Both the Medium and Narrow Bambach Saddle Seats are 17” across at the rear, but this measurement is irrelevant because the body and thighs extend beyond the edges of the seat itself. The real issue is the spread of the knees (hip abduction). Unfortunately, the width of the front part of the seat (the pommel) is also irrelevant, because the thighs drape across the seat at an angle which can vary depending upon seat height and the user’s anatomy (e.g., muscular or thick thighs vs. thin or soft thighs). It’s the front dimension (the pommel) that affects the spread of the knees (hip abduction) and the position can vary from individual to individual in the same seat.
People who have had hip surgery rarely have problems fitting into the Bambach Saddle Seat. However, there can be problems when the joint itself is sensitive to direct pressure. This occurs when the muscles surrounding the hip joint are atrophied to the point they no longer cushion the hip joint, or when the joint is inflamed (e.g., active arthritis). In these cases, any pressure to the upper thigh/inner buttock area can be uncomfortable.
The only way to know for sure is to try the seat in person. If you are in the San Francisco Bay Area, are welcome to trial the various saddle seats in our office.
Hip osteoarthritis (OA, also called degenerative joint disease) is the most prevalent pathologic condition at the hip joint and is characterized by degeneration of the articular cartilage. As the cartilage breaks down, there is pain and mobility restriction. Surgery is usually considered in advanced stages of hip OA when there is severe pain and stiffness.
The problem with sitting
In conventional sitting with the hips at a 90-degree angle, the weight of the body produces compression forces through the ischial tuberosities which transfer to the hip joint; which in turn decreases the joint space and puts pressure on the cartilage. You can reduce pressures in your hip joints up to 50% by opening the hip angle. The ideal hip angle is 45-degrees (i.e., 135-degrees between thigh and torso). You can also reduce pressures in the hip by sitting with your knees apart (i.e., hip abduction).
Doctors often prescribe a “hip chair” for their patients with osteoarthritis. A hip chair is nothing more than a conventional chair on tall chair legs. Because the seat is higher than a conventional chair, you can perch on the front edge to keep your hip angle open and it is easier to get in and out of the chair from this high perch position. Unfortunately, if you sit back in a hip chair it is no better than a conventional chair, because the seat-to-back angle is still close to 90-degrees. If you perch on the front edge of a hip chair, you will quickly experience uncomfortable pressures behind your thighs that can impair the circulation and pinch nerves.
How a saddle stool helps symptoms associated with Hip Osteoarthritis
- Strengthening and mobility exercises play an important role in the treatment of hip OA. A saddle stool can provide the same benefits by helping to regain lost mobility and range of motion, and may reduce the need for surgical intervention. The high straddle posture gently stretches and strengthens the hip joint, while reducing loads and pressures on the joint cartilage.
- A saddle stool alleviates pain and other symptoms associated with hip OA; strengthens core muscles, maintains good posture and increases functional ability because it positions the hip joint in its natural neutral position. When a person is in a relaxed straddle posture on a saddle seat, the thighs rotate outwards and the legs naturally spread into an abducted (knee open) position. This position opens the hip joint (external rotation of hip), increases the joint space and decreases the compression forces on the hip joint cartilage, stretches the hip adductor muscles, and prevents backward movement of the pelvis.
- When the hip joint is in a relaxed position (as observed when using a saddle seat) the cartilage has greater ability to imbibe greater amounts of nutritional fluid, which in turn can reduce inflammation and help maintain the health of the cartilage in the long run.
- Poor sitting posture (slouched sitting) internally rotates the hips, compresses the hip joints and can increase the pain associated with hip OA.
- A saddle stool improves spinal alignment by maintaining the pelvis in a slightly anterior tilted position allowing the spine to maintain its natural ‘S’ shape as observed in standing. This position also recruits postural muscles in the back and abdomen thus improveing core stability of the body and optimizes freedom of movement for the upper limb thus improving the functional ability.
Which saddle stool is best for Hip Osteoarthris?
The simple answer, is the one that fits your bootie best. But seriously, it depends on how advanced the arthritis is and on how restricted your hip mobility.
In early mild cases, you can use any saddle seat that comfortably fits your anatomy. Any saddle stool will provide the right therapeutic benefits. And the sooner you start, the less mobility you will lose. It’s even possible to reverse the stiffness you have already acquired.
In moderate or severe cases, you may need to select a saddle stool that is more narrow or slim, at least to start. The Bambach Saddle Stool requires less hip abduction (i.e., knee spread) than do the Salli and Kanewell brands. After a year or two or three, your hips will have gradually loosened, and you may be able to use the wider saddles just as easily. Be patient. It can take a long while for your hips to regain lost flexibility.
If you have had hip surgery, it’s hard to predict which saddle will be most comfortable for you. Not all hip surgeries are the same, and your muscle and soft tissues around the hip and buttocks may not be as supple as they once were. In our experience, the Bambach Saddle Seat is preferred by most people with hip joint replacements or hip fusion. The Bambach Saddle Seat can also “cut down” to accommodate special hip problems.
