Sit Up Straight

We’re often told to sit up straight, type with our feet flat against the floor, and keep our shoulders relaxed. Thanks to the field of ergonomics, we now have these tips—and plenty of others—that help us to keep our bones and joints healthy while on the job.

Ergonomics defined

Ergonomics, as explained by the International Ergonomics Association, is the study of the way the human body interacts with its environment. Overall, ergonomists look at how to fit work into people, as opposed to having people warp themselves to fit into their work.

Workplace ergonomics and your health

According to the Work Foundation, musculoskeletal disorders such as back, neck, and arm pain cost Canadians upward of $20 billion per year. The link between most of these nonspecific pains and work—particularly seated work—is well documented. As the majority of jobs in Canada involve prolonged sitting, it stands to reason that much of ergonomics is focused on improving sitting postures and positions.

The creator of the website Are You Ergo?, Matt Gereghty explains that ergonomics provides all of us with guidelines that help prevent a number of common workplace issues, including pain in the neck, back, and shoulders; carpal tunnel syndrome; and poor posture. Are You Ergo? is dedicated to raising awareness about common but easy-to-fix problems that arise from poor ergonomics.

A reformed “slouch potato” turned professional ergonomist and occupational therapist, Gereghty knows all too well about the types of injury that can result from prolonged desk work. As a student, he lived a life of excessive sitting, slouching, resting his feet up on desks, and other typical positions he now calls “evil.” The damage he suffered as a result only took five days to compound, and this otherwise healthy young man wound up with debilitating hip pain and a bruised tail bone.

Poor ergonomics, as Gereghty can attest to, may have serious consequences for a person’s quality of life—not just for the short term, but in the long run as well. Subjecting our bodies to poor posture and other environmental stressors can cause chronic injuries that require years of treatment and wreak havoc on our quality of life.

The many facets of ergonomics

Ergonomics involves “the habits, positions, and lifestyles that make up one’s day,” says Gereghty. It considers any physical, sensory, or even social stress a work setup may have on its inhabitants.

Physical setup

The physical aspects of ergonomics include workspace layout as well as work routines that may cause bodily discomfort due to incorrect positioning, repetitive motion, or unnecessary twisting or leaning.

With respect to layout, specific angles determined by aspects such as the height of your desk and chair, and the placement of your computer monitor all affect the ergonomics of a workstation. For example, the backrest of a chair should be at a 90- to 100-degree angle to the floor to help reduce back and neck pain.

Personal habits

With respect to work routines, how long you spend on one task, how you communicate with your colleagues, or how meetings take place all impact workplace ergonomics. Social ergonomic recommendations often include more frequent breaks, or more face-to-face communication instead of instant messaging, email, or phone conversations. Gereghty is also a proponent of the walking meeting.

Sensory stimulus

Sensory aspects of ergonomics range from the brightness of your desk lamp to the way the sound carries from one workstation to another. In some industries, the temperature of the work environment, or the amount of vibration or turbulence a worker experiences, can be the main factor when it comes to making work a healthier, more ergonomic place.

How to make sure you’re “ergo” at work

Working with a professional ergonomist is the best way to ensure that you minimize your risk of musculoskeletal pain due to work. An ergonomic assessment, which involves having a professional ergonomist simultaneously evaluate and adjust the ergonomics of your personal workstation and surrounding environment, takes about one hour and gets you immediate improvements to your workstation, as well as a written report for ongoing changes. Many businesses now invest in ergonomic assessments because they result in happier, healthier, and therefore more productive employees. Not a bad return on investment!

If a professional assessment is not accessible, you can also try the Ergo Tool (areyouergo.com/ergo-tool), a 15-minute online assessment designed by Gereghty to have an immediate impact on your work habits. The Ergo Tool is uniquely effective because it injects memorable humour into otherwise dry topics such as wrist angles and keyboard height. The Ergo Tool targets the most common ergonomic errors—and the quick fixes for them.

However, Gereghty’s number one tip for ensuring that you are “ergo” at work is to move. Given the aforementioned ill effects of prolonged sitting, make a point to stand, walk around, or stretch every 30 minutes. No desk, chair, or keyboard, no matter how ergonomic they claim to be, is as effective as having a walking meeting or getting into the habit of standing while talking on the phone. The risky business of sitting for too long can be stopped in its tracks with one simple ergonomic tactic: stand up and move.

