10 signs you’re ready for an ergonomics evaluation

Have you been mulling over what to do about the nagging pain in your [insert pain here: neck/back/shoulder/wrist/thumb/all of the above]?  You may be wondering if an ergonomics evaluation may help you.  Here’s a list of 10 things to help you decide if an evaluation is right for you:

  1. Your pain gets worse at work
  • If your pain intensifies while you’re at work, it’s a pretty good sign that work is contributing to your pain. Even if your pain was caused by an injury outside of work, your pain can be aggravated by the movements you do at work.
  1. Your pain subsides over the night and/or weekend
  • If you feel better once you stop working for the day, or you feel better on the weekends after not working, this is also indicative work may be causing or aggravating your pain.
  1. You used to have sporadic pain, but now your pain is constant
  • If you had pain that used to come and go, but now does not go away, it’s time to do something about it. Unfortunately, things won’t get better from here and will likely get worse.  Intervention through therapy or an ergonomics evaluation is needed.
  1. Your workstation doesn’t feel “right”
  • Maybe when you sit down to work at your computer, you just don’t feel comfortable. Or maybe when you stand at your workstation, things feel off.  A lot of the time, it’s because the heights and distances in your workstation are not right for you.  For example, the monitor might be too far away, the chair tilted the wrong way, the height of your desk or workstation might be too high, etc.  Try changing heights and distances to increase comfort and consider an evaluation if you can’t get it right.
  1. You spend a lot of time at work doing one thing
  • Do you spend all day at the computer? All day standing in an assembly plant?  All day walking in a factory?  Unfortunately, too much of one posture or movement is not good for your body.  It will protest because it’s hard to use the same muscles to do the same thing all the time.  Try alternating the tasks you do during the day if you can.  Otherwise think about having an evaluation so that you can learn how to make some changes in your work habits.
  1. Your work involves repetitive motion
  • People who spend most of the day keyboarding, mousing, assembling, lifting, or any other type of work that involves the same motion over and over are at risk for pain and injury. When you keyboard all day, the muscles in your hands, wrists, and fingers get overused.  When you lift, the muscles in your back are at risk because they keep working with no breaks doing the same thing.  Try to eliminate the repetitive motion at work – an evaluation can help you with this as well.
  1. Your work puts you in awkward postures
  • An awkward posture is where your joints are out of neutral and subsequently puts you at risk for injury. For example, if you are typing, it is best to keep your wrists straight as this is neutral posture.  If you bend your wrists upward because your keyboard is too high or too slanted, you are now in an awkward posture.  Your body does not like this one bit – even very minimal bending in a body joint can cause some people quite a bit of pain.  Try to eliminate the awkward postures in your work and have an evaluation if you can’t get them all.
  1. Your work involves either too much activity or not enough
  • Some people don’t get enough activity and are sitting all day. Some people get too much activity walking, bending, and reaching all day.  Neither scenario is great and it puts you at a greater risk of injury.  See what you can do about increasing or decreasing your activity during your breaks and leisure time.  An evaluation can help you target what the problem is and what to do about it.
  1. You are going for physical/chiropractic/massage therapy and you are not getting better
  • Getting therapy for your pain is a great idea, but sometimes it’s all for naught when you go to work. For example, if you are having therapy because of neck pain and you go to work where your monitor is too high; therapy is not going to work as well as it could unless you get that monitor lowered.  An evaluation can pinpoint all the areas that could be causing your pain.
  1. You have tried ergonomics equipment, but it has not helped
  • Some people go ahead and get an ergonomic mouse or a split keyboard, only to find that it does not help their pain. I find it’s better to have an evaluation first before spending money on equipment.  Many times it’s cheaper to have an evaluation because you might not even need equipment, just a workstation adjustment.  And if it’s found that equipment is needed, the right kind with the right features will be recommended for you during the evaluation.  Most importantly, an ergonomics evaluation will involve key components that equipment alone won’t provide – help with adjusting your posture, making sure the heights and distances are correct for you, and guidance on how to pace yourself during the day.
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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!

The paleo lifestyle and ergonomics

I recently read an article that included ergonomics as part of the paleolithic lifestyle.  At first I was baffled – how does changing your diet to eat like a caveman correspond with ergonomics?  But as I did some more research, I found out more about the paleo lifestyle and I agree that ergonomics does play a part.

The paleolithic lifestyle has arisen from the thought that it is more natural for humans to live like cavemen did for millions of years than how we live now in the Neolithic or agriculture era which has only been around for 10,000 years.  It is thought that if we adopt the lifestyle of a hunter-gatherer, there will be less obesity, cardiovascular disease, allergies, depression, and chronic stress due to healthier foods and being more active.

One of the cornerstones of ergonomics training is not to stay in one position or movement for too long.   The body is meant to be active in a variety of postures and movements, and staying in one position or movement for too long causes health problems.  These problems stem namely from reduction in blood circulation (which results in muscle cramping and strain on the tissues of the body) and from overuse (repetitively stressing the muscles, tendons, ligaments, etc. of the body).  On a longer term basis, this can result in musculoskeletal disorders such as carpal tunnel syndrome and chronic low back pain as well as diseases such as obesity, high blood pressure, high cholesterol, diabetes, and heart disease.

