Preventing Repetitive Injuries & Office Ergonomics Richard Chau, D.C. Q.M.E. Certified Ergonomic Assessment Specialist Alliance Occupational Medicine
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Preventing Repetitive Injuries & Office ErgonomicsRichard Chau, D.C. Q.M.E. Certified Ergonomic Assessment SpecialistAlliance Occupational Medicine
AGENDA•Preventing Repetitive Motion Injuries
•Office Ergonomics
•Stretches
•Workstation Adjustments
•More Stretches
PREVENTING REPETITIVE MOTION INJURIES
RMI/CTD
•Many names
•Many symptoms
- Pain in the neck & shoulders
- Pain in the forearms & elbows
- Tingling in the hands
- Headache, etc.
Poor Posture Position
POSTURE AT YOUR WORKSTATION
•Head forwards
• Rounded Shoulders
• Sitting position in chair
• Slouched low back
• Forearms/wrists resting on surface
RESULTS OF POOR POSTURE
Tightness & shortening of the chest muscles, sub occipital muscles, and anterior neck muscles
Over stretching and weakness of the back & posterior shoulder muscles
RESULTS OF WORKING FOR EXTENDED PERIODS OF TIME
• Static contraction of the forearm muscles
• Ischemia/decreased fresh blood supply to the forearm muscle
• Abnormal forearm, wrist & hand positions – causing repetitive stress, wear & tear of the tendons
● Tendons are most commonly affected● They are the weak link; they transmit forces generated by the muscles● They are enclosed in the lubricating synovial sheaths which can get inflamed● Tendons have limited blood supply, hence delayed repair & recovery● RMI is the result of the repeated & prolonged tensing of the muscles● At times combined with excessive “rubbing” on nearby structures
STRUCTURES AFFECTED
OTHER STRUCTURES AFFECTED
● Muscles – due to sustained contractions affecting circulation, causing tenderness, tight knots – in the forearms, shoulders & upper back
● Nerves – due to direct pressure or compression in the tight muscles or swollen tissue
RISK FACTORS INVOLVED
• Force – pushing/pulling/gripping/pinching • Awkward posture – head forward, rounded shoulder• Repetition – continual typing/mousing• Duration – long days• Contact Stress – resting forearms or wrists affecting circulation
OTHER FACTORS
• Aerobic fitness
•Muscular strength
• Flexibility
• Coordination
• Excessive volume of activity
• Inadequate recovery time
• Advancing age
• Chronic Illness (diabetes, low thyroid)
• Smoking
SOLUTIONS
• Optimal work station to improve posture & pressure• Micro stretch breaks – to enhance circulation• Correct typing & hand held tool techniques – to lower abnormal forces
OFFICE ERGONOMICS
What can you do?•Create an optimal work station to improve posture & pressure
•Micro stretch breaks – to enhance circulation
•Correct typing & mousing techniques – to lower abnormal forces
Office Ergonomics
Office Ergonomics
Ergonomics• Most frequently used items closest
• Keyboard tray with space for mouse
• Headset
• Curved or split keyboards
At Your Workstation
Document Holder Placement
Headset and Split Keyboard
Mouse Position
Awkward Positions
Awkward Sitting Positions
Awkward Writing Positions
Awkward Leg Positions
UPPER BODY STRETCHES
What Can You Do? – Get Up and Stretch!
• Take small breaks to stretch
• Find a stretching buddy!
Tendon Glides
Wrist Extensor Stretch
Keeping elbow straight, grasp
left hand and slowly bend wrist
forward until you feel a gentle
stretch. You may curl your
fingers as necessary to increase
the stretch.
Hold 10-15 seconds. Relax.
Repeat on the right side.
Wrist Flexor Stretch
Keeping elbow straight, grasp right hand and slowly bend wrist back until youfeel a gentle stretch. KEEP FINGERS POINTINGDOWNWARDS. Hold 10-15 seconds. Repeat on the left side
Neck Stretches
PULL YOUR CHIN BACKand bend head backward.Do this only if it is pain free.
