Are You Sitting Comfortably
I’ve written this blog so that readers can understand the basic principles of workstation setup and why this is so relevant in the workplace and at home. In this ever-changing situation we find ourselves in of combined working from home and office we are constantly needing to adjust or working environment. I’m positive this blog will give you the tools to be able to do a basic ergonomic workstation assessment or your workstation in both locations to help you maintain optimal musculoskeletal health.
What happens to our bodies when we don’t move?
Even when posture is good, staying in one position for too long can cause us problems. Muscles and other soft tissues can fatigue when we’re static for longer periods. As the stabilising and postural muscles fatigue we can sometimes start to recruit different muscles to keep us upright against gravity. We can start to use the muscles differently around our shoulders and back and get an imbalance of the activity around our neck and upper back which can lead to shoulder and neck pain. The shoulder and upper back muscles work to support the limb allowing the wrist and hand muscles to do the smaller controlled movements and specific functions we require at a desk. Repetitive movements to these smaller muscles can sometimes be underestimated and if the supporting muscles are not playing their role in the correct way it may lead to overuse of the muscles in the limb leading to fatigue and overuse.
Physiologically when we are static, we generally get reduced circulation, reduced energy levels and fatigue. A build-up of lactic acid within tissue can contribute to levels of pain. These chemicals irritate the nerve endings which can contribute to a painful stimulus. In addition to the reduction in circulation we can also have a reduction in the oxygen in our body due to changes in our breathing pattern, particularly if we slump and prevent our diaphragm from moving in a normal pattern. This can contribute to changes in body pH and calcium levels which further have an effect on muscle and nerve function and hence pain.
So, what’s the answer…
Simply move…You may well already know that the body likes to move and are aware that you start to fidget when you’ve been sitting for too long or you just feel the need to stretch. You can see from how lack of movement and being static can have negative impacts on the body and to counteract this then simply moving more often could be helpful. The human body has evolved to move almost constantly, and many modern health problems are directly related to static posture and sedentary lifestyles. Unfortunately, our modern workplace and society doesn’t always facilitate this. How comfortable would you feel getting up in the open plan office to do stretches? Perhaps if we had a shift in our mindset and that movement and stretching in the office became the norm then those that weren’t doing it would get the strange looks. This would be eutopia from a Physiotherapists perspective!
What can lead to poor posture?
There are lots of factors that can contribute to poor posture and often there are a combination of these habits that have developed over time. When we look at our own posture in a mirror, we can sometimes see the posture and stance of our parents facing back to us. It’s not really known how much of our posture is contributed to by nature and our bony alignment or if there is a level of learned behavior to the extent, we copy the postures of our parents. This doesn’t mean that we don’t have the ability to learn new movement patterns or improve our posture.
We are in a society that doesn’t stop, and I mean this from a mental stance.
Modern life means we are always switched on whether it’s constant connectivity, trying to do too much, being time poor and having less time for recreational and stress relieving activities. This goes hand in hand with sustained levels of stress hormone within our body. Stress hormones influence our physiology and breathing patterns, heart rates and blood pressure to name but a few. Altered beathing patterns certainly change the functioning of the muscles around our neck and upper trunk which can have an impact on posture. Which is the biggest culprit I wonder poor posture or stress/anxiety or is it that combined effect giving us a perfect storm?
Let’s face it a general lack of activity is never going to get our tissue at optimal performance, so little or no activity outside a sedentary job will certainly not do us any good if we are wanting to keep our body functioning optimally. We know that reduced activity levels have a link to a reduction in metabolism and poorer control of blood sugars. Now I’m not saying that static postures are the cause of these changes, but it is a pattern in our life that we need to be aware of and make the adjustments accordingly. Moving more and getting stronger are key.
Simply being tired and fatigued can also lead us to sit in poor postures.
Physiotherapists are well placed to help you identify some of the problems that may contribute to your workstation issues.
What are the common problems we see?
We often talk to our patients about posture because they frequently present with neck, shoulder, or back pain sometimes of unknown and insidious causes. Headaches can also be a feature of prolonged sitting or use of display screen equipment. Tendons in the wrist, elbow and hand can also be affected because of overuse and treatment can be of benefit to restore the health of these tissues and implement changes to help with the long-term management.
The consequences can be quite wide reaching if we have persistent pain relating to our workstation. Work absence for employers and employees is problematic for both parties financially along with a reduction in productivity if pain is influencing function at work. The potential need for the individual to invest in physiotherapy services also has time and cost implications. Impacts can then be had on our home life and leisure time if constant pain becomes an issue.
Getting Comfy
Before you start adjusting your workstation the first thing you need to check out is that all of your equipment is working properly and in good condition. Having a quick check that seat pads are not worn through that there’s no exposed metal work, the wheels are in good working order and the chair is maintaining its height as it should. Reporting screens that flicker to your IT department or arranging through the correct channels any repairs as required. Check your working environment are you warm enough and is there a lot of glare coming in through a window affecting your vision of the screen. Systematically going through your works station can be very helpful
Desk & Keyboard
I usually start at the desk because this is more often the fixed unit that is most difficult to adjust. When you sit on your chair and move into the desk ideally you would sit with the elbows at approximately 90 degrees and your feet would also be supported on the floor. In some circumstances this isn’t possible. Rather than resting the feet on the floor we can find ourselves resting our feet on the legs of the chair, perching on the chair, or tucking the legs under the chair. A footrest can be helpful to give the limbs the support they need, reducing the load put through the lower back and the back of the legs. As we have said the elbows need to be near 90 degrees and the shoulders want to be in a relaxed position. You don’t want to be hitching your shoulders up for your hands to reach the keyboard. The centre of the keyboard should be positioned in line with the centre of the monitor and the wrists resting lightly on the desk. Aim for the keyboard to be positioned close and in line with edge of desk and adjust the tilt of the keyboard to keep your wrists neutral. Document holders between the keyboard and monitor can be helpful.
