Posted by Rich Leach on 10/09/2008 9:27:PM. Categories: I.T. Aches & Pains
Ergonomics Are Everything
(8 Steps to Beating Cervical Radiculopathy) Proper Ergonomics For The Computer Professional - From The Ground Up
As it turns out humans were not really built to sit in front of a computer all day. We don't do "stationary" all that well. As a matter of fact we're really bad at it, and to make matters worse when we quit using the large muscle groups (thighs, glues, chest, shoulders) for our primary daily activities and instead use smaller, finer muscle groups (hands, forearms, neck) - and use them repeatedly we develop problems. Big problems from little muscles. Because we stopped using the bigger muscles. And started using the smaller muscles, repeatedly. Are you seeing this big (yet small) picture yet? Typing keys on a keyboard, pushing a mouse and bobbing your head up from a document to a monitor screen and down again will most likely give you some kind of repetitive stress injury. You might be thinking that the word "injury" is a little harsh; well, if doing something long enough causes you pain, reduces your ability to work and even forces some folks out of their chosen careers, then yes, "injury" will do nicely. In this installment of The 8 Steps to Beating Cervical Radiculopathy we dug in (mostly into my neck, shoulder and arms), researched, consulted with doctors, physical therapists, orthopedists and experts in this kind of thing and came away with a list of things that we hope you'll apply to your work and home computer workstation arrangements. We? Yes, me (Rich Leach, the poor guy who went through all of this) and Mary Heinz, Certified Massage Goddess/Certified Fitness Trainer. I worked with Mary during some of the toughest and most painful times of my C/R (cervical radiculopathy) and her massages worked wonders. What follows are collective guidelines, and as you'll read, a few tweaks were needed to accommodate my individual situation so keep that in mind as you review these suggestions for building your very own ergonomic computer workstation oasis.
Seat Positioning: Feet Flat
As the picture below illustrates, position yourself on your office chair so that your feet rest flat on the floor with the tops of your thighs parallel with the floor. Not too high, not too low, just right.
One thing I noticed in recent years is that my lower back seems to fatigue sooner in the day if my legs are sprawled out in front of my body instead of having my feet firmly planted on the floor. I'm about 6 feet tall so I'd welcome feedback - especially from those who are shorter or taller - if you find the same thing. Office supply stores (and maybe even some of our affiliate advertisers listed on this page) sell foot rests. I've known people to also use reams of printer paper, old phone books, shoe boxes and slats of wood - all of which can be height adjusted to suit your needs.
Seat Positioning: Sit up! But Not Too Far Up
Now that we have your feet in the right place (flat on the floor with your knees at 90 degrees), how far forward, or back should your glutes and hips be on the chair? We've heard a few variations of this rule, but the "fist rule", "5 finger rule" all the way down to "3 finger rule" seemed applicable. I found that based on my height (I also seem to have slightly longer legs relative to my body height so feel free to experiment with this to suit your own body type) the "3 finger rule" worked best for me, so here's a little demonstration of the "3 finger rule": (I muted the sound to keep the bandwidth lower - no need to adjust your speakers)
Arm Rests Optional-Use Them For Support, Not As A Crutch
Position yourself on your chair with your forearms parallel to the floor. I've had a few on-site assignments where I'd be parked in a chair for a long time and suddenly find myself with my arm on the arm rest and my body leaning on it as I was reviewing some printed documentation. Not only was I putting pressure on the elbow but also the ulnar nerve passes through this area in a passage known as the cubital tunnel, which when bumped the wrong way ironically invokes the not-so-funny-pain of your "funny bone". Additionally, my spinal column was curved and I was slouched forward. Since my cervical radiculopathy experiences I now try to read and review documentation using my document stand. I'll even change venues and either slide over to my desk or go to a different room (where its quiet and more productive). Make it a goal to get away from being in front of your computer, if possible.