Tips for every type of work

No matter what the industry, ergonomics applies. Here are some of professional ergonomist Matt Gereghty’s top tips for being more “ergo” at specific types of jobs.

If you’re at a desk ...

• Ensure that the top of your computer screen is at the height of your eyes, whether you use a standing desk or a traditional one.
• To optimize your back posture, sit as far back in your chair as possible.
• Try to maintain a 90-degree bend in your knees and elbows.
• Make sure that you’re never resting your wrists on the corners of a table or on your keyboard.
• Position your arm rests so that they support your arms with your shoulders in a low and relaxed position.
• If using a standing desk, try to keep your shoulders low and relaxed, with your elbows at 90 degrees.

If you’re on your feet ...

• Keep loads close to your body. The farther away a load is from your body, the heavier it feels.
• Use a pressure-relief mat for added comfort and support.
• Make sure you’re wearing a supportive pair of shoes. Absolutely no high heels, Gereghty insists.
• Use a footrest or any surface 8 to 12 in (20 to 30 cm) tall. It will allow you to lift one leg at a time and will give you a much needed change in posture.
• Mix in some sitting in with the standing. It’s all about switching up your positions.

If you’re operating a vehicle ...

• Take breaks from driving by getting out and walking around. If you can do so in a group, the more the merrier!
• Check that your shoulders are not hunched up around your ears, but are instead low, relaxed, and level. One shoulder shouldn’t be higher than the other.
• Try to keep your neck straight. Many people have a tendency to lurch their neck forward as they drive.

Your lumbar area should be well supported, either by your car’s seat or with an external lumbar pillow (a rolled towel works too).

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Smooth Running

Glucosamine sulphate occurs naturally in joint structures in the body and is an important compound in the manufacture of cartilage, which covers and protects the ends of bones. When cartilage degeneration leads to loss of mobility and accompanying pain, glucosamine sulphate supplements can help.

Cartilage degeneration is the main cause of osteoarthritis, the most common form of arthritis. According to the Arthritis Society of Canada (arthritis.ca), it afflicts nearly one in 10 Canadians, making it one of the most prevalent diseases.

The Effects of Aspirin and Ibuprofen

Nonsteroidal anti-inflammatory drugs (NSAIDs) such as Aspirin and ibuprofen remain the most common form of treatment for osteoarthritis. These drugs reduce pain and inflammation, thus offering some relief. However, high dosages are usually needed to achieve these results, increasing risk of side effects such as heart attack, tinnitus (ringing in the ears), and stomach upset.

Another side effect is the ability of NSAIDs to actually inhibit cartilage repair. It appears that while NSAIDs are effective in suppressing symptoms, they actually inhibit cartilage formation and thus accelerate the progression of the disease. In fact, clinical studies have associated NSAID use with acceleration of osteoarthritis and increased joint destruction. This, in part, may explain why individuals with osteoarthritis who are on medications usually worsen with time.

Why Glucosamine Works

A breakthrough came decades ago when European researchers noted that as some people age they seem to lose their ability to manufacture sufficient quantities of glucosamine. Researchers found that this loss gives rise to a decrease in the water-holding capacity of the joint (its level of synovial or lubricating fluid), which then leads to a decreased ability of the cartilage to act as a shock absorber.

Eventually researchers began administering glucosamine to patients with osteoarthritis and the results were so impressive that clinical studies soon followed.

Researchers found that glucosamine stimulates the manufacture of cartilage components and promotes the incorporation of sulphur into cartilage. In other words, glucosamine not only stimulates the manufacture of natural substances that are necessary for proper joint function but also plays an important role in stimulating joint repair.

Studies Prove the Point

Numerous double-blind studies have shown glucosamine sulphate produces results comparable to NSAIDs in relieving the pain and inflammation associated with osteoarthritis. Researchers have concluded that although glucosamine sulphate exhibits little anti-inflammatory effect and no direct pain-relieving effects, it does appear to address the underlying cause of osteoarthritis.

In a double-blind placebo study involving 212 patients with osteoarthritis of the knee, 106 patients were given 1,500 mg of glucosamine sulphate daily for three years; the other group was given a placebo for the same period. Joint space measurements of the knees were done before and after the three-year period. At the end of the study, the group taking glucosamine sulphate had less joint space narrowing than the placebo group. In the study published in 2001 in the medical journalLancet, researchers concluded that glucosamine sulphate did, in fact, reduce the progression of the disease and thus should be considered as a disease-
modifying agent in osteoarthritis.