Mouse
The mouse wants to be positioned on the desk next to the keyboard and don’t let it drift away so you’re not stretching out for it. This will reduce the load on the shoulder and reduce the tension and strain into the neck. If you are struggling with tendonitis and pain in the wrist an upright mouse might be a good adjustment to make, even trying alternate right / left use of the mouse can be helpful to offload aggravated soft tissues. Avoid holding mouse when not in use and learning to use the keyboard functions can also be a help to reduce the strain if pain is arising from using a mouse for extensive periods.
It’s generally encouraged to keep desks clear so the space on the desk is clear for the equipment and paperwork being used at that time. It’s also been suggested that reducing the clutter on a desk can help reduce stress.
Keep the space under the desk clear so you can move your legs and stretch out helping to facilitate that much needed movement and change in position. Removing obstructions can help you move in and out of the desk space easily and reduce hazards of tripping over anything.
Chair
A really common problem I have encountered previously is individuals not knowing all the adjustments on their chair. Seat height, back rest height and angles, Lumbar support adjustment of pressure, seat pad adjustment can sometimes move forwards and backwards to give more thigh support, seat tilt adjustments and arm rests can often be moved up and down but sometimes slide forwards and backwards.
Do you know what functions your chair has? Does it have more than you realised? Do you change it during your working day to help adjust your posture and allow movement within your workstation area? When you get a new chair check all the functions it has. Look up the model/make and see what else it does!
So, you know all the functions your chair has now so let’s see about getting it in the best position for you!
Adjust the seat height so that the knees are just slightly lower than the hips, this will assist the curves in your back giving your spine the best support. Ideally the feet should be flat on floor or supported on a footrest. Thighs want to be supported but with some space behind the knees from the seat pad. The back rest angle wants to be between 90-110 degrees for most situations, particularly more computer-based work as opposed to written/reading type tasks. There is no problem using a more reclined position whilst not working on the computer, for example some phone calls may facilitate changes in posture and movement, which we encourage.
Finding the right position for lumbar support can sometimes be tricky. Usually, the deepest part of the back and where we want the lumbar support to rest is at the level of the elbow. Adjusting the backrest height so the lumbar support sits in the natural arch of the back can feel more supported. The tension in office chairs can also sometimes be adjusted.
Some office chairs have a function that allows the whole seat to tilt back and not just the back rest. The angle of the back rest and seat pan stay fixed, this function can be used for more relaxed sitting but is not recommended whilst working at the computer.
Another adjustment that is worth checking is the seat pad angle. The actual sitting surface can sometimes be angled to tilt forwards or backwards. Either extreme of this can feel uncomfortable but a slight tilt forwards will help with the natural curved position in your back. Finally look to see if the seat pad will slide forwards or backwards. If you have a longer thigh than average, then a seat pad that can slide forward can give a little more support and reduce the feeling of pressure at the back of the thighs. Try to sit back as far in your seat as possible so the tail doesn’t tuck under. Lastly, take the time to adjust your chair position before prolonged use. Particularly if musical chairs being a frequent occurrence in the office or you hot desk!
Screen
The screen wants to be approximately arms-length from you. Measuring from a comfortable sitting position move your arm in front of your body. Where your fingers touch the screen is usually the best focal point. You can raise or lower the monitor height if necessary. The aim is to have your eyes level with top of the screen. It’s important to be aware though that if you wear bifocal glasses the screen will need to be lowered to prevent prolonged extension into the neck. Taking the time to adjust the screen position to remove glare or reflections and adjusting the brightness and contrast to reduce eye strain may be needed depending upon the different levels of lighting in an office during the day.
We are increasingly seeing the use of 2 monitors. Position them at the correct distance from you but having the chair facing the middle point of the two monitors allows a more equal neck activity. However, if you only use one for short periods of time the advice is to keep the main screen in front as a single monitor would be and the second screen slightly to the side at an approximate angle of 0-15 degrees.
Challenges
Some of the biggest challenges people encounter is home working and trying to make do with what they have or hot desking where they can be at a different workstation every day of the week. Variations in body proportions sometimes makes this tricky. Desk heights are often fixed, and we are frequently using ore portable devices often with small keyboards. Portable devices were designed for short use unfortunately they are becoming the main device for use my many workers particularly in newer hybrid ways of working.
Common Habits
Not moving and changing position.
Crossing legs – changes the rotation loads through the lumbar spine and pelvis.
Curling leg underneath the body or sitting on the foot – Alters pelvis alignment and alters loads around the lumbar spine sacroiliac joint and hip. Reduces circulation to lower limb.
Sitting with the feet on legs of the chair – brings the lumbar spine into a greater arch and leads to shortening into the hip flexors at the front of hip.
Leaning on arm rests- side flexes into lumbar spine. Increase compression or tension/stretch on one side of trunk
Leaning on the elbow on a desk - rotation at thoracic spine and sustained load on shoulder. Elevates shoulder and potential to increase loads into neck.
Hooking the phone in the neck
Allowing the mouse to drift out to the side/forwards – sustained positioning of scapular forwards and potential increase activity into neck
Helpful tips!
Take a minute to check where your body segments are
Do you favour one side/one hip/one elbow?
Do you rotate the trunk in one direction?
Do you like to sit with the neck rotated?
Are your shoulders up round your ears even when you’re ‘relaxed’?
In standing do you take more weight onto one leg than the other?
How might this relate to your hobbies? For example, do you sit with your trunk rotated in one direction and might this affect the golf swing or tennis stroke.
Useful Resources
