Home Work Station Tips Part 2

Movement

Moving often may be the most important tip for preventing computer-related pain.  Any posture (sitting, standing, slouched, upright, etc.) for prolonged periods can lead to pain in various areas.1-9,34 In fact there’s now a focus on preventing sedentary postures rather than demonizing sitting specifically.  Sustained postures are clinically reported by patients to be the thing that aggravates their pain the most.10 Aside from pain, sedentary behavior in general has been shown to be associated with an increased risk of obesity, hypertension, type II diabetes, metabolic syndrome, venous thromboembolism (blood clots), cardiovascular diseases, cancer and also increased all-cause mortality.4,7,10-12 Sit-stand desks and computer prompting, or just a simple alarm, have been shown to decrease sitting significantly.9,34 Although switching between sitting and standing has been shown to be beneficial, prolonged and uninterrupted standing (2 hours) may be associated with health issues including venous insufficiency, atherosclerotic progression, back and lower limb discomfort, and decreased cognition.4

Changing positions every 20-30 minutes has been shown to have positive effects on musculoskeletal and metabolic issues.2,8,10 An active break, ideally with postural change, for 2-5 minutes every hour or switching from sitting to standing every 30 minutes have both been shown to be beneficial for musculoskeletal (pain), blood glucose, blood pressure, and cardiovascular risk issues.3,5-9,11,13,33

Consider taking 1-2 minutes to perform one or more of the following exercises every 20-30 minutes while working at your computer, or sitting in general.

Active Low Back Extension:  Perform 5-10 slow repetitions, holding for 1-2 seconds.  Do not push through pain.   Sitting is largely a trunk flexion position for many people and this exercise does the opposite, thus lengthening tissues that are in a shortened position for prolonged periods.

Cat Cow:  Perform 5-10 slow repetitions, holding for 1-2 seconds, and taking slow easy breaths.  Breath in through the nose on the way to the cat position (back arched towards the ceiling) and out through pursed lips on the way to the cow position (belly hanging towards the floor).  Do not push through pain.  This is a great exercise for spine mobility while limiting compression on the spine.

Standing Posture with Chin Tucks:  This is a great exercise for postural awareness with the wall providing tactile feedback.  Phase 1 is to simply stand with your back against the wall and ideally the back of your head, in between your shoulder blades, and top of your tailbone being in contact with the wall.  If you can place more than one hand behind your low back, tuck your tailbone under (posterior pelvic tilt) to slightly decrease the curve in your low back.  Imagine there is string pulling from the top of your head towards the ceiling to lengthen your spine.  Perform 5-10 slow easy breaths.  Be aware of your posture as you step away from the wall.  Avoid excessive strain and stiffness throughout the body.  Phase 2 is adding the chin tucks as shown in the video.  Perform 5-10 repetitions, holding for 1 -2 seconds.  Phase 3 is the wall angels described next.

Wall Angels:  This exercise tends to be much harder than it looks.  It helps with posture by strengthening the muscles (in the back and shoulders) that improve posture and stretching the muscles (in the chest and front of shoulders) that tend to pull you into a rounded back posture.  When you place your forearms and elbows on the wall, you will most likely need to tuck your tailbone (posterior pelvic tilt) to decrease the curve in your low back.  You should only be able to place about 1 hand behind your low back.  Take slow easy breaths and perform 5-10 slow repetitions.  Do not push through pain.

Child’s Pose:  Perform 1-2 repetitions holding for at least 30 seconds and taking slow easy breaths.  This is an excellent stretch for your low back, hips, knees, ankles, and shoulders.  Do not push through pain.  If you have pain in the shoulders, slide your arms back so your elbows are resting on the floor.

Childs Pose

Neck Flexion/Extension:  Perform 5-10 slow repetitions.  Do not push through pain.  Many people go through less and less of these end ranges, especially with jobs requiring looking at a computer screen for prolonged periods, which leads to a lack of mobility when you need it.  If you don’t lose it, you lose it.

Neck Rotation:  Perform 5-10 slow repetitions.  Do not push through pain.  This exercise goes with the one above and limitations typically show up with activities like checking your blind spot while driving.  If your limited with these motions, there’s a lot you can do to gradually regain your mobility.

