean forward again. The first step is figuring out how to straighten up; the next step is figuring out how to straighten up without the guidance of the wall. You don't need to stand with your back against the wall to work, you need to be as comfortable as possible then. The wall is just a training tool for the exercises you will do to try to help with the back pain.

One of the best things you can do for your posture is to sit down a lot less, but you have that goal already, so you are probably ahead of the game. Good posture while sitting is about pelvic tilt. People tend to slide forward on their chair and allow the small of their back to be pressing against the back of their chair if there is one. The more you sit in chairs the rounder your back will be, but you don't want that. Good posture in a backless chair is the same as in a chair with a back - You're not supposed to actually use the back of the chair to support you, if you want good posture. It's there to support you when you get tired, and possibly there to keep you warmer. If you need to lean against the chair back as soon as you sit down you've gone into a resting limp position already.
posted by Jane the Brown at 2:33 PM on March 27, 2020 [1 favorite]

Definitely check for a better mat, exercises, and ergonomics. And while this isn’t something you can check NOW you may want to be evaluated for scoliosis. It’s very common to have a small curve in the spine that can cause pain. I have a smallish S curve in my back that causes pain in the middle. It especially flares with a lot of standing or sitting in certain positions. It may open up different options to manage it.
posted by Crystalinne at 2:48 PM on March 27, 2020

Response by poster: Jane the Brown, thank you so much for your posts! Thank everyone, of course, but thank you :)

I think one thing I'm still unsure of is how my pelvis should be when I'm sitting in a backless chair. It sounds like when "standing straight," my pelvis indeed should be tilted back (well, upwards), to create more straightness in my back.

But when sitting, is that still the case? For some reason I thought that when sitting we needed to tilt our pelvis forward/down, to avoid slouching. So I'm a bit confused.

A saddle chair arrived today that seems promising, and I will potentially do sitting/standing. But not quite sure about the pelvis aspect!
posted by wooh at 9:04 PM on March 27, 2020