This article is about how to take your sit-stand desk and schedule to the next level. In fact this article would still be useful for someone with just a sitting desk who is looking to get more activity into their day. Let’s start with the facts. For certain we know that musculoskeletal injuries (aka strains or sprains) are the most prevalent type of office injury. Targeting prolonged static postures like sitting is one tactic you can do to reduce the likelihood of it occurring by optimizing sitting and standing durations. However, research has noted that there is a lack of established guidelines so the exact ratios of sitting to standing have varied considerably and this obviously can lead to a lot confusion regarding the right or most optimal sit-to-stand schedule. For this reason instead of just sharing a researched supported sit-stand schedule I want to share the value of looking at this through a bigger lens to get better long-term results. In this post I’m going to describe a systematic approach that optimizes 3 things: the set-up, the schedule, and an already established wellness program. Scroll down to see the 3 parts for an effective sit-stand plan… 

The 3 Parts to an Effective Sit-Stand System

1. Set Your Desk Up Optimally.

Let’s start with the basics of this strategy. A key component is ensuring that the workstation is set-up optimally no matter if the person is sitting or standing. Obviously, no one wants to work in workstation that causes them to be uncomfortable or even contributes to pain. Below you’ll find some useful rules of thumb.

Rules of Thumb

Realistically every workstation must be set up for its specific user. If there are multiple users at one workstation, each person must be able to re-adjust their workstation to fit them optimally. There are core principles to an ergonomic set-up that should be always met – no matter if you are sitting or standing:

1. Eyes slightly higher than monitor height
   • The top of the screen (not the monitor) should always be slightly lower than the neutral eye height. Neutral eye height is found by the natural or most comfortable neck position; the chin will be parallel with the ground.
   • In addition, the bottom of the monitor should be slightly tilted upwards towards the user.
2. Neutral elbow height slightly higher than the hand working height
   • Why use neutral elbow height in the first place? Neutral elbow height is one of the major principles in the office because it is associated with the least amount of risk for the development of discomfort or a work injury.
   • To find neutral elbow height: with relaxed shoulders, position your elbows at approximately 90 degrees next to the torso. The key thing is that the elbows should be positioned in a manner that is comfortable and there shouldn’t be any discomfort or strain in the shoulder area.
   • If there is some strain then take another look at the elbow position to make sure that whatever device that is being used (for instance the keyboard or mouse) is slightly lower than the resting elbow height.
3. For the seated workstation: The back must always be comfortably positioned into the chair’s backrest, most importantly with the optimally positioned lumbar (lower back) support.
4. For the seated workstation: The feet must always be securely in contact with the ground OR footrest. 

2. Find A Sit-Stand Schedule That Works With You.

The second component of this system is to ensure that an optimal sit-stand schedule is used. The challenge with this is:

• Fitting the variations in posture (switching between sitting and standing) to everyone’s schedule, and
• Personal preferences to any suggested sit-to-stand schedule

One of the purposes of using a sit-stand workstation is to introduce needed physical variations so you avoid the negative health consequences of too much sitting or too much standing. The goal is to do so in a safe way. One schedule will unlikely make everyone happy nor fit their needs. In my experience, frameworks are much more of a value-add than a hard lined schedule. Don’t sweat the details; it’s the sustained static postures (for either sitting or standing) that are the concerns for ergonomic risk.

Take a look at the table below that is from this research. These are all acceptable sit-stand schedules (and should work within the green/yellow/red risk stoplight categories that I also review in the next part of this section). However what these researchers found that certain schedules just seem to work better for some people and this choice of a particular schedule may be very individual. In this table office workers preferred the 1:1 ratio (60 minute sit/60 minute stand); 2:1 (80 minute sit/40 minute stand); and 3:1 (90 minute sit/30 minute stand) the most. These are rank ordered, meaning that the 1:1 ratio was the most liked. Office workers tended to not like the 7:1 ratio (105 minute sit/15 minute stand); this was the schedule with the shortest standing. Interestingly, the schedules listed in the table do not improve nor worsen foot swelling and spinal loading.

