An Interview with Chiropractor Dr. Casey Loewy

To help our community better understand what prolonged sitting does to the body, we spoke with Dr. Casey Loewy, a chiropractor with over 13 years of clinical experience. 
We discussed what really happens when we sit for long periods, how floor-sitting changes the equation, and what practical shifts can help us live and work with less pain. 

The Impact of Prolonged Sitting

Q: What body parts are most affected by prolonged sitting? What do people often overlook? 

Dr. Casey: The hips, lower back, and neck are the most common and obvious parts. But breathing and the nervous system are often overlooked. 
We tend to take movement or just our body for granted. When we're stuck in one position for long periods of time, our body starts to guard and tighten. Often we don't even notice until we try to take a deep breath. 
We may not even realize whether we're breathing through our mouth or nose, and then that can lead to stress or vice versa, the stress causes the change in breathing.

Q: If someone sits for 8 to 10 hours a day, but changes positions often, does that reduce some of the issues? 

Dr. Casey: Yes, but small movements aren’t enough. You still need intentional exercise at least two or three times per week. Early in rehab, pain and discomfort may not go away right away. But once you get stronger and work on those stability muscles and movements, then the stretches and the breaks in between sitting relieve it much faster.

Q: Do you prefer one longer workout at the end of day or small movements throughout the day? 

Dr. Casey: It is hard to choose. Ideally, every 30 minutes to an hour, you should get up from the desk to stand, do a few squats, or take a walk. That is what I would call a true “get out of your desk” movement for five-ish minutes. 
If you can't stand up, you should move in your seat. Do pelvic tilts, shift side to side, or open your chest. If you've been leaning forward for 10 minutes, sit up a little bit taller for a few minutes. The key is to counteract whatever position you’ve been in. Don’t stay stuck in one posture for an entire hour.

What Changes When You Sit On The Floor

Q: What changes when you sit on the floor versus sitting on a chair? 

Dr. Casey: It is truly beneficial to be able to sit on the floor because moving from standing all the way down to the floor is excellent for our bodies and joints. If the transition becomes difficult, it can signal limited mobility and increase risk of injury, stiffness, and arthritis.
The cool thing about the floor is you have more space to move in and out of different positions. It also requires more core engagement. Without a chair or backrest supporting you, you naturally sit more upright. 
If you have hip mobility issues, you can sit on a slightly elevated yoga block or a rolled-up towel to help. From there, you can move into shin box positions or 90/90 positions.

The “Baby Milestone” Connection

Dr. Casey: When babies learn all these milestones, they move through positions we should still be able to do as adults. In my rehab, I use a method called DNS (Dynamic Neuromuscular Stabilization) from the Prague School. It revisits positions babies learn, including core-intensive transitions like touching the opposite hand to foot, crawling on all fours, and half-kneeling. 
These are the same transitions we use when sitting on and getting up from the floor. We’re not necessarily losing ability because we’re aging. We’re losing it because we don’t give ourselves the opportunity to move that way anymore. We simply need more opportunity to move. 

 

The Brain–Body Connection

Q:  I am very interested in the brain-body connection. Are you saying that we lose a lot of that during our everyday general sitting? 

Dr. Casey: Yes. When we sit, we don't think about what muscles we engage or how we move our feet. Over time, we lose awareness. Prolonged sitting is like wearing super tight shoes. If one area gets irritated, the effects can trickle all the way up. When the foundation of our body, our feet, isn’t engaged, the rest of the body is going to compensate.Similarly, while sitting, it’s hard to engage our core, so our lower back compensates. It’s also hard to breathe fully through our diaphragm while sitting in a hunched position. 
This is similar to what we see in children with low muscle tone, meaning their center isn’t strong enough to keep them upright, and they tend to fall forward. To sit up without falling, they must actively strengthen their core. From the very beginning of life, we build this strength. But over time, with excessive sitting, we gradually lose it again.

 

Lost Movements in Modern Life

Q: You've mentioned several floor-sitting positions. Are there any underexplored positions or movements people have lost in modern life? 

Dr. Casey: 
One of the biggest losses is simply knowing how to properly get in and out of positions, especially transitioning from the floor back to standing. 
We’re not using our core efficiently or optimally. When picking something up from the floor, we often bend forward and round our lower back. That’s okay occasionally. But if you’re tired, stressed, or not physically prepared for that position, that’s when injuries happen. 
Ideally, we should move closer to what we’re trying to pick up. Instead of bending and reaching from far away, we could lower into a half-kneeling position. Move closer, let your body work smarter, not harder.

Small Changes, Big Impact

Q: Are there any small changes that would make like a very disproportionate difference? 

Dr. Casey: I would start with a proper ergonomic setup. Everyone's limb length and torso length are different. That's why a standard chair can be tricky; it may not truly fit the individual. The same goes for desks, unless they are electronically adjustable and can move up and down. 
I usually start simple: if you have a laptop, get a separate keyboard and mouse, and raise your screen up to eye level. That’s one easy change that can make a big difference; it naturally encourages you to sit more upright.
The second thing is building the daily habit of changing positions. Wherever you are, standing, sitting, or on the floor, don’t stay in one position too long. Whenever you feel like you're getting tight, that's a little alarm that reminds you “okay, change my position.” 

A lot of the issue isn’t that people choose the “wrong” position. It’s that they forget to move. 

Q: If you could redesign the work environment based on what you see in your patients, what would change?

Dr. Casey: I would normalize movement. A lot of my patients say they feel awkward being the only person stretching or rolling out a yoga mat at work. It shouldn’t feel unusual. 
Movement breaks should be built into the culture, whether that’s five minutes every hour or a longer reset during the day. It should be universal, not something one person feels self-conscious about doing.