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Work. Move. Play. Feel Better.
- Ronald Pierce
- 6 days ago
- 9 min read
Your Health is Your Gameplan, Sometimes You Just Need Help
Earlier this month I had the pleasure of being invited to speak at a local business to support their Health and Wellbeing Initiative. This week also happened to be BackCare Awareness Week, so it just felt right! Founded in 1968 by businessman Stanley Grundy, BackCare, formerly the National Back Pain Association, has spent over fifty years promoting spinal health and supporting people living with back pain BackCare, n.d., check them out for a multitude of different resources.
As described in my introduction blog, one purpose was I set out to help as many people as possible. Sure for this talk I was in Bede's workplace, but I didn’t want to stand up there and lecture them about posture, ergonomics and perfect ‘alignment’. Not only because they have workplace assessments regularly to do that for them already, but also because frankly… It's mostly bullshit. I know that statement is going to catch some flak, but.. hey, it did the job then. However, I stand by it but I will take a half step back to allow room for nuance if needed. That said, by and large most current evidence and best practices have shifted toward interventions that get people moving and taking breaks from their desk. This is a large contrast from ergonomics and posture assessments that seem to have dominated the previous few decades and still remain stubbornly stuck in the minds of the average office worker. It isn’t their fault really, some physiotherapists continue to argue among themselves about this very topic; even more frustratingly, my fellow chiropractors can’t seem to let it go in even greater numbers.
When you have experts that can’t seem to agree or get on the same page when it comes to current best evidence misinforming their clients, the average office worker never stood a chance.
I set out to begin setting the record straight, but more importantly, empower employees to feel like they aren’t doomed. They aren’t broken. They simply, likely, do not move enough. I set out to do that without shame and without antagonizing anyone.
Let's start with the evidence. First of all, I find it incredibly ironic that Chiropractors especially can’t let go of the posture / pain relationship when it is such a simple, reductionist and mechanistic explanation. My experience in the field tells me most are not fans of mechanistic explanations… but that is a topic for another day.
For now, call it what you want, modern pain science, the biopsychosocial model, common sense but it’s not up for debate anymore. Every major guideline says the same thing: pain is complex, it is multifactorial, people aren’t machines, every person’s experience can vary, and posture alone isn’t the problem. Human bodies can adapt and overcome and break down in such a myriad of ways, there is a reason there are multiple professions attempting to understand and manage the processes. Every major health and governing body, from NICE to the WHO, The Lancet Commission, to The General Chiropractic Council recognize the biopsychosocial model as crucial to our understanding and treatment of pain..
Now that we have that firmly established, let's get into it:
A 2019 umbrella review of systematic reviews, a review for all reviews if you will (Swain et al., Journal of Biomechanics, PMID 31451200) analysed dozens of posture and / or exposure related studies and concluded that there is “no consensus that spinal posture or physical exposure causes low back pain.” A rare moment where the title pretty much succinctly summarizes the findings. To simplify that further; the study found we can’t point to a single spinal position or movement that reliably predicts pain, even if there is a small correlation.
The 2018 Lancet Low Back Pain Series (Hartvigsen et al.) called for abandoning overtly, or exclusively, mechanical explanations of pain. The series embraced multifactorial explanations of pain. Sleep, load, stress, systemic issues.. All play a role in turning the “dial” up or down on the pain we experience.
If we try to isolate ergonomics, similar challenges or pitfalls emerge. “Hoe et al., 2018 (Scandinavian Journal of Work, Environment & Health) found that workplace exercise programmes outperformed ergonomic positional changes for preventing neck and shoulder pain. Driessen et al., 2021 (Applied Ergonomics) showed that ergonomic changes may improve comfort and reduce discomfort when pain or injury was present but had little to no impact on injury rates over a longer time frame.
For balance, Roffey et al., 2010 (Occupational & Environmental Medicine) noted that heavy or repetitive flexion tasks, such as manual lifting or nursing, can modestly increase risk of low back pain, but only in high-load contexts, not typical office work. Guess what… that doesn’t account for common lifestyle issues that may compound the movements involved in these professions. The authors also acknowledged something that was a weakness within many of the articles used for this meta analysis; anytime mechanical load is added into the equation, recovery is a factor that in and of itself is also multifactorial. Sleep, food, diet, and substance use (rx or otherwise) will all be just a few of the factors that will have a day to day impact on recovery.
So what does this mean? Why does it matter? If ergonomics and posture can’t prevent pain or injury, what does?
Movement. It is most often that simple.
Now before anyone kicks off, this piece is focused on general workplace health and wellness. Things get a lot more complicated and a lot more granular in the nitty gritty world of exercise science. I will save that for others who know more than me, and more expertise in the field.
Movement is most often the answer for people who aren’t elite level, professional athletes… It just gets a lot more complicated of an equation when it comes to “balancing” work load with recovery.
In 2023 the UK’s Health Survey for England found that only approximately 61% of adults meet the minimum activity guidelines, and just 1/4th complete the additional recommended 2 days per week of strength training. While desk based workers tend to sit over 9 hours per day on average .
In the United States, it isn’t better. Adults 65 or older, only 13.9% of individuals meet activity guidelines. While only 24.2% of adults 19-64 meet the combined aerobic and strength training guidelines. While less than 50% meet either guideline independently .
Meeting those minimal activity levels shouldn’t be just a box ticking exercise, though because research also shows that approach isn’t sustainable. Not for the average person, at least. We need to help people find ways to exercise or meet those activity goals without feeling like a chore. As I grow in this profession, this goal, lowering the barrier of entry, whether it be physical, mental or preference… it is becoming a mission.
