Sitting Posture: Upright or Lay Back?

"Sit up and work hard!"

"Lay back and have a brew~"

A lot of times, sitting upright in office might give people an impression that you are highly focused at work and if you have google "work hard" you will definitely know how people sit when they are working hard.

A sitting upright posture... looks smart!

A focused businessman inclining forward
 with a strong arm supporting his head.

On the contrary, lying your back comfortably on the back of chair have not been successful to show people that you are productive and working hard enough... for example:

Sleeping...

Tired businessman...
description taken from the original website.

However, this perceived good sitting posture over centuries has proven to be wrong. A team of researchers, leaded by Dr. Waseem Amir Bashir, presented their research at an annual meeting (2006) of Radiological Society of North America (RSNA) and suggested that sitting at an angle of 135 degree would be the best to protect the spine.

"A 135-degree body-thigh sitting posture was demonstrated to be the best biomechanical siting position, as opposed to a 90-degree posture, which most people consider normal" Dr. Bashir

A diagram showing sitting at 90 degree
would reduce the natural lordosis at lumbar spine.

 The research was conducted at a hospital in Scotland, and it recruited 22 healthy participants to examine their vertebral disc movements under three most common sitting postures: slouching forward, sitting at 90 degree and reclining backward at 135 degree. It aimed to find out which sitting position would give the least strain to our spine. It concluded that sitting at 135 degree was the best comparing to the other two sitting postures. The result showed that a 135-degree-posture gave the least strain to the lumbar spine while the other two put more stress on the vertebral discs leading to misalignment with the vertebral spine and reduction of disc height.

Okay so... as the evidence suggested, do both: sit comfortably and work well! Charging yourself into a battle mode with an upright sitting posture might be good for your psychological mind but poor for the spine!

Yes I am focusing!

Reference:

• http://www2.rsna.org/timssnet/media/pressreleases/pr_target.cfm?ID=294

Risk of Impotence (Cycling)

However, Walton, cycling may increase the risk of having impotence (無能/陽萎)!

http://hk.news.yahoo.com/%E9%95%B7%E6%9C%9F%E8%B8%8F%E5%96%AE%E8%BB%8A%E6%9C%89%E9%99%BD%E7%97%BF%E9%A2%A8%E9%9A%AA-223000836.html

But... only happen when you cycle everyday consecutively and last for at least 5 years.... I think of one of the tutors in Keele.....

Exercise recommendation in Hong Kong

In 2001, the Hong Kong government has organised a campaign called "Healthy Exercise For All". The exercise recommendation for the adults is:

minimum of 30 minutes moderate-intensity aerobic exercise, 3 days per week (preferably 5 days). (90-150 minutes per week)
(http://www.lcsd.gov.hk/healthy/physical_fitness/b5/index.php)

Comparing it with 3 other countries: Australia, UK and US

1) Australia (http://www.health.gov.au/internet/main/publishing.nsf/content/health-pubhlth-strateg-phys-act-guidelines#guidelines_adults)

• minimum of 30 minutes moderate-intensity physical activity on most, preferably all, days" (210 minutes per week)

2) UK (http://www.nhs.uk/Livewell/fitness/Pages/physical-activity-guidelines-for-adults.aspx)

• minimum of 2 hours and 30 minutes moderate-intensity physical activity per week. (150 minutes per week)
• "also undertake physical activity to improve muscle strength on at least two days a week"

3) US (http://www.health.gov/paguidelines/pdf/adultguide.pdf)

• minimum of 2 hours and 30 minutes moderate-intensity physical activity per week. (150 minutes per week)
• "also undertake physical activity to improve muscle strength on at least two days a week"

Although it has mentioned "preferably 5 days per week" in the HK exercise recommendation, minimum of 3 days per week is suggested, which the amount of exercise is less than the minimum requirement for Australia, UK and US. Moreover, there is an additional guideline for the UK and US public to also strengthen the muscles rather than just cardiovascular fitness only.

Spinal Cord And Nerve Root Compression

Here's a website comparing the difference between myelopathy and radiculopathy!

http://www.dynamicchiropractic.com/mpacms/dc/article.php?id=44569

It clearly points out how a patient will present differently with either spinal cord or nerve root compression. Have a look, it is very useful to understand the clinical features of spinal conditions =D

Forward Head Posture

FHP is the result of misalignment of your upper back, shoulders and head.  

          (L) Poor Posture                              (R) Proper posture 

I find my posture always looks weird, especially for my neck. Perhaps it's due to my awkward posture. during activities. I develop this when I'm concentrating such as using computer and phone, reading, reading, watching tv, etc. I did not know I was in that poor posture. My head leans forward gradually and silently once I am focusing on things. This gives me neck sore and stiff which is not a good stuff. Anyway, I found this useful link in Youtube talking about the correction exercise for the Forward Head Posture. I am going to try these exercise and hope to get a better posture and relief the stiffness. Here you go.

