THE PROBLEM

The standard approach is to make the computer operator fit their configuration to the computer and workstation. The equipment is adjusted according to the directions on the box, or information learned from book, class or even a consultation at their workstation. Then the operator fits him or herself to the workstation. Renowned universities and brilliant engineers have come up with the formulas. They work great in theory, even in computer simulations.

Sounds good? Wrong!

The operator must use constant muscle contraction in some part of their body to fit themselves to the equipment, and to hold themselves in that working posture. This subtle contraction could be anywhere from fingers to hand, wrist, forearm, elbow, shoulder, head and neck, low back, legs or feet.

This method does not take into account an individual’s areas of tension, pain or restriction resulting from old injuries and imbalances of muscle strength and flexibility (the subject of a future article).

THE SOLUTION

It is actually very simple! Put the operator into the most comfortable, relaxed, stress free position first; then adjust the equipment to the operators body. Check out www.workpainfree.com for a free version of Work Pain Free. You will have no-strings-attached access to a step-by-step system that will take you through the process to find your perfect ergonomic position. You will have more energy, be more productive, and have less tension, pain and injury.

]]> http://www.workpainfree.com/blog/the-universal-ergonomic-mistake/feed/ 0 http://www.workpainfree.com/blog/the-proper-care-for-your-hands/ http://www.workpainfree.com/blog/the-proper-care-for-your-hands/#comments Fri, 14 Nov 2008 20:34:20 +0000 Barry http://www.workpainfree.com/blog/?p=42 Hands are important for doing many jobs. Preparing food in the kitchen, serving meals, cleaning a room, laundry, moving luggage, manufacture, or working at a computer are just a few.

If you use proper hand technique, work is easier and you protect your hands from stress. These simple guidelines will eliminate hand tension and fatigue, making work easier & more productive.

• Avoid using a pinch grip. Grasp objects with as much of your hand as possible. A pinch grip using only your fingers increases stress in the hand and wrist.
• Keep the wrist in a straight or neutral position when working. You may have to move your equipment, or alter your shoulder or foot position.
• Position your feet so the legs assist with the movement when a task involves pushing, pulling or moving items sideways while grasping.
• Find more than one way to grasp when a task requires prolonged or repetitive grasping. The muscles that work while grasping with one type of grip will be resting when you use a different type of grip. For example, use 2 or more ways to grasp a plate or grasp linen while fluffing or pulling.
• Avoid looking down too often. If you must look down a lot, take 3 second stretch breaks 2-4 times per hour. Looking down frequently reduces blood flow to your arm and makes the hand and arm weak and tense. Try to work without looking down.
• Take stretch breaks 2-4 times per hour, if you have hand, wrist, elbow or forearm tension, fatigue, or cramps. Do the stretch that makes you feel better after you do it. Some choices are: Hand stretch -  Shoulder stretch – Fist Rolls. For complete stretches, see Work Pain Free.
• Do strengthening exercises outside of work that simulates your job if grasping is difficult for you. This can be done with weights or rubber tubing. The proper resistance is enough to cause mild muscle fatigue after the 3rd set of 8 repetitions, done 3 times per week.

Hello Karen,

Your question does not have a straightforward answer. When you go through the Work Pain Free program, you will learn how to pick the best position for you……and that may vary throughout the day. The bottom line is the position that feels best, and has you feeling better at the end of the day is your best position.

The general rule is your elbows are relaxed at your side, there is a slightly open angle at the elbow, and the wrist is straight.

The wrist rest helps maintain the straight wrist and gives all of the arm, shoulder, neck and upper back muscles a rest when you pause, even for a moment.

Another option is that your arms are able to relax on the desk top while typing. The seat height desk top relationship must be such that the arms and shoulders are relaxed.

There are then other factors to take into consideration, such as low back support, leg support, etc.

The work Pain Free training is a system that will correlate all factors so you feel the best and are the most relaxed and productive

I hope this information helped you and I look forward to hearing back how good you feel.