So what can you do to adopt a more paleo lifestyle using ergonomics?  Here are a few ideas:

  • Move – If you sit all day, take standing breaks.  If you stand all day, take sitting breaks.  People who work in an office environment on the computer should get up from their chairs every 30 minutes.  People who stand at work should have a place to sit down every 30-60 minutes to give their bodies a break.  These breaks in posture don’t have to be long – even 30 seconds helps – but they do have to be as frequent as possible.  They should also involve additional body movement – circle your shoulders, swing your arms, and twist from side to side.
  • Change position – If you can’t get away from your chair, move in your chair.  Sit forward, sit back, cross your legs, uncross your legs, slouch, sit up, lift your bum off the chair and lower to one side or the other.  If you have to keep standing, move your hips around, raise one knee up at a time, swing legs to the side or across the body.  Don’t forget your neck, shoulders, and arms – raise, lower, circle, and stretch.
  • Change, add, or take away equipment – People who sit all day should consider a sit-stand workstation so they can change positions.  Another option is sitting on an exercise ball for 10 minutes out of every hour (I don’t recommend using an exercise ball exclusively because using it for too long puts a strain on your back muscles).  People who stand in one place all day should consider using a 6 inch footrest so they can prop up one foot or the other periodically during the day.  If you can, go barefoot or shoeless occasionally.
  • Surround yourself with nature – Wherever you work, try to involve nature.  Bring plants or rock arrangements to your workplace.  Hang pictures of mountains, forests, or the ocean – even pictures have been found to provide the healing effects of nature.  Go for a walk during your lunch break – try to go where there are lots of trees, grass, rocks, or water.  Make sure to bask in the sun for a bit too.

I’m sure everyone can agree that anything that we can do to help prevent disease is worth trying.  The paleo philosophy of keeping active and staying in tune with nature corresponds with the ergonomic principle of working in a variety of different postures and movements – these are things I think we can all see the benefit in.

Screen time overload

How many peoples’ day goes something like this?  You get up in the morning, shower, have breakfast, and in-between you check your emails and the news using a computer, laptop, tablet or phone.  Then you go to work, during which time you are likely using your phone or tablet if you go by subway or train.  While you are at work, you spend a large amount of time on the computer.  Really when you add it up, you are on the computer 90% of your day, 95% if you eat lunch at your desk and use the computer then too.  Then you commute home with more screen time.  Eat dinner, and then likely some more screen time after dinner, and maybe even more screen time with your tablet in bed.  Then you go to bed and start it all again the next day.

Unfortunately this type of day brings the risk factor “overuse” into overdrive.  Your body cannot get a break from screen time and these parts of your body start to suffer:

  • Eyes – strain from looking at screens all day
  • Neck – from bending your head over your phone or tablet
  • Shoulders – from holding your phone or tablet and when using your laptop or computer
  • Forearms, fingers, and thumbs – from using your muscles to type, mouse, swipe, point, etc.
  • Wrists – from holding your phone or tablet

 Overuse isn’t the only risk factor.  These risk factors also come into play:

  • Force and contact stress– from gripping your phone or tablet
  • Repetitive motion and awkward postures– in the neck, forearms, wrists, fingers, and thumbs
  • Static postures – in the back, hips, and legs from sitting/being inactive too long

So what can you do?  The most important thing is to take frequent breaks from screen time.  Check your emails and the news in the morning, but limit your time to 10-15 minutes.  Don’t use your phone or tablet during your whole commute –listen to music or an audio book and give your hands a break.  Get up from your desk every hour at work – walk around the office, shake out your hands, rotate your wrists,  loosen up your neck (bring your ear to each shoulder and look over your shoulder on each side a few times).  Don’t each lunch at your desk or at the very least, don’t spend your whole lunch hour there – take a walk outside or socialize with co-workers.  Limit your screen time at home too.  Watch TV or movies so your arms are relaxed.  Or better yet, get away from all screens – take a walk, listen to music, play with your children or dog, do yoga, go for a bike ride, or just chill.  Take a break from screen time and your body will thank you.

Carpal tunnel syndrome – causes and solutions

Part 3 in a Series

In 1997, NIOSH (National Institute for Occupational Safety and Health) released a publication called Musculoskeletal Disorders and Workplace Factors, A Critical Review of Epidemiologic Evidence for Work-Related Musculoskeletal Disorders of the Neck, Upper Extremity, and Low Back http://www.cdc.gov/niosh/docs/97-141/pdfs/97-141.pdf . Although this report over 20 years old, the valuable information about what causes work-related injuries remains current.

