I was roasted by a physician for sitting weird but they gave me some great tips for healthier gaming

I remember the stigma attached to gaming chairs even 10 years ago. The general consensus among many being they're all style over substance. Browse most major retailers and you're sure to find some specimens even today, many of which leave ergonomics to the imagination. That's gradually changing—as is the science behind sitting.

I recently had a chance to speak to Dr. Lindsey Migliore to find out from someone that knows a thing or two about it.

Dr. Migliore is a physician working in esports medicine. She wrote a book about it and founded a consultancy on esports health, GamerDoc, in 2020. She's also teamed up with Herman Miller and Secretlab, acting as an ergonomic advisor to the gaming chair company. That's where I met Dr. Migliore, at Secretlab's HQ in Singapore—everyone calls her Dr. Lindsey.

I offer to show Dr. Lindsey my own sitting position, which I sheepishly admit is absolutely dreadful. I hunch forward. I don't mean to but I catch myself gradually moving towards the screen throughout the day. Maybe it's my eyesight—that's what I tell the doc, anyways—but it doesn't protect me from the savaging yet to come.

Dr. Lindsey had a lot to say about my sitting position. Little of it good. Even besides my persistent and problematic hunching, my feet aren't always flat to the floor and I don't use my standing desk as often as I should. I'm a great example of what not to do.

Dr. Lindsey judges my posture and quickly—maybe too quickly—suggests I suffer from lower back pain in the morning. It's actually an ongoing issue, and now I'm sat in front of a physician who accurately diagnosed the issue in seconds, I start to wonder if I've entirely created it through my own awful posture.

"Starting to catch up on you a little bit?" Dr. Lindsey says as I hunch over the desk in the Secretlab showroom. "Back pain in the morning? Can't touch your toes?"

Dr. Lindsey is correct about the back pain. Though I can touch my toes because I do yoga, which I quickly interject to try to make it appear that I'm not a complete and utter gremlin.

Thankfully, this isn't merely an exercise in mocking me. The doc goes through some steps to better fit the chair to my body and support me throughout the day, which you may find useful in your own quest for better posture and a longer shelf life behind a desk.

...you've got to get your butts moving.

Dr. Lindsey Migliore

"Feet flat on the floor is the number one most important thing."

"Knees in line with hips, maybe hips a little bit above," Dr Lindsey continues, suggesting I should raise the height of the chair a little.

"When you adjust the seat depth, you want two to three finger breadths behind your knee and the chair."

What Dr. Lindsey means by this is, when sitting upright with your feet flat on the floor, extending two or three fingers together on one hand, slot them between the end of the seat and the inside of your knee. If you can fit your fingers there, but no more, you're in a good position. If not, adjust the seat depth.

"So you want your low back flat against this," Dr Lindsey says, tapping the lumbar section of the backrest. I'm sat in Secretlab's new Atlas chair, which Dr. Lindsey has been brought in to speak about, but this advice works for anything with a reasonable attention to ergonomics.

We move onto armrests, which I'm thankfully no longer required to demonstrate. Dr. Lindsey is surprisingly easygoing when it comes to setting them to a preferred height for personal comfort.

"Some people put their armrest right at desk level, which is great, because then you can sit like this," Dr. Lindsey sits with her arms across the armrests and atop the desk. "I put them a little bit below, and then raise my desk up so I can get more close and use kind of more the desk as my armrests."

"So the arm is usually at about the level of the desk, but it's more personal preference. You just want your wrist to be neutral."

A neutral wrist, which is a focus of ergonomic keyboards and mice, is to reduce the risk of carpal tunnel syndrome. With a neutral wrist position—the position they'd take if you loosely hang your hands by your sides—the pressure is relieved from your carpal tunnel, which sits between the two bones extending towards the hand.

The monitors should be an arm's length away, and then the top of the monitor should be at or just below eye level.

Dr. Lindsey Migliore

"Any extension, or flexion, the pressure on the nerve that runs through there sky rockets, and that's what causes compression over time. So you want to keep your wrists in neutral, and that's really what the armrests do, and kind of offload the weight on the forearms a little bit."

A desk that can be adjusted to your height is a handy thing to have, Dr. Lindsey admits, but suggests you can get by with stacking books under the legs as she once did.

"So when you're thereat the desk, the desk is going to move to you so your elbows are at 90 (degrees), and then the monitors should be an arm's length away, and then the top of the monitor should be at or just below eye level."

A lot of this is the ideal posture, which Dr. Lindsey is keen to point out is only half the battle. Sitting upright is good, but movement is key. I can hunch, if only for a bit, so long as I mix up my sitting position shortly thereafter. I should aim for good posture, but I should also aim for lots of postures throughout the day.

"Ergonomics isn't just physical anymore. It's got to be behavioral. It's got to be something that makes it easy for you to move."

Life's not a video game where we get to choose another character. We are stuck in this.

Dr. Lindsey Migliore

"When I started working, it was like the 90-90-90 rule, which was stiff, upright elbows," Dr. Lindsey says as she demonstrates an upright seating position. "The perfect posture."

"And then we started applying it more to office workers and how we all kind of sit in the early 2000s and that's when adjustability started blowing up. And we got split keyboards, vertical mice, sit-to-stand desks. And adjustability is great. It's essential. But they replaced, like perfect, upright sitting with perfectly supported stillness. You know, there was no movement, there was no intentionality to movement."

Dr. Lindsey explains how the muscles in our body are meant to take load and respond with tension. Otherwise we'd flop over. The issue is that sitting for a long period of time causes strain to muscles holding tension. The symptoms of this strain change with time.

"In the short term, it's pain, it's discomfort, but in the long term, the tissue remodels. The tissue remodels to get used to stillness, to get used to lack of movement.

"So now what we're looking at in modern ergonomics is you've got to get your butts moving," Dr. Lindsey says.

One piece of advice is to actually use the tilt functionality on your chair if it has one. Flip the lever and relax a little—moving the muscle tension elsewhere, if only for a while before moving back. Another piece of advice is for anyone with multiple monitors, especially those with a monitor off to one side. It is, simply, to move the monitor from one side to the other from time to time so that your neck isn't always craning one way. It seems so simple as to be obvious, but I'd never done it before.

Nowadays, I have a single ultrawide monitor, and thankfully the advice is pretty straightforward there: plonk it right in front of you, considering the eye-level and arm's distance away advice mentioned earlier.

Another solid recommendation is for anyone with a standing desk. That is to always stand when you remember you have a standing desk. It's a habit builder—Lord knows I need new habits as someone that infrequently stands throughout the day.

As for me, since my meeting with Dr. Lindsey, I've become acutely aware of my poor posture throughout the day. I'm trying to remember to do something about it. I was told "It's not too late for you," though admittedly I forgot my own age when asked and Dr. Lindsey thinks I'm 32. I'm 34. Maybe it is too late for me.

"You still have time to reverse these changes. You know, life's not a video game where we get to choose another character. We are stuck in this. So, I think you've got some actionables."

"I'm not gonna bully you anymore," she says. But I get it. The message is loud and clear, Doc. Better late than never.