We sit usually 12–16 hours a day. In the daytime an average woman is either sitting or walking to the next chair. Small breaks come from activities done in standing and the time spent in physical exercise. The main exception is mothers with young children.
Traditional sitting in traditional chairs creates a major genital health threat for women. The problems appear inside and outside the pelvic area. Sitting pressure blocks pressure-sensitive micro and macro circulation in the blood and lymph vessels, and also in lymph nodes. Circulation is the basic factor to metabolism and health. There are about 7.000 km of vessels in 1 kg of soft tissue, such as muscles, skin, and fat. Circulation is generated by movement and small differences in pressure.
Sitting affects the following internal main pelvic organs: ovaries, uterus, vagina, rectum, urethra, and bladder. They are all just a few centimetres under the skin, in the pelvic floor. Sitting pressure also has a very negative effect on the different tissues of the vulva.
The following health problems are connected with sitting
- Circulation disturbances inside the pelvic area (varicose veins etc.). The chair padding creates pressure inside the pelvic area by pushing soft tissues (skin, fat, muscles, and connective tissue) into the area between the sitting bones. The pressure spreads inside and affects all the internal pelvic organs.
- Cancer. 24 % of all women’s, and 49 % of men’s, cancers occur in the pelvic area, within a space the capacity of which is just over one litre. Poor circulation and pressure disturb metabolism and make tissues sourer, which is known to be a cancer risk.
- Inflammations in vagina, bladder and urethra. Chair paddings increase the temperature and humidity in the vulva area, which helps the pathogens to grow. Poor circulation slows down the access of the white cells and other defenders to the area to destroy the pathogens that have slipped in through the skin. This way the inflammation gets a head start before the immune defense can stop it. Antibiotics are often used after this diagnosis.
- Problems with the pelvic floor muscles and rectum. When sitting on traditional chairs, we sit in a poor posture for most of the time. The weight of the upper body increases pressure in the abdominal cavity, which, in turn, is the biggest risk for the gynecological descend where all the internal pelvic organs slide downward permanently. Sitting pressure against the chair padding disturbs the normal functioning of the rectum because all the pelvic floor tissues, including the anus, are pushed up and the rectum remains in the pressure field.
- Pudendal nerve and vessel dysfunctions. These problems are most common amongst women who sit a lot on bicycle, horse saddle, or on a one-part saddle chair. The situation is even worse when the work requires leaning forward, like in dentistry and in laboratories. In such conditions changes in the circulatory system may be expected, and the sensitivity of the nerves is reported to have weakened.It is likely that also endometriosis benefits from the conditions that exist during long term sitting. All local defenses are weakened due to the disturbed circulation in the area
Picture: In female pelvic floor, the pudental vessels serve the whole pelvic floor and genitals just as they do in the male pelvic floor too. For women there is a special danger when super bacteria etc. difficult pathogens travel from anal area into the genital area, find a way through the thin skin and cause an inflammation area where the immune defences are poor, due to reduced circulation caused by sitting. Sitting on a two-part saddle chair and pressure-free and loose clothes improve the situation considerably compared to the traditional way.
Original source of picture: Paulsen, Waschke, Sobotta Atlas of Human Anatomy, 15th Edition 2011©Elsevier GmbH, Urban & Fischer, Munich.
How to avoid sitting disorders in the pelvic area
The main thing is to ensure, as much as possible, good circulation. It is also important to restore good ventilation and metabolic activity as well as possible. The following measures are useful and helpful:
Use of a two-part active saddle chair. With this kind of chair the following benefits can be gained: The gap in the seat eliminates the pressure from the pelvic floor and vulva, and also most of the pressure from inside the pelvic area. The gap itself restores better ventilation to the area, which means lower temperature and dryer skin. The swing mechanism of the seat automatically increases physical activity of the pelvis and lower back, which in turn activates circulation. Saddle sitting (with the important gap where the pubic bone can go) helps one to get good posture. This decreases the pressure in the abdominal cavity and thus also the pressure on the pelvic organs from above. Good posture and the gap also help the rectum to function normally, decrease its diameter and thus decrease the pressure of the rectum against the uterus and vagina.
Loose and cool clothes that don’t cause pressure in the pelvic area. Loose clothing helps circulation to function normally and does not get tight on the buttocks, crotch and genital. This is meaningful in terms of the circulation of the lower extremities and lower stomach. Tights and underwear that leave red marks on the skin are not good. Pressing belts or tight waistbands are very harmful too. Trousers with middle seam digging deep into the labia is bad for circulation. When you select clothes for sitting test them in sitting position. Be sensitive and careful that they do not press you at all in your typical sitting position.
Physical activity. It´s very smart to have breaks during your sitting sessions; for example, when talking on the phone you can walk around with a bluetooth headset or go up and down stairs. You, or rather your smart employer, should also keep some real exercise equipment (gym sticks, flexi bars, hand weights, kettle bells, stretching carpets, step boards, etc.) available. During calls or informal meetings you can do a so called "slow workout”. After a few minutes your circulation is increased for a long time but you won’t get sweaty or breathless. This eliminates the "shutdown” of your body and brain caused by decreased circulation.
- Detailed adjustments of your work place. It’s ergonomically beneficial to adjust your chair, e-table and monitors, use elbow supports, adjust the distance of the monitors and the size of text font to be as optimum as possible, and adjust the table according to whether you are typing or reading. Such advanced awareness and activity in ergonomics surely brings relaxation to the whole upper body that also reflects positively to the pelvic area as well. There are lots of risks but also many ways to avoid them. By improving your pelvic health environment you also improve the whole sitting health. It only requires some awareness and activity to put the preventing measures in action.
The statements on the page are based on the following sources:
Michael Adams, Nikolai Bogduk, Kim Burton, Patricia Dolan: The Biomechanics of Back Pain
David A. Rubenstein, Wei Yin, Mary D. Frame: Biofluid Mechanics, an Introduction to Fluid Mechanics, Macrocirculation, and Microcirculation
Marcus J. Seibel, Simon P. Robins, John P. Bilezikian: Dynamics of Bone and Cartilage Metabolism, Principles and Clinical Applications