 Jan Van Houcke, Ashwin Schouten, Koen Vermeulen, Gilles Van Acker, Gunther Steenackers, Christophe Pattyn, Emmanuel Audenaert; The Impact of Sitting Configuration on the Hip Joint Reaction Force and Hip Flexion Angle, Journal of Hip Preservation Surgery, Volume 3, Issue suppl_1, 1 September 2016, hnw030.075, https://doi.org/10.1093/jhps/hnw030.075
Be patient. In the vast majority of cases, the hips stretch out in time. How much time depends upon your age and whether or not there is some hip joint pathology. It could take anywhere from a few weeks to a year or more. It’s well worth the wait. Once the hips become flexible, not only does posture improve when you sit, but also when you stand. You may also walk and run with a longer, smoother, and more upright stride. In general, the more flexible your hips, the less strain on your back.
For optimal hip positioning, make sure you are using the saddle stool at the proper height. Your body should be half-way between sitting and standing with a thigh-torso angle of about 135-degrees. If your hips are quite stiff, you may have difficulty positioning the seat high enough at first. Keep trying. It can take some time for hip joints to loosen.
A saddle chair may feel excessively firm if adjusted too high. When the saddle seat is higher than it should be, the entire weight of your body is on your sitting bones. When the seat is at the proper height, your feet are firmly on the ground, allowing your legs to carry more of the load.
Be careful that your saddle seat is not too low. If you use a saddle seat lower than it should be, your pelvis tilts backwards and your back slumps, which increases pressures on your sacrum and tailbone.
Your saddle seat may feel hard if you sit too far toward the front of the seat. Your buttocks should be nestled into the rear of the seat, which is anatomically shaped to comfortably cradle and support your pelvis. With your pelvis nestled toward the rear of the saddle, it is each to roll the pelvis forward when you must reach while working.
For people with a very sensitive buttock area, the anatomical contours on the Bambach Saddle Seat are usually more comfortable. For people with very sensitive genital tissues, the open center gap of the twin 2-part saddles developed by Salli Systems are usually more comfortable.
In saddle chairs with an open center (e.g., 2-part seat), it is even more comfortable to sit for long periods of time. Because of the gap, there is no pressure to your genital area, thus there is no need to tilt the pelvis back to relieve pressures. Tilting the pelvis backwards causes the back to slump and round, which is harmful for the spinal disks and overall health of the lower back.
Have you ridden a horse? Remember when you first get into the saddle you have to wiggle around, sit back and deep into the saddle, then after a while it becomes quite comfortable. It’s the same with the Saddle Seat. If you experience some saddle soreness, try adjusting the seat angle to a more horizontal position so you can sit down and back. And remember, in time your body will comfortably adjust.
Explore all seat tilt and height variations. Small adjustments will change the distribution of pressures.
BACKREST USERS: For the first few weeks push the backrest as far back as possible so you are using the seat only. Begin using the backrest only after you become fully comfortable in the seat. Adjust the seat tilt (usually backward) until you are as comfortable as can be considering your current fitness. Your fitness for healthy sitting will improve and as it does, you will find yourself using the seat in a more central position.
MEN: Some men have difficulty in adjusting. This is made easier by having the seat tilted down at the front to the maximum. Also, when sitting down, sliding back onto the seat helps to position the male parts more comfortably, the same as horse riders.
TIGHT HIPS: Some people experience tightness in thighs and hips. Again your body will adjust. The position with your knees apart greatly reduces the chance of hip joint disease at a later age. Tight muscles, tendons and ligaments will soften and relax over time, which is desirable.
When saddle-sitting riding-style, spinal posture is automatically correct and there is usually no need for a backrest. The pelvis is in an ideal upright position, which makes keeping your back straight as easy as if you were standing or walking. We do not need any backrest when we are standing either.
In a conventional chair with a backrest, the thighs and upper body form a tight 90-degree angle, which rotates the pelvis backwards. This is what rounds the back and causes it to slump, leading to muscle fatigue and back strain. Traditional “ergonomic” chairs attempt to counteract the slumping by pushing into your lumbar curve with a backrest. This support strategy frequently fails.
We generally discourage the use of backrests on saddle seats, both because they can restrict normal body movement, and because they can distort the balanced perch posture on a saddle. However, a backrest can be helpful in cases where the sitter has impaired balance, motor control, or weakness (e.g., cerebral palsy, multiple sclerosis, stroke, muscular atrophy, etc.), or in cases where the task is static, precise, and prolonged (e.g., microsurgery or dental procedures lasting hours).
Take care not to position the backrest so far forward that it pushes you onto the front pommel of the seat. That hurts. In a saddle Seat there should be no pressure from a backrest pushing into your back.
Desk heights for saddle-sitting are several inches higher than for conventional seating. Therefore, it is important to adjust your saddle seat to the correct height first. After you determine your correct sitting height, raise your desk to a comfortable height for working.