Yours in health,

Dr. Barry Carlin

Depending on several factors, your head can weigh anywhere from 8-15 pounds. Imagine you rested your elbow on a table and had your arm pointing up with a bowling ball, the weight of your head, in the hand. If that bowling ball is balanced in your hand, you could easily sit there for a few minutes ad have a conversation. But if you tilted the bowling ball several inches to one side, from holding that weight, the muscles would immediately begin to tire, hurt, and you would soon have to put it down. You may have arm pain that lasts hours.

The same scenario applies to your head. If it is directly over your body while you are working at the computer, all the neck, shoulder and upper back muscles are at rest. But if your head is tilted forward a few inches, like the bowling ball in the example above, all of the muscles in the back of your neck, upper back, and shoulders are constantly working to hold your head from falling forward.

If these muscles constantly contract:
• they become tense and inflamed which causes pain in the muscles
• they become shortened and restrict or alter movement in the bones of the neck which they attach to, possibly pinching nerves. This causes pain in the neck and traveling into the shoulders and arms
• the tight muscles pull on the back/base of the skull. This leads to the pain of a headache at the back of the head
• the muscles, from working constantly become fatigued so your head feels heavy

Your monitor position will unconsciously put your head in a position when you look at the screen. If it is too low, too high, or off to the side, your neck muscles are constantly working and you will have tension, pain and fatigue. If the monitor is in the correct position, for you, you will feel good, have more energy, get more work done with less mistakes, and prevent injury.

Complete corrective measures for neck and shoulder pain are included in Work Pain Free. Get the free version here.

Shoulder Pain: Causes and Preventions
There is a common type of shoulder pain that results from any activity that has you reaching out and up like ironing, playing volleyball or when you have your mouse positioned off to the side, causing you to reach for it.

When you frequently reach up and out, the ball and socket joint in your shoulder rubs on the top of the socket. If this is done often (as you do daily working on a computer with a poorly placed mouse), the irritation of the bones rubbing on each other causes a little bone spur to grow. Then, when it gets big enough, the bone spur rubs slightly on the rotator cuff tendon which is just below it. Eventually, that rubbing irritates the tendon and there is pain. Most people just live with it and the rubbing eventually causes a teat in the tendon. Now you have disabling pain that limits many of your activities, makes working on the computer painful or impossible, and can only be fixed by surgery.

The prevention is simple and free. Just position your computer equipment and mouse so your arms are relaxed at your side, you have a slightly open angle at the elbow, and your wrists are straight.

Complete corrective measures for neck and shoulder pain are included in Work Pain Free. Get the free version here.

I have lower neck and left sided upper back scapular pain that is severe from working on my computer and I don’t know how I can continue in my job without pain.

Dear Donna,
Thank you for your interest in Work Pain Free.

Your discomfort is a common one. The cause is simple to determine and there are several solutions. The work pain free program will empower you to determine which skills will solve your problem.

The solution has two parts, sometimes three.
1) Correct your equipment and workstation ergonomics (how it fits your unique body) and working technique so you are not causing physical stress from simply sitting at your computer.

2) Learn and perform the appropriate 3 second stretches to reduce the inflammation, muscle spasm or nerve irritation that is causing the pain.

3) The condition may be advanced and you may need to see a chiropractor or physical therapist for evaluation and treatment to correct the injured tissues. Then the above two procedures will keep the problem from returning.

The most common cause of the symptoms you describe are the monitor is too low, no document holder, or working with a lap top on the desk which results in prolonged or repetitive forward head posture, rounded shoulders, and upper back bent forward while working.

RISKS:
This posture causes a stretching of neck and upper back ligaments, and a tension in associated muscles. This then results in muscle contracture and weakness, joint irritation, headache, fatigue, neck and upper back pain.

In addition, the chronic tension results in significant muscle weakness making the worker prone to sprains and strains from otherwise innocent activities.

The forward head and upper back posture also results in the discs in the spine being pushed to the rear and bulging out a little, which eventually will irritate the spinal cord and nerve roots. In the neck this can cause muscle tension, headache, neck pain, and pain traveling into the arm and hand. In the upper back this can cause a well localized deep ache or a sharp pain between the shoulder blades, mid scapular tension or cramping.