In another study that compared glucosamine sulphate with ibuprofen it was shown that although pain scores in the ibuprofen group decreased faster in the first two weeks, by the fourth week the group receiving 1,500 mg of glucosamine sulphate daily was doing significantly better than the ibuprofen group (see graph below).

This demonstrates that the beneficial results of glucosamine are more obvious the longer it is used. Treatment with glucosamine takes time because it is not a pain-relieving or anti-inflammatory drug. But once it begins to work repairing and building new cartilage, glucosamine will produce much better results than prescription and over-the-counter medications.

Common Concerns

Many people wonder whether it is best to take glucosamine in combination with chondroitin, but no strong scientific research proves that these supplements work better together.

Individuals who have allergies to shellfish often believe they cannot take glucosamine because it is derived from chitin, a substance found in the shells of shrimp, lobsters, and crabs. But the pure glucosamine sulphate distributed by regulated companies will not trigger allergic reactions.

Diabetics, however, should contact their health care provider before using glucosamine sulphate, as the supplement contains glucose.

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Solutions to Male Depression

If you’re a man with symptoms of depression or chronic fatigue, and have been offered an antidepressant, you may want to consider checking your hormone levels first. Recent evidence shows symptoms of depression and fatigue in men may be linked to declining adrenal, thyroid, and sex hormones, namely testosterone.

After about the age of 40, men increasingly experience symptoms of fatigue and depression. Irritability, weight gain, loss of confidence, and social isolation often result in a diagnosis of depression. Severe fatigue is often attributed to burnout.

For many men, vacations, counselling, and medication fail to produce sustained improvement. They may find themselves on a raft of medications aimed at controlling their symptoms, rather than addressing the root cause of hormone decline. In addition, these same men may be diagnosed with hypertension, obesity, elevated cholesterol, heart disease, elevated blood sugar, or erectile dysfunction, all of which may be managed separately.

Andropause

Andropause, or male menopause, is related to the decline in testosterone as men age, which begins after about age 25. Because of the slow onset, andropause can go unaddressed. The faster and deeper the decline in testosterone, the faster a man ages, resulting in increased heart attacks, strokes, diabetes, dementia, arthritis, osteoporosis, and cancer. Recent research shows men with low testosterone have anywhere from 57 to 88 percent increased risk of death from all causes.

Andropause, however, is only part of the bigger picture of hormonal decline. When testosterone begins to wane, thyroid, adrenal, and growth hormone output are also affected. Antiaging health practitioners often refer to this interaction as the thyroid-adrenal-gonadal axis.

The thyroid-adrenal-gonadal axis

Alteration in function of the adrenals, thyroid, and gonads can have tremendous effects on energy, mental function, mood, and metabolism. I often describe these three glands as three legs of a barstool: if even one is not in balance, the barstool will not stand, to the detriment of physical and emotional health.

The adrenal gland
In my practice, I consider the most important of the three glands to be the adrenal, since it supplies the cortisol that the other hormones require to access cells. Symptoms that suggest adrenal deficiency include poor productivity, decreased energy, anxiety, poor stress tolerance, poor memory, depression, irritability, dizziness, allergies, frequent chest colds, or bronchitis. If low adrenal output is not identified and addressed, treatment with testosterone and thyroid hormones can be marginally effective or completely ineffective.

The thyroid glandIf cortisol is inadequate, a person with a normal thyroid test, called a TSH, may have symptoms of hypothyroidism, such as dry skin, constipation, sluggishness, hoarse or weak voice, and depression. Many men will be given antidepressant medication for their symptoms because their thyroid is considered to be normal, based only on the TSH test, though testing active thyroid hormone (T3 and T4) tells us what the thyroid is actually producing. 

This oversight can have negative consequences, since sluggish thyroid function has been identified as a risk factor in heart disease, hypertension, cancer, metabolic syndrome, and diabetes. Low T3 levels have also been shown to be associated with poor outcomes in cardiac patients.

