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Working From Home: The New Normal

  • baweiss0
  • Aug 8, 2020
  • 5 min read

The Covid-19 pandemic has not only caused havoc on our lives socially, financially, mentally and physically, but with more individuals working from home, many of us therapists are seeing an increase in hand, arm, shoulder, neck and back issues due to poor "work station" set-ups at the home. You may have a good set up at work, with a good chair, table, possibly keyboard tray, even some may have a sit/stand set-up that helps vary positions during the day, helping with back, neck and arm issues.


However, with more people working from home, these ergonomic set ups may NOT be carried over in your place of residence. Too often, people are sitting on the couch, chair at the dinning room table, in bed or an improper height desk with a bad chair. We are seeing more patients with neck, shoulder, arm and hand pain as well as numbness and tingling symptom in their hands, due to poor posturing and set-ups. This causes decreased circulation to the structure of the whole arm, compression of the nerves at the neck and shoulders as well as the elbows and the wrists. In my blog of June 7, 2020, I started talking about posture and the psychological effects of poor posture. I touched only briefly on the physical aspects of poor posture. All the nerves, arteries and veins coming from the neck, through the shoulder and down the arm can be compromised, if you present yourself with all your activities in poor posture.








If you look at the picture on the left, you will see how the nerves from your neck, pass under your clavicle bone, on top of your upper rib cage and down through your arm pit, where they then branch out and travel to different sides of your arm to your hand. They also travel through the neck muscles as well as the chest muscles that are on top of your ribs. If you maintain good posture, all these structures are aligned so that there is no compression either in the muscle, around the ribs or under the clavicle. The picture on the right shows what happens when you progressively start flexing forward in your shoulder, head, clavicle and your rib cage starts to elevate. Neck and chest muscles tighten and shorten, and the arteries, veins and nerves that fall in between these structures begin to not function as well. This can cause decreased circulation throughout the arm and hand, possibly increased swelling in the hand, decreased function in the muscle efficiency of the upper arm, forearm and hand, and possible tingling and numbness due to compression or compromised circulation to the nerves, even after only a short time using your arm and hand. So if you are wondering, why you are starting to get pain, fatigue, numbness and tingling in your elbow, forearm, wrist and hands.... this could be one of the main reasons these symptoms are happen.


So what does this have to do with working from home in poor posture....... EVERYTHING! No more working on your laptop on the couch or bed. When you do this, you are setting your upper body in a position of POOR POSTURE. If you end up on the couch or bed, then it is important that you set your body up with the best possible posture. One idea is to use a laptop stand/tray (sort of like a meal tray), to assist you with improved posturing while you are working on your computer in a sitting or lying position. If the laptop is directly on your legs, this brings your neck and shoulders more forward. If you have your legs out straight in bed or the couch, there needs to be either a pillow under your knees, or you need to bend your knees, with your back upright (scoot your behind all the way back). This position helps to keep the pelvic rotated correctly and spine and neck straighter and shoulders relaxed back and more open. I usually recommend the use of the “Back Joy Posture” insert for sitting on any chair, couch, bed and even in the seat of your car. This simple design places your pelvic in the correct position and assists your upper body to be in good alignment with no effort. https://www.amazon.com/BackJoy-Posture-Chair-Cushion-Adults/dp/B006R3FOKK/ref=pd_ybh_a_26?_encoding=UTF8&psc=1&refRID=N57KMHANZEB96JM66H6T

Here is a very short video of how this works.






Here are also some pictures of “do’s and don'ts” for sitting or lying on the bed or couch.


These are NO positions



















These are better positions



This keyboard tray or the one below for the couch or bed is good overall, but the angle is not good.. it should be more flat, so that you are not keying with your wrists in extension. When using a tray like this, both knees should be bent.The set-up in this picture would be better if she was sitting up a little more and possibly had the Back Joy under her. This is just ONE example of a set-up.There are tons of laptop stands that may work for you.



This set up is not too bad either




Some of these picture are good, the one on the left top, her arms are reaching too far forward and she should be having her laptop closer with more relaxed arms by her side, and with knees bent.












If you use a laptop or desktop computer on a table, the table needs be to set up in a way that keeps the whole upper body, neck and head in good alignment. Therefore, your keyboard, mouse and monitor need to be considered. If the table is too high, your arms and hands will overwork, reaching up and out. That static holding is very hard on the whole arm, including all the way up to the neck and shoulders. Ideally you should have a work station set up that allows the keyboard and mouse to be placed close to the edge of the table or keyboard tray. The mouse should also be at the edge so that you are floating over the mouse, not leaning the wrist on the table. The most ergonomic option would be a vertical or semi-vertical mouse and a keyboard that does not have a number pad on the right, unless you are an accountant or type numbers all day. Goldtouch has a nice keyboard and vertical mouse that I usually recommend. The keyboard is adjustable for angling if needed. .





The Chair should be comfortable and adjustable, especially the height. Your feet should be flat on the floor. But again, I recommend the use of the Back Joy Seat insert for effortless postural alignment in any chair, even a great ergo chair.

Here is an idea of a computer table that might work for people at home. If you find standing helps, then consider a stand/sit portable stand that you can put on your table, to easily switch between sitting and standing.






In any event, with more people working at home, it is SO important that you set up a working area to minimize any strain in any part of your body. The other main suggestion as well, whether you are working from home or in an office, is, of course, take lots of mini breaks, move around, and do upper arm and shoulder stretches on a regular basis... Drinks lots of water as well..........all of which is another topic all together...

Be safe computing!

 
 
 

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