Lockdown has meant working from home has become the norm rather than the exception. It has curbed sport and physical activity, with gyms closed and group exercise outlawed. Only the highly motivated are maintaining activity at levels close to regular. This has had negative impacts on waistlines, mental health, and on musculoskeletal health.
Even for those who are normally sedentary, the lockdown has forced a new level of inactivity. They have lost the movement associated with travelling to and from work. They forgo the physical and mental stimulation associated with interactions with colleagues. They likely work in an environment that is ergonomically inferior and that discourages regular change of position.
Not surprisingly, people in these situations are suffering a greater frequency of back and neck pain. What may be somewhat surprising is that peripheral joints are suffering as well. These are the cases I am seeing more frequently during lockdown.
Back and neck pain
The increased time spent sitting means that posturally vulnerable tissues are under strain for greater proportions of the day. This not only leads to persistent pain states. Acute low back pain episodes are also more common. Despite lack of research evidence, experience and logic tell us that a high volume of sitting is the number one contributor to both acute and chronic low back pain. There are several reasons for this. Put simply, the persistent strain applied to certain soft tissues makes them vulnerable to injury at loads well below that of healthy tissues.
Peripheral joints
Lack of regular movement can cave negative impacts on any part of the musculoskeletal system, with some regions being more vulnerable than others. In particular, I am seeing:
1. Knee problems. Prolonged positioning with the knee bent at close to 90 degrees causes chronic loading of the patellofemoral (kneecap) joints. Also, the menisci and articular cartilage are loaded unevenly and differently from normal. Nutrition and homeostasis within these avascular (no blood supply) structures are affected, and degenerative regions that are normally asymptomatic can become problematic. For patients with moderate to advanced knee arthritis, lack of movement and exercise is just as bad as overloading the joint.
2. Lateral hip pain and buttock pain. These regions may become painful secondary to lumbar spine dysfunction. Sitting also leads to direct compression of gluteal and hamstring tendons, into the greater trochanter and ischial tuberosities respectively. This is a primary contributor to tendinopathies in these regions.
3. Shoulder pain. Neck dysfunction can affect the shoulders. And postural adaptations to the scapular position may alter scapulohumeral positioning in ways that lead to impingement and chronic muscle strain.
4. Elbow pain. While "tennis elbow" is usually caused by repetitive over-exertion - playing tennis, heavy lifting, gripping, and squeezing activities, it can also arise due to repetitive use of the keyboard & mouse. And the arm is more vulnerable when posture is not optimal.
It is more important than ever to remain disciplined and motivated when it comes to movement and exercise. Frequent changes of position during the day will enhance musculoskeletal and general health, and regular exercise helps us to compensate for the negative impacts imposed on us by this ongoing interruption to our regular lives.
