Countering the Sitting Epidemic

Over millennia, the evolution of our ancestors from quadrupedal to bipedal beings gave rise to hips designed for dynamic movement. The Homo erectus, emerging about 1.9 million years ago, bore a pelvis and hip joints devised for walking, running, squatting, bending, and stretching as they foraged for food and hunted.¹

However, as agriculture arose about 10,000 years ago, people stopped walking long distances and started planting seeds and tending to crops and animals.² Archeologists note that bones lost density and the prevalence of osteoarthritis spiked.³

Another significant change occurred when humans shifted from agricultural societies to factories and urban environments. Factory work is repetitive and sedentary, while urban living promotes less varied physical movement.⁴ Today, the situation is worse.  

Evolutionary Design Meets Contemporary Living 

Whether watching television, answering texts, working at computers, or playing video games, most people living in modern societies spend 7–10 hours sitting in front of screens, according to researchers.⁵ With hips optimized for a life of varied movements, prolonged sitting poses significant challenges to the intricate biomechanics of the lower kinetic chain. 

For example, bones lose density, circulation slows, and repetitive stressors lead to joint degeneration. Prolonged sitting causes the hip flexors to tighten and hip extensors to grow weak, resulting in anterior pelvic tilts and exaggerated lumbar lordosis. Additionally, a lack of strength or flexibility in any of the 21 muscles that cross the hip joint can lead to abnormal force distribution and dysfunctional movement patterns. It’s no surprise that osteoarthritis and greater trochanteric pain syndrome are common causes of pain, muscle guarding, inflammation, and the adoption of compensatory adaptations.   

Countering a Sitting Culture 

One principle of Myoskeletal Alignment Technique (MAT) is to get clients moving. People who experience physical pain often fear moving because they believe it will worsen their condition. As we expose clients to pain-free movement, the body can safely downregulate nervous system activity and drop protective muscle guarding, enhancing session outcomes.

MAT typically takes a holistic approach to biomechanical issues. For example, correcting faulty foot mechanics might be essential for proper hip function. I’ve focused on five methods to help clients counter sitting culture and encourage bodyworkers to introduce more movement into their treatment toolbox. These techniques should not be painful. Discontinue any technique that is uncomfortable for the client. 

Hip Decompression, Part 1 (Image 1)

The client is supine with their right knee flexed and their left leg resting flat on the table. Snake your right arm around and through the popliteal space and grasp your left arm above the elbow. First, pull the client’s thigh to distract the hip, then push the thigh toward the pelvis to compact the hip. 

Repeat this movement 2–3 times. With the client’s hip distracted, ask the client to pull their hip toward the therapy table against your resistance to a count of five and relax. Distract and compact the client’s hip 2–3 times, ending with the hip distracted. 

Hip Decompression, Part 2 (Image 2)

With the client supine, ask them to pull their knees up and together with their feet flat on the table. Wrap your arms tightly around the client’s knees. Ask the client to abduct both knees as hard as possible against your resistance while you hold the knees together or rock the client’s lower body. 

Continue holding the knees and ask the client to bridge up, pause, and lower back down. Repeat this series 2–3 times.

The Jelly Roll (Image 3)

This trunk-flexion technique helps relieve compression at the lumbosacral junction. With the client supine, stand on the client’s right side and ask the client to grasp both knees tightly up to their chest. Use your left arm to brace the client’s folded arms so you can use their knees to rock them back and forth. 

As the client’s hips come away from the table, slip your right hand under the client’s pelvis. As the client rocks with the knees coming toward their forehead, use your fingers and palm to tug on the sacrum. Repeat this maneuver 3–5 times. Then, rotate the spine by taking the client’s knees to their left shoulder for 3–5 rocking motions and then to the right shoulder for the same number of rocking motions. Always work within the client’s comfort level and back off if the client reports pain, an increase in pain, or an increase in other symptoms.

Anterior Hip Capsule Stretch (Image 4)

With the client prone and their knee flexed, grasp under the client’s right knee with your right hand. Use your left hand to pin the tissue below the client’s ischial tuberosity. This hand position creates a counterforce. Step onto your left foot and lift the client’s hip into extension. Resist this movement with your left hand. 

This counterforce stretches the anterior hip capsule, creates joint play, and hydrates the iliofemoral ligaments. Repeat this stretch 3–5 times and repeat it on the opposite side. Don’t use this technique if the client has had a hip replacement.

Spindle-Stim Glutes (Image 5)

This technique creates tone when the gluteal muscles are inhibited by eliciting a mild stretch reflex and stimulating the dynamic gamma motor-neuron system of muscle spindles. With the client prone, position their leg in a “figure four.” Use extended arms and soft fists to rapidly compress the gluteal muscles. Work in all directions on the muscles at a fast pace while maintaining firm compression (not tapotement) for two minutes. Repeat this technique on the opposite side. 

Notes

1. Matt Cartmill and Fred H. Smith, The Human Lineage (Foundation of Human Biology), 2nd ed. (Hoboken, NJ: Wiley-Blackwell, 2022). 

2. Yuval Noah Harari, Sapiens: A Brief History of Humankind (New York: Harper, 2015). 

3. Alexandra Fletcher, Daniel Antoine, and JD Hill, ed., Regarding the Dead: Human Remains in the British Museum (Winston-Salem, NC: The British Museum Press, 2014). 

4. Daniel Lieberman, The Story of the Human Body: Evolution, Health, and Disease (New York: Vintage, 2014). 

5. Janna Anderson and Lee Rainie, PEW Research Center, “Stories from Experts About the Impact of Digital Life,” July 3, 2018, www.pewresearch.org/internet/2018/07/03/stories-from-experts-about-the-impact-of-digital-life.