Sitting for Long Hours: Posture, Cushions and Movement Breaks

What too much sitting does

• Muscles weaken. Muscles that are not used shrink quickly. Weak thighs make standing up harder, which makes people sit more.
• Joints stiffen. Hips and knees held bent for hours lose range, and the back loses mobility.
• Circulation slows. The calf muscles pump blood back to the heart when we move; sitting still lets fluid pool in the legs, causing swelling and increasing clot risk. See swollen legs in older adults.
• Blood sugar and blood pressure suffer. Muscles that move use glucose; those that do not leave more in the blood.
• Skin is squeezed. Constant pressure on the same areas can cause redness and sores; see pressure care in a wheelchair.
• Posture worsens. Slumping rounds the back, strains the neck and compresses the chest, making breathing harder.
• Falls become likelier. Weak legs and poor balance make a stumble more dangerous.
• Mood and thinking can decline. Inactivity is linked with low mood and poorer memory.
• Bowels slow down. Constipation is more common; see constipation in older adults.

The good news is that breaking up sitting with short bursts of movement brings real benefits, even without formal exercise.

How long is too long?

There is no exact limit, but a common guideline is to avoid sitting for more than 30 to 60 minutes without moving. For someone at risk of pressure sores, shift weight every 15 to 30 minutes. A person who cannot stand can still move the arms and legs, change position and stretch.

Set up the chair well

A good set-up reduces the strain.

• Seat height. Feet flat on the floor, knees at about hip level. See choosing a chair for an older person.
• Depth. The back of the knee should not press against the seat edge.
• Arms. At a height that lets the shoulders relax.
• Back support. The lower back supported, perhaps with a lumbar cushion; see lumbar cushions.
• Cushion. A firm, supportive seat cushion, with a gel or pressure-relieving cushion for long sitting; see seat cushions for older adults.
• Footrest. For short people whose feet do not reach the floor, a low stool keeps the legs supported.
• Table and screen height. Things should be at eye level, to avoid craning the neck.
• Light. Good light on reading material.
• Within reach. Water, glasses, the phone, the remote and medicines should be within reach, so that standing up is a choice, not a necessity. Paradoxically, though, placing a few things a short walk away encourages movement.

Sit well

• Sit all the way back with the hips against the backrest.
• Keep the feet flat and slightly apart, knees bent at about 90 degrees.
• Keep the back supported, not slumped or perched on the edge.
• Keep the shoulders relaxed and the head over the shoulders.
• Do not cross the legs for long periods, which restricts circulation.
• Change position often: lean back, lean forward, shift to one side, then the other.

Movement breaks that work

You do not have to leave the chair for every break, though standing and walking is best.

Every 30 minutes (for 1 to 2 minutes):

• Stand up, with a hold on the chair arms if needed, and stand for a count of 30.
• Walk to the kitchen, the window or the door and back.
• Roll the shoulders and stretch the arms overhead.

While seated (at any time):

• Ankle pumps. Point and flex the feet 15 to 20 times, which boosts the calf pump.
• Ankle circles. Circle each foot ten times each way.
• Knee extensions. Straighten one leg out and hold for 5 seconds, then lower; repeat 10 times each leg.
• Marching. Lift each knee alternately, as if marching, for 30 seconds.
• Heel and toe raises. Raise the heels, then the toes, 10 times each.
• Shoulder rolls and shrugs.
• Arm circles and gentle neck turns.
• Seated twist, with hands on the chair arms, gently turning the upper body, if comfortable.
• Sit-to-stand. Stand up from the chair without using the arms if able, 5 to 10 times, with something to hold; see chair exercises for seniors.

A pedal exerciser under a table or chair lets a person cycle gently while sitting; see pedal exerciser guide.

Make it a habit. Tie breaks to something: each television advertisement, each cup of tea, each phone call, or the end of each programme. A timer or a reminder from a family member helps.

Circulation and the legs

For long hours of sitting:

• Keep the legs uncrossed, and avoid pressing the back of the knees on the edge of the seat.
• Do ankle pumps often.
• Raise the legs when resting, if appropriate; see leg elevation pillows.
• Wear compression stockings only if prescribed; see compression stockings guide.
• Drink enough fluids and avoid tight clothes at the waist and thighs.
• Watch for one-sided calf swelling, pain or redness, and seek help at once; it could be a clot.

Skin care for long sitting

If your parent sits for many hours, particularly if thin, frail or less mobile:

• Check the skin over the buttocks, hips and tailbone daily.
• Shift weight every 15 to 30 minutes.
• Use a pressure-relieving cushion; avoid ring cushions; see ring and donut cushions.
• Keep skin clean and dry; see barrier creams and skin care.
• Change position between chair and bed through the day.

The carer's role

• Encourage, don't nag. Suggest a short walk together, or a chore that involves a few steps.
• Make movement part of the day: watering plants, setting the table, a walk to the letterbox or a short walk around the building.
• Set up the home so that a few steps are needed to reach the kitchen or the toilet.
• Join in. Do exercises together.
• Watch for fatigue, breathlessness or dizziness, and stop if present.
• Review aids. A walker or rollator can make short walks easier; see rollator buying guide.
• Celebrate small gains.

Other aids

• A standing desk or raised table for reading or hobbies, if the person can stand for a few minutes.
• A lift chair, where standing is hard; see choosing a chair for an older person.
• A footrest or leg rest for comfort.
• A walking aid nearby, to encourage movement.
• A phone or watch that reminds the person to move; see fall detection watches.

When sitting is unavoidable

Some people cannot stand or walk, or spend long hours in a wheelchair. For them, movement still matters: shift weight, change position, exercise the arms and legs within ability, use pressure-relieving seating and take regular lying-down rest. A physiotherapist can design an individual plan. See pressure care in a wheelchair.

When to ask a professional

Ask a physiotherapist for a safe exercise plan if your parent has heart, lung or joint conditions, has had a fall or is very weak. See a doctor for leg swelling, calf pain, breathlessness, chest pain, dizziness on standing or skin changes. Our care advisors can arrange a physiotherapist visit and recommend seating and equipment.