How to reduce finger, thumb, hand, wrist, elbow and arm pain

With the advent of today’s technology, we are using our hands and arms more than ever and in very different ways. Tablets, smartphones, and computers have changed the way that we work, play, and live. The technology is great, but the pain we experience from it, is not so great. It’s not surprising that we feel pain – there are many ergonomic risk factors associated with our devices:

  • Force – from holding our phones and tablets;
  • Repetition – the same movements of keyboarding, mousing, swiping, and pointing are performed over and over;
  • Awkward posture – how we hold our phones and tablets, as well as incorrect set up at the computer;
  • Overuse – the sheer amount of time we use our devices for work and play;
  • Static posture – staying in one place while using our devices, as well as holding our devices with one hand position for too long;
  • Contact stress – our phones and tablets digging into our hands, desk contact while keyboarding and mousing.

But our devices don’t have to cause us pain if we follow a few simple rules:

  1. Prop it up – Force from gripping and awkward wrist postures can be greatly reduced by letting go of your tablet or phone. Prop it up on a stand, or a pillow on your lap, or your backpack/briefcase.
  2. Elbows free – Nerves run through your elbows and can be aggravated with the pressure of leaning. Pain and tingling (“pins and needles”) can start here and travel down to your hands. Keep your elbows free and try not to lean them on anything, no matter how soft.
  3. Hands free or switch hands – Use your earbuds when speaking on your phone or remember to switch hands and ears often. The same elbow pain can result here from bending your elbow and holding it up for too long.
  4. Use all your fingers to type – Try to avoid typing with your thumbs only on a tablet. Many tablets are too big for comfortable typing with your thumbs – pressure is placed into your palm and your thumbs really have to reach to type some keys. Place the tablet down flat to type or set it up with an external keyboard.
  5. Keep it straight – Make sure all your joints are in neutral. Don’t have your thumbs extended down, keep your wrists straight, keep your elbows in-between (not completely straight, and not completely bent).
  6. Switch it up – Avoid using one set of muscles for too long. If you usually text with your thumbs, switch to typing with one finger to take pressure off your thumbs. If you usually hold your phone or tablet in your left hand and swipe/point with your left, switch it up and hold with your right and swipe/point with your left (it’s easier than it sounds!) If you point with your index finger, use another finger instead. If you use certain keys constantly when typing, try other keyboard shortcuts to take pressure off those fingers. If you use your mouse too much, try replacing some movements with keyboard short cuts.
  7. Move constantly – Don’t stay in one position for too long. Move around in your chair or on the couch or stand up. Keep moving your phone and tablet around in your hands. Reach your hands to the sky and stretch up, rotate your shoulders and wrists. Perform any movement you can – just keep moving!
  8. Mini breaks – Incorporate mini breaks into your posture constantly. For example, don’t hover your hand over your mouse when your reading your screen – rest it instead; put your phone or tablet down while it’s loading – look up and give your neck a break from looking down; during breaks in keyboarding – put your hands in your lap.
  9. Shorter, more frequent is better – If you are using your device for a long period of time, it’s better to use it in short stints with breaks in-between. A good rule of thumb is 15 minutes on, 1-2 minutes off.
  10. Less is more – Of course the best thing your can do is use your devices less. Spending the day at work on the computer and then spending the rest of your day on your phone or tablet is just too much device time. Ditch the device as often as you can!
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Student Learning Improves with Ergonomics

Improving the performance of students is a constant and evolving goal.  A recent study, Designing learning environments to promote student learning: Ergonomics in all but name by Thomas J. Smith, School of Kinesiology, University of Minnesota, finds that the design of classrooms and buildings is a strong predictor of improved performance in K-12 students.  This follows the ergonomics principle of “fitting the task to the person, not the person to the task”.  Ergonomically, how can we make the environment better to encourage learning?