Keyboard Tray Optional But Try The Ergonomic Keyboard
This is a biggie, most "experts" are usually adamant about using a keyboard tray to help with proper alignment of your shoulders, arms, elbows and wrists. However I think it was the orthopedist who pointed out why I could never seem to get comfortable with that darn keyboard tray.... Since I lift weights pretty regularly there's just a little more mass in my upper arms and upper back then a typical computer user might have (trust me, I'm hardly Arnold Schwarzenegger) but between having just a little extra "meat on the bones" and the fact that relatively speaking, my shoulders are actually somewhat on the narrow side (my scapula bones (shoulder blades) aren't as far apart as other peoples' - a physical, logistical observation I just never picked up on), so getting my arms to hang straight down from my shoulders just isn't comfortable and I prefer either being slightly reclined or having my arms in front of my body. And on came the light bulb - I know a lot of computer folks who fit this similar physical description - not because they're weight lifters, but unfortunately because they're overweight. In this case body mass is body mass and be it fat or muscle your joint alignment could become affected by it. One size doesn't fit all, necessary adjustments may be subtle and "proper posture" suddenly becomes a relative thing. Who knew?! Your goal should be to sit with your feet flat on the floor, knees at 90 degrees so that your forearms can comfortably parallel the floor when you're typing at a keyboard. If you're really dialed in your hands are lightly touching the keys and you're not resting your palms on that cool feeling gel wrist cushion; they're hardly touching it - floating - if you will. You also need to be aware of your elbows - don't let them flare out unnaturally; if you're fighting a slightly rotund midsection then your arms will naturally rest against your sides. This is where the positioning of your hips and a slight pivot may or may not be necessary, try it out and see what works best for you. As for those laptop keyboards, they're simply too small and usually force folks into a hunched position forcing their elbows inward, also not a good thing. Splurge for the external keyboard, and in all honesty, it only took me about 15 minutes to adjust to an ergonomic keyboard. The differences between a regular keyboard and an ergonomic keyboard are small, but the benefits are significant - give the ergonomic keyboard a try.
Sit Up Straight (The Physical Therapist AND My Mother Told Me This One)
It's always the simple things that get overlooked.... Spinal compression problems can be caused due to slouching posture. When I first visited the physical therapist about my cervical radiculopathy she sat me on the end of the exam table and noticed I was slouching. Granted it was the end of my day and I was tired, but poor posture is poor posture. (Naturally, I read into her observation that I needed a vacation but she just wouldn't write that prescription for me ;-)) So how do you re-establish and hold proper posture? You practice it and train your muscles and brain to do it. Try re-adjusting the rear view mirror in your car - sit up straight with correct posture and adjust the mirror. Next time you check the mirror and you only see half the view because you're slouching immediately correct your posture, not the mirror. Same goes for your computer workstation. Try this simple stretch of lengthening your spine to see over your monitor (a former co-worker of mine actually positioned a small digital clock strategically above but behind his monitor, forcing him into this stretch). You'll quickly become aware of your body's position in space which is a good thing, and leads me to the next point:
Get Fitted Correctly First Then Adjust Your Monitor And Environment
Simply stated, adjust your posture elements first, then set your tools and environment to your new, correct posture. The pundits seem to say your eyeballs should be level with the top of your monitor, but my personal preferences had me elevate the monitor another few inches. Same for the document stand. I believe an ancillary benefit I discovered with this idea was that my eyes didn't seem as tired at the end of the day, most likely because my need to focus and re-focus were minimized with documents and the monitor being on the same plane. However that was just a perk. The real benefit came from reducing the strain on those smaller, finer muscles near the brain stem, since my monitor and document stand height adjustments allowed for a more subtle "float" side to side and less of a vertical nod. You may find that you need to adjust your chair at the dinner table as well and even check your posture when you're relaxing watching TV. Become aware! One more thing: have your monitor close enough and/or adjust the resolution so that you're not straining your eyes to view your screen, which may inadvertently bring your head forward and down (neck slouch). Not good.
The following video clip shows you the results of my posture "re-education". (I muted the sound to keep the bandwidth lower - no need to adjust your speakers)
Finally, a few tips:
Dress comfortably. Sounds obvious, but uncomfortable clothing can affect how you sit and interact with your environment.
