Břevnov Monastery · 3 November 2026
Health is an asset.
Pain is a liability.
How the body keeps its books. A twenty-minute talk by Paul Bielak and Marcin Dochnal, kept here as five minutes of reading for the people who were in the room and for the colleagues they send it to.
1Hands up
Three questions
Marcin asked the room for hands, three times. Count your own.
Have a look around. That was most of the room, and Marcin was in the same row.
Movement is good. A good thing done wrong does the same damage as a bad thing. Even water, in the wrong dose, is harmful. The key is to do the right thing, the right way, in the right amount.
2Before the books
Brain and spine: one system
One piece of anatomy explains why a chiropractor came to talk about health and not about backs. Tap a layer.
Mental health is the headline. Back pain is the leading cause of disability. Same structure, and it is where most people break.
This is not a claim that a good back cures a bad stomach. It is the observation that a person whose frame is in pain does not sleep, move, eat or think the way they otherwise would. Health shows up in many forms, and a lot of it is decided at the frame.
3How the body keeps its books
Every body keeps a balance sheet
The room keeps books for a living, so Marcin put it in their language.
| Assetswhat you can draw on | Liabilitieswhat falls due later |
|---|---|
| Enough sleep | Sleep you owe |
| Breakfast and regular meals | Lunches skipped in closing week |
| Time outside in daylight | Screens late at night |
| Strength and room to move | Hours sat still |
| People you like | Worry carried home |
| Total: health | Falls due as: pain |
Assets minus liabilities is your reserve. It is what you work, lift and think with.
None of the liabilities hurts on the day you book it. A liability falls due later, and these fall due as pain. Carrying some is normal. Every business does. The trouble starts when they grow faster than the assets and nobody is reading the statement.
Stay in overdraft long enough and something defaults
The limit moves with how you slept, what you ate, whether it is closing week, whether a child is ill at home. Step outside it for a day or a week and nothing happens. Stay outside it long enough and far enough, and something defaults. That is the pattern behind almost every complex case that reaches the clinic: rarely one big event, usually a long overdraft and a small trigger. A suitcase, a sneeze, a bad night on a hotel mattress.
Which creditor calls first is personal
- Lower back
- Neck and headaches
- Sleep
- Mood
- Relationships
Same overdraft, different default. In clinic, back pain rarely arrives alone: less sleep, more worry, a shorter fuse at home, and a person who is at work without really being there. Marcin has lost count of the partners who brought the other half in and said: please get them out of pain, I cannot live with them like this. The body never kept those as separate accounts, so neither do we.
4The biggest number in the talk
were living with low back pain in 2020, the study's latest year. It is the leading cause of disability worldwide, and the WHO expects 843 million by 2050.
Closer to home. Central and Eastern Europe have the highest rates of any region, and the study ranks Czechia second of 204 countries, behind Hungary.
Where it comes from. The study attributes 22% of the disability to how people work, 12.5% to smoking and 11.5% to body weight. Work is the largest cause it can measure. It does not say why one country sits above another, and its authors caution that country rankings rest on thin data in many places.
Not a niche clinical topic. It sits inside every payroll.
Sources: GBD 2021 Low Back Pain Collaborators, The Lancet Rheumatology (2023), estimates for 2020, published 2023; World Health Organization, Low back pain fact sheet (2023), 2050 projection.
5Every hour
Sitting is a liability the body books every hour
The hours in between are not neutral either. Four findings, kept brief; the references are at the end of the page.
+16%
all-cause mortality for mostly-sitting work, and +34% cardiovascular
Alternate sitting and standing, and most of the excess disappears.
3 × 1 min
bursts of effort a day, in people who never exercise
Cardiovascular mortality roughly halved.
52%
smaller blood sugar rise from a seated calf movement kept up for three hours
A small laboratory study.
2×
the mortality risk when sitting comes in the longest unbroken stretches
Breaking up sitting matters, not only the total.
Not a promise to prevent any of this. A case for the right movement, in the right amount, often.
6The line
Three stops on one line
Where the three of us stand, and the one boundary between us.
Before
Good Health Society
The daily habit, for many people at once. A few minutes a day, taught to teams before anything breaks.
When it breaks
Roots Health Clinic
Where Marcin works once it has broken: one person, one problem, after the fact.
After
Advance Training
Where people go after the clinic, with Paul, to rebuild what they lost and learn to move well again.
Then the line loops back to the habit.
The clinic treats. The programme teaches. The two never mix.
The most important person on the line is the owner of the back. Most of what keeps a spine healthy is done by the person who owns it, and it is not overwhelming: small, and daily. The three of us exist to make that small thing clear, and to catch what it cannot.