When we speak about design in the classroom, it can mean a number of different things:

  • Physical design – textbooks, audiovisual materials, desks, chairs, computers, and classrooms
  • Cognitive design – skills, tasks, knowledge, and curriculum
  • Social design – interaction between students and teachers

So how can ergonomics help students learn?  In looking through the literature, it appears that research still needs to be done.  Here are a few ideas based on ergonomic principles that I think warrant further investigation:

  1. Adjustable and/or different sizes of chairs – Students spend many hours in chairs that do not fit their bodies.  Ideally they would be provided with adjustable chairs and shown how to adjust them.  At the very least they should be provided with chairs of different sizes and education on how to sit properly.
  2. Less sitting – Providing standing workstations as an alternative to sitting should be provided in every classroom.  The standing workstations can be single for one person or for group activities.  Changes in posture would reduce discomfort, increase blood flow, and foster creativity.
  3. Adjustable keyboard trays and monitor risers – Now that technology has become a larger part of learning, adjustments must follow.  Keyboard trays need to lower to just above lap height and monitors need to be raised to eye level.
  4. Limits on laptops and tablets – Many schools are providing laptops and tablets to students.  Although helpful for learning, they force the student to conform to awkward postures that can result in injury.  They should be used minimally or with the option to dock so that an external keyboard with tray and monitor can be used.
  5. Textbooks – Textbooks are cumbersome, both physically and mentally.  There is still a place for textbooks in school as an alternative to screen time, but with less emphasis than in the past.
  6. Noise – The noise level in classrooms has been found to deter learning ability, both from students being unable to hear and noise affecting concentration.  Classrooms should be built with more sound absorption qualities in the ceiling tiles and flooring.  Corkboards and fabric on the walls also helps.  Baffles to cordon off part of the classroom should be available.
  7. Air quality – More emphasis should be focused on providing “green” materials in the classroom.  Volatile Organic Compounds (VOC’s) are found in paints, cleaning supplies, furnishings, photocopiers and printers, and art supplies.  Care must be taken to reduce exposure.  HVAC systems must be inspected and cleaned regularly.  Other pollutants associated with moisture and vehicle exhaust must be eliminated.  Green walls would be wonderful additions to schools.
  8. Emerging technology – More research needs to be done in this area to investigate which technologies are helpful and which are harmful.  One area that has been investigated is delayed response feedback problems.  Delay in feedback from the computer has been shown to disrupt performance more than any other design feature (T.J. Smith, 1993; T.J. Smith, Henning, and Smith, 1994).
  9. Curriculum – Hands on learning has found to be more effective than standardized tests so this needs to be incorporated.  Every student learns in different ways so teachers need additional training on how to achieve this when presenting the curriculum.
  10. Social design – Investigation into the student-teacher relationship.  What social qualities promote learning? The Collaborative for Academic, Social and Emotional Learning (CASEL) indicates there are five key sets of social emotional learning/emotional intelligence skills; self-awareness, social awareness, self-management and organization, responsible decision making, relationship management.  These need to be taught in the classroom through the learning of rules, how to problem solve, how to show respect, how to be positive in the classroom, how to talk about feeling, and how to resolve conflict.  A socially positive environment will improve learning.

Taking into account these suggestions, the most important part of integrating ergonomic principles into schools is to determine what strategies work.  Those strategies should then be integrated into school policy at the community level, and ideally a national level.  Making learning easier through ergonomics is a task well worth taking on.

Computer use in vehicles

Before starting, it must be made clear that the computer use in vehicles I will be referring to is when the vehicles are parked and turned off.  Not by any means should a computer ever be used while a vehicle is in operation. 

Computers are used in vehicles by workers on the road for delivery or monitoring, e.g. police, firefighters, home care professionals, couriers, etc.  Information related to the delivery or monitoring usually needs to be entered as soon as possible into a laptop or tablet.  And while this is a timely and efficient way to input data, it unfortunately results a poor ergonomics setup.  So while an “office-in-a-vehicle” can never be completely ergonomically designed, improvements can be made.

