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Chris Gabriel, OCS, CSCS

Look around you – modern society has us sitting a great deal more than our grandparents every thought was possible.  Between working on the computer, texting, and driving (hopefully not at the same time!), we are on our rears nearly all day in some cases.  Even for those of us who are active, a large part of our day can be spent sedentary.  This has numerous health consequences from obesity, diabetes, back pain, and various other orthopedic problems. 

When we spend long periods of time in the sitting position, multiple things happen:

  • Muscle groups held in a shortened position can become tight – hip flexors and hamstrings are two of the most common.
  • Other muscles which are held in a prolonged stretched position can become weak and inhibited- the gluteus medius and maximus are two examples. 

These are the muscles that help extend and abduct our hips, and also provide stability to our low back.  When these muscles shut down we have a downward spiral of function often leading to knee or low back pain. 

It is essential that we get up and move around during the day, even if it is just for a few minutes at a time. Avoid sitting longer than 20 -30 minutes without getting up.  Some offices provide standing work stations for employees to use periodically during the day.  Setting a timer can provide a much needed reminder.

From an exercise stand point, it is helpful to develop a strategy to help loosen up the tight muscles and strengthen the weak ones.   Foam rolling can be a great way to relax tightness in the hip flexors, IT Band, and hamstrings that can be a result of too much sitting.  You should also try to strengthen the glutes.  Exercises such as side clamshells, bridges while pressing up through the heels, and one leg Romanian deadlifts can be part of a good program to address this chronically weak, but vitally important group of muscles.

Chris Gabriel, OCS (Board Certified Orthopedic Specialist), CSCS (Certified Strength and Conditioning Specialist), practices physical therapy with the OrthoCarolina Wellness Center. Chris and his team treat a range of patients for orthopedic and sports medicine needs.  He enjoys working with various local high school, college, and professional sports teams. 


July 20, 2016

Hi Shelly, Many people have some tilt to the patella, but it does not necessarily mean surgery is necessary. Sorry to hear that the injections did not help. I would communicate closely with your doctor about the medication issues. Pain around the kneecap can be a very complex issue. You are correct in that sitting around too much is not a good thing, but many types of exercise can be painful. We typically suggest low or no impart cardio just to get some movement in the joint. Not sure what would be an option for you, but stationary bike and pool are two good options. Make sure you are eating a healthy, well balanced diet and keeping your weight under control. It will take a lot of pressure off the knee. Doing things like leg raises and balance work will help strengthen the whole leg but not put a lot of stress on the knee. Sometimes a brace may be helpful but I would talk to your doctor about that first. Best of luck, Chris
- OrthoCarolina

July 19, 2016

Hello I would like to know what does it mean when your patella is tilted does that mean you need surgery and when you have arthritis throughout your knee also liquid you tried cortisone shots and they did not work, I have tried over the years just about anything to help my knee I was born with PFD which means proximal femoral focal deficiency I'm a Class D I've had an artificial leg my whole life at least for as long as I can remember which is about 3 years old I have osteoarthritis along with degenerative bone disease and I just would like to know how I can get some relief I have A9 year old daughter that I'm still trying to raise but if I'm always sitting on my butt I'm not sure how much how healthy I should say this is for me more or less for my daughter that she means it this way I need physical therapy but Medicaid will not pay for it and I'm not sure exactly why I have Medicare and Medicaid I am currently on medicine for chronic pain which I hate I know most people love them but for me they make me extremely drowsy and I feel like I'm not in control so I do not take them as prescribed they have me on oxycodone 10 milligrams up to 6 times a day also cyclobenzaprine 10 milligrams 3 times a day I do not take my oxycodones that many times a day unless I'm in so much pain I just cannot take it anymore I would like to get off these drugs I just don't know if I'm ever going to be able to get off of them do you have any suggestions for my knee
- Shelly Fenley