In November 2007, the National Athletic Trainers' Association published "10 Steps to Combat Low Back Pain". Causes of low back pain include the stressors of poor posture, unusual movement or activities, or even a sedentary lifestyle. This press release outlined a plan to prevent low back pain with a general conditioning, strengthening and healthy living program.

These same 10 steps can be just as important in combating the mechanical stressors and pain that occur from computer and desk work. By slightly modifying these steps, you can avoid the stresses that put you at risk for repetitive injuries such as carpal tunnel and tendinitis. Here are the 10 steps with my adjustments and explanations made for the computer athlete.

• Identify Negative Stresses - Computer and desk-work related stressors often include a poor ergonomic set-up that leads to a forward head posture and rounded shoulders. These postures place tension on the nerves as they exit the cervical spine and tighten the chest muscles while weakening and stretching the back muscles. Learn more about ergonomics and efficient work postures at the computer and at your desk.
  Perfect Posture - The Basics
  
• Make Yourself Mobile - Tight muscles can start pinching nerves and cause postural imbalance leading to muscular tension or "knots". Stretch the muscles that tend to tighten while working at the computer and at the desk. For computer workers, some of the most important muscles to stretch include the chest muscles (the pecs) and the forearm muscles (turning palm-up, stretching the wrist forward, and pulling the wrist back). Think of the position that you are in while at your computer and stretch frequently into the opposite direction.
  
• Increase Strength - Strengthening the core muscles and the back muscles can help promote postural balance and alleviate some of the problems often associated with forward head and rounded shoulder positioning.
  
• Perform 20 Minutes of Aerobic Exercise Daily- Aerobic activity increases the blood flow to muscles improving the oxygen flow and healing ability of the body's tissues. Aerobic activities improve muscular endurance and general cardiovascular fitness. Aerobic activity also increases the production of serotonin, the body's natural stress reliever.
  
• Pay Attention to Posture - Ergonomic adjustments to your computer and work stations will improve your posture and help you avoid muscular imbalances that can often lead to repetitive strain injuries.
  Ergonomics - Improving Posture
  
• Sit Up Straight - Adjust the chair, the keyboard and mouse height and position, and the monitor height per ergonomic guidelines to improve comfort and reduce body stressors while working. (Modified from "Stand Up Straight" in the original article).
  Ergonomic ABCs
  
• Use the Proper Ergonomic Set-Up - Make the appropriate adjustments to your computer and work station. (Modified from "Use Proper Lifting Mechanics" in the original article).
  Basic Ergonomic Principles
  
• Get a Good Night's Sleep - Most of our body’s healing occurs at night. The body needs time to recover from the normal microscopic damage and tearing that occurs with daily use. Make sure you are getting plenty of rest, especially during times of increased stress or when working extra hours on a project that needs to be completed.
  
• Warm-Up Before Physical Activity - Warming-up the muscles improves flexibility and prepares the body for activity. Sports enthusiasts recognize this principle. However, even less physically stressful activity or maintaining a static posture, if repeated for hours or in poor positioning, can be stressful to the body. Perform stretches prior to working. Park farther away and walk quickly into your work facility, or take the stairs in order to get the muscles ready for activity.
  
• Live a Healthy Lifestyle - Obesity and smoking have been associated with an increased risk of developing carpal tunnel syndrome. The better the nutrition and oxygen flow to the muscles, the better the body can heal the microscopic damage that occurs with normal daily activity. The Effect of Smoking on Repetitive Strain Injuries

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.