Should I have a stand-up workstation? I get this question ALL the time. My answer… it depends. Side note: My first-year students at Creighton really dislike that answer, but it is soooo true. Humans are pretty darn complicated. The students eventually get it and use the same phrase when explaining how occupational therapy works to their clients, families, and their own students.
What does it depend on? Your alignment, my friend. And, your understanding of what your body needs related to movement. So, it depends on your knowledge of ideal body alignment combined with the body’s need for movement. This blog is NOT about treadmill workstations. Although there is some research that says they may be good for you, most of us either can’t afford them, or our cubicle is way too small.
Why do you need proper alignment? If you take a body that is not in proper alignment, then move it from sitting to standing, you add a host of additional forces on that body. Imagine toes that point outward and ankles that turn inward? Then the knees almost face one another and are slightly bent or hyperextended. Maybe one of each! Of course, we must add the butt tuck. Think this alignment is uncommon? Nope. I see it quite regularly in my practice and places like the grocery store. Yes. I’m looking. I can’t help it.
When a body is out of alignment and then asked to perform daily tasks such as standing at a desk for hours at a time or walking the dog, we experience forces our bodies were not designed to handle on a regular basis. Now is when your fascia steps in and saves the day, sort of. When your fascial system detects trouble, such as repeated forces on a misaligned joint, it will tighten up to protect the joint. Thank you, fascial system, for helping me function even though I’m out of alignment! Yeah! But, there is a cost. Your fascia is connected from head to toe and fingertips to fingertips. When it is tight in one area, it affects the entire system. You may not even feel anything unusual in your misaligned ankle, but you have a tugging sensation in your lower rib cage. This is how fascia works. It really is all connected.
This person may seek treatment for pain in the rib cage. Traditional therapy and logical thinking based on our current textbooks would lead you to treat the rib cage. First, we must make sure they have seen the appropriate health professional to rule out any medical causes such as a tumor, of course. With so much research coming out on the fascial system, we must look beyond the rib cage. We can start at the ribs and probably make them feel a lot better very quickly. But, they’ll be back. Why? We haven’t addressed alignment and the tightness around the misaligned ankle. So, no one gets out of my office without a clear understanding of where they can improve their alignment and how.
So, back to the stand-up workstation. If you are going to sit or stand at your workstation for many hours per day, you must understand and practice proper alignment. But, a huge but, you can’t stay static in that perfect alignment all day long. You must consider your best alignment posture your home base. Hang out there. Learn to feel comfortable there but vary from it regularly. The more comfortable you are in proper alignment, the safer you will be in other positions. I suggest exploring as many different positions as possible that you can get away with at your workplace. If you have a door that closes and people don’t come to visit you often, that can be a lot of positions. But, if you greet the public all day long in a professional work environment, you are likely to be pretty limited if you want to keep your job.
Even if you are limited, there are some easy things to do to keep moving but first let’s discuss ideal body alignment in a stand-up workstation. Your feet should be pointing straight ahead. Reach down and find the long bones in your feet. Point the middle ones straight ahead. Now place them directly under your hip bones. Feel the bones. Most people overestimate the width of their hips. If you feel pigeon-toed in this position, you have work to do.
While we’re working with the feet, let’s discuss shoes. Choose the lowest heeled shoes possible. This applies to men and women. A heel, any heel, will tip you forward. You will compensate all the way up the chain of joints in your body. The compensation may be small, but we are talking about a lot of time. Small misalignments over long periods of time can cause problems. Let’s skip up to the knees. If we get them in proper alignment, we’ll likely pull the ankles right along. Make sure your knees are pointed in the same direction as your feet, straight ahead. For some people, this takes a lot of effort and coordinating muscles they haven’t used in a long time. You must use the muscles in your thighs and hips to pull them into alignment.
Next, check your hips and your pelvic tilt. Finding the correct angle can be challenging to do yourself if you have been out of alignment for a long time. Most people tuck their tailbone. Reach around and feel your low back. You should feel a gentle curve in your spine. Your tailbone should angle away from you, not under you. Before we move up any further, shift your weight to your heels. Stack your knees and hips over your heels. Avoid putting too much pressure in the front of your foot for too long. The large bone in the heel can bear this pressure. The smaller bones in the front cannot.
Now that your weight is in the heels stack your shoulders on top of your hips, knees, and ankles. Pull your head back, too. Your ears should be over your shoulders. Be careful that you are not just tilting your ribcage back. Keep your ribs still and bring your head back. Next, reach and feel the base of your skull. Tip your chin until your eyes are level with this point. If you are straining about now, think like you must look weird or feel like you might lose your balance backward, you have more work to do. 
Finally, the shoulders and arms. In sitting or standing, they tend to be the source of quite a bit of trouble. To get them in best alignment I’m going to walk you through a few movements. First, be sure the rest of your body is in best alignment from your feet to your head. Gently squeeze your shoulder blades together and keep them as far down away from your ears as you can. Turn your palms up, bend your elbows to about 90 degrees. Keep your elbows at your side and rotate your shoulders, so your hands are out to the sides. You are now externally rotating your shoulders. Feel that position in your shoulder joints. See if you can maintain as much of that feeling as possible and while keeping your elbows close to your side, slowly move your hands as if you are going to type on a keyboard. That my friends is proper arm alignment. As you slowly release the effort of holding your shoulder in that perfect position, notice where your shoulders gravitate. If they round forward, you have more work to do. If you found this confusing, you can watch my short video on the shoulder alignment stretch.
As we said earlier, this alignment is your home base. Vary from it regularly. Step away from your desk and sneak in a brisk walk with a lot of arm swing as often as you can even if it is just to the water cooler and back. Stretch your arms above your head and rotate your wrists. If you can paint the bubble without attracting too much attention, paint it as often as you can. If you are not sure what that means, see my short video. Painting the bubble is easy to do if you are reading from your monitor. It feels amazing.
Have something under your desk to step one foot on occasionally. Use a yoga block, an old book or binder or a fancy ergonomic footrest. I like to have something I can move around easily so I can either step on it or use it to stretch my calves. I have another video on calf stretching that is great to do while at your standing workstation or any other time of day. Stretching your calves qualifies as movement at your workstation. Do it! Shift your weight, slouch a little, cross your ankles. It is all good as long as you’ve worked on proper alignment enough that it comes naturally to you and feels as comfortable as any other position you can contort your body into. If you can achieve and hold proper alignment easily, get going on that stand-up desk. They are awesome. If you can’t figure out or easily hold proper alignment, get some help. Your investment in proper alignment will serve you well beyond your stand-up workstation time.
Mayer Wellness, LLC Introduction to Alignment Workshop Series