Why?
In a grossly oversimplified, but important answer, people who meet or exceed the minimum physical-activity guidelines trend massively toward experiencing less musculoskeletal pain, better work ability, and improved quality of life compared with those who remain inactive . This is not to shame those who are under active. I can attest personally to when shit happens… sometimes the lack of activity sneaks up on you even when you are trying your damndest to find balance in your life. It can be a battle and overwhelming, especially when you know all the ‘little things’ that you are supposed to do to be healthy but all you really need is to find some consistency on just one or two things to get started.
As an example more studies found that office-based and sedentary workers who stay active report fewer shoulder, back, and neck complaints, and even when activity-related soreness or minor strains occur, overall injury rates and chronic-pain risk remain lower than in those who rarely move.
It doesn’t take much to read between the lines here, it all will relate back to the biopsychosocial model where you can see the connection between physical wellbeing and mental wellbeing. They clearly influence each other, at a minimum.
My philosophy has evolved over the years into one main idea:
Younger me would’ve told you everyone needs to lift weights or play a sport. Older me knows that’s not realistic, or entirely necessary. What matters is finding that meaningful movement that fits your life and your preferences. Equally… There is no denying the positive impact movement has.
Ok, so have you been convinced yet? Convinced to find that activity that gets you moving more, that you enjoy? Maybe enjoy it enough to take up physical exercise that you don’t enjoy as much, or at all…but you are willing to do it because of how it helps you enjoy your hobbies even more!? Great… Oh.. but what ARE the recommendations?
At least 150 min of MODERATE intensity per week…
- 50-70% your max Heart Rate
- Talk Test (talk but not sing)
- RPE 5-6/10 (Rating of Perceived Exertion)
- 3.0 to 5.9 METs - AKA 3-6 x the metabolic energy your body burns just at rest. I even had to look that up to remind myself what a MET was.
OR
At least 75 min of VIGOROUS intensity per week…
- Vigorous intensity = ≥ 6.0 METs
- Can’t Talk Much (Talk Test)
- 70–85% of max heart rate
- 7-9 on the RPE simplified Scale
So I can only imagine how many of you can feel your eyes starting to roll back into your head. Or nearly clicked away instead of continuing to read. I think this is where a lot of young trainers, GPs, Physios, coaches and Chiros can go wrong; we’ve ‘educated’ you by regurgitating this information and defining terms for you, but unless you are already a sportsman or a truly avid gym goer, you have no frame of reference for what that actually means.
Let’s reframe that for you:
Moderate activity is when your breathing and heart rate are up, but you can still talk. You are warm, eventually you begin to sweat. You can tell you are working but you can keep going.
Vigorous activity is when you’re sweating, pushing, and can barely get out a sentence. Depending on your fitness level and experience, you won’t be able to sustain this effort for more than a couple minutes at a time. You likely begin to sweat immediately.
Examples? Brisk walks, skating, gardening, climbing, or DIY projects can all count. Even PokémonGo walks, hiking, and pilates qualify. If you’re moving and it’s challenging you. The preceding are all moderate activity for the most part. Things like dance, swimming, interval training, various grappling or MMA sports will very likely hit vigorous intensity with drops to moderate. That is great! Progress is important as I often see people begin a new, light exercise activity which starts off moderate, but as your body adapts, it may drop out of that zone as well. So strength training is a fantastic option. But as I said above, if that is not your preference you will need to progress in other ways.
Some activity is better than none, and remember, it is at least 150 or 75 min respectively. As some of the sources above hinted, benefits can be made when we surpass those minimums. If you are doing a new hobby you wish to perform better at, use those complimentary activities to go above the minimum.
On the other hand, now is also a good time to be cautious for a moment. One common mistake I see, and I’ve made it myself, is doing too much, too soon, after doing too little for too long.
I often dislike cliche phrases to summarize a complex point, but it is important to note that new exercise and activity routines… often come with soreness and slight injury risk. Most often it is simply the aches and pains of your body adapting to new demands. Most often the fix isn’t to stop completely. In fact that is often worse. It’s to modify load, pace, or recovery. Sometimes it is better to be the tortoise than the hare for the sake of your sustainability.
That is my goal here. That was the goal of my presentation I had the pleasure of giving at Bede. To lower the intimidation factor, the stress of picking up a new activity. To assure people it is not a huge hurdle to cross. It’s just about enjoyment, sustainability and building from there.
Positive health changes don’t happen from one-off talks like this - they happen when barriers are lowered, confidence is built, and people have support . It’s not about the ergonomic posters - it’s about reinforcing and building a culture where moving, asking questions, and looking after yourself becomes normal while acknowledging that this is a harder process to start for some than others. It is about cultivating a workplace culture that supports activity.
Bede is doing that better than some, demonstrated by this past week's invitation and the greater health and wellness support initiative enacted by Bede.
I want to take a moment here to thank them for asking me back for a third time and allowing me to bring to them a fresh perspective and new content. I look forward to any future endeavors and collaborations.
Please do not hesitate to reach out through my website here with any questions or concerns!
Cheers!
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For any inquiries, please contact:
Ron Pierce
Email: Ron@GameplanChiropractic.com
P.S. I wrote this blog complete with footnote citations in Google Docs.. however that formatting broke when adding to Wix.. So if you insist on checking my sources, fairplay, check out the original writing here: https://docs.google.com/document/d/1ZQ6IeaAxmVLh1NjcaOPMpOALH9jt1m9FKzhlQ8PLsjg/edit?usp=sharing
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