In addition, check out my general strength and flexibility program here.  Regular strength training has been shown to increase strength, increase bone mass density (lower the risk of osteoporosis), improve sleep, decrease depression, decrease all-cause mortality, reduce cognitive decline, decrease the risk of falls, decrease systolic blood pressure, and decrease musculoskeletal pain.14-19  It’s recommended that adults strength train major muscle groups (legs, hips, back, abdomen, chest, shoulders and arms) 2-5 days per week for 30-60 minutes.14

Aerobic Exercise

A good goal to shoot for is 150-300 minutes (30-60 minutes 5 days per week) of moderate to vigorous intensity aerobic exercise per week for adults.14

People who exercise aerobically for this amount of time have been shown to have a decreased risk of diabetes, metabolic syndrome, and increased weight maintenance and executive functioning, all of which have been shown to be adversely affected when people are more sedentary.14,20

Psychosocial Aspects, Stress Reduction, and Breathing

Pain and injury recovery are rarely limited to physical aspects alone.  This is obvious to most folks who have had to deal with a prolonged injury or illness.  Its depressing, frustrating, affects relationships, and can magnify preexisting issues with work, friends, and family life.   Chronic pain, including low back pain, has been shown in numerous studies to have a strong psychosocial component.13,21-31,34 Some specific examples related to the workplace are monotonous work, perceived high workload, pressure of time, lack of decision-making authority, and job dissatisfaction.25,34 And given the current state of our global pandemic, mitigating stress is of huge benefit to keeping our immune systems in top shape.32

There are many ways to address excessive stress.  Simple breathing exercises can be found here (mine) and here (from Jan Goldberg).  Check out the “chronic pain” section of my article here for many other options, including the “4 pillars” of chronic pain intervention (aerobic exercise, education, goal setting, sleep).  Seeking individualized help, from someone we trust and jive with, for stressful situations prevents us all from having to reinvent the wheel.

 

Stay Strong!

Check out Beyond Tape: The Guide to Climbing Injury Prevention and Treatment for more information about warming up, stretching, and other climbing (and non-climbing) injury related topics.  Like my Facebook page and follow me on Instagram for updates and more information and rate/review Beyond Tape on my website or here My primary motivations for Beyond Tape and any of the posts are to:       1. Check out the most relevant and up-to-date research for each topic in order to dispel myths, sift out conflicting views, and help people to prevent or heal from injuries – letting me know about new research or opposing views is helpful and greatly appreciated       2. Contribute to the local and global communities by donating 100% of my net profits from Beyond Tape to service-based non-profit organizations, such as Rotary International, Doctor’s Without Borders, Access Fund, etc.

 

References:

