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If you’ve worked a job that requires you to be on your feet all day, you may already be aware that it can—to use a less than medically correct term—completely suck ass. Your joints ache like you’ve aged 30 years in an eight-hour shift; your heels alternate from numbness to needle-stabby agony. You’ve felt firsthand the kind of all-encompassing fatigue that follows a double, requiring you to Netflix-and-pass-the-hell-out the second you return home.
“Work is pretty much the only environment where people tend to stand for prolonged periods of time,” said Peter Smith, a senior scientist at the Institute for Work and Health in Toronto. “When you stand for long periods of time, things can happen to your body.” Smith’s research has found that “occupational standing” can as much as double your risk of heart disease. Not great! Over time, standing at work can contribute to circulation problems and varicose veins, and some studies have shown that standing at length can lead to chronic back pain and musculoskeletal disorders. In a more immediate sense, there are an array of associated health issues: back and foot soreness, joint aches, neck and shoulder stiffness, and uncomfortable swelling in the legs and feet. In a perfect world, no one would have to stand so long at work that it caused them physical pain. “I think we’re all now in roles that were kind of never designed for human beings—to be doing one thing repetitively all day, or to be standing in one position all day,” said Ahmad Nassr, an orthopedic spine surgeon at the Mayo Clinic. But we don’t live in a perfect world, we live… here. And here, unfortunately, all kinds of jobs—hospitality, retail, nursing, manufacturing, teaching—keep you on your feet for extended stretches.
To learn how to best take care of your body if you are in one of those professions, VICE spoke with spine experts, foot surgeons, physical therapists, and folks who stand for work to find out how to best mediate pain and soreness and prevent long-term health problems as a result of prolonged standing.
According to Smith, one of the reasons standing at work can be a problem is that blood tends to pool in your lower limbs. This can cause stiffness in the legs and feet—plus, to compensate for this pooling blood, your body has to up your heart rate to get blood moving. “Over long periods of time, this can increase damage to the cardiovascular system,” Smith said.So how do you combat that? Don’t stand still, if you can help it. “I always say your best posture is your next posture—meaning, you don’t want to be in a certain position for long periods of time,” said Ryan Balmes, an Atlanta-based physical therapist and spokesperson for the American Physical Therapy Association. Balmes tells patients who have to stand for long periods to set reminders on their phone or smart watch “that get you moving in a different direction.” He also recommended varying your work environment as much as you can—for example, if you’re a grocery store employee, you shouldn’t be on the register for the whole shift. If you do have to be at the register for long stretches of time, switch sides so that you’re performing movements with your opposite hand. “That variability not only challenges your body, but it changes things up to make sure certain patterns don’t set in and solidify,” Balmes said. Bounce up and down on your feet or walk in place—anything so you’re not standing flat-footed and stationary.
Move around as much as possible, and get off your feet whenever possible
“The best thing for an employer to do is give people the opportunity to move throughout the day.” Smith said. “We need to recognize that prolonged standing at work is a health problem, and the more we can do to help people move throughout the day, the better.” Smith said this is true for folks who stand and folks who sit at work, because the opposite of sitting isn’t standing—the opposite of sitting is actually moving. From a health perspective, the more you move, the better off you are.
Robert Lee, Chief of Podiatric Surgery at the UCLA Santa Monica Medical Center, spends his days treating patients who have foot pain. “A lot of them have foot pain that’s related to their occupations,” Lee told VICE.There’s a tough-to-avoid reason blood pools in your lower limbs: gravity. When you stand all day at work, the earth’s gravitational pull is actually pulling blood downward, which can cause pain and swelling in your feet and lower legs and eventually lead to varicose veins. For vein issues and associated swelling, “The most important way of treating it is using compression stockings,” Lee said. Compression socks work by limiting how much the leg can expand or swell and gently facilitating the movement of blood in the legs, returning blood back to your circulation. This improved circulation limits swelling and pain in the lower limbs, and prevents blood from pooling in veins. (It’s part of the reason professional athletes have started using compression socks; Lee himself wears compression socks skiing, and finds it helps him from getting fatigued.)
Wear comfortable, supportive shoes (and socks).
Another crucial piece is wearing good shoes. “If you know that you have some trouble with your feet, then having proper footwear is really important,” said Maura Daly Iversen, dean of the college of health professions at Sacred Heart University and an APTA spokesperson. “Because, over time, that’s going to bother your knees, that’s going to bother your hips, and it’s going to bother your lower back.”If you’re working on your feet all day, four-inch high heels probably won’t be the best choice for you. No ballet flats, either—ideally, you want thick soles. “The thicker the sole, the more shock absorption it’s going to provide for you, and the more cushion,” Lee said. This helps to better disperse weight through the whole foot, rather than focusing it on the balls and heel. Inserts can also be helpful—especially for folks with high arches, Lee said. He also recommended making whatever adjustments you can to your work setting: “A lot of workplaces will provide soft mats, especially if the floor is hard cement. That lessens some of the stress that’s going to be transmitted to your legs and feet,” he said. Some places will provide a little portable work step, which allows you to change where the pressure is on your foot from moment to moment.
On breaks (and Lee, too, was adamant that frequent breaks are a must), you can literally kick your feet up. Doctor’s orders! “When you have the opportunity, you want to elevate your legs. Because now you’re reversing the effects of gravity to your advantage,” he said.