Stand up often. Set an alarm if you have to, but remember, humans don't do "stationary" very well. A great way to work this in is, if possible, stand up to take your phone calls. I think I picked this one up in a time management book, but standing when you're on a call puts all of your attention to the caller (they like that), subconsciously motivates you to get them to the purpose of the call (you both like that) and ultimately helps your productivity (your boss LOVES that). AND it gives you an excuse to stand up.
Get a phone headset. I sincerely hope you aren't still cranking your neck to hold the phone while you work with both hands during a call....
Elevate your laptop, as well as your monitor and your document stand. One of the primary killers of a laptop is heat, and a simple wire "in basket" turned upside down will get the air flowing and cooling underneath where the heat typically collects.
Improvise as needed. Don't be afraid to try using towels, cushions, foam wedges, braces, and pillows to get your posture and alignment "just right".
Keep everything close. Your mouse, phone, pens, calculator, etc. should all be within half an arm's length reach. But take that heavy manual or hard covered book to a proper desk or meeting room if you can.
Nice tips -- thanks -- I hope you'll post the remaining steps! Posted by Art CR on 12/20/2008 at 9:39:AM... sorry for the delay in getting the rest of this series out -
I've actually had it written but got busy with work stuff. I'll
be presenting it over the next 2 weeks, hang in there! Posted by Rich Leach on 01/25/2009 at 6:04:PMRich,
I am suffering from the exact symptoms you have mentioned. I
had the tingling to begin a week ago. Shoulder pain started one
month ago and I thought someone had hugged me to hard from the
side and dislocated something. I have the tingling and numbness
in right hand - thumb to middle finger.. During this week, I
have had tingles all through arm sometimes if resting on console
in car when driving. I went to Ortho and he diagnosed rotator
cuff tendonitis and physical therapy. I have gone to
chiropractor as well.
I will print this off for all to read what is your immediate
suggestions. I know that this is coming from work posture and
possibly and a bad tennis serve from the last 5 years. I
haven't played tennis since October due to tearing two ligaments
in wrist playing...
Thanks for all the info!
Ossie Posted by Ossie Brewer on 06/13/2009 at 8:39:AMThank you so much; the advice is outstanding. I have had the
pain under my shoulder blade for a while now, and also though I
had just gotten a kink in the area; then the numbness in my hand
started up a couple of days ago. Your site has really helped me
to figure out what is going on, and to get some help. Do you
have any recommendations for a type of chair? Posted by Ellen Allen on 10/10/2009 at 1:46:PMEllen-
So glad this helped you! As for chairs.... you'll have to test
drive a few at your local office supply store but don't be
resolved to thinking you have to spend a ton of money; you'll be
amazed at how expensive chairs can be but you may not need all of
those bells and whistles. Look for a model that offers more
adjustment points than just raising or lowering the chair and
even then it may take a while to dial in your settings. As I
mentioned in my blog posting - you may end up trying everything
from pillows, blankets, foam wedges to get it just right. Good
luck and keep us posted! Posted by Rich Leach on 10/10/2009 at 1:54:PMHi, Thank you so much for this article, you share the same
problem I am having, and I can really understand it more. I
have one question, do you recommend massages, or would it
irritate the nerves. Posted by Helen Pickett on 08/13/2010 at 6:15:AMHi Helen- I really can't recommend anything to you since I'm not
a doctor and I'm not really familiar with your case, but I know
massage definitely helped me, as a matter of fact it was a
massage therapist who actually located the root of my problem and
ultimately gave me relief. Massage really helped me, but visit
with your doctor and understand what nerves are affected then let
your massage therapist know that. A good massage therapist will
be able to work around your situation. Also, you should view the
other presentations that I put together, I'm sure they'll help
you to understand more. Best of luck to you! Posted by Rich Leach on 08/13/2010 at 8:39:AM
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ADDITIONAL RESOURCES FOR COMPUTER AIDED ERGONOMICS
