A Guide Book For Working at Home
 - Eliminate aches & pains!

In the current COVID-19 world, many of us find ourselves working from home and may not be set up with a home office that is meeting our needs. In fact, many New Yorkers when working from home, work from their couches, beds, kitchen counters or makeshift desks if you are lucky. You may be spending 8-10+ hours a day working and with the added stress of the current situation and limitation on your normal exercise routines and stress relieving recreation your bodies may very well be complaining by now. The more efficiently you set up your work situation, the less stress you will experience on your neck, back and arms.

Here is a little test – can you sit up tall without support and your feet flat on the floor for 5 minutes without fidgeting or adjusting and without an increase in pain? If you cannot then your core musculature does not possess the endurance for an 8 hour day in a chair. You need to restore your normal curves using your antigravity (core) muscles so you can maintain proper posture and prevent pain and degeneration of your joints throughout your spine, in your shoulders, hips, knees, ankles and feet. See my prior blog on this topic at ….

Ergonomics definition is – an applied science concerned with designing and arranging things people use so that the people and things interact most efficiently and safely. 

Ergonomics strives to keep your joints in a neutral position to minimize the stresses on the muscles and ligaments. People come in different sizes so no two desks should look alike. Here are some suggestions for easy adjustments to your desk:

When you are sitting your knees should be bent at approximately a 90-degree angle with your feet resting on the floor. If you are petite and can lower your desk this is ideal but most desks do not have modifiable heights. If your feet do not touch the floor, bring the floor up to your feet with a footrest or even a small box. My favorite footrest is  https://kareproducts.com/adjustable-foot-rest/

The end of your seat should reach to four finger lengths to the back of your knee. Any farther forward can pinch nerves in your leg and make it uncomfortable to sit. Legroom under your desk should be at approximately 24 inches to allow for easy foot movement.

The backrest should be adjusted so that there is a convex surface supporting your low back. (If your chair does not have this, I would suggest an adjustable lumbar support. My favorite is the wonder roll https://www.wonder-roll.com/

which can be adjusted for the size of your inward curve, self inflates and rolls up and weighs next to nothing for travel. 

The arm rests if you have one should be positioned so that your elbows are slightly forward and bent at near a 90-degree angle. 

I have used and recommended kareproducts for years and still highly recommend them for their outstanding suitability as they can be adjusted for all sizes and are reasonably priced Ergonomic Mid Back Chairs, Task Chairs

There are other excellent designer chairs such as Humanscale’s freedom chair Ergonomic Executive & Office Chair | Freedom Task Chair | Humanscale

I also love kneeling chairs. The Balans chair was the first invented and positioning of the lower extremity helps to keep the pelvis in an anterior tilt and helps upright sitting. Inexpensive versions can be purchased but I have found that cheaper foam on the shins and seat can get uncomfortable with prolonged sitting. Varier Variable™ balans® Original Kneeling Chair

 I am asked a lot about therapy balls as chairs and other active chairs such as can be seen at www.fully.com/chairs. While I think these are good, spending 8 hours a day on a therapy ball requires a lot of core endurance. If you would like to sit on a ball to work I recommend keeping another good chair nearby for when your back becomes fatigued until you have built up adequate core endurance

Keyboard 

When you are typing your wrist should be supported and your elbows should be at a 90-degree angle. Because your arm rests should also support you at a 90-degree elbow angle it sometimes comes in direct conflict with your keyboard. I would suggest table length arm rests (they are shorter and allow you to push your chair up to the desk) on your chair or none at all if you are mostly on the computer or writing while at your desk.

Mouse 

A traditional mouse used to control your cursor can add increased stress on your arm and shoulder because you have to elevate your arm for long periods of time. I recommend a trackball mouse. Your hand rests on the mouse and your thumb moves a roller ball that controls the cursor. They are inexpensive and your neck and shoulder will thank you.

Computer Screen

When you sit upright at your desk your eyes should be level with the top line of your screen. It is much easier for your eyes to track inferiorly without affecting your neck posture than it is for your eyes to track superiorly. If your computer screen is too high, we tend to push our head forward and angle our head upwards, which tightens the back upper neck musculature. You might have noticed this common forward head posture resulting in the dreaded “Dowagers Hump”.

If you have a laptop it is harder to modify. I suggest putting it on a pedestal to raise the screen up and buying a wireless keyboard or getting a dock. This will be necessary if you are going to use a sit to stand desk or desk adapter, discussed later.

Divide Your Desk Into Angles 

Items that you use constantly should be within a radius of 50 cm – which means you do not have to reach far or rotate your body to grab them.  Items you use less can be a short reach away. 

Standing Desks 

The big question is, should I get a standing desk. My answer is workers who stand all the time have muscular skeletal problems too so the answer is a sit to stand desk so you can change positions so you don’t end up hanging on your ligaments and slumped over your work whether sitting or standing. 

You can make yourself a standing station at your desk or home counter but you have to pay attention to the position of your screen for your spine and your arms, wrists and hands as mentioned above especially if you are using a laptop. Poor angles will lead to pinched nerves in your neck and wrists with resultant pain and numbness. 

Up down desk modifications can be found at https://www.vari.com/ or other sites. It’s important to have an adjustable height for the screen, the keyboard and mouse. An anti fatigue mat such as Ergodrivern or mats that can be found at Kare Products, Inc and other sites will reduce the stress from a hard floor when standing. 

If you do a lot of reading the optimal reading angle is with a 45-degree slanted desk and if you are writing the optimal angle for your elbows is with a 15-degree slanted desk. 

Breaks

It is important to get up and walk around to give your body breaks from being in one position. Most people become so engrossed in what they are doing that they forget so I propose setting your cell phone to go off every 1-2 hours. A 5-minute walk around your office will help clear your head and give your muscles a chance to relax. 

If you have any further questions about how to modify your workstation or you want a professional to assess your sitting ability, please do not hesitate to see a PT at Duffy and Bracken Physical Therapy, A Division of Maiden Lane Medical.