1Korakakis V1, O’Sullivan K, et al. Physiotherapist perceptions of optimal sitting and standing posture. Musculoskelet Sci Pract. 2019 Feb;39:24-31.
2O’Sullivan K1, O’Sullivan P, et al. What do physiotherapists consider to be the best sitting spinal posture? Man Ther. 2012 Oct;17(5):432-7.
3Waongenngarm P1, Areerak K2, et al. The effects of breaks on low back pain, discomfort, and work productivity in office workers: A systematic review of randomized and non-randomized controlled trials. Appl Ergon. 2018 Apr;68:230-239.
4Mula A1. Ergonomics and the standing desk. Work. 2018;60(2):171-174.
5Goode AD1, Hadgraft NT, et al. Perceptions of an online ‘train-the-champion’ approach to increase workplace movement. Health Promot Int. 2019 Dec 1;34(6):1179-1190.
6Davis KG, Kotowski SE. Postural variability: an effective way to reduce musculoskeletal discomfort in office work. Hum Factors. 2014 Nov;56(7):1249-61.
7Heneghan NR1, Baker G2, et al. What is the effect of prolonged sitting and physical activity on thoracic spine mobility? An observational study of young adults in a UK university setting. BMJ Open. 2018 May 5;8(5):e019371.
8Sheahan PJ1, Diesbourg TL1, et al. The effect of rest break schedule on acute low back pain development in pain and non-pain developers during seated work. Appl Ergon. 2016 Mar;53 Pt A:64-70.
9Shrestha N1, Kukkonen-Harjula KT, et al. Workplace interventions for reducing sitting at work. Cochrane Database Syst Rev. 2018 Dec 17;12:CD010912.
10Sheeran L1, van Deursen R, et al. Classification-guided versus generalized postural intervention in subgroups of nonspecific chronic low back pain: a pragmatic randomized controlled study. Spine (Phila Pa 1976). 2013 Sep 1;38(19):1613-25.
10Straker LM, Dunstan DW, et al. Sedentary work. Evidence on an emergent work health and safety issue. Final Report, Canberra: Safe Work Australia. Safe Work Australia’s Emerging Issues Programme. March 2016.
11Toomingas A1, Forsman M, et al. Variation between seated and standing/walking postures among male and female call centre operators. BMC Public Health. 2012 Mar 2;12:154.
12Neuhaus M1, Healy GN, et al. Iterative development of Stand Up Australia: a multi-component intervention to reduce workplace sitting. Int J Behav Nutr Phys Act. 2014 Feb 21;11:21.
13Lacaze DH1, Sacco Ide C, et al. Stretching and joint mobilization exercises reduce call-center operators’ musculoskeletal discomfort and fatigue. Clinics (Sao Paulo). 2010 Jul;65(7):657-62.
14Global Recommendations on Physical Activity for Health. WHO Guidelines Approved by the
Guidelines Review Committee. Geneva: World Health Organization; 2010.
15Kraschnewski JL, Sciamanna CN, et al. Is strength training associated with mortality benefits? A 15year cohort study of US older adults. Prev Med. 2016 Jun;87:121-127.
16Seguin R1, Nelson ME. The benefits of strength training for older adults. Am J Prev Med. 2003 Oct;25(3 Suppl 2):141-9.
17Liu-Ambrose T1, Donaldson MG. Exercise and cognition in older adults: is there a role for
resistance training programmes? Br J Sports Med. 2009 Jan;43(1):25-7.
18Pedersen M, Blangsted A, et al. The Effect of Worksite Physical Activity Intervention on Physical Capacity, Health, and Productivity: A 1-year Randomized Controlled Trial. J Occup Environ Med. 2009 Jul;51(7):759-70.
19Van Eerd D1, Munhall C2, et al. Effectiveness of workplace interventions in the prevention of upper extremity musculoskeletal disorders and symptoms: an update of the evidence. Occup Environ Med. 2016 Jan;73(1):62-70.
20Guiney H1, Machado L. Benefits of regular aerobic exercise for executive functioning in healthy populations. Psychon Bull Rev. 2013 Feb;20(1):73-86.
21Curran M1, O’Sullivan L2, O’Sullivan P3, Dankaerts W4, O’Sullivan K5. Does Using a Chair Backrest or Reducing Seated Hip Flexion Influence Trunk Muscle Activity and Discomfort? A Systematic Review. Hum Factors. 2015 Nov;57(7):1115-48.
22Curran M1, Dankaerts W, O’Sullivan P, O’Sullivan L, O’Sullivan K. The effect of a backrest and seatpan inclination on sitting discomfort and trunk muscle activation in subjects with extension-related low back pain. Ergonomics. 2014;57(5):733-43.
23O’Sullivan K1, O’Keeffe M, O’Sullivan L, O’Sullivan P, Dankaerts W. The effect of dynamic sitting on the prevention and management of low back pain and low back discomfort: a systematic review. Ergonomics. 2012;55(8):898-908.
24van Niekerk SM1, Louw QA, Hillier S. The effectiveness of a chair intervention in the workplace to reduce musculoskeletal symptoms. A systematic review. BMC Musculoskelet Disord. 2012 Aug 13;13:145.
25Al-Otaibi ST1. Prevention of occupational Back Pain. J Family Community Med. 2015 May-Aug;22(2):73-7.
26O’Keeffe M1, Dankaerts W, et al. Specific flexion-related low back pain and sitting: comparison of seated discomfort on two different chairs. Ergonomics. 2013;56(4):650-8.
27Gifford, L. Pain, the Tissues and the Nervous System: A conceptual model. Physiotherapy Volume 84, Issue 1, January 1998, Pages 27-36.
28Moseley, L. Reconceptualising pain according to modern pain science. Physical Therapy Reviews 12(3):169-178 · September 2007.
29Louw A1, Butler DS, et al. Development of a preoperative neuroscience educational program for patients with lumbar radiculopathy. Am J Phys Med Rehabil. 2013 May;92(5):446-52.
30Louw A1, Diener I, et al. The effect of neuroscience education on pain, disability, anxiety, and stress in chronic musculoskeletal pain. Arch Phys Med Rehabil. 2011 Dec;92(12):2041-56.
31Louw A1, Nijs J2,3, Puentedura EJ4. A clinical perspective on a pain neuroscience education approach to manual therapy. J Man Manip Ther. 2017 Jul;25(3):160-168.
32Vitlic A, Lord JM, et al. Stress, Ageing and Their Influence on Functional, Cellular and Molecular Aspects of the Immune System. Age (Dordr). 2014 Jun;36(3):9631.
33Mongini F, Ciccone G, et al. Effectiveness of an Educational and Physical Programme in Reducing Headache, Neck and Shoulder Pain: A Workplace Controlled Trial. Cephalalgia. 2008 May;28(5):541-52.
34Hoe VC, Urquhart DM, et al. Ergonomic Interventions for Preventing Work-Related Musculoskeletal Disorders of the Upper Limb and Neck Among Office Workers. Cochrane Database Syst Rev. 2018 Oct 23;10(10):CD008570.

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