Help Employees Snap Back from Forced Sedentary Time

This article features Chris Studebaker, DPT, OCS, PT, the national director of onsite therapy and athletic trainers for Concentra.

Employees may choose to engage in physical activity at work and at home. But what if they can’t? An extended period of forced sedentary time can result from something as unprecedented as the COVID-19 shelter-in-place orders or a more usual circumstance like major surgery. Employers can pave the way for employees to return to prior levels of activity by understanding the compelling reasons for movement and exercise and by promoting an exercise plan to restore physical activity safely, in gradual steps.

Coping with involuntary inactivity and isolation

One way humans differ from lower-order animals is in the need to be busy, said Raj Raghunathan, PhD, of the University of Texas McCombs School of Business. Citing peer research, he said, “Most humans would find a life (of doing nothing) utterly miserable. It appears humans have a desire to be busy.” But there’s a catch. “We need a reason for being busy,” he said.¹

It’s not a large jump from these natural tendencies to the response University of Tennessee researchers saw soon after the coronavirus emergency virtually shut people in their homes, secluded from their normal activity. The first 7,300 responses to a survey the researchers conducted showed people were responding to the COVID-19 emergency by “eating more than before, becoming more sedentary, and feeling increasingly stressed and lonely.”²

Employee responses to involuntary inactivity and isolation are complex in how they play out for each person, both in physical and mental health. To further complicate things, employees’ attitudes about being out of the normal work setting can change over time. At first, there is a spirit of banding together. But, eventually, “People are going to get tired of it. That increases stress. That brings mental health more into focus. Stress, by itself, is not a mental health condition,” but it is a factor employers confront, said Les Kertay, PhD, a consulting psychiatrist. Kertay served as a panelist for the WorkCompCentral.com national webinar, “The COVID-19 Effect and the Expected Impact on Workers’ Compensation” on April 24, 2020.

It all begs the question: How can employers help?

“The simplest thing is to reach out to your people in genuine concern and say, ‘How are you doing?’ That simple question is probably more important than suggesting a program of meditation or yoga,” Kertay said. “Employees feel supported when someone from the company reaches out and shows concern. That has been shown by many studies to be a great predictor of return to work and also alleviates stress.”

Physical health declines with sedentary behavior

Although people like to be busy, much activity takes place in front of a computer screen. “Research shows pre-industrial employees were 2.3 times more active than their modern counterparts,” said Chris Studebaker, DPT, OCS, PT, national director of onsite therapy and athletic trainers for Concentra. Well before COVID-19, “It was estimated that American adults will spend more than half of their waking hours engaged in seated or sedentary activities,” said Studebaker.³ Involuntary inactivity during the COVID-19 response makes this predicament even more pronounced.

“One study (Hu, Li, Colditz, et al.) reported that every two-hour increment of sitting was linked to a five percent increase in obesity and a seven percent increase in diabetes. Prolonged sitting also can contribute to more back and neck pain, particularly when posture is poor, which causes pressure on the lumbar disc to increase. For example, lumbar disc pressure is 25 percent in a supine position, or lying down, compared to 100 percent when standing, 140 percent when sitting erect, and 185 percent when sitting in a slouched posture,” Studebaker said.

Research also shows a link between prolonged sitting and thromboembolytic events, such as deep-vein thrombosis, a potentially life-threatening condition, although there are different theories on why this is the case. “A popular explanation is that sitting reduces muscle contraction in the lower extremities, which reduces blood flow back to the heart and increases the risk of thromboses forming in the veins of the leg, potentially breaking free and traveling to the lungs or brain,” said Studebaker.