SOLUTION: Alter your equipment so without thinking about it you sit relaxed, with your head above your shoulders and you are not slumped forward

A] Raise monitor so top of standard size screen or top third of large monitor is 1 – 2 inches below operator’s eyes. This is done with an adjustable monitor arm, a monitor riser (which has desk top storage), or placing the monitor on items such as reams of paper.

B] Install a document holder. Ideally, the document will be close to and at the same level as the monitor. This can be placed on the desk top or attached to the monitor and can swing to be placed right or left. OPTION: The document holder is a slant board between the keyboard and monitor. This is especially good for 3 – ring binders and books. The document holder should be periodically moved between the right and left to reduce neck stress from prolonged turning in one direction.

C] Raise laptop so screen is appropriately placed and install a standard keyboard. All laptops have a USB Port that an add on keyboard and mouse will easily connect to. A hard cord model is $20 and a cordless model is $35 at most electronic stores.

D] Place laptop keyboard in appropriate ergonomic position. Install a standard monitor.

E] Monitor is off center resulting in prolonged and repetitive neck and trunk rotation.

Twisting of the spine in the neck and upper back causes excessive muscle work to maintain a rotated posture, with resultant fatigue and tension.

SOLUTION: A] Move monitor by rearranging desktop so operator, keyboard, and monitor are lined up. B] Leave the monitor where it is and install a keyboard tray so the operator can face the monitor. C] When the monitor is at the corner of an L-shaped desk, install a corner extension to hold the keyboard. D] Rearrange workstation for the task at hand, to minimize twisting to reach for items. E] Improve the mechanics of the chair, its wheels, or install a hard surface to facilitate operator turning entire chair to avoid trunk twisting.

Try out Work Pain Free for pictures, audio and complete solutions.

Paulette asked:

I started getting pain in the back of both legs (feels like sore tightened muscles) from my hips to my ankles. Wondering if this could be related to walking down a boardwalk and back which is about 2.5 miles, which I don’t normally walk more than a block on any day. I also work on a lap top, with a small 15″ screen and posture has not been supported by a pillow or anything.

With this pain starting 4 days after returning from my weekend in Wildwood Crest, it now 2 weeks and the pain is more severe that my gait and simple movement have become painful and difficult. Have you ever heard these symptoms from extensive computer use? I have never experienced this ever before. Please give me your thought?

Dear Paulette,

It is unlikely that the long walk was the cause of your pain. It could have aggravated an already existing situation in your low back, and that is very likely from the position you describe using your laptop. Now that the injury has occurred, the posture you are working in will maintain the injury and the painful pinched nerve. Below is an explanation of how the poor low back posture will cause the pain you describe, and several suggestions to correct the problem.

You describe a condition that needs to be evaluated and treated by a health care professional. I feel a chiropractor who uses therapy, rehabilitative exercise and teaches proper body mechanics as part of his treatment will be the best choice.

Then, the advice below will prevent the same condition from returning. I have had many clients that had a painful condition like you describe resolve simply by correcting their workstation as described below, but it is still best to be evaluated by a health care professional.

Sitting leaning forward to a laptop without properly positioned low back support.

RISKS:

This results in a reversal of the normal low back curve and a forward head posture. The resultant stretching of muscle and ligaments results in chronic tension, fatigue, and back ache, and a tendency to injury from otherwise innocent activities, such as a long walk or lifting.

These forward bending postures of the spine also result in a posterior deformation of the disc tissue. These mildly bulging disc tissues irritate the nerves and spinal cord, which are directly behind them, and cause symptoms as mild as tension, ache, or as severe as pain, tingling, and numbness traveling down the leg. The most common location of the pain in your legs is the back of your legs.

Yours sounds like a pinched nerve in your low back because there is no structure in the legs that would be felt as a continuous pain from the hips, to the thigh, past the knee to the calf and ankle, except for a nerve.

