An occupational therapy expert offers strategies for optimizing positioning and minimizing pain
How’s your back? A little stiff? How about your hips, elbows, and wrists? If you work at a computer regularly, and you’re feeling creaks and kinks, that’s no surprise. In the wake of the COVID-19 pandemic, with so many white-collar jobs having shifted to home offices (or to kitchen tables, couches, and living room floors), and with many jobs requiring workers to bounce back and forth between home workspaces and traditional offices, ergonomic troubles abound.
“People plop into workspaces and then contort themselves to fit those spaces,” explained Nancy Baker, associate professor of occupational therapy at Tufts. “It’s a problem that’s particularly prevalent at home, where people tend to set up in odd places that don’t support computer work.”
However, Baker said, individuals can do a lot to adjust their workspaces—and taking the time to make adjustments is key. “When it comes to computer work, the number one principle for maintaining ergonomic health is this: you should not fit yourself to your work environment; your work environment should fit you.”
If anyone should know the basics of ergonomic health, it’s Baker. As an internationally recognized expert in the prevention and treatment of work-related musculoskeletal disorders and a specialist in chronic pain, she has spent decades considering how people can position themselves—literally—to do their best work. Her research incorporates evidence-based practice and clinical experience to develop innovative approaches, including Baker’s current area of focus: the use of virtual reality to mitigate pain.
But no need to go out and buy a VR headset yet. Baker has a number of tips in actual reality for setting up a workstation to prevent pain—or to address pain you’re already experiencing.
Start with your chair. Because it supports your entire body, it’s the most important part of the workstation. As a result, you want it positioned for optimal comfort. Ideally, you’ll have a high-quality, ergonomic chair. “I always recommend a chair that is as adjustable as you can afford for a home office, or as adjustable as your workplace is willing to buy for you,” said Baker.
But you can’t just get that chair and sit in it, she cautioned. “You have to take the time to tinker with it and make it fit.” Making it fit means, first of all, ensuring that your feet touch the floor. This is especially important for women, Baker said, because most chairs are made to fit men; that often results in a seat that’s too large, causing shorter legs to dangle. If your feet don’t hit the floor, use a footrest so that there’s a surface for them to land on. If the size of the seat requires you to slide forward so that your back is unsupported, adjust the backrest or use a lumbar roll.
Finally, position the armrests so that your elbows can remain on them while you’re typing. “You should avoid having your elbows floating in the air,” Baker said.
Keep your monitor at eye-level and centered relative to your body. In other words, if you’re using a laptop, that’s a problem. “Laptop computers are not really designed for human bodies,” explained Baker. “The screen is too low.” It’s okay to work briefly on a laptop, she elaborated, but if a laptop is your primary machine, you are likely to end up hunched over during the day, resulting in poor posture and a lot of aches and pains.
“Your best bet is to treat your laptop like a CPU (desktop) unit and add an additional monitor, a mouse, and a keyboard so that you can adjust all the necessary elements and be comfortable,” Baker said. Once you get that monitor, keep it aligned with your body’s center, at eye-level, and at an arm’s length distance.
Aim for neutral positioning. The reigning concept for the best workstation position is 90/90/90, Baker said: in other words, your knees, hips, and elbows are all at 90-degree angles, forcing you to sit upright with a straight back. “This isn’t a bad principle,” she added, “but it’s really about finding a position in which you are comfortable. If leaning back in your chair is comfortable for you, that’s what you should do. Ideally, your elbows will be close to 90 degrees while you type, but for some people a little bit of a wider angle is more comfortable, or a little bit of a tighter one.”
The key, according to Baker, is to aim for neutrality—a position in which you don’t notice your positioning at all. Your posture and the angles of your knees, hips, and elbows should feel natural.
The same goes for your wrists. “I’m not fond of wrist rests,” Baker said, “because people plant and then type, and that’s hard on the fingers; it’s better if you float a little bit. But it is nice when you’re not typing to have something to put your wrists on. The key is not to rest your wrists on them endlessly but to use them as support when you’re done typing.” In addition, as with your other joints, you want your wrists in a natural, neutral position. As Baker put it, “It’s really about synergy, having all the parts positioned comfortably in relation to each other.”
“When it comes to computer work, the number one principle for maintaining ergonomic health is this: you should not fit yourself to your work environment; your work environment should fit you.”
Stand if you want to—but don’t only stand. “Some people adore standing desks, but for others they’re not comfortable,” noted Baker. Whether you opt to stand or not, it’s important not to be standing all day: “It’s too hard on your body,” she explained.
Instead, switch back and forth between sitting and standing. “That in itself is a healthy thing to do,” according to Baker. “Bodies are designed to move. Just the act of getting up from a chair is great for you. So, even if you don’t work in a standing position, get up frequently.”
If you do stand, Baker added, be sure to follow the tenets of ergonomic health: your monitor still should be central to your body and high enough that you can see it easily without either hunching over or stretching up. And you should have a footrest that lets you keep one foot off the ground; doing so prevents you from locking your pelvis or knees in an unhealthy way while standing. (“Think about bars,” Baker said. “They have a roll along the bottom for people to rest a foot on so that they’ll be more comfortable—and drink more!”)
Finally, two accessories can make standing healthier: padding if you’re going to lean against something and anti-fatigue floor mats.
Have someone critique your posture. It takes a lot of self-awareness to understand your own comfort at a workstation, and it can be tricky to have a sense of your body in space. Thus, it’s helpful to have someone come and study you. “Set everything up and then ask a colleague, family member, or friend to check you out. They might be able to spot awkward positioning right away, and they can say, ‘Oh, your arms are way too high,’ or ‘You’re hunched over.’ That can be extremely helpful.”
If no one is available for a critique, Baker said, “you can video-record yourself. Check to make sure that you look even all around while you’re working. The most important thing,” she added, “is to take the time to ensure a proper setup. Otherwise, your body pays the price.”
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