Upper Trapezius Stretch
DO NOT USE YOUR HANDS. Gently bend your head towards theleft shoulder while grasping your seat with your right hand or while bending your right arm behind you. You should feel a gentle stretch in your upper shoulder.
Hold for 15-20 seconds.
Posterior Capsule Stretch
Gently pull on right forward elbow with other hand until stretch is felt in shoulder.
Hold 10-15 seconds.
Inferior Capsule Stretch
Gently pull on right raised elbow with other hand until stretch is felt in shoulder.
Hold 10-15 seconds.
Chest and Shoulder Stretch
Lace fingers behind backand squeeze shoulderblades together. Slowlyraise and straighten arms. Hold 10-15 seconds.
STRETCH BREAKS•Every 20-30 minutes; never less then hourly •Stand up•Take several deep breaths•Rotate Stretches•Do your favorites more often•Walk at least 10 minutes at lunchtime •Once a day, do all exercises in one session•Exercise 20-40 minutes most days
WORKSTATION ADJUSTMENTS
Chair Adjustments
1) Stand in front of chair with height below knee cap
2) Sit tall in chair with feet flat on floor and chair ending 1-3 inches from knee
3) Adjust back rest to push hips slightly forward
4) Bent elbows at side of body should not contact armrests
Adjust Your Monitor
Monitor Height – Eye Level
Proper Distance – Fingertip Distance
Do You See Anything Wrong with the Following Pictures?
Good or Bad?
Good or Bad?
Good or Bad?
Good or Bad?
Good or Bad?
Good or Bad?
Good or Bad?
Good or Bad?
Proper Location of Document Holder
Mousing Examples
Mousing Examples
Mousing Examples
Keyboard Tray – Proper Typing Techniques
BACK AND LOWER BODY STRETCHES
Lumbar Extension
Supporting your low back bend backwards to make the hollow of the low back deeper.
Hold 2-3 seconds.
Quadricep Stretch (Standing)
Pull right heel towards buttock
Hold 5-10 seconds.
PNF Strengthening Resisted
Stand with resistance band around each hand, bring right arm up and ways, thumb back
Strengthening Chest Pull
Stand with resistance band around each hand, with arms straight out, stretch band across chest.
PNF Strengthening Resisted
Stand with resistance band around each hand, bring right arm up and ways, thumb back
Additional Stretches
PNF Strengthening Resisted
Stand with resistance band around each hand, bring right arm up and ways, thumb back
Bridging
Slowly raise buttocks from floor, keeping stomach tight.
Hold for 5-10 seconds if possible.
Partial Sit Up for lower abdominals
With legs over chair and arms clasped behind neck or folded across chest, tilt pelvis to flatten back.
Raise head and shoulders from floor.
Partial Sit Up for lower abdominals
With legs over chair and arms clasped behind neck or folded across chest, tilt pelvis to flatten back.
Raise head and shoulders from floor.
Hip/knee/back/legs
Stand with right foot back, leg straight, forward leg bent. Keeping heel on floor, into wall until stretch is felt in calf.
Hold 15-25 seconds. Repeat on other side
Double arm side bend
With hands clasped, reach over head and reach over to side. Repeat on other side.
Hold for 10-15 seconds.
Hip/Knee stretch
With leg crossed over other thigh, place elbow over outside of knee. Gently stretch buttock muscles by pushing bent knee across body.
Hold for 15-20 seconds.
Upper trapezius stretch
Gently grasp right side of head while reaching behind with the other hand.
Hold 15-20 seconds.
Upper back corner stretch
Standing in corner with hands just above shoulder level, lean forward until you feel a comfortable stretch.
Hold 10-15 seconds.
Thank You
Any Questions?
By Richard Chau, D.C.
Alliance Occupational Medicinewww.allianceoccupationalmedicine.com
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