Although it is helpful to work with an ergonomic specialist who can show you ways in which to make your work less stressful on the body, a common-sense approach to activities can also make a difference. This multi-part series offers some common-sense tips - based on the ergonomic principles of avoiding repetition, force and awkward postures - that can help you avoid pain while working.

IMPROVING POSTURE CAN REDUCE JOINT STRESS AND MUSCLE STRAIN

One of the best ways to prevent injuries is to keep a relaxed and neutral posture while working. Awkward postures while performing repetitive, forceful, or prolonged activity can place excessive stress on the joints and overwork muscles to the point of strain and fatigue. A basic principle of ergonomics is that, if possible, the job or work station should be modified to enable to worker to be in good posture and to reduce the need for awkward positioning and work habits. Seating and standing systems, ergonomically designed equipment and tools, and positioning of work equipment and tools can help make this possible.

For those who work at a desk or on a computer, the forward head and rounded shoulder posture can be prevalent. In spite of the best in ergonomic equipment, subtle positioning shifts can cause other awkward postures that contribute to pain problems. Having a friend or co-worker take pictures or video while you are working can be an enlightening way to detect the cause of potentially painful work habits.

I recently consulted to a gentleman who had been having neck pain for over a year. His pain began �overnight� after years of having his monitor placed on one side of his �L� shaped desk and his keyboard on the other. After moving the keyboard in front of his monitor on the right side of the desk, his pain improved but not disappear. Now, after several months, he is beginning to have some lower back pain. His employer purchased an adjustable monitor arm, an under-the-desk keyboard tray, and provided a chair with improved lumbar support. When I observed this gentleman at work, we noticed that he slightly shifted his chair to the left to center himself comfortably in his desk space. When he shifted, his left side was too close to the left side of his �L� shaped desk, jamming his arm into that side of the desk. To give his left arm more room, he would place it on top of the desk. This caused his left shoulder to elevate. In addition to the body shift to the left and the shoulder elevation, this gentleman would then shift his head to the right to center his eyes on the monitor screen. Seen from behind, his spine was in a subtle, reverse �S� shape. This was most likely throwing his hips out of alignment and causing the lower back pain. Placing the keyboard tray and monitor diagonally across the joint of the left and right side of the desks will increase the amount of space that this gentleman has to work in, preventing the awkward positioning, decreasing the reverse �S� shaped curvature of the spine, and potentially allowing his painful symptoms to finally improve.

Tips for Improving Posture

• The head should be upright with the neck relaxed.
  
• The monitor should be at a height that allows you to view it directly in front of you � not looking up or looking down or to one side or the other.
  
• Use a copy holder if you work input information from hard copies.
  
• The ears, shoulders and elbows should be vertical alignment.
  
• The shoulders should be relaxed, not elevated.
  
• Arm rests are optional.
  
  • If you do use arm rests, position them at a height that does not push your shoulders towards your ears.


• The keyboard and most work should be positioned at a level just slightly below elbow level.
  • However, depending on the type of work, this may need to be adjusted. For example, for fine motor tasks and manipulation, the work surface may need to be positioned higher.


• The wrists should be in the neutral position � flat and straight. They should not be bent forward or back, or angled to one side or the other.
  
• The fingers should be relaxed.
  • Don�t pound on the keyboard.
  • Use the lightest touch possible to activate the keys or any tool controls.
  
  
• There should be plenty of leg room beneath the desk or work table.
  
• The feet should be fully supported either on the floor or on a foot rest. One leg should not be crossed under the other.
  
• The knees should be at hip level or just slightly below.
  
• The lower back should be fully supported.
  
• Frequently used items should be placed between shoulder and hip height and within an easy arm�s reach.
  
• If phone work and keyboard tasks need to be performed simultaneously, a head set or speaker-phone capability is a necessity.
  
• If more than one employee uses the same work station, adjustments for chair, table and equipment height should be easy to make.
  
• Find tools that reduce awkward positioning or muscle or joint stressors (for example, write with a pen that has a larger barrel to relax the pinch required while writing; use a hammer with a curve in the handle to avoid having to angle the wrist; find a keyboard with the wedge-shaped keyboard to help position the wrists in the neutral position).

This is a multi-part series.

Part 1 discussed methods of reducing repetitive movements in the workplace.
Part 2 discussed methods of reducing forceful movements during activity.
Part 3 discussed methods of reducing awkward positioning.

Next Week � Putting It All Together � A Summary of Common-Sense Ergonomics
Marji Hajic is an Occupational Therapist and a Certified Hand Therapist practicing in Santa Barbara, California. For more information on hand and upper extremity injuries, prevention and recovery, visit Hand Health Resources.