The preference for the schedules with more standing could be because research shows that there is a tendency of having less muscle fatigue with a longer standing schedule. Just to reiterate, office workers prefer sit-to-stand durations in the range between 1:1 (60 minutes sitting/60 minutes standing) and 3:1 (i.e.: 45 minutes of sitting/15 minutes of standing). Keep in mind that active break time activities may be more effective in reducing muscle fatigue and foot swelling than just standing along – see the next category for more details! Further, this study found that office workers did not prefer the schedule with the least amount of standing. Additionally, experts recommend a gradual increase to the amount of standing in a workstation – standing for 2 hours/day initially, to a 4 hours/day eventually, this is detailed in the quote below:

For those occupations which are predominantly desk based, workers should aim to initially progress towards accumulating 2 h/day of standing and light activity (light walking) during working hours, eventually progressing to a total accumulation of 4 h/day (prorated to part-time hours).

To be the most effective, whatever sit-stand schedule that the worker chooses to use must fall within the stoplight analogy to prevent long-term sitting and standing ergonomic risks. This research has categorized safe durations of standing into safe, slightly unsafe, and unsafe. There is a more detailed explanation to be used below:

1. The ‘Safe’ Category (lowest ergonomic risk AKA GREEN LIGHT): Standing continuously for less than 1 hour AND for a maximum of 4 hours total throughout their shift.
2. The ‘Slightly Unsafe’ Category (moderate ergonomic risk AKA YELLOW LIGHT): Standing continuously for more than 1 hour OR more than 4 hours total throughout their shift.
3. The ‘Unsafe’ Category (highest ergonomic risk AKA RED LIGHT): Standing continuously for more than 1 hour AND more than 4 hours total throughout their shift.

3. Incorporate It With Your Organization’s Wellness Strategy.

Piggybacking ergonomics to an already established wellness or continuous learning strategy is a good hack to encourage long-term sit-stand desk use. This is because wellness programs usually can provide:

1. Education and coaching regarding the most optimal sit-to-stand schedule, and
2. Promote more ‘activity’ instead of just standing for posture breaks. For instance, I have seen walking programs be quite popular in many workplaces.

Long-term use of sit-stand desks tends to be quite low between 6 months and over a year after they are installed, as shown in this research. This is why I recommend proper training and education whenever a sit-stand desk is brought into a workplace; in many workplaces wellness education or employee health typically falls under the umbrella of that organization’s wellness programs, which can be synonymous with ergonomics. A wellness program that promotes and educates employees about sit-stand desks should be just as important as providing sit-stand desks to employees in the first place. 

People will always need to use their discretion when determining if a sit-stand schedule works for them. They must be educated on suitable schedules as well as signs and symptoms of when it may be necessary to switch between sitting and standing.

Intertwining ergonomics with a wellness program is a must, yet is often overlooked. Simply giving someone a sit-stand desk and expecting staff to use them can lead to disappointment on both sides. Instead, combine a sit-stand desk with education on its value, the ergonomics involved, and useful strategies. This can eliminate confusion and add a sense of efficiency for employee’s using their sit-stand desks.

Using the wellness program to support ‘active’ types of work breaks or posture variations can bring bigger results in the reduction of pain and discomfort than just using a sit-stand desk by itself. Research shows that those who had a higher intensity level of physical activities during breaks (like going for more walks) had significantly lower muscle fatigue on the shoulder and low back muscles as well as muscle fatigue and foot swelling compared to those who used a typical sit-stand schedule (ie: stood to take a break from sitting). This is a perfect complement to many organization’s corporate wellness programs and can go far in improving employee well-being. Adding ergonomics to an employee wellness program can ensure that sit-stand desks and other ergonomic initiatives are being used consistently and for the long-run.