If you normally work at a traditional office or computer desk, you need to raise it quite a bit to benefit from saddle sitting. Place a shim under the desk legs (for example, using Raise Its™, wood, or bricks) or use a riser to raise your computer screen and keyboard.
Desk height for a conventional chair is lower.
Desk height for a saddle seat is higher.
If you usually work on a high drafting stool or in a standing posture, you may be able to switch to a saddle seat with little or no adjustment of your working height.
Your hand tasks should be approximately at the level of your elbows, give or take, depending upon the task. Visually demanding hand-tasks are positioned a few inches higher, and hand tasks requiring some force (e.g, gripping, pounding, twisting) are positioned a few inches lower.
- Touch typists who can type without looking at the keyboard, can position their keyboards at or below elbow height.
- Typists who must see the keyboard to type accurately, must position their keyboards a few inches above the elbows and further away from the body, in order to bring the keyboard into view.
- Paper-handling and reading tasks are generally 2″ or more above elbow height.
- For visually demanding tasks, for example reading or fine hand work, the desk can be several inches higher.
- If your desk is not height-adjustable, you can raise it with bricks or boards or purchase commercial desk risers (i.e. Raise Its.
- If you work without a desk, adjust your hand-task so that you don’t need to bend over at all.
When standing next to your saddle seat, the seat contour (the hollow part) should be about two inches (5 cm) above the crease at the back of your knee. This height opens your hip angle and allows your feet to rest comfortably on the floor.
There are three pneumatic lift sizes available to customize the height of your Saddle Seat.
A saddle seat can only keep your back straight if your knees are spread wide. If your knees come together you will slump, no matter the shape of the saddle. The angle formed by your thighs and torso should be about 135 degrees. If you sit lower than that, it will be difficult to get your legs into the proper straddle position.
Some saddles are wider than others. If the saddle is narrow it must provide additional support for the pelvis. This is usually done with sacral support, for example, a cantle or rise in the rear of the seat. While this can help keep the pelvis upright, but can create saddle fitting problems. For people with more ample buttocks, a sacral support often pushes the body forward in the seat and creates pressures on the genital anatomy toward the front.
Be sure your clothing does not interfere with your hip abduction (leg spread). Wear loose trousers or a wide skirt.
The position of the pelvis is different on a bicycle seat. The pelvis is tilted back, the body is not upright, and the hips are not abducted (not in the spread position). This makes the legs work very hard to stabilize the body.
In a kneeling chair your feet are locked in underneath you. In the Saddle Seat your feet are free to operate equipment or help you scoot around your work area with your feet in full contact with the floor.
Getting in and out of a kneeling chair is difficult as your feet get entangled in the kneeling pad. Getting in and out of a Saddle Seat is easy.
You will especially benefit from a saddle seat if your work involves:
- close hand-eye coordination requiring precision and accuracy.
- a lot of reaching.
- moving your body along with your arms.
- work spread out over a large area.
- varying work heights.
- dealing with heavier objects or forces.
- viewing closely or at odd angles.
- long periods of standing.
- getting up and down often from your seat.
If you suffer from painful conditions of the neck, back, or upper limb, or if you have a neurological or musculoskeletal condition, you may also benefit from using a saddle seat.
A conventional chair cannot support healthy sitting for active work. In a conventional task chair your center of gravity is behind your sit bones (ischial tuberosities) with your pelvis rolled back. If you work while reclining, this is OK. But if you need to work in an upright or forward position, especially if you work with your hands, your lumbar spinal curve will flatten. This leads to stressful muscular activity and increases pressures in the spinal disks, impairs circulation, compresses the internal organs, and loads the hip joint cartiledge.
A saddle seat satisfies the requirements for active sitting better than a conventional ergonomic chair. When sitting on a saddle chair, the spine is almost in the same position as when standing. The pelvis rotates upright and positions the body’s center of gravity over the ischial tuberosities (these are our seat bones). This position is natural and easy to maintain.
Sitting on a saddle chair expands the thoracic (chest) and abdominal regions to allow full function of the lungs and abdominal organs. In the upright position supported by a saddle seat, the diaphragm is not pushed up into the vital organs as in a conventional seat. Muscle tone, blood and lymphatic circulation is enhanced,
A saddle chair’s high, straddle posture supports and stabilizes the body, freeing the hands and feet for work and movement. It is easy to move about in your workspace to reach equipment, or to reach a foot switch. This stable, straddle posture also improves hand accuracy and power, and improves sitting balance.
One “rides” the saddle seat just as one rides on horseback. It is the ideal sitting posture. The hip joints rest in a relaxed open position and the spine is in perfect balance. The hip joints are in abduction and external rotation which reduces hip joint stress, as the ball of the hip joint now rests comfortably within its socket in the pelvis. This straddle position with knees apart is also thought to have preventive value against future hip disease (according to Prof. Dr. G. Schumoe, Orthopedic University Hospital, Bonn, Germany).