One of the most interesting parts of the report is the evidence of work-relatedness to injuries.  From the 40 epidemiologic studies they evaluated, NIOSH judged how strong they felt the evidence was that the injury or musculoskeletal disorder (MSD) was caused by the ergonomic risk factor.   Ergonomic risk factors include:  force, repetition, awkward postures, and static postures to name a few.  The categories they used were:

  • Strong Evidence of Work-Relatedness (+++) – a causal relationship
  • Evidence of Work-Relatedness (++) – convincing epidemiologic evidence for a causal relationship
  • Insufficient Evidence of Work-Relatedness (+/0) – could not conclude the presence or absence of a causal relationship
  • Evidence of No Effect of Work Factors (-) – the specific risk factor is not related to MSDs

What they found for hand/wrist injuries and Carpal Tunnel Syndrome (CTS) was this:

1.  Evidence of Work-Relatedness (++) between highly repetitive work and CTS (repetitive work was defined as activities which involve continuous arm movements which affect the hand and wrist area); between forceful work and CTS (forceful work was defined as powerful wrist or hand movements, which generate loads to hand and wrist area) and between vibration and CTS (vibration primarily from hand tools).  Strong Evidence of Work-Relatedness (+++) between exposure to a combination of risk factors (repetition, force, vibration and posture).

  • Meatpackers, poultry processors, and automobile assembly workers were found to be the most at risk here.
  • Ergonomic tools, rest breaks for warming up, and redesign of tasks with a consideration on automation would all help here in reducing CTS.
2.  Evidence of Work-Relatedness (++) between any single factor (repetition, force, and posture) and hand/wrist tendinitis
  • Industry workers in manufacturing plants for electronics, sewing, and appliances are at a high risk.  Office workers are also at a risk with continuous keyboarding and mousing.
  • Changing the way tasks are completed, job rotation with differing tasks, and proper heights and postures for keyboarding and mousing would all be good ergonomic interventions.
3.  Strong Evidence of Work-Relatedness (+++) between high level exposure to hand-arm vibration and hand-arm vibration syndrome
  • Forestry workers and stone drillers/cutters would have high levels of vibration in their jobs.
  • Tools with lower levels of vibration and vibration-reducing gloves would help here.

I will continue with further body parts in my next post – identifying further jobs where there may be risks and providing guidelines for ergonomic intervention.

Shoulder injuries – causes and solutions

In 1997, NIOSH (National Institute for Occupational Safety and Health) released a publication called Musculoskeletal Disorders and Workplace Factors, A Critical Review of Epidemiologic Evidence for Work-Related Musculoskeletal Disorders of the Neck, Upper Extremity, and Low Back http://www.cdc.gov/niosh/docs/97-141/pdfs/97-141.pdf . Although this report over 20 years old, the valuable information about what causes work-related injuries remains current.

One of the most interesting parts of the report is the evidence of work-relatedness to injuries.  From the 40 epidemiologic studies they evaluated, NIOSH judged how strong they felt the evidence was that the injury or musculoskeletal disorder (MSD) was caused by the ergonomic risk factor.   Ergonomic risk factors include:  force, repetition, awkward postures, and static postures to name a few.  The categories they used were:

  • Strong Evidence of Work-Relatedness (+++) – a causal relationship
  • Evidence of Work-Relatedness (++) – convincing epidemiologic evidence for a causal relationship
  • Insufficient Evidence of Work-Relatedness (+/0) – could not conclude the presence or absence of a causal relationship
  • Evidence of No Effect of Work Factors (-) – the specific risk factor is not related to MSDs

What they found for the shoulder area was this:

  1. Evidence of Work-Relatedness (++) between highly repetitive work and shoulder injuries. Repetitive work was defined as activities which involve continuous arm movements which affect the shoulder muscles.  It should be noted that the studies also involved awkward postures or static postures along with the repetition.
  • Hairstylists and dental hygienists are two professions where there is continuous arm and shoulder movement.  They are at risk for shoulder injuries.
  • With some professions where the job can’t be changed much, the solution is to change the way the job is done.  Proper rest breaks, alternating tasks throughout the day and stretching and strengthening of shoulder muscles will help to prevent injury.
  1. Evidence of Work-Relatedness (++) between repeated or sustained shoulder postures with greater than 60 degrees of flexion or abduction and shoulder injuries.  These are jobs that involve working with the arm above chest level.
    • Landscapers and drywallers require lifting the arms above chest level a great deal of the time.  This increases their risk for shoulder injuries.
    • This also requires a change in the way the job is done.  Proper rest breaks, alternating tasks throughout the day and stretching and strengthening of shoulder muscles will help to prevent injury.  Both professions would benefit from ergonomic tools with contoured handles and proper angles.
  1. Insufficient Evidence of Work-Relatedness (++) between both force and shoulder injuries as well as vibration and shoulder injuries.  Force means shoulder movement combined with a load and vibration means using a tool that vibrates or being on surface that vibrates.
    • It should be noted that the currently available epidemiologic studies did not provide enough evidence at that time.   Future studies may prove otherwise.
    • I could find only one other study done by the University of Waterloo “Overhead Work: Evidence-Driven Job Design and Evaluation”.  It found that by changing the direction of hand force to be in line with gravity, muscular activity lessened in the shoulder.  This decreased fatigue and in turn could reduce injuries.

I will continue with further body parts in my next post – identifying further jobs where there may be risks and providing guidelines for ergonomic intervention.