Working (on Posture) From Home

by Kelly Thomsen, PT

With millions of Americans working from home, ergonomics and posture are more important than ever. As many of us had to set up home offices quickly, we may be starting to feel the effects of working at a table that is too low, hunching over a laptop, or sitting in a chair that is too high. Let’s take a look at how to make working from home feel better through proper ergonomic posture.

 

Good posture, also known as keeping a “neutral spine,” is the result of the work of several muscles, with the shoulder blade and abdominal musculature being some of the most important. Scapular muscles (shoulder blade) need to be strong in order to keep the shoulders from hunching forward, which in turn keeps the neck in a neutral position. The abdominals, along with low back musculature, work to keep the trunk in an upright posture.

Unfortunately for us, sitting in a chair all day can cause joints to feel tight and stiff. Prolonged sitting can lead to tightness in the iliopsoas (hip flexor) muscle, as well as decreased blood flow to the gluteal musculature, which assist in supporting the spine.  Slouching can cause a strain on spinal ligaments and discs, leading to back pain and stiffness. Sitting for long periods also increases the likelihood of poor postural habits. When working on a computer all day, it is easy to fall into a hunched posture, with the neck forward and shoulders rounded.

To improve your postural alignment, try the following:

• Sit up straight and keep back and shoulders flat against the chair. Utilize a lumbar pillow or towel roll for extra support to your low back.
• Keep feet on the ground and avoid crossing your legs or ankles.
• Computer screen should be at eye level.
• Elbows should fall flush with the table, with wrists in neutral position on the table. 
• Be creative! Use items from around the house to create a proper workstation.
• Books to increase laptop height so it is level with eyes
• Stool to place under feet if feet do not reach the floor 

Proper posture can take some getting used to, so here are some exercises that can help train your postural muscles.

• Scapular Retractions – Squeeze shoulder blades down and back.
• Chin tucks – Slowly draw your head back so that your ears align with your shoulders.
• Bridges – Lying on your back with knees bent, tighten your lower abdominals, squeeze your buttocks and then raise your buttocks off the floor/bed as creating a "bridge" with your body. Hold, then lower yourself and repeat.
• Doorway stretch –  Standing in a doorway, place your arms up on the door jam of the doorway frame. Step through the doorway with one foot, and bend the front knee until you feel a stretch through the chest. Your upper arms should be parallel to the ground and forearms should lie up along the doorframe, perpendicular to the ground. 

Most importantly, get up and move! A study conducted by Diaz et al. (2017) showed that adults who sit for 1-2 hours straight without moving have a higher mortality rate than adults who sit for the same total amount of sitting time in shorter stints. In addition, prolonged sitting has been linked to chronic diseases such as diabetes, cancer, cardiovascular disease, obesity, and metabolic syndrome. To combat this, try setting a timer to remind you to stand up to walk around and stretch every 30 minutes. This will help keep joints and muscle from stiffening up. Working in a standing position at a counter or high table for part of the day can also help keep the body more limber.

 

 

References

1.     Columbia University Medical Center. “Long Sitting Periods May Be Just as Harmful as Daily Total.” ScienceDaily, ScienceDaily, 11 Sept. 2017, www.sciencedaily.com/releases/2017/09/170911180004.htm.

2.     Corliss, Julie. “Too Much Sitting Linked to Heart Disease, Diabetes, Premature Death.” Harvard Health Blog, 22 Jan. 2015, www.health.harvard.edu/blog/much-sitting-linked-heart-disease-diabetes-premature-death-201501227618.

3.     Diaz, Keith M., et al. “Patterns of Sedentary Behavior and Mortality in U.S. Middle-Aged and Older Adults.” Annals of Internal Medicine, vol. 167, no. 7, 2017, p. 465., doi:10.7326/m17-0212.

4.     Edward R. Laskowski, M.D. “Sitting Risks: How Harmful Is Too Much Sitting?” Mayo Clinic, Mayo Foundation for Medical Education and Research, 8 May 2018, www.mayoclinic.org/healthy-lifestyle/adult-health/expert-answers/sitting/faq-20058005.

5.     Pronk, Nicolaas P., et al. “Reducing Occupational Sitting Time and Improving Worker Health: The Take-a-Stand Project, 2011.” Preventing Chronic Disease, vol. 9, 2012, doi:10.5888/pcd9.110323.

6.     Zemp, Roland, et al. “Occupational Sitting Behaviour and Its Relationship with Back Pain – A Pilot Study.” Applied Ergonomics, vol. 56, 2016, pp. 84–91., doi:10.1016/j.apergo.2016.03.007.

Treating Back Pain: A Spine of the Times

by Jill Jonda, PT

You’re 34 years old with a 9-5 desk job, but you still regularly go to the gym and play a couple pick-up games of basketball a week. One day you wake up and have nagging, gnawing pain just to the right of your spine in the low back. You wait a couple days and it’s not getting any better: in fact it’s traveling into your right buttock. You think, “But I’m just 34 years old! What’s happening to me?”

Unfortunately, this is a pretty common internal dialogue. According to the NIH, about 8 of 10 adults will experience back pain at some point in their lives. Luckily, physical therapists are equally as used to diagnosing and treating back pain, and the McKenzie Method of Mechanical Diagnosis and Therapy (MDT) is a well-studied, noninvasive approach for diagnosing and treating pain of a mechanical origin (mechanical pain).  But what is “mechanical pain?” 

Mechanical pain is produced when a stress or force is placed on an anatomic structure and can be aggravated or relieved with greater or less deformation on those tissues. You can demonstrate this easily with just a finger: if you bend your index finger backward to the point of resistance, you’ll experience a strain. Initially, it’s uncomfortable but as you hold it there, pain – the brain’s way of saying to the body, “Stop doing that!” – starts to set in. Once you relieve the stretch on the finger, the pain should subside. The same is true of mechanical pain: many times it completely goes away once the mechanical stress is eliminated.

More often than not, back pain originates from mechanical stress. The spinal column consists of vertebrae and intervertebral discs, which sit between each vertebra. The disc is a very mobile structure consisting of 2 layers – an outer fibrotic layer and an inner gelatinous layer – kind of like a jelly donut. When we flex our spine (bending forward and rounding it), we put greater mechanical stress on the front portion of the disc. The disc becomes displaced backward to the area of least pressure. This generally isn’t a problem, but repeated force on the front portion of the disc can cause the back portion to weaken and start to bulge. The bulge can press on nerve and/or other tissues along the spine, causing pain in areas away from the spine, such as in the buttock or even into the leg (sciatica). Eventually, a bulged disc can lead to a herniation: the jelly center of the disc begins to squish out of the fried dough part, and that’s not ideal for donuts or spines.

As physical therapists, it’s our job to evaluate each of our patients and treat the not only the symptoms but also the cause of their pain, while also preventing similar pain to return in the future. I know my patients think I’m the “posture police,” but for those with pain originating from either the cervical or lumbar spine, I always recommend sitting with good lumbar support in a firm chair to promote a neutral spine. Sitting with slouched posture is bound to produce some sort of mechanical pain, either in the neck or low back, because of the stresses placed on the spine. Also, if sitting is bothersome, stand up and reverse the curvature in your spine by walking around for a few minutes.  Remember, you should see your PT or healthcare provider if your pain isn’t improving. We can help you stand (and sit) corrected!

Resources: 

Treat Your Own Back by Robin McKenzie