Alternate Standing and Sitting as You Work

By Lauriann Greene and Richard W. Goggins
[Savvy Self-Care]

To reduce your risk of work-related injury, take a look at how much time you spend standing or sitting as you do hands-on work. Both positions have their benefits and downsides, so it is important to alternate between the two throughout a session.

Most treatment sessions should offer opportunities to switch between the two positions. How much time you choose to spend in each will depend on your own level of physical conditioning and how much fatigue you are feeling at that moment, as well as the specific techniques you are using. As a good rule of thumb, try to sit during at least one-fourth of the time in any treatment session to avoid fatigue from prolonged standing. For a 60-minute session, try to spend at least 15 minutes of that time seated.





• Allows you to use the larger muscles in your core, hips, and legs to generate force, so it’s helpful to stand when you want to apply deep pressure.

• Easier to use a wider variety of motions, which will help you avoid repetitive motion (a major risk factor for injury) due to using the same stroke over and over.

• Enables you to move over a large area with longer strokes.


• Can be fatiguing, not only to the leg muscles, but also to the lower back.

• Can also lead to blood pooling in the lower legs, which may cause varicose veins.





• Allows you to rest your legs, and lowers your position relative to the table so you aren’t bending or stooping.

• Provides more stability and precision as you work on delicate structures of the face, hands, or neck.

• Using a height-adjustable stool allows you to change your height relative to the client, which is a plus if you don’t have a height-adjustable table.


• Creates more strain on the lumbar spine (lower back) than standing upright.

• Tends to limit you to using the muscles in your upper body, since it will be more difficult to use your lower body to help create force and pressure.

• If you try to cover larger areas while sitting, you can end up reaching out from the shoulder, which over time can put you at risk for shoulder injury.


  Lauriann Greene, CEAS, and Richard W. Goggins, CPE, LMP, are coauthors of Save Your Hands! The Complete Guide to Injury Prevention and Ergonomics for Manual Therapists, 2nd Edition (Body of Work Books, 2008). They offer continuing education and a Certified Injury Prevention Instructor (CIPI) program at