7The frame
You are stronger when all is connected
Think of a digger. The bucket lifts only what the base can hold, and every joint between passes the force along. The body works the same way. Tap a part.
Strength travels along the chain. So does pain. A weak link anywhere, and every other part works harder.
8Stand up
One minute, every hour
Paul had the whole room on its feet for a few minutes: one everyday movement done two ways, so everyone could feel the difference. That was the programme, not a description of it. This is the part you can take with you.
- Stand up.
- Palms to the ceiling.
- Reach up and lengthen.
- Breathe. One minute.
Once an hour, every working day.
If reaching up causes pain, stop. This page teaches a habit. It does not examine or treat anyone.
The trap
If you tried the minute above: well done on your deposit. Your asset just grew in value.
The body does not book what you know. It books what you did.
The trap catches senior, busy people who are determined to stay sharp. We read the books, listen to the podcasts, save the articles. It feels like progress. Knowing is not doing. A lot of what we consume is entertainment that feels like education, and it costs time and energy we do not have. Nobody needs to reinvent health. We need to hold ourselves accountable and do a little, every day, in the right direction.
9What we learned
What three years taught us
13
years in clinic
Marcin. Tens of thousands of people in back pain.
15+
years in training
Paul. Thousands of people in back pain.
3
years upstream
Good Health Society. A few hundred people, in different sectors and countries.
Partners sell expert hours after something has gone wrong. So does a clinic. Three years ago we started to move upstream with Good Health Society: online courses about back pain, then workshops inside companies. So our conclusions come from both sides: decades of fixing people after the fact, and three years of trying to get there first.
Our job is the dose: the smallest daily amount that works, done correctly. A few minutes, once or twice a day, like brushing your teeth. Good for you. Across a whole company, good for the business.
10What worked
Five things that worked
How do you get a client to hand over their receipts? It is not difficult. It is tedious, and everyone finds an excuse. You remind them, remind them again, sometimes you mention a penalty, and in the end they do it. Nobody can fine anyone for skipping a back routine, so this is what worked instead.
- A few minutes a dayShort enough for an ordinary Tuesday.
- Easy, never in the wayOne tap. Nothing to set up, nothing to find.
- Something you can feelA difference before and after, every time.
- Small groupsNobody does it alone.
- A reward and a leaderSomeone they can see doing it too.
We made the information mistake ourselves at first: we told people everything at once and never reminded them why it mattered. What worked was simpler. Find a way to do what you need to do in a way you like doing it. Liking it means you feel something good during or straight after, and it does not get in the way of everything else.
Software carries the routine. People carry the accountability.
11Why this matters here
Why it is relevant, and what it costs
The law moved
8 November 2025
Chronic lumbar spine disease caused by long-term heavy physical work has been on the Czech list of occupational diseases since 1 January 2023. Government regulation 428/2025 Sb. eased the criteria for recognising it. It covers work that means lifting, carrying and bending, not desk work. Employer liability insurance premiums are set by sector and do not change with claims.
The days
62 days
The average Czech sick-leave case for a musculoskeletal diagnosis in 2023. Fifteen percent of cases, but thirty percent of all days lost: the largest share of days of any diagnosis group. The employer pays the first fourteen days of every case.
At work
3 in 4
Three quarters of the productivity lost to pain is lost while people are at work, not through absence: at work without really being there. A US workforce study. When it does become absence, it is expensive: in Sweden, people treated in hospital or specialist care for back pain lost about €8,900 each in work in a year, against €3,500 for people of the same age and sex. Worldwide, the WHO calls chronic low back pain a major cause of work loss, and in the EU roughly three out of five workers report musculoskeletal complaints. And prevention pays: Australia modelled a ten percent cut in back problems as worth 41 billion Australian dollars of GDP over ten years.
The first reaches employers with physical workforces. The second and the third reach every employer, desks included.
12What we are building
A toothbrush by the sink, not a portal
- An icon on the home screen. One tap, no login.
- Today's session: three short video blocks, at the desk or on the floor, in English or Czech.
- A streak with grace days, and a team champion who knows you are doing it.
Every firm has a client portal nobody opens, and every company has a benefits platform nobody logs into. So this is not a portal. Think of a toothbrush by the sink.
Built by clinicians on biomechanics, ergonomics and exercise physiology. The participant app is in build ahead of the first pilots.
13The ask
A pilot inside your own teams
Most firms already do something for their people: an ergonomic assessment, a workshop, a benefits card. Keep all of it. Those efforts are episodic, and the body books every day. The pilot adds the daily layer in between.
January to April
Your busiest season, so a fair test.
