Free yourself from computer-related pain

Happy cheerful hipster man with a laptop sitting outdoors in nature, freedom and happiness concept

It’s a brand new year and now’s the time to finally do something about those aches and pains you’ve been having at the computer.  Maybe it’s just a bit of discomfort or the feeling that things are not set up right, or it’s actual pain that is just not getting better and in fact may be getting worse.  Maybe it’s at work on the computer, or at home on your laptop, or when you read on your tablet, or when you text a lot on your phone.  Regardless of which medium, there are many ways you can reduce or stop discomfort with a few little tweaks:

Check your neck position – Do you spend a lot of time looking down?  Adjust your monitor height so the height of the monitor is level with your eyes.  Get an external keyboard for your laptop so you can raise the laptop monitor to be level with your eyes.  Prop up your tablet on a stand or put a pillow under it so you don’t have to look down as much.  Use voice dictation for texting.

Check your elbow/forearm position – Do you lean on your desk or armrests a lot?  The contact stress can cause problems with blood and nerve supply so it’s best to limit leaning.  Laptops promote a lot of leaning on your forearms – also a good reason for getting an external keyboard and lowering it so your forearms are parallel to the ground with your elbows at 90 degrees of flexion.

Check your wrist position – There are three things to watch for:

  1. Your wrists should be straight – no bending up or down;
  2. Your wrists should be straight – no bending side to side when typing, try to float your hands over the keyboard;
  3. Your wrists should not touch any surfaces – no resting on the desk or wrist rest when typing.

Be sure to check your wrist position when holding your tablet too – it’s very easy to adopt an awkward wrist posture.

Check your back position – Raise or lower your chair so that when your feet are flat on the floor, your knees and hips are at 90 degrees of flexion.  If your chair has lumbar support, position it in the curve of your lower spine (usually just above your belt).  If your chair does not have lumbar support, get a small pillow or towel and place it in the correct position.

Check your sitting and/or standing position – Do you stay in one place longer than 5-10 minutes without adjusting your position?  Try moving around in your chair frequently – no position is necessarily “bad” unless you hold it long periods of time.  If you’re standing in one place, shift your weight from foot to foot often and alternate propping up each foot on a rest 6-8” of the floor for a different position.

Check your rest breaks – Do you ever sit any longer than an hour at your desk without getting up?  It’s important to take a little walk-around every hour and stand in place at your desk every 20 minutes.  This promotes good blood supply and undoes the damage you do your body by staying in one position.

Check your activity level – How many hours do you spend on a screen each day?  If you spend all day at work on your computer, it’s best to limit your personal screen time at night.  Your body does not like staying in the same position and using the same muscles for long – the result is discomfort, then aches and pains, and finally injury.

Do you stretch? – Stretches throughout the day loosen up tight muscles and promote that good blood supply.  Here’s a good three-minute routine for your upper body: hang your head and rotate it side to side slowly.  Then, where you feel the most tightness on each side, hold in place for 30 seconds.  Grasp your hands behind your low back with your arms straight and lift up slightly – hold for 30 seconds.  Twist in your chair and grab your back rest – hold for 30 seconds each side.

There, now you’re ready for a great start to the new year.  Enjoy your new-found freedom!

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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.

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.

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.

Neck and 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 neck and shoulder area was this:

  1. Evidence of Work-Relatedness (++) between highly repetitive work and neck and neck/shoulder MSDs. Repetitive work was defined as activities which involve continuous arm movements which affect the neck/shoulder muscles.
  • So for people who have jobs like painting overhead or lifting to higher levels in a warehouse on a continuous basis, there is evidence that their work causes neck and neck/shoulder injuries.  Even people who keyboard and mouse all day are at risk if their keyboards and mice are too high (activates the trapezius muscle in the neck).
  • Proper use of ladders and the installation of a keyboard and mouse tray would be good ergonomic interventions here.
  1. Evidence of Work-Relatedness (++) between forceful exertion and neck MSDs.  Forceful work was defined as powerful arm or hand movements, which generate loads to the neck/shoulder area.
  • People who do heavy assembly work overhead or construction work would be at risk here.
  • Lowering assembly work levels and rotating jobs in construction should reduce risk.
  1. Strong Evidence of Work-Relatedness (+++) between high levels of static contraction, prolonged static loads, or extreme working postures involving the neck/shoulder muscles and neck and neck/shoulder MSDs.  Static contraction and loads refer to postures being held for a long period of time.  Extreme postures would involve overhead reaching, bending, and squatting usually combined with twisting and reaching beyond comfort levels.
  • People who carry trays of food in banquet halls or move furniture or appliances would be at risk for prolonged static loads.  People who have to work in confined areas with very awkward postures and reach would also be at risk.  And people who keyboard and mouse all day with their shoulders hunched due to their keyboard and mouse being too high would be at risk too.
  • Weight limits on trays, lift assists for furniture and the installation of a keyboard and mouse trays would be helpful here.

In my next several posts, I will be discussing other areas of the body where there is evidence of work-relatedness to various injuries and identifying further jobs where there may be risks.  Ergonomic interventions will be included too.