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UnityPoint Clinic Urgent Care - Sunnybrook

5885 Sunnybrook Drive
Sioux City, IA 51106

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Cross Out Lower Back Pain or Sciatica, Hip and Knee Pain

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How many of you spend most of your day crossing your legs, sitting on your feet or sitting with one leg crossed? Men, do you stand with one or both of your feet toed out when standing? A very common standing posture for men is to stand with both feet pointed to the outside. As we become overweight, this toe out posture habit becomes even more common in both men and women. Ladies also tend to stand in what I call the “sexy pose,” with one foot pointed forward and the other foot pointed ninety degrees to the side with a hip shift. 

Over time, these are some of the most common awkward sitting and standing posture habits that may lead to increased musculoskeletal disorders (MSDs) stiffness and pain risks for the lower back, sciatica, hip, or knee. 

Why is this and how does this occur? What can I do daily at work and at home to reduce my MSD risks of having lower back, sciatica, hip, or knee pain? This month’s article is all about becoming more aware of the primary postures we use daily and how to reduce the risks of pain and injury while improving your quality of life.

The more time you spend sitting with your legs crossed, sitting on your feet, or standing with your toes pointed out, the more you tighten your hips’ powerful external rotator muscles, such as your piriformis.

This piriformis muscle becomes shortened or tighter the longer you sit with your legs crossed, spread apart or stand in toe out postures. These awkward postures externally rotate the hip and compress the large sciatic nerve that runs directly beneath this piriformis muscle. Nerves don’t like compression forces but they love freedom and flowing movement of the body and a good blood flow to stay healthy and avoid irritation. As this sciatic nerve gets compressed by your tight piriformis muscle may lead to numbness and tingling down the back of your leg. This significantly increases the biomechanical risks for lower back pain, sciatica, hip, and knee pain or MSD injuries such as a sprain or strain overtime. 

The tighter your piriformis muscle and hip external rotators become, the more your hips may lack proper hip internal rotation with everyday movements. This lack of proper hip internal rotation is one of the most common biomechanical problems leading to increased risks of lower back muscle strains and ligament or joint sprains, lower back pain, hip, knee, and shoulder sprain or strains. This hip internal rotation is needed every time we go from sitting to standing, squat down to pick something up, lunge in any direction or go up and down stairs throughout the workday. When we lack this proper loading of the hip with hip internal rotation, our lower back, knees, hips, and even our shoulders take the added biomechanical stress. As we age, this is one of the leading risk factors for why total joint replacements of the knees and hips are so very common.

How can we reduce our risks of sciatica or lower back, hip, knee, and shoulder pain or stiffness as we age?

When sitting, it is best to keep both of your feet flat on the floor or on a footrest if needed and to keep both of your hips slightly spread apart, ideally with your hips being slightly higher than your knees. You may extend one leg or the other, shift your body weight from left to right side, and even occasionally cross your legs for a short period of time. Try to limit your time spent daily crossing your legs, sitting on your feet, or sitting with both legs spread wide apart to slow the aging process and greatly reduce the daily wear and tear to your joints. 

Perform the “Sitting Piriformis Dynamic Stretch” one to three times per day with a three to five second hold for one to two repetitions. This WorkSmart stretch will reverse and help counteract these awkward sitting and standing posture habits, reducing sciatic nerve compression and greatly reducing the risks for pain and stiffness.

This stretch is performed by sitting up tall and crossing your right leg over your left knee, to stretch the right side. Turn your body to the right and gently pull your right knee up towards your left shoulder (opposite side) and hold for three to five seconds, and repeat one to two times. Then repeat other side. You will want to perform this WorkSmart dynamic stretch more often daily to the side that you find to be tighter while performing this stretch. 

When you are sitting, try to sit with both feet flat on the floor or on a footrest, sitting up tall with your back against the back support of your chair, with knees slightly apart. When standing, try to spend more time in a staggered stance posture with one foot in front of the other, feet slightly wider than shoulder width and with your feet slightly toed out which improves your balance and reduces risk of injury.

Here’s to slowing the aging process of your body and the improved daily energy and vitality of your lower back, hips, knees, and shoulders.