In terms of where to put your laptop or tablet while in your vehicle, we can look at a study from Marquette University in Wisconsin where researchers tested out four different scenarios for mounting a laptop in a vehicle.  Results were as follows “Placing the mobile computer closer to the steering wheel reduced low back and shoulder muscle activity. Joint angles of the shoulders, elbows, and wrists were also closer to neutral angle. Biomechanical modeling revealed substantially less spinal compression and trunk muscle force.” (Biomechanical Effects of Mobile Computer Location in a Vehicle Cab;  http://hfs.sagepub.com/content/53/5/474.abstract)  So instead of placing your laptop on the passenger seat, it is much better to have it mounted beside the steering wheel to reduced twisting and awkward postures.

Here are some other tips for working in the car/truck:

  • Pull your shoulders back and keep upper back straight and flat (to reduce strain to back and shoulder muscles)
  • Sit with your back against the car seat (to provide support to your back muscles)
  • Relax shoulders – avoid elevating or “hunching” shoulders (to reduce strain on neck and shoulders)
  • Relax elbows close to torso – do not extend your arms in front of you (to reduce strain on your shoulders)
  • If present, adjust the lumbar support in your seat (the lumbar support should rest at the curve of your low back).
  • Use a laptop or tablet stand on your lap if your laptop or tablet is not mounted (to reduce neck strain)
  • Use headset or speakerphone at all times (to reduce strain to the neck and shoulders from cradling the phone)
  • Keep wrists neutral when keyboarding and mousing, i.e. keep wrists straight (to reduce wrist strain)

And finally, keep data entry in the vehicle to a minimum.  Save longer tasks for when you’re in the office with a better ergonomic setup.  Mobile computing is useful and important, but it shouldn’t leave with you ergonomic injuries.

How to use your iPad ergonomically

The iPad is a wonderful device which allows you quick access to the internet anywhere along with thousands of apps to keep you entertained and informed.  But ergonomically, there are some pitfalls.  The main problem is that iPads are like laptops, but on an even smaller scale.  When you can’t separate the keyboard from the monitor, you either feel it in your neck from looking down at the screen or in your shoulder, elbows, wrists, and hands from raising your arms to type and mouse.  But as long as you use your iPad with care, you can reduce the risk of injury.  Here are some tips to help you enjoy your iPad experience with greater comfort:

  1. Placement – Ideally you would not grip your iPad with one hand while using it with your other.  The ergonomic risk factors of pinch grip force and awkward posture of your hand and wrist put you at an increased risk for injury.  You would also not want to put the iPad on your lap or even flat on a table.  This increases neck flexion which could in turn cause neck and shoulder problems and possibly headaches.  There are some good devices on the market that do alleviate some ergonomic risk factors.  One holds your iPad at the height and tilt you want it while clamped to a table or desk (iWare).  Others are tilt adjustable stands that sit on a table or desk for a cheaper option (Griffin A-Frame).  Or there are hand attachments for the back of the iPad that eliminate the pinch grip requirements (Hand-e-Holder).
  2. Reduce frequency of use – The iPad is not a device that you would want to use for hours.  The neck flexion and raised arms put you at a greater risk of injury than a desktop computer.  If you want to spend hours, you should be at a properly designed ergonomic workstation with a monitor, keyboard, mouse, and keyboard and mouse tray.  As a rule of thumb, try not to use the iPad any longer than 20 minutes without a break of at least 5 minutes or longer.
  3. Mix it up – Try not to use one finger or your thumbs continuously.  Use a mixture of hand positions and swipes to reduce repetitive motion.
  4. Task dependent – If you are using your iPad to read, place it higher so that your neck flexion is reduced.  If you are using many applications with lots of swiping and scrolling, place your iPad at a lower level to reduce awkward postures in hands and wrists.
  5. Change hands – Try alternating your hands, e.g. use your left hand to swipe and scroll, and your right hand to hold (don’t give up on this too easily– you will get better with practice!)
  6. Use both hands – Don’t hold and swipe/scroll with one hand.  This combines a myriad of ergonomic risk factors increasing the risk of injury considerably.
  7. Swipe, scroll or click? – Clicking is the best, followed by swiping, and scrolling last.  Scrolling has more awkward postures and more force is required.

The proper postures and movements, combined with regular rest breaks and non-continuous use, will allow you to have a great iPad experience with minimal repercussions from injury.