Thursday, January 27, 2011

Mission 2011: Stand Less, Recline More

it's more restful to recline
As January comes to an end, it's time for one last Mission 2011 post on the topic of making activities fibro-friendly by modifying body position.

This week I revisited the concept of a body position hierarchy and reviewed the things I need to keep in mind whenever I am standing, sitting and reclining.

The Body Position Hierarchy

It might seem strange to look at body positions and arrange them in an order from most energy consuming to least. But when you live with chronic illness you quickly realize that how you move your body can have a tremendous impact on your pain and fatigue levels.

Did you know that your heart rate is a pretty good indicator of how hard your body is working? I learned this when I wore a chest strap heart rate monitor while engaging in my every day activities. It really helped me see the impact my body position had on my heart rate. It was quite enlightening! (You can read more about the benefits of using a heart rate monitor at the CFIDS and Fibromyalgia Self Help site.)

The Workout = Standing

The act of standing actually recruits a large set of your muscles, from your legs, buttocks and stomach to your back and shoulders.
Plus while you stand your muscles are continously contracting.

Fortunately, I've learned some strategies for dealing with, and avoiding, standing:

  • I bring along a cane/seat combination and sit instead of stand. (This one is my hands-down favorite.)
  • I use the shopping scooter the store provides. If it is not available, then I grab a shopping cart to rest one foot on the bar between the back wheels and lean against the handle while waiting in line.
  • I place one foot slightly in front and one foot slightly behind my body and sway forward and back while standing. The movement allows my muscles to alternate between contracting and resting, which in turn helps me stay upright longer. (I was taught this technique by a physical therapist who said this movement is more energy conserving than swaying side-to-side.)
The Energy Conserver = Sitting

This body position save a ton of energy over standing, but still can be pain and fatigue inducing.


For starters, with your legs positioned below your thighs, your heart needs to use extra energy to get the blood in your legs back to your heart. For most healthy people, this isn't even noticeable, but if you have problems with fatigue, raising your heart rate even a little over an extended period of time can make fatigue worse.

Another consideration is that maintaining this position for extended periods can actually contribute to more stiffness and pain. This is especially true when you are stuck in the car or on a plane while traveling. Taking the time to gently stretch, wiggle or get up and move every hour or so combats this problem. Look here for some suggested seated stretches for people with fibromyalgia.

Plus if you are short in height like me, another problem you may run into is not being able to rest your feet flat on the floor. Having to support the weight of your legs with your thighs while you sit is going to burn even more energy, not to mention contribute to back pain.

This is especially problematic for me in, of all places, the doctor's office. My legs always dangle off the edge of the exam table, so I move to the chair or stool in the room while waiting for the doctor. At home, something as simple as a phone book or small stool will make a huge difference when you are seated in a chair that is too tall for you.

The Most Restful = Reclining

You have probably figured out that reclining solves the problem of your heart having to work a bit harder to keep blood flowing back from your legs. While a La-Z Boy recliner can get the job done in royal style, you can also achieve this in a simple and more budget-friendly manner by placing an ottoman, stool, coffee table or another chair in front of you while sitting. Soften up a hard surface by adding a pillow or cushion and you'll be comfortably reclining in no time.

Even while lounging in a top-of-the-line recliner, you may find you need to add a lumbar support pillow or neck support pillow to achieve a truly comfortable and ergonomic position.

Knowledge is Power

I think knowing this body position hierarchy can help anyone make more informed and fibro-friendly choices.

For example, knowing that sitting is more energy conserving than standing, you might choose riding a bicycle instead of walking for exercise to stay at a lower target exercise heart rate. You might buy a reclining couch instead of a stationary one the next time you replace the furniture in your living room. You might find more ways to do chores and tasks in a seated position. You might decide it's time to give up showering while standing up and purchase a shower bench.

A word of caution
: while reclining in the front passenger's seat of a car might sound like a good idea, it's not. It has been associated with serious, paralyzing spinal injuries and even death, which you can read more about in the article Death Nap.

In Summary...

The take-away lesson here is:

  • standing is more tiring than sitting
  • sitting is more tiring than reclining
  • to conserve energy, aim to recline more than you sit and sit more than you stand
  • minimize standing as much as possible with cane seats, walkers, scooters and other aids
  • when you are sitting or reclining, be sure to wiggle, gently stretch or move around every hour or so to keep from getting more stiff and sore

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Emily said...

Thanks for this. I wish those people who tell you that all you need to do is exercise would see it. Life is exercise for me!

Wacky Lisa said...

I needed to read this today.

I almost always sit with my legs up on the sofa cushion with me. If I leave them down, even tho my feet touch the floor, I get more tired and dizzy faster.

The movements you've suggested seem a bit different than the ones I've learned to make standing easier for those with POTS/dysautomia. I'll have to see if those work for me.

Because of my poor vision I haven't found a way to do things I like in my recliner or in bed. Although I know I'll get over a flare faster if I'm good and stay in bed or back in the recliner and use text-to-speech and don't try to play video games that aren't meant for the blind.

Felicia Fibro said...

Great post, Selena! Maybe I will strap on my heart rate wrist watch and experiment a little too!