Good Posture—Tips to Avoid Injuries

Follow these tips at work for good posture...

Your Chair:

The seat height of your chair should be approximately the length of your tibia (lower leg), creating a 90 degree angle at the knee. The chair’s seat depth should be 1" to 3" from the front edge of the seat to the crease of your knee.

Make sure that the seat width is 2" wider than your buttocks for adequate support.

Although arm rest adjustability is not a common chair feature, the arm rest should be slightly higher than the point of the elbow when your arm is resting at your side with the elbow bent at 90 degrees.

Your Computer Station:

Your computer monitor should be directly in front of you and slightly below eye level, at a distance of 13" to 19".

A copy holder will bring your work up to eye level.

Elbows should rest at 90 degrees.

Use a wrist rest to help keep your wrists in neutral.

Your Desk:

The height of your desk should reach 1-1/2" above your bent elbow.

You can significantly decrease stress to neck and upper back musculature by using a 15 degree slant board.

A headset can free your hands to perform writing or computer tasks while helping to maintain proper sitting posture.

The Safe Zone:

Keep desk accessories and equipment (e.g.: phone, memo pad, schedule book) within easy reach.

Used by permission of
Baton Rouge Physical Therapy

Ergonomic Interventions Reduce Injuries at Work, School and Home

As a physical therapist specializing in industrial rehabilitation services, Steve Allison, PT, OCS, HMS, CAE, (PTPN Member, Tri-State Physical Therapy, Shreveport, Louisiana) explains ergonomics and how we can all take advantage of its potential at work, school, and home.

The goal of ergonomics is simply to enhance human performance while minimizing injury risk by addressing recognized risk factors. Risk factors for injury should be evaluated in three key areas—personal risk factors, work habit risk factors, and ergonomic risk factors. Ergonomic risk factors include awkward or static postures, repetitive motion, excessive force requirements, contact stress, and exposure to vibration. It is a combination of these risk factors and not a single factor that contributes to most injuries, according to the National Institute for Occupational Safety & Health (NIOSH).

Regardless of the environment, there are a few basic ergonomic interventions that can easily be applied to reduce injury risk:

• Store heavier items that must be lifted on shelving no lower than 24 inches and no higher than 48 inches from the floor.
• Raise work surfaces so that the height of any standing work activity occurs between 36 - 42 inches.
• Tilt the top of the workstation forward to reduce awkward low back and wrist postures.
• When performing repetitive activities such as work on the computer, it is best to limit the activity to 2.5 hours at one time and take a brief break with every 20 - 30 minutes of repetitive activity to change postures and stretch.

• Computer workstations should be adjusted properly to avoid getting into awkward postures. This includes keeping keyboard and mouse next to each other on the same surface and within easy reaching distance. The computer monitor should be positioned so that your eyes are level with the top of the monitor screen when sitting in normal posture.

Personal risk factors include poor physical fitness or wellness levels, obesity, smoking, alcohol abuse, and pre-existing medical conditions that can predispose individuals to injury. Being physically capable of safely performing a task is an important prerequisite to making sure the ergonomic risk factors of the task have been minimized. If an individual is not physically conditioned to safely perform a task, it doesn’t matter how ergonomically safe it has been deemed to be.

The most frustrating and difficult risk factors to deal with are those related to poor work habits. Poor lifting mechanics and the use of hands as tools are the most common work habit risk factors leading to injuries. Being able to finish a task more quickly is the most common reason reported by individuals for using poor work habits. For example, your son may wear only one strap on the backpack so he can put it on and take it off more quickly. Would you allow your child to continue to do this and risk future back problems? Likewise, would you allow other family members, co-workers or employees to continue to use poor work habits and risk injury?

In the work environment it will be a combination of company profits and federal or state guidelines that will drive ergonomics more into our lives. Improving our physical conditioning levels, breaking bad habits, and using sound ergonomic principles can positively impact our health and minimize injury risk regardless of the setting.

How to Stop the Clock This Year and Stay Young, Healthy and Fit

Many of us make New Year’s resolutions to get in better shape and take control of our weight. How are we doing? People of all ages, including baby boomers and seniors desiring to stay young and healthy, are using physical therapists as resources in their quest for fitness and general wellness.

“Physical therapists are the best qualified teachers and support for wellness program participants because they are rehabilitation experts,” said Ruth Gomez, DrPH, PT (PTPN member, Progressive Physical Therapy, Tarzana, California). “They have extremely specialized and in-depth training for problem assessment, movement, strengthening, stretching, and progression in exercise of the body, which is especially important for those with any dysfunction. Exercise is not a one-size-fits-all proposition, and physical therapists are able to adapt exercise movements according to an individual’s needs, and promote flexibility, which is key to staying young.”

For those who want to get in shape without joining a fitness club or wellness program, Barry Inglett, PT, Cert. MDT, (PTPN member, Wayne Physical Therapy & Spine Center, Pompton Lakes, New Jersey) has some advice for getting exercise within daