Work Station Set-up

As talked about in the previous post, set up is the key to preventing injuries/pain. So what is the right set up??

Work surface

• Keep most used items within an arms reach: phone, document holder, etc. The less frequently used objects should be positioned further away.
• Use a document holder if able versus setting on desk or keyboard.
• Working surface should be height adjustable.

Sitting position

• Hips positioned slightly higher than the knees-shoulder basically be a 90 degrees angle at the hips and knees.
• Back angle upright or slightly or reclined.
• Arms relaxed at side. Can be supported by armrests, but should not elevate shoulders.
• Maintain the “S curve” in her spine-use a lumbar support.
• Feet supported on either ground or a stool-they should never be hanging unsupported!

Computer screen

• Positioned 20-28 inches from eyes-about an arms reach away
• Top line on the screen should be at or slightly lower than eye level-about 20 degrees
• Screen should be directly in front of you-should not have to twist to see the screen
• Position screen away from bright light sources to avoid glare or contrast

Keyboard/mouse

• Positioned at or slightly lower than elbow height
• Wrist/forearm/hand should be in alignment
• Options: split keyboards; mouse with a trackball

Phone

• Avoid cradling the hand set between your shoulder and head 
• Use a headset or speakerphone if able

Hope this helps with your set-up! The next post will be on stretches and general tips for you to hopefully make it through the workday without pain!

 Josiah Thunshelle, PT 

Office Ergonomics Part 2

The Basics of the Body

Before getting into how to set up the workstation and what to do to prevent/deal with injuries, we must first understand why issues occur in the first place.

1. Neutral spine: your body has 3 basic curves. If you were to look at the spine from the side, it would look similar to an “S”. This is the ideal position and it allows for ideal length of your muscle tissues and optimal position

2. The weakness and tightness relationship: the most important and sometimes most complicated question that I have to answer with my patient’s is this…is the muscle tight because it is weak, or weak because it is tight? You may be asking yourself why I would ask this question or why it matters, so here is why. Muscles are designed to be at a certain length at rest and be strongest at a different length. If outside of those boundaries, there is dysfunction and eventually injury. But back to the original question…say your shoulder muscles are weak, your other muscles will tighten up to create the stability that is lacking. The opposite is also true. If some muscles are tight, other muscles will be weak because they are no longer needed to provide that stability. I know, complicated question. If you want more of an explanation just let me know!

3. The point: the average set up at a workstation does not encourage a neutral spine or the optimal muscle length/strength causing injury. Thus, we must find a way to maintain proper alignment of the body.

Josiah Thunshelle, PT

Office Ergonomics

Our culture is one that is steadily becoming more sedentary and the trend in the workplace is no different. The number of jobs that are classified as either “light activity” or “sedentary” has risen from 50% in 1960 to 80% in 2006. This has led to an increase a variety of issues including neck and low back pain, headaches, repetitive stress injuries, and obesity. While there is not much we can do about the trend of jobs becoming more sedentary, we can work to try to offset some the negative effects of those sedentary jobs. This is first of a series of posts that will address how to set up your office and tips for stretching and exercise. Stay tuned!

Josiah Thunshelle, PT

References

1. Church T, Thomas D, Tudor-Locke C, et al. Trends over 5 Decades in U.S. Occupation-Related Physical Activity and Their Associations with Obesity. PLoS One. May 2011; 6 (5).

http://www.plosone.org/article/info:doi%2F10.1371%2Fjournal.pone.0019657

Return to Running

Running is a complicated and intense (force on your stance leg is 2.5x your body weight!) activity. Millions of people do this every year, and unfortunately injuries are bound to occur. What is most people’s solution when they get injured? Yep, you guessed it, put a little ice on it and take some Ibuprofen. This strategy sets people up for future and more serious injuries. Every injured runner should seek care from a rehab professional to guide them through the recovery process. Here are a few guidelines to use for making a safe return to running.

1. There are no signs or symptoms of inflammation present.

Running while there is inflammation will result in further injury and prolong your recovery. Signs of inflammation include pain, swelling, warmth, and redness. Using anti-inflammatory medications is alright initially, but avoid masking the pain after the initial 5-7 days. If you mask the pain now, it will only return in even greater intensity at a later time. Finally, just because you are no longer in pain does not mean that you are ready to run again. The issue that caused the injury in the first place is more than likely still present. Find a rehab professional to assist you with correcting your issues.

2. You can correctly complete functional movement patterns.

You have to possess the appropriate flexibility, strength and stability in order to load your body properly while running. Four patterns that must be normal include:

Toe touch: can you touch your toes with a symmetrical curve of your spine? This is an excellent way to see if you have the ability to fully take your forward step. Lack of mobility here can lead to excessive trunk/hip rotation to compensation.

Extension: can you lean backwards with the front of your hips crossing your toes and your shoulder blades past your heels? This is a great way to see if you can fully extend your hips and have an appropriate stride length. Lack of mobility here can lead to excessive trunk/hip rotation to compensation.

Single leg stance: can you balance on each leg for 10+ seconds with eyes open and eyes closed? Running is predominantly a single leg stance activity. If you are not able to maintain your balance in a static position, how do you expect to do it while running?

Deep squat: can you complete a squat (buttocks below knees) with your trunk and shins parallel, no inwards/outwards collapse of your knees, and your heels on the ground?

3. Appropriate running mechanics have been restored.

The previous point measures the minimum requirements needed for appropriate movement. They were all static tests; however, running is not a static activity. You may be able to have correct alignment in a static position but can you do it when running? Or do your hips rotate inwards, knees collapse, and toe off occur on a toe other than the great toe?

4. Can you tolerate a walk to run progression?

No normal person would ever decide they were going to run a marathon the week before and then go out and do it would they?! Of course not! No, there is a progression over time that is followed. Maybe it is 3 miles for 2 weeks, then 4 miles the next week, etc until the final distance is achieved. This is the same for a return to running after an injury. An injury changes the way you run and hopefully the rehab that you went through changed it for the better. The fact is though, that you need to get used to this. You should start walking first gradually increasing the distance and speed. If you are able to walk for 45 minutes at a moderate speed (4mph) then you can begin running. Start running at a comfortable speed for 1 mile, then slowly increase distance and speed as able.

Josiah Thunshelle, PT 

What are the Right Shoes for Me?

Selecting the right shoes is the first and one of the most important decisions that you will make for your running experience. It could be the difference between many years of enjoyable running or pain and misery!

What you should know before you go

1. If you have any foot problems (pronation/supination). It is a good idea to consult with a medical professional such as a chiropractor or physical therapist to identify if you have any issues. Pronation is a common problem which may or may not be corrected with specialized exercises. You do not want to get a shoe that artificially supports improper running patterns which can be corrected naturally.

2. Mileage you are running each week. This will determine the type of shoe you will get.

3. Type of surface you are going to be running on. This will determine the type of shoe you will get.

What to bring when you are buying new shoes

1. Your old running shoes. This gives the person helping you a better understanding of how you typically wear down your shoes.

2. Your orthotics. If you wear orthotics, bring them to make sure they fit in the shoe. Remember fit the shoe to your orthotic, don’t modify your orthotic, let a professional do this.

General Rules

1. Go to a local specialty shoe store. Often times these places will have a treadmill that your gait can be evaluated on.

2. You usually get what you pay for. If it is a really cheap shoe, then it probably did not cost a lot to make and there was not a lot of time put into developing it. I am not saying that this is always the case, but typically it is.

3. If it does not feel comfortable right away, it probably is not the right fit. You should not expect the shoes to “break in”. If your first impression is not good, run away!

4. Stick with what works. Always stay one step behind the new industry fads. If a certain type of shoe has worked in the past, don’t change!

Josiah Thunshelle, PT