In some cases there is a loss of coordination and strength in the legs. It appears as difficulty climbing stairs or rising from a crouched position, fatigue from walking, and difficulty performing complex movements.

ACTION:

To properly sit and position a low back support, move buttocks to the back of the seat and arch your back. The support is placed at the deepest point of this curve. Keep in mind that as you get more or less stiff, from injury, stress, or exercise, the location of the curve may change. Apply this at your workstation, in your car, when watching TV, eating, etc. The proper size of the low back support is the comfortable size for you.

A] Chair with adjustable size and height Lumbar support.

B] Add Lumbar pillow to your seat.

C] Roll a towel and secure with rubber bands.

D] Roll a sweater or sweatshirt at a restaurant, movie, or meeting.

E] If the operator leans forward when working, sit on a foam wedge or use forward tilt option on the chair. This tilts the pelvis forward, maintaining the low back curve, and positions the head properly above the body.

F] Raise your laptop so the top of the screen is just below your eyes. You can but a laptop stand, or just use a few books. Buy a standard keyboard and mouse and connect them to your laptop. You can get a hard wired set for about $20, or a wireless set for about $40.

Set them so your elbows are relaxed with an open angle at your side, and your wrists are straight. This position, along with the low back support will minimize stress on your low back muscles, bones, discs and nerves.

Adjust your entire workstation as is shown in the work pain free program. To minimize the physical stress on your body, it is necessary for your entire body to be balanced and relaxed.

I am confidant that this information will help you to become pain free when working at your laptop. Please contact me if you have any other questions.

And check out the free or full version of Work Pain Free for further information on optimum laptop ergonomics.

Very sincerely,

Dr. Barry Carlin

1. Sit with your buttocks to the back of the chair
2. Stick out your belly and reach behind and run your hand up and down your back to feel where the deepest part of your low back curve is (it is usually higher than you think).
3. Place proper support in the deepest part of your curve. That curve location can slightly change day to day from muscles being tighter from lifting, drinking too much coffee and alcohol, or sports; or muscles being more relaxed from yoga, stretching, drinking a good amount of water, or a great nights sleep. There are many things that can affect how tight or relaxed your back is which then changes the position of your low back curve. It takes only 3-4 seconds to test the location and place the support in the right spot when you sit down.

The correct size is a comfortable size. It is probably small for a firm chair & larger for a soft chair. I don’t know, try a few different sizes or adjustments. The correct size will be obvious in that it will instantly feel good.

What can you use for low back support? There are a variety of commercial and simple free home made devices. They all work if you follow the guidelines in this article. Here are a few:

1. Many chairs have a built in lumbar support. They are only useful if they can adjust in or out, and if they go up and down so you can have them support your curve. If they are a little above or below the deepest part of your curve as described above, it will actually cause stress, fatigue, tension and pain. If it does not adjust up and down, and it happens to be in the correct spot for you, then it is an OK chair without the ability to adjust up and down.
2. Any chair can have perfect low back support as to size and position by using a commercial pillow. Simply test where your curve is today, and place the pillow there.
3. The pillows come in many shapes. The can be round, round where they touch you and flat where they touch the chair, and different shaped curves. They can also be different thicknesses and consistencies. Try a few. The one that is right for you will feel good instantly.
4. You can also make your own. Roll up a towel and secure it with rubber bands. This works for many as good as a commercial pillow. As above, make several sizes an try them all. The right size for you will feel great instantly.

When should you use low back support? The low back tension is cumulative or builds up over time. Always sit with low back support. Not just at work but in your car, the movies, watching television, eating, reading……everywhere.

You have tremendous control over how you feel, how much energy you have, how productive you are, and if you are going to get injured. It is easy! With a little knowledge, all you have to do is do it.

Headaches from computer work are upsetting my life! For the last few years I have been getting a headache at the base of my skull after 2-3 hours working on the computer. It used to be a few times per week and would soon pass after I stopped working. It has been coming more often and now it comes every time I work on the computer, and is so strong I have to take medication or I can not keep working. The thing that is scaring me is that in the last few weeks I have felt it when reading at home. Can I solve this problem or do I have to find a new job? I hope you can help me,

Alisha in Chicago

Dear Alisha,

Do not worry. The headaches you are describing are “Muscle Contraction Headaches” and are easy to eliminate.

