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A big new study of 70,000 Danish workers1 shows that taking breaks to do tiny workouts — micro-exercises to build strength — prevented at least 10% of long-term absences from work due to injury and illness. That is a big benefit, easily achieved, and it might be the best evidence available to date that even low-hanging fruit exercise is worthwhile — although it may have as much to do with complex social factors as getting stronger.
A big problem
Like most papers, Andersen et al kicks off with the details of what a big problem we have: workers not working! A plague of long-term sickness absence, LTSA, OMG! People get knocked out of work by back pain, overuse injuries, and other body meltdowns, and this just keeps happening despite decades of trying to reduce risk factors (ergonomics!) and an emphatic public health focus on encouraging physical activity.
How these initiatives could possibly have failed is beyond human understanding. 🙄2
A small solution
We need to do better. One option is micro-exercising: little exercise breaks at work. “Simple and brief strengthening exercises designed to strengthen the primary muscles used during work.”
And just how brief and simple? “Typically for 10 min three times a week without the need for changing clothes, going to a gym or showering afterwards.”
I have been calling this idea “microbreaking” for, oh, a good twenty years now: it makes a lot of sense, and research has been backing me up here and there all along.34567 But it’s all very “where there’s smoke there’s fire” evidence: small and flawed studies, never enough data to know if it’s actually solving the Big Problem of LTSA on a population scale.
Andersen et al. thought they could answer that question using a Danish superpower. And they did!
Hunting for answers in a unique data set
The Danish have some seriously high quality data on what their citizens are up to, real Big Brother stuff that few countries have (and quite a benevolent Big Brother in this case, I think). This made it possible to do a simply enormous long-term study of the effect of workplace micro-exercise on health.
Andersen et al. tracked over seventy-thousand Danish worker bees for two years (and they invited three times that many). These were healthy people, by and large; none had ever missed a lot of work before.
Several thousand people in the study (about 8%) ended up missing a lot of work due to illness or injury — and they were a bit less likely to miss work if they were doing micro-exercises, a small benefit that really added up. The data shows that 12.8% cases of LTSA were prevented by micro-exercising.
In a study this size, that’s several hundred people. In a whole country? A lot more.
What’s the active ingredient?
The authors point out that the benefits detected here have not been found in home micro-exercise programs. Micro-exercising at work tends to be social, which has all kinds of complex benefits. Exercise is not just about getting stronger! Andersen et al.:
The underlying mechanisms of LTSA prevention from micro-exercise during working hours are likely to be multifactorial in nature, including both physiological, psychological and social factors.
Active ingredients, then. Which is why the type of exercise probably doesn’t much matter. Stretching and breathing exercises might well do the trick too.
Whatever the active ingredients may be, they acted equally on everyone regardless of age, sex, or education. Exercise is good for a lot of people, and micro-exercise appears to be particularly easy and helpful, making its benefits accessible to countless people who would otherwise not exercise at all.
Exercise isn’t everyone’s cup of tea
This study contributes substantially to the reputation exercise has for being the closest thing we have to a miracle cure,8 and so it also feeds the belief that everyone should exercise (a surprisingly alien idea just a few decades ago).
Please do bear in mind that not everyone enjoys exercise. People may have a good medical “excuse” for this, but they don’t need one. People are allowed to just dislike exercise, whether that’s driven by unknowable biological factors, personality, or circumstance.
So please beware of the holier-than-thou impulse to withhold sympathy from people who aren’t fit. Karma may have you struggling to exercise sooner rather than later.
- Andersen LL, Skovlund SV, Vinstrup J, et al. Potential of micro-exercise to prevent long-term sickness absence in the general working population: prospective cohort study with register follow-up. Sci Rep. 2022 Feb;12(1):2280. PubMed 35145176 ❐ PainSci Bibliography 52027 ❐
A little sarcasm there. Ergonomics has always had underwhelming benefits for preventing workplace injuries, because it has been clear for a long time that posture and alignment are just a small part of the puzzle of pain and injury.
And lecturing a population to be more active probably does have some benefits, but was always doomed to fail by many measures — particularly with the people who stand to benefit the most.
- Sundstrup E, Jakobsen MD, Brandt M, et al. Workplace strength training prevents deterioration of work ability among workers with chronic pain and work disability: a randomized controlled trial. Scand J Work Environ Health. 2014 May;40(3):244–51. PubMed 24535014 ❐
- Jakobsen MD, Sundstrup E, Brandt M, et al. Physical exercise at the workplace prevents deterioration of work ability among healthcare workers: cluster randomized controlled trial. BMC Public Health. 2015 Nov;15:1174. PubMed 26607232 ❐ PainSci Bibliography 52043 ❐
- Escriche-Escuder A, Calatayud J, Andersen LL, et al. Effect of a brief progressive resistance training program in hospital porters on pain, work ability, and physical function. Musculoskelet Sci Pract. 2020 08;48:102162. PubMed 32250836 ❐
- Benatti FB, Ried-Larsen M. The Effects of Breaking up Prolonged Sitting Time: A Review of Experimental Studies. Med Sci Sports Exerc. 2015 Oct;47(10):2053–61. PubMed 26378942 ❐
- Loh R, Stamatakis E, Folkerts D, Allgrove JE, Moir HJ. Effects of Interrupting Prolonged Sitting with Physical Activity Breaks on Blood Glucose, Insulin and Triacylglycerol Measures: A Systematic Review and Meta-analysis. Sports Med. 2020 Feb;50(2):295–330. PubMed 31552570 ❐ PainSci Bibliography 52040 ❐
- Academy of Medical Royal Colleges. Exercise: The miracle cure and the role of the doctor in promoting it. AOMRC.org.uk. 2015 Feb. PainSci Bibliography 53672 ❐
This citation is the primary authoritative source of the quote “exercise is the closest thing there is to a miracle cure” (although it are no doubt many variations on it from other sources over the years).
The big four “proximate” causes of preventable ill-health are: smoking, poor nutrition, lack of physical activity and alcohol excess. Of these, the importance of regular exercise is the least well-known. Relatively low levels of increased activity can make a huge difference. All the evidence suggests small amounts of regular exercise (five times a week for 30 minutes each time for adults) brings dramatic benefits. The exercise should be moderate – enough to get a person slightly out of breath and/or sweaty, and with an increased heart rate. This report is a thorough review of that evidence.
Regular exercise can prevent dementia, type 2 diabetes, some cancers, depression, heart disease and other common serious conditions — reducing the risk of each by at least 30%. This is better than many drugs.