August 2010 
The Pain Center |  Live More Comfortably  |  eNewsletter Header
We hope this note finds you continuing to do well and living your valued life. The article below by Mark DeKraker, The Pain Center's Occupational Therapist, can help you maximize your ability to function.
Computer Workstation Ergonomics
For those of you who either work at a workstation where computer use is large part of your work responsibilities, or you frequently use a computer at home, set up and positioning are very important to minimize risk of developing symptoms during that activity.  Let's look at a few important ideas that can keep you more comfortable. 
Seating Adjustment 
This is the starting point when we look at overall positioning.  Too often, people are not familiar with the adjustment capabilities of the chair that they spend so much time in during the day.  While the more adjustments available make it easier to get into a more neutral position, they do no good if the user is unfamiliar with them or how to use them.  Take some time to look at the manual/instruction sheet for the chair if you have it, or look over the chair.  Look under the seat, and look closely at and under the backrest to see what is available to you. 
For most people, we want to adjust the chair so that the hips are slightly higher or at least equal in height to the knees.  This will help maintain more normal arch of the lumbar spine. If the knees are higher than the hips in sitting, the result is more bending in the low back as the pelvis rolls backward to accommodate the higher knee position.  The adjustments that you will use to keep the hips higher than the knees will be the seat height and the tilt of the seat pan (not tilt of the seat back). 
If the seat back is adjustable, adjust it so that the lumbar support fits you well in the low back.  Sometimes, there is a separate adjustment to increase or decrease the feeling of support you get in the low back.
If your chair has an adjustment to move the seat pan forward or back (sometimes the seat back does this and not the actual seat pan), this can be used to adjust for varying leg lengths.  If the depth is too much, posture will likely be worse as you move forward in the seat to avoid pressure from the seat pan in the posterior knee area. 
Personally, I encourage patients to lock the reclining mechanism on the chair, or at least tighten it.  While reclining periodically is okay, if the seat back has too much "give" to it, you will likely end up extending your reach to the work surface, and often this leads to a forward head position posturally. 
Finally, if you have armrests that are adjustable, move your upper arms to your side into a resting/comfortable position.  Then, adjust your armrests to support you in that position.  You shouldn't have to lean to the side to use them, nor should they push your shoulders higher (adjusted too high). 
Arm and Keyboard Positioning 
Generally, we want to have your upper arms positioned in line with your trunk.  If you are too far away from the workstation/keyboard, you will extend the reach away from the body, which not only increases the work of the shoulder muscles to maintain that position, but the reach will inevitably pull you forward into a more bending posture in the low back.  Once your upper arms are in line with the body, move your forearms into a position parallel to the ground (approximately 90 degree bend at the elbow).  Then adjust your keyboard height to meet your hands in that position.  This will minimize risk of issues with carpal tunnel syndrome and tennis elbow. 
Monitor Height
If you wear corrective lenses, they should be in place when you go to adjust the monitor height.  While sitting with good posture, adjust the height of the monitor so that the top row of the working part of your screen is at, or slightly lower than eye level.  This is important to keep the head and neck in a good neutral position.  If the monitor is too low, it can lead to bending of the head and neck forward.  With regard to vision correction, if the height is adjusted before bifocals/progressives are in place, the height adjustment often ends up being too high, and the person will be looking at the screen by extending the head/neck.
Laptop Considerations  
While laptops give the advantage of portability, one big disadvantage is that they often lead you into poor posture.  Whether the laptop is on a workstation, or your lap, the fact that the monitor is connected to the unit typically leads to an even more dramatic forward head/neck position than is seen when one uses a desktop computer.  On the other hand, if you raised the laptop up, it leaves the arms/hands in a very awkward typing position.  If you use a laptop for extended periods of time, the easiest and most cost effective solution would be to attach a secondary keyboard.  This allows you to adjust the laptop to a higher position to keep head/neck in better posture, and adjust for arm/hand position by adjusting the secondary keyboard separately.
News & Updates
Listen to the audio clips of Dr. O'Connor discussing the importance of focusing on valued living while in pain and one of our graduate successes (from the WGVU Morning Show with Shelly Irwin).
More than the programs ...
At The Pain Center, all of our doctor's and therapists see patients outside of the programs. If you have a new injury, significant stressor, severe pain flare-up or need to adjust your home exercise program - come back to the team that you trust. We're happy to help.
Have a question about a flare up?
You are still a part of The Pain Center family. If you ever have a question, please give us a call at 616.233.3480 and we'd be happy to answer it.

Nicole DeHaan, PT
Physical Therapist 
The Pain Center at Mary Free Bed Rehabilitation Hospital
In This Issue
Computer Workstation Ergonomics
News & Upates
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