So, how is that sardine commute affecting your health?

Spending yet another morning squished into a bus or tram? It might be having a toll on your body as well as your nerves.

As a result of overcrowding and sometimes design – in Sydney, the new metro train network comes with more standing room and fewer seats as a selling point and in Melbourne many trams now have pack 'em in standing-room areas – many of us travel to and from work standing up on a moving vehicle for long periods, clinging onto straps and poles above our heads and braced against our fellow commuters.

In Sydney, the light rail and metro train network have been designed to offer more standing room and fewer seats. Credit:Louise Kennerley

But, how does a standing "sardine" commute affect our bodies?

Lucy Clay, a physiotherapist at Square One Physio in Sydney, has never had a client report an injury directly caused by an incident standing up on their commute, although plenty have had existing injuries aggravated.

"After approximately 15 minutes in one position, our muscles have a tendency to shorten in that certain position, a phenomenon known as muscle 'creep'," she explains. "On our commute, workers are crammed into a small space and they don’t have the room to move around and adjust their posture and relieve any discomfort."

The average standing commuter is possibly using more muscles than they realise, says Professor Timothy Olds from the University of South Australia's School of Health Sciences.

"You're working a lot of muscles to maintain your posture: your lower hip and your glutes, your back, and also your abdominal muscles to stabilise yourself," he says.

"Then, if you're reaching above you, perhaps to hold onto a strap, you're using the top part of your deltoids [shoulder muscles]. To maintain your posture and balance, you're also using some relatively small muscles, as well as your calf muscles, in a way you might not normally."

While we might think of an incidental workout as a bonus, Olds warns it could be causing more harm than good: "The concern is that the muscles are not being used in a wide range of motion; they are semi-contracted all the time."

Olds cites previous research on workers in production lines, in which muscles are similarly contracted, have shown higher prevalence of muscular-skeletal problems, lower back pain and neck and shoulder problems.

While we might think of an incidental workout as a bonus, Olds warns it could be causing more harm than good.

"We don't know if this is directly transferrable because [commuting] is not repetitive motions like on a production line, but studies on standing desks have found similar results," he says, adding that a lot of the old wisdom on the health benefits of standing versus sitting has been been debunked.

If you do have a long standing commute, Olds recommends changing positions frequently, alternating between different ways of bracing yourself (i.e. on a strap above, or on a seat or pole lower down).

Clay agrees, adding that commuters should try to stand with their feet kept apart to maintain a wide base of support and their weight evenly on both legs, keeping their knees soft so they can rebalance quickly.

Although, Olds admits no solution is ideal: "Best of all is to really have more seats."

The concern is that the muscles are not being used in a wide range of motion; they are semi-contracted all the time.

What about the germs?

"I'd be really happy if one day the train designers went back to making windows that slide open," says UNSW infection control expert Professor Mary-Louise McLaws.

For McLaws, whose place of work will be serviced by Sydney's soon-to-be-opened light rail, the health risks of commuting which cause her concern aren't necessarily tied to standing or sitting: the influenza virus, for example, can spread up to 2.6 metres breath, so sitting in your own seat as opposed to standing up in someone's armpit is probably not going to make a huge difference.

"Influenza virus can be spread by tidal movement just in our breath, such as by speaking on the phone," she explains. "And a person can be highly contagious up to 24 hours before they have symptoms."

Cross-ventilation provided by open windows, as well as UV light, low humidity, temperature all help reduce the spread.

"If the windows open and if the doors open at regular stops, the action of the wind can kill some of the viruses."

If you have a regular standing commute, McLaws recommends using an alcohol-based hand rub to after you alight as the poles and straps you hold onto are likely to be covered in bacteria. Then, of course, all commuters should get their annual flu vaccine, and a whooping cough one if you're over 50.

"We can't really say where you'll catch something, but we can tell you that being vaccinated will help you to not catch it."

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