Let’s first understand what they are. There are several muscles from your neck and upper back that attach at the upper end to the base of your skull, exactly where you are having your headaches when working on the computer. The most commonly affected muscles are the Trapezious, the Levator Scalula, and the Cervical Erector Spinae.

When something causes these muscle to work constantly, or repetitively without a chance to recover, the muscles become constantly tense and they then shorten, and pull on their attachments such as where you feel your headaches from working on the computer.

There is usually no or very little discomfort in the muscle itself, but from pulling on its attachment at the base of the skull, it triggers a headache.

This article will present the equipment and technique situations that contribute to these computer caused headaches, and how to eliminate the [tag]computer headaches[/tag] by customizing your workstation and technique, and simple 5 second exercises that will reduce or eliminate the muscle tension and headache when it is present.

This first concept is necessary to understand why your equipment position can cause headaches from working on the computer.

If I sat with my elbow on a table, my forearm straight up, and a 14-pound bowling ball balanced in my hand, I could easily hold that position for quite a while.

But if I held my arm with the bowling ball off center, how long could I hold it? I would be shaking in a few seconds and would drop it in 1-2 minutes, probably with arm-muscle pain for a few days.

Your head weighs as much as a bowling ball. If you set up your work so your head is above your body, then muscles do not have to work to hold it up and they stay relaxed. But if you work so your head is bent or off center, then upper back and neck muscles must constantly work or contract to hold your head/ bowling ball up. From the constant work they become tense, causing neck and upper back pain, headaches, and can lead to other injuries.

Now let’s look at the computer workstation set-up that can cause the operator to work with the head off center.

Causes and solutions are offered in a 6 part series of short articles. View them under computer headaches

Many people think you have to get the most expensive chair to feel good. That is a mistake. There is a way to customize any chair, even a simple inexpensive one.

The only necessary factor is it must be adjustable in height. Sit in the chair and adjust the height so your feet are flat on the floor. If the chair is so high that your heels are off the floor, you do not realize it but you are constantly contracting leg muscles to hold that position. This contributes to fatigue and leg tension, which will then travel up your leg to your trunk and low back. This then make you prone to low back pain and injury.

If there is a reason that your chair must be higher than just described, or if your legs are short and the heels are off the ground when the chair is at the lowest, then you must bring the floor up to your feet so they can be flat on the ground. This is accomplished by using a foot stool. If you do not have a commercially produced foot stool, you can use a box, a few old telephone books taped together, a briefcase, etc.

The next adjustment to look at is how the height of the chair affects the knee hip angle. The knees should be slightly lower than your hips. This creates an open angle at the knee and there is good blood flow to the lower leg.

If there is a right angle at the knee, or if the knee is higher than the hips and there is an angle less than 90 degrees, this causes a mild pinching of the blood vessels. Then with decreased blood flow to the lower leg, there is leg tension and fatigue which can lead to other problems as described earlier.

This decreased blood flow to the lower leg can also lead to blood clots which can lead to a life threatening medical condition. You may have read articles in the last few years about airline passengers getting leg blood clots. The cause is the short seats and spending several hours in a sitting position with the knees higher than the hips, which of course led to decreased blood flow to the legs. The same thing can happen from prolonged sitting in an improperly adjusted seat.

Without drinking enough water, you become dehydrated and this causes muscles to be unhealthy and tighter, and causes or intensifies headaches. Some people drink soda, tea, coffee, etc. and no water. Increasing water intake will often reduce many minor muscle discomfort.

This series of articles explained the most common causes of headaches from computer work, how to evaluate your workstation and technique to see if you have conditions that need to be corrected, and how to make the corrections.

==>> This is a part of a 6 part series of short articles on the causes and solutions to headaches related to working on computers. View them all under computer headaches.