As officials across the country implement shelter-in-place orders in response to covid-19, many Americans are spending a lot more time at home. I don’t know about you, but I’ve spent a lot of time on my couch, most of it with a video game controller in hand. But there’s a drawback to spending hours a day replaying The Witcher 3: back pain.
“I’ve been getting a ton more calls regarding neck pain and back pain, just because people are sitting all day,” Dr. Scott McAfee, DPT, a physical therapist with physical therapy firm Movement-X, told me over the phone. “The more we can prevent people from having to call a physical therapist, such as myself, the better off people will be during this time.”
As many of you probably know, hurting your back sucks a lot. But these days, with medical resources in many areas stretched to a breaking point, it’s a good time to put a little extra effort into avoiding preventable issues. Here are a few steps you can take to keep your back healthy.
In the throes of a video game, the last thing you might focus on is your posture. You’re probably hunched forward, spine bent like a clamshell, thighs pulling double duty as makeshift armrests. You don’t need a doctor to tell you that sustaining such a position wreaks havoc on your back. No matter how tough the boss fight or intense the Smash match, try to lean back and sit up straight.
“Thinking about keeping your rib cage over your hip bones and sitting up tall with your trunk or core muscles, like a strong container, is helpful for good posture,” Katie Mack, a New York City-based personal trainer, told me over email.
PC gamers also have to consider their screen placement. As Oregon-based physical therapist Dr. Alice Holland, DPT, told me over the phone, an improperly placed monitor is one of the main reasons people slouch their upper back. But there’s an easy solution: Sit in front of your computer and close your eyes. Adjust your posture until there’s no tension or discomfort in your neck or back. Then open your eyes. Wherever you’re looking at is where your monitor should land.
Same goes for anyone gaming on a laptop. You can find solid monitor risers or laptop stands online for as low as $20. Or, as Holland suggested, “In a pinch, you can always use a laundry hamper or large books.”
Protecting your back means more than focusing solely on your back: You also have to look out for the other muscles in your body. Muscles don’t function in isolation; they’re part of a connected network.
“The best thing to do is keep your feet on the floor,” said Holland. “If you can’t keep your feet on the floor, use a stool or a phone book, if you have one of those, to make sure that your knees are at ninety degrees.”
Keeping your knees at an angle greater than ninety degrees strains your calf muscles, while sitting with your knees at an acute angle can tighten your hamstrings. A perfect right angle is the sweet spot.
There’s a popular saying among physical therapists: “Motion is lotion.” Getting up and moving around is the best thing you can do to protect your spine. Experts don’t agree on how often you should get up—some suggest an hour; others, half an hour—or what exactly you should do for movement, but they’ll all tell you to periodically switch things up.
“A good quote that I always reference back to is, ‘Your body will get better at whatever you tell it to do,’” said McAfee. “If you tell it to sit and play video games all day, you’re gonna be great at doing that. But, if you want to do other things when this is all said and done, you have to make sure that you’re getting up, moving, and avoiding those kinds of prolonged positions.”
You could set a timer to remind yourself to get up, though that won’t do you much good if you’re playing a game that can’t be paused. What I’d suggest is this: Every time you encounter a loading screen—whether that’s a result of a game over or a long pre-match queue—make a conscious effort to stand up. Grab a drink or a snack, or play with your pet—anything that keeps you from spending too much time sitting down. If you’re feeling particularly inspired, you could even use that time to some isometric ab exercises. A strong core means a strong spine!
If you’re serious about protecting your back, you can also do some stretches during your sitting breaks. Here are a few to try.
For loosening up your back, you could try a popular yoga stretch known as cat-cow. Get on all fours on the ground. Slowly arch your lower back down, pushing your belly toward the floor and your head toward the ceiling. Then reverse your positioning, pulling your belly and lower back back up and lowering your head. Repeat the cycle a few times. (Here’s a video for reference.) According to Tsao-Lin Moy, MSOM, an alternative and Chinese medicine expert, this helps “engage the back chain of muscles, unsticking and moving the fluid in the spine.”
Another potentially helpful yoga stretch is child’s pose. “A child’s pose stretch can be very beneficial to the lower back,” McAfee said. Start by kneeling on the floor, Geralt-style. Stretch your arms out above your head. Then slowly lean your upper body forward until you’re totally face down. (For reference, here’s a video.)
Mack suggested something called a doorway stretch. Start by finding a doorway that’s not too wide—one where you can place your forearms on the threshold, fingertips pointing toward the ceiling, with your elbows in line with your shoulder blades. (You should “look like a goal post,” Mack said.) From there, lean in just far enough to feel something near your collarbone.
Mack also suggested lying with your back on the ground and extending your legs up a wall. “It’s a good stretch for the hamstrings,” she said.
Holland suggested another short stretch that makes use of a wall. Stand with your back against the wall. (“You can bend your knees if you want to,” she said.) Then, push both the back of your neck and the back of your head against the wall, making sure to look forward and not up. “This centralizes your neck,” said Holland. “A lot of people tend to stoop and bend forward their neck, and this [stretch] pushes your neck back and stretches those neck muscles.”
You can also stretch your back from the comfort of your couch, without standing up.
“My favorite is called the chin tuck exercise,” McAfee told me. Put your thumb on your breastbone and extend your index finger to the base of your chin. Then, pull your head back from your index finger and hold it for a few seconds. The goal is to increase the distance between the tip of your chin and the tip of your index finger with each rep. “You’re exercising the muscles in front of your neck that naturally get weak from sitting all day,” McAfee said. “And what that’s doing is you’re stretching the muscles in through the base of the skull.”
PC gamers have it even easier. Dr. Febin Melepura, the medical director at the Sports Injury and Pain Management Clinic of New York, pointed out a stretch you can easily do from a computer chair. While sitting—with your feet planted firmly on the floor—place your left hand on your left thigh and raise your right arm over your head. Then slowly lean left. Hold for 15 seconds. Then do the opposite on the other side. Repeat this whole process three times, at least once an hour.
With any of these stretches, you want to be mindful not to push yourself too far. Some discomfort is good, but not too much. Otherwise, you risk injuring yourself.
“I always use the analogy of a green light, yellow light, red light kind of pain,” McAfee said. If you’re at a “green light,” you’ll feel a faint tension in your muscles, and very little pain, if any at all. A yellow light is a “good kind of hurt.” A red light is what it sounds like: pain that you want to stop. “I recommend being somewhere in that greenish yellow area,” McAfee said.
Investing in lumbar support is one way you can make sitting less of a strain on your body. There are many kinds of lumbar supports, from seat cushions to posture correctors. But you probably have all the ingredients in your home to make solid lumbar support without spending a penny.
“What I actually like to do is get a bath towel and roll it up into a cylinder,” Holland told me. “You can tie that to the back of the chair and put that at the level of your low back.”
If you do end up hurting your back, don’t hesitate in getting an expert’s opinion. Physical therapist offices may be closed, but you can still get help.
“There are a lot of physical health therapists doing telehealth sessions,” McAfee said. “Just touching base with them and seeing like, ‘Hey, what can I be doing?’ is a really good way to make sure that you’re not doing something stupid and making things worse by continuing on.”