The gonadsThe gonads (testicles in men) produce testosterone in response to signals from the pituitary gland. Testosterone travels throughout the body, stimulating muscle growth and strength, improving mood and libido, and strengthening bones. Low cortisol levels from the adrenal can impair the ablity of cells to absorb testosterone, making the testosterone less effective.

Low thyroid hormone levels can impair the cell from responding to testosterone, again making it less effective. Without all three glands functioning properly, testosterone does not work, even if the blood level is within the normal range.

Pitfalls of testosterone replacement

Of course, testosterone replacement is important in maintaining optimal male hormone levels. There is now medical evidence supporting the safety of testosterone therapy, even after prostate cancer surgery. However, simply supplementing with testosterone may not result in higher tissue levels and may actually increase estrogen production.

As men age, their visceral fat produces larger amounts of an enzyme called aromatase, which converts testosterone into estrogen. This is undesirable for two reasons. First, in the body’s effort to control estrogen levels, it also binds testosterone, making it unavailable. Second, estradiol (a form of estrogen) causes a reduction in testosterone production.

Taking this hormone interplay into account, we can understand why some men have an adverse response, or no response at all, to testosterone therapy. They may experience weight gain, worsening of erectile dysfunction, or breast enlargement—all from the aromatase activity that produces high estrogen levels. Or they may experience no effect at all, which can be related to poor adrenal function.

Recent medical studies have shown that simply by blocking conversion of testosterone to estradiol, we can restore testosterone production. Natural aromatase blockers should especially be considered in overweight men with metabolic syndrome or diabetes, since treating them with testosterone may only increase their estrogen and worsen their condition.

A healthy adrenal-thyroid-gonadal axis can provide renewed energy and sense of well-being to men with symptoms of depression. Hormone augmentation should be the last step in a pyramid of changes that start with a base of proper nutrition, stress reduction, exercise, and natural health supplements. If these changes are not effective, the final point of the pyramid is testosterone replacement balanced with thyroid and adrenal hormones.

Help for hormones

Keys to improving adrenal function

• adequate sleep
• proper diet
• avoiding alcohol and caffeine
• adequate vitamin C and B-complex
• adrenal adaptogens, natural products to help manage stress: maca, licorice root, ashwagandha, astragalus, Siberian ginseng, or Rhodiola rosea
• porcine adrenal extract
• DHEA (dehydroepiandrosterone)*: an adrenal hormone and precursor to testosterone
• bioidentical cortisol*: life-changing for the severely impaired adrenals

Keys to boosting thyroid function

• adequate selenium, iodine (also protective against prostate cancer), and tyrosine
• zinc: plays a role in activation of thyroid, testosterone, and growth hormone receptors
• desiccated thyroid*

Keys to balancing gonadal function

• saw palmetto, pumpkin seed extract, chrysin, and zinc: block conversion of testosterone to estrogen
• calcium D-glucarate: improves estrogen elimination 
• bio-identical testosterone*
• pomegranate juice: can slow the growth of established prostate cancer
• prescription aromatase inhibitors

Always consult with your health practitioner before starting new medications or supplements.

* available by prescription at Canadian compounding pharmacies

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The Truth About Sports-Enhancing Supplements

Here’s the lowdown on the most popular sports supplements.

Caffeine

Claim: improves athletic endurance

Research:

• enhances performance of trained athletes when low to moderate doses (3 to 6 mg/kg) are taken in supplement form
• enhances performance when taken 15 to 30 minutes before exercise
• Benefits high-intensity exercise such as soccer and rugby

Risks:

• can cause insomnia, nervousness, irritated stomach, nausea, vomitting, increased heart rate and respiration; large doses may cause irregular heartbeats and even death

DON’T take caffeine with ephedrine.

Creatine

Claim: improves exercise performance and builds muscle mass

Research:

• builds lean body mass
• improves athletic performance during brief, high intensity activities such as sprinting
• works best for young, healthy athletes
• does not improve strength or body composition in people over 60

Risks:

• safe at recommended doses
• can cause stomach pain, nausea, diarrhea, weight gain, and muscle cramps
• draws water to muscles from other parts of the body; drink extra water to stay hydrated

DON’T take creatine with caffeine and/or ephedrine; this may cause serious side effects such as stroke.

DON’T take creatine with nephrotoxic drugs that can cause kidney damage.