Sedentary behavior also has been shown as a link to increased risk of dementia in a new meta-analysis involving more than 250,000 participants. Even after researchers controlled for a number of factors, including age, gender, and education, the meta-analysis continued to suggest that “sedentary behavior was independently associated with a significantly increased risk of dementia.”⁴

A phased exercise solution following involuntary inactivity

Some employees may have the discipline and knowledge to create their own workout programs during an extended forced sedentary period. But many others will likely look to their employer for support and guidance – support you will want to give because workforce health contributes to employee engagement, general well-being, and productivity.⁵

Employees who have been sedentary for an extended period should not immediately jump into long, intense workouts. Start small. Even non-exercise movement, such as alternately sitting and standing or fidgeting can help increase energy expenditure.⁶

If the prolonged sedentary period involves several employees, such as the COVID-19 response, employers may wish to consider some type of team-based, “welcome back” event that involves easy physical movement. Such an activity can help promote a fun atmosphere around renewed physical activity.

Whether planning for a group or encouraging an individual employee in the effort to become physically active again, experts at the American College of Cardiology recommend keeping “the three E’s” in mind.⁷

• Energy. Encourage the person to start with very easy exercise (such as light walking or bicycle riding) at the time of day when his or her energy level is highest. Have good hydration and wait an hour after eating for greater comfort.
• Environment. Don’t begin a new exercise routine in temperature extremes or bad weather. The environment should be comfortable and allow the individual to perform the chosen exercise consistently without undue hardship.
• Effort. The exercise maxim, “No pain, no gain” can wait a while. The individual should be able to easily converse with another person while exercising.

Renewed physical activity should be an easy type of exercise the individual will enjoy. Daily exercise of just five minutes, gradually building up time, is a good place to begin. Even though exercise may be very light in intensity, a few stretches to warm up and then cool down are always a good idea.

Rejuvenate your team with an on-site athletic trainer

If you want to capitalize on that team spirit that’s likely to form as large groups come back together after an extended absence – or even build a team spirit in workplaces where most employees have remained on the job – an athletic trainer is the ideal occupational health professional to invite into your workplace. An athletic trainer can help convey and reinforce these positive aspects of team identity – and the need to keep everyone healthy, safe, and productive in the workplace. Whenever an employee is injured or away from work for an extended period, a sense of identity with the team can be lost.⁸ An athletic trainer knows how to keep everyone focused on safety for a stronger team.

Contact Concentra to learn more about how an athletic trainer can help your business.

Chris Studebaker, DPT, OCS, PT is the national director of onsite therapy and athletic trainers for Concentra. He has worked more than 15 years as a physical therapist and an ergonomics consultant in heavy industry. He is board certified in orthopedics. Chris also has certifications in manual therapy (Manual Therapy Institute) and health coaching. He earned his doctor of physical therapy degree from Arcadia University and his bachelor’s degree in physical therapy from Daemen College.

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NOTES

1 “The Need to Be Busy,” by Raj Raghunathan, PhD, Psychology Today, June 14, 2011.
2 “University of Tennessee Survey finds people eating more, more sedentary during COVID-19,” Fox News, Nashville, March 31, 2020.
3 Studebaker CD, Murphy BP. Prolonged Sitting: Current Concepts on the Physiological Effects of Seated Postures at Work. Professional Safety, September 2014.
4 Yan S, Fu W, Wang C, Mao J, Liu B, Zou L, Lv C. Association between sedentary behavior and the risk of dementia: a systematic review and meta-analysis.” Translational Psychiatry. April 21, 2020; 10(1): 112.
5 Miller S. “Employers See Wellness Link to Productivity, Performance. Society for Human Resource Management, February 25, 2015.
6 Koepp GA, Moore GK, Levine JA. “Chair-based fidgeting and energy expenditure.” BMJ Open Sport & Exercise Medicine. 2016; 2(1).
7 Traynor K. Planning an Exercise Regimen for the Sedentary Patient: What a Cardiologist Needs to Know. May 16, 2016. American College of Cardiology.   
8 Robbins J. Understanding the Psychology of Injured Athletes and Returning to Play. Podiatry Today. 2012; 25(6): 78-85