Pictures reference: http://activespines.com/clients/7950/images/back_pain_solution_forward_head_posture.jpg

http://www.euclidchiropracticinc.com/wp-content/uploads/2012/01/postural-distortions-and-posture1-300x291.jpg

Uncovertebral Joint Degeneration

Vertebrae are very fundamental to our body, they allow movement as well as to offer protection to our nerves, blood vessel and other internal body structures. Thus any defects at the vertebrae can lead to various levels of disabilities. In this post, one of the spinal condition - Uncovertebral Joint Degenration will be discussed.

Lets start discussing about it by learning from the term~

Uncovertebral Joint

Cervical Spine

First, we know that this condition involves uncovertebral joint! (as the name tells) You can only find uncovertebral joint in cervical spine (more specifically is from C3 - C7). Here's a diagram on the right showing the structure of cervical vertebrae. You can see that the upper border of the vertebral body forms a line of smile, where both sides slope upwards instead of staying flat all the way. This is a specific feature of cervical vertebrae - existance of uncovertebral joint. It cannot be found in other levels of spine i.e. thoracic/ lumbar/ sacral.

Degeneration
- There are different causes leading to this condition, below I will be using disc degeneration as an example (disc degen => joint degen)

So, here we come to the second part of the name - degeneration, what does it tell us about the condition?

Smile like the upper border of C vertebral body!

In between two vertebral bodies of the vertebrae, there is a disc which act as a shock absorber as well as to facilitate spinal movement. There are three basic structures composite the disc: the nucleus pulposus, the annulus fibrosus and the vertebral end-plates.

Using a car tire as an analogy: nucleus pulposus is like the air trapped inside the tire while annulus fibrosus is the circular wall of the tire. Normally the air pressure within the tire is sufficient enough to be fully inflated in a good shape. A degenerative disc happens when there is air leak out of the tire. The drop of pressure deflates the tire and it becomes flatten under pressure. Same thing happens in our spine: water leaks out through annulus fibrosus in a degenerated disc. The disc is then unable to withstand pressure and its height reduces under weight. When this happens, the uncovertebral joint space is narrowed, increasing pressure against it in spinal movements. Osteophytes (often called bone spurs) then formed around the affected area in order to increase stability of spine.

What is worrying?
It is believed that the cells within the nucleus pulposus requires oxygen and nutrients to work efficiently to produce fluid within the disc. Without the nutrients, pressure within the disc drops due to reduced production of fluid. The above disc degeneration will then occur. It is inevitable with increasing age...The best way to prevent it to happen in an early stage of life is to exercise the spine regularly. It can facilitate the exchange of fluid within the disc, so nutrients can be transported into the disc and wastes can be removed from the disc constantly. Therefore, the disc is kept healthy and fresh as much as it can =]

Reference:
http://neckandback.com/conditions/cervical-degenerative-disc-disease

Dook Fishball (1) - Jammed Finger

Jeremy Lin

This post will be discussing a common hand injury happened in basketball games - Dook Fishball. It often happens when u miscatch a fast-coming ball, or while an agressive player trying to steal a ball but accidentally poke onto the ball (._____.)... Although we often refer this to "dook fishball", however two conditions might actually occur when we look into the anatomy of our fingers. Depending on the site of injury, the two conditions are mallet finger and jammed finger. So what is the difference? What structures are involved?




Jammed finger


Where?
Jammed finger is more commonly seen then mallet finger. It can be considered as a sprain of PIP joint. It is poorly defined; you can also find out that some of the websites actually say jammed finger can occur at both DIP and PIP joint.

How?

When there is an unexpected force applying to the tip of the finger. Several structures are responsible to hold the finger joints such as ligaments and joint capsule. High impact force coming from a fast moving basketball can compress the joint or rupture the ligament, causing the swelling and bruising. More severe cases can happen when the finger is forced into hyper-extension, which either PIP or DIP allow only limited extension. As a result, the extensor tendon (or referred as central slip) ruptures. 'Boutonnière deformity' is often referred as the case when this happens. (Click this link to learn more about BD: http://orthoinfo.aaos.org/topic.cfm?topic=A00004&return_link=0) Bone avulsion can also happen (a small part of bone is teared away by the pulling force of a stretched tendon in this case).

What to do?

Buddy Taping

Ice (20 mins per session) and rest should be the first priority right after the injury. Elevation of the finger can increase venous blood flow to your heart to remove the waste produced locally. You can do this by putting your hand on a high table while sleeping or sitting, just remember to keep it above the level of your heart. Taping can help stabilising the injured joint and reducing local swelling. If you want to stabilise the injured joint in a greater amount, buddy taping would help (see diagram).

After the swelling and pain has gone down, remember to do some mobilising exercises! 

The above would be appropriate and helpful in general. If you suspect that your case is more serious, for example you experience a sharp unbearable pain while moving the finger or you cannot move your finger in an unexpectedly large extent, do not hesitate to consult a related medical profession for diagnosis!

Mallet finger will be covered in the coming post =]