Iversen at the APTA is upfront about this: Everybody slouches. Whether we work at a desk or stand all day, people tend to roll their shoulders forward, arching downard. But good posture is important, and thinking about posture all the time is, while admittedly annoying, unfortunately, the best way to improve it. To combat this, think of a drill sergeant or a ballerina standing tall, with their chest out. Keep your back straight and your core engaged. “You can set an alarm on your phone that just says, ‘Make sure I’m doing a few posture exercises’ and set it around lunchtime,” Iversen said. Apps like Perfect Posture Workout walk you through exercises and gently vibrate if you’re slouching, letting you track your improving posture over time. And in your off time, she added that core exercises like planks and twists are great for posture.There are also several stretches Iversen recommends—stuff you can do before, during, or after the workday—to help with posture (and tightness elsewhere in the body). Since most of us tend to slouch, stretching the muscles in the front of your chest is really important; do so by standing at a door frame with your palms at the edges (like you were going to do a pushup) and leaning forward, keeping your feet flat, bringing your shoulder blades back and stretching your front.
Make adjustments to your posture, and stretch whenever you can.
You can stretch out back muscles by standing with your feet flat and slowly bending forward to try and touch your toes. (Don’t bounce!) Lunges are good for relieving leg tightness, and you can achieve the same effect by standing on the edge of a step and lowering your heels. Hold any of these stretches for 30 to 60 seconds, moving slowly until you feel tightness, then going just a little further, trying to get a tiny bit more tension.
Let’s be honest: Often, when you’re busy with work, you’re not thinking about caring for your body. “In terms of a hierarchy of importance, you’re just trying to survive, get the job done,” as the APTA’s Balmes said. “Posture, health—you’re not thinking about that … people are in jobs where they don’t have that luxury. It’s not realistic.” Servers, bartenders, and retail workers tend to agree—and, from experience, they have practical advice for making it through the workday with minimal agony.“I feel like it's all obvious stuff, but working in restaurants for years, it’s really easy to forget to hydrate yourself,” one Minnesota-based server said. Hydration is especially important if you’ve got a job that’s tough on the ol’ bod—and so is eating well. You might not be able to help it, but you probably aren’t eating the best during a shift, but try to get your nutrients when and where you can. Get your rest and recovery from sleep. (Yes, this can also be tough if you’re bartending until 2 a.m.)
Recover and listen to your body.
There are other little recovery-focused things you can do after a long day at the job. For example, “When I worked retail, the best tip I got was when you get home, lay with your back on the floor with your legs resting up against a wall,” said a former employee at Mall of America American Eagle, where long hours on the floor assisting customers were followed by long hours folding stock and cleaning up. To do this, picture an “L” shape, where your back is the bottom and your legs are the vertical line in the letter. (It’s actually a pose used in restorative yoga practices.)“After working long, long retail days, Epsom salt baths helped my aching hips and feet,” added a former Mall of America visual merchandiser—work that entailed pushing around heavy tables and platforms full of clothes. (Put another way: “Soaking your feet after a shift is a lost art.”) Massage devices, Jacuzzi foot baths, salt soaks—all of these can help with recovery. Lee at UCLA said one very cheap, very simple way of massaging and loosening up the small muscles in the foot is to just get a golf ball or tennis ball and roll your foot over it while you’re sitting on the couch. Just press down to your comfort level and feel the stress dissolve. Whatever makes you feel better in terms of recovery: do that. “Do what makes you feel good,” Balmes said. “Because work is hard, and days off are meant for you to recover.”
All of the experts VICE spoke to for this story said (sorry!) that exercising when you’re not on the clock is important. I know, I know—we get home from work, and we’re exhausted. We’ve already been on our feet all day. “It’s kind of hard to justify: Can I get some time for myself to exercise?” Nassr at the Mayo Clinic admitted. “But low-impact aerobic exercise—really increasing the blood flow to the legs, using these muscles that were abused during the day in a more fruitful way to build both endurance as well as cardiovascular endurance—[this is] one of the keys to being able to stay healthy over time.” While it’s recommended that most people get a half-hour of physical activity in each a day, the good news is you don’t have to start distance running or weightlifting (unless you want to)! Nassr says yoga and pilates are good for the spine, and even a 30-minute walk or leisurely bike ride can be enough to get your muscles firing and your joints moving.
Exercise when you’re off the clock.
If you find that none of the above stretching, hydrating, exercising, focusing on your posture, eating well, and sleeping enough is helping your pain: It’s time to call in a professional. “There could be more significant underlying pathology that needs to be evaluated by a physician,” Lee said. “If it’s not getting better and they’re suffering, they should go seek professional advice.” Experts note that the longer you put a troubling health issue off, the worse the problem can get. I’ll say it again: It’s bullshit that people have to work in jobs our bodies weren’t designed to do—and not only that, but do so for long hours that make aches and pains nearly inevitable. Capitalism, baby! (To that end, if you’re uninsured or underinsured, there are resources out there that can help you get the care you need.)Worse, it’s not even really necessary to stand, a lot of the time. “When you look at prolonged standing at work, a lot of it is sort of not necessary, in terms of the jobs that people have to do,” said Smith at the Institute for Work and Health. Say you’re a cashier at a convenience store counter. There’s no real reason you couldn’t do your job seated—it’s just that for whatever reason, managers feel like when people are standing they’re more attentive. “But people can sit and be attentive,” Smith said. It might be worth making sure with your boss that you do, in fact, have to stand during your whole shift.If standing on the job is non-negotiable for you: Take care of yourself as best you can for now, and hopefully these tips—along with some strategic stretching, a little light exercise, and enough H20—help mediate your pain until we can overthrow the billionaire class for good.Follow Em Cassel on Twitter.