Measured
Agreed in writing before anyone starts.
A report
What moved, and what did not.
There are many routes up this mountain. This is the one we know.
Or write to us directly
info@goodhealthsociety.com
- Paul BielakCo-founder, Good Health Society. Ergonomics specialist. Advance Training, Prague.
- Marcin DochnalCo-founder, Good Health Society. Chiropractor, Roots Health Clinic, Prague.
A pilot is designed to show whether people do the routine and how they feel before and after. Absence is tracked, not graded: one pilot group is too small to prove a change in sick days, and we will not claim one.
Questions we were asked
Is this treatment?
No. Good Health Society teaches a daily habit to groups of people. Treatment is one person, one problem, in a clinic, and the two never mix. If you are in pain now, see a clinician.
How much time does it take?
A few minutes, once or twice a day, plus one minute every hour. Short enough for an ordinary Tuesday, and for closing week.
We already run ergonomic assessments and workshops. Does this replace them?
No. Keep them. They are episodic: a chair gets adjusted once, a workshop happens once. This is the daily layer that runs between them, and it works better when the other things are already in place.
What would a pilot show?
Whether people actually do the routine, and how they feel before and after, with the measures agreed in writing before anyone starts. Absence is tracked, not graded. One pilot group is too small to prove a change in sick days, and the report will not claim one.
Who is behind it?
Paul Bielak, an ergonomics specialist with more than fifteen years in training, and Marcin Dochnal, a chiropractor with thirteen years in clinic in Cambridge and Prague. Good Health Society is their education company, based in Prague. The clinic and the gym are separate businesses with separate jobs.
Sources
- World Health Organization, Low back pain fact sheet (2023): 619 million in 2020, 843 million expected by 2050, work loss: who.int
- GBD 2021 Low Back Pain Collaborators, The Lancet Rheumatology (2023): burden of low back pain 1990 to 2020, regions, countries and risk factors: doi.org/10.1016/S2665-9913(23)00098-X
- Gao et al., JAMA Network Open (2024): occupational sitting, leisure activity and mortality: jamanetwork.com
- Stamatakis et al., Nature Medicine (2022): vigorous intermittent lifestyle physical activity and mortality: doi.org/10.1038/s41591-022-02100-x
- Hamilton et al., iScience (2022): the soleus push-up and blood sugar: doi.org/10.1016/j.isci.2022.104869
- Diaz et al., Annals of Internal Medicine (2017): patterns of sedentary behavior and mortality: doi.org/10.7326/M17-0212
- Ekelund et al., British Journal of Sports Medicine (2019): sitting and mortality by activity level: doi.org/10.1136/bjsports-2017-098963
- Lunar et al., European Journal of Preventive Cardiology (2026): sitting, activity and cardiovascular disease: doi.org/10.1093/eurjpc/zwag263
- Nařízení vlády č. 506/2021 Sb. (lumbar spine disease on the list from 1 January 2023) and č. 428/2025 Sb. (criteria eased from 8 November 2025): e-sbirka.gov.cz
- Ministry of Health (2023), leaflet for doctors and patients: why lumbar spine disease was added to the list of occupational diseases: mzd.gov.cz
- Ministry of Health, Věstník 1/2026: guideline on assessing chronic lumbar spine disease as an occupational disease: mzd.gov.cz
- SZÚ (2024), Bořiková: chronic lumbar spine disease as an occupational disease, the clinician's view: szu.gov.cz
- Vyhláška č. 125/1993 Sb.: statutory employer liability insurance, premium rate by the employer's predominant activity: e-sbirka.gov.cz
- NKÚ (2020), audit 19/12: statutory employer liability insurance, premium rates by economic activity: nku.cz
- ČSÚ (2024): work incapacity for illness and injury in the Czech Republic, 2023, from ČSSZ data: csu.gov.cz
- Public Defender of Rights (2026): sickness benefit leaflet; the employer pays the first 14 calendar days: ochrance.cz
- Stewart et al., JAMA (2003): lost productive time and cost due to common pain conditions in the workforce: jamanetwork.com
- EU-OSHA (2019): work-related musculoskeletal disorders, prevalence, costs and demographics in the EU: osha.europa.eu
- Gedin et al., BMJ Open (2020): productivity losses among people with back pain, a register-based study in Sweden: doi.org/10.1136/bmjopen-2019-036638
- Docking et al., JAMA Network Open (2025): productivity losses due to long-term back problems in working-age Australians: doi.org/10.1001/jamanetworkopen.2025.27284
- ETL GLOBAL Czech Republic × eurodata, partner meeting, 2 to 3 November 2026: etl-czech.cz