Protein

Claim: supports muscle growth, mass, and strength

Research:

• dairy and whey sources of protein appear to be most effective
• enhances muscle size (hypertrophy) when ingested shortly after exercise

Risks:

• safe for most adults when taken appropriately
• high doses may cause thirst, bloating, cramps, nausea, and increased bowel movements

DON’T take if you are pregnant, breastfeeding, or have milk allergies.

Ephedrine (ephedra)

• DON’T USE
• Health Canada has issued several notices warning consumers not to use products containing ephedrine (ephedra), either alone or in combination with caffeine and other stimulants, for purposes of weight loss, body building, or increased energy.
• Ephedrine (ephedra) may be listed on products by names such as “Ma Huang, Chinese Ephedra, Ma Huang extract, Ephedra, Ephedra Sinica, Ephedra extract, Ephedra herb powder, Sida Cordifolia or epitonin, all of which indicate a source of ephedrine.”
• Use of products containing Ephedra or ephedrine in combination with caffeine and other stimulants may have serious, possibly fatal, adverse effects. Health Canada advises consumers that these products are not authorized for use.Before taking any fitness supplements, consult your health care practitioner.

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Stress-Busting Exercises - Stop, breathe, & stretch

Stress, for many people, is something to dread. For others, it is the means to their existence. While stress is a natural occurrence, and our response to it has helped us evolve and survive through the centuries, too much stress on a regular basis can be detrimental to our health.

Over 30,000 years ago the Cro-Magnon man needed his body’s response to stress to be swift, especially when hunting for, or being hunted by, large predators. Our Cro-Magnon guy needed this mechanism of his autonomic nervous system (what is termed the fight-or-flight response) to allow for important adjustments in the face of danger—in his case, to eat or to be eaten.

Caught in the cycle

Unfortunately, in today’s high-stress culture, the stress response is activated so often that the body doesn’t always have a chance to return to normal—resulting in a state of chronic stress. It is this perpetual stress that can make us susceptible to disease and illness.

The effects of long-term stress are numerous. They include exhaustion, muscle breakdown, an altered immune system, a lowered thyroid function, cardiovascular stress, and alterations in blood sugar levels.

Stress causes elevated levels of the hormone cortisol, which leaves us craving high-calorie, high-fat and high-sugar carbohydrates. This in turn causes weight gain, which then usually creates more stress. A very nasty cycle.

Controlling chronic stress

Can we completely avoid stress in our lives? Absolutely not! In fact, I am fairly certain that even the Dalai Lama gets stressed once in a while. What we can manage are our reactions to daily chronic stressors. We can also identify whether we are encountering real stress or just plain old simulated stress, compliments of our busy lifestyles and the urgent-seeming nature of many aspects of modern life.

Next time you feel yourself getting a little worked up, try these three exercises designed to bring the mind back to the moment and help you go from stress-junkie to Zen-master-in-training.

Deep belly breathing This exercise can be performed anywhere and in any position—seated, standing, in the car, or in bed. Breathing deeply not only gets your mind focused on something that you can control (and off what you can’t), it also provides extra oxygen to the blood and causes the body to release endorphins—brain chemicals that re-energize and assist the body in relaxation.

Place your hands on your belly and, if you are able to, close your eyes. Using your nose, take a deep inhalation for five seconds, filling all the way into the lower lobes of the lungs. You should feel your rib cage expand underneath your fingertips. Hold the breath for one to two seconds, then slowly exhale through a slightly opened mouth, this time feeling the rib cage deflate under the fingertips. Continue breathing like this for two to five minutes.

Neck stretch Most people hold their stress in their neck. Try the following two static stretches to help bring the shoulders down and relax and loosen the tight muscles running along the sides and the back of the neck. Both the neck stretch and side neck stretch should be performed two to three times.
Stand or sit up straight with the pelvis rolled under—do not arch your back. Slowly drop your chin into your chest and hold. You should feel a stretch running down the back of the neck all the way down the spine. Hold for a few breaths and then bring the head and posture back to a neutral position.

Side neck stretch

1. Stand or sit up straight with the shoulders relaxed.	2. Drop your left ear to your left shoulder, keeping the chin centre.

3. Turn your chin in toward the left armpit and slide your left hand on top of the head. 4. Apply slight pressure on the head, drawing the chin closer toward the left shoulder. 5. Hold for a few breaths and complete the same steps for the right.

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