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As medical research about the health dangers of prolonged sitting has poured in over the past few years, standing desks have emerged as a valuable workplace perk.

The 2018 Employee Benefits Survey from the Society for Human Resource Management (SHRM) found that company offering of standing desks to workers grew by nine percentage points (from 44 to 53 percent) in the previous 12 months.

Last June, Apple CEO Tim Cook shared that all his employees had standing desks, saying that the combination of sitting and standing was “much better for [the employee’s] lifestyle.”

The spike in interest also ties into the fact that “individual workspaces have shrunk a lot over the years”, Jonathan Webb, VP of Workplace Strategy at KI says. “Providing the freedom to move vertically throughout the day often makes up for the lack of horizontal movement in a larger workstation.”

So, if you have the luxury of a standing desk in your office, how can you use it best? What sort of stretches might help get the blood flowing and what furniture accessories can help you get the most benefits on a budget?

Standing too long can be as bad as over-sitting

First, one must note that a standing desk shouldn’t replace sitting — and that standing for very long periods isn’t something doctors or physical therapists recommend.

“Standing idly can cause problems, mostly vascular,” says Dr. Andrew Elkwood, MD, founder and director of the Center for Treatment of Paralysis and Reconstructive Nerve Surgery at Jersey Shore Medical Center. “Standing all day puts a lot of pressure on your legs which can cause swelling, varicose veins and hemorrhoids.”

Dr. Susan Chan, physical therapist at Stanford Health Care, adds that prolonged standing can lead to “collapsed veins in the lower extremities,” as well as “knee pain, back pain and hip pain.”

If using a standing desk, be sure not to overdo it, and remember to sit down periodically. “Find moderation between sitting and standing. Alternate every hour or so,” Chan says.

Build up to hours of standing in 15 and 10 minute increments

If you’ve just set out using a standing desk, you have probably found that it can be tiring to stand straight for an hour straight.

This should become easier in time, but take care in building up to a level of comfortable tolerance.

“On your first day, [stand] for 15 minutes,” says Chan. “See how that goes and then sit down for a bit. Add 10 minutes as you’re able to tolerate it. Your body needs to acclimate. Working on some core strengthening, back strengthening and leg exercises will be important and helpful to get your body in shape for standing. An office person isn't normally active [in the office], so we need to learn to move in realities and environments that we’re not used to doing so in.”

In the beginning, set an alarm to remind yourself to stand

"Using a standing desk does take some getting used to,” says Webb. “We get so used to sitting in a sedentary position all day, so we forget that we have this sit/stand desk to use. I encourage users to set alarms on their phones or on their computers to remind themselves to stand up — and sit back down. You can set the times for whenever you want. After a while, it’ll become second nature to sit and stand throughout the day."

Idleness is the enemy: Mix in movements and stretches

Chan uses a standing desk as do many of her clients, and while she appreciates the benefits, she’s emphatic that a standing desk must not replace walks, stretches and other movement.

“For 60 seconds [every hour] do something [such as] heel rises, knee bend squats, marching in place or walking up and down the hallway just to get blood flow going,” Chan says. “The key thing is moving.”

Juliet Guisasola, a yoga teacher based in Los Angeles, has been hired to teach yoga to corporations to alleviate pain associated with sitting or standing for too long of periods, and finds that both can be problematic.

“Besides stretching at your desk I encourage people to get their body moving throughout the day,” Guisasola says. “Take the stairs, park further away, and walk to your co-workers desk to ask them something instead of shooting an email.”

Work in these yoga moves for neck, shoulders, back and legs

If you can work in a few yoga poses throughout the work day, consider these suggestions from Guisasola:

For neck/shoulders: Neck rolls, shoulder rolls, chin retraction, eagle arms, cross body arm stretches, cow-face pose

For your back: Cat/cow on a chair, puppy dog at desk or wall, twists side to side at chair.

For your legs: Calf stretches, lift knees while standing, one leg chair at desk (standing, or sitting in a chair)

Good posture is critical to standing desk success

Good posture at a standing desk is key to the benefits, as hunching, “can cause significant neck strain, whether you are standing or sitting,” says Dr. Leo Rozmaryn, orthopaedic surgeon for The Centers for Advanced Orthopaedics. .

Dr. Chan adds that using a standing desk while holding “postures that aren’t the best”, (like for instance, leaning predominantly to one side) can create negative effects.

While we tend to know what good posture looks like, it can be trickier to know what it feels like. How do you know you’re doing it right?

“One of the best metaphors I ever got while studying ballet, that I repeated to my students for years, is that your skeleton is designed to hold your weight without your body working too hard. You just have to line up your joints,” says Auburn Scallon, a former ballet teacher.

“So, imagine a string from the crown of your head holding your spine straight while keeping your chin level (not dropping it down towards your neck). Envision your shoulders sitting in a straight line above your hips above your knees above your ankles and then let your body rest on that solid structure. Throughout all of this, picture your ribcage closing and your tailbone pointing towards the floor, not arching towards the back wall or tucking forward.”

Create an 80-degree angle in the elbows, and have keyboard at belly button height

“Both the keyboard and mouse should be at belly button height, which creates a bend in the arm that is 80-85 degrees, a neutral position,” says Rozmaryn. “The monitor should be approximately 18 inches from the face with the top of the screen at eye-level, so you are looking down 10-15 degrees.”

Take frequent breaks from typing

Whether you’re sitting or standing, it’s important to give your wrists rest periods from typing.

“I recommend not typing for more than 20-25 minutes at a time in order to allow the muscles to recover — a two to three minute break can be very helpful,” says Rozmaryn.

If able, do some gentle arm and wrist stretches to help prevent/combat Carpal tunnel syndrome — WebMD has a helpful roundup of exercises.

Wear shoes with firm insoles and arch support

In offices where more formal wear is required, employees may not be able to get away with working in a pair of sneakers, but comfortable shoes with support are integral to reaping the benefits of a standing desk.

“One of my clients switched to standing desk, and it increased her back pain,” says Carol Michaels, a personal trainer. “I then discovered that she was wearing four-inch heels while standing at her desk. So when using a standing desk you must have proper footwear.”

Dr. Rozmaryn recommends investing in shoes “with a good cushion inside and significant arch support or putting gel foam shoe inserts into an existing shoe. It doesn’t need to be a sneaker, but a firm sole is best.”

Dr. Elkwood adds that “the higher the heel more unhealthy. Weight is meant to be distributed along your footprint. Anything that changes that isn’t good.”

Consider these budget-friendly standing desk accessories

Dr. Drew Schwartz, DC, the owner/head chiropractor at Shaker Blvd Rehab and the mind behind FTW! For the Wellness Blog, often reviews ergonomic furniture and accessories for his blog (with no brand affiliations).

He has provided NBC News Better with his top picks for decking out one’s standing desk to maximize the health benefits.

He adds that “most people can get by with using a couple of these items to make a huge improvement in their day to day work lives.”

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Standing desk mat

Yoga teacher Guisasola champions using a standing desk mat — also called an anti-fatigue mat, as does Schwartz. These are designed to be supportive yet uneven, so it forces you to engage your core and bring light balancing movement to your stance. Schwartz recommends the Topo Mini by Ergodriven for $69 on Amazon.

An ergonomic chair

Since sitting down doesn’t go out the window when you get a standing desk, what chair you’re using might need to be reconsidered. Schwartz recommends the Modway Articulate Ergonomic Mesh Office Chair.

A dual monitor stand

Aligning your computer screen with your eyes is important, as Dr. Rozmaryn highlighted. A monitor stand can help you do this. Schwartz recommends a dual monitor stand by VIVO, available for $40 on Amazon.

The right mouse

Keeping in mind Rozmaryn’s tip for 80-degree angles in the elbows, the right desktop mouse is important. Schwartz recommends a wireless vertical mouse by Anker on Amazon for $20, as well as a Steelseries Mouse, which goes for $29 on Amazon.

A split ergonomic keyboard

A split ergonomic keyboard can be really tough to learn if you’re used to a traditional keypad, (take it from me, someone who has Carpal tunnel syndrome and inanely refuses to depart from the regular laptop design), but chiropractors like Schwartz highly recommend them. He picks the Kinesis Freestyle split keyboard for $90 on Amazon.

Taking a sitting break? Give your feet a literal rest. Schwartz recommends the Mind Reader Adjustable Footrest for $19 on Amazon.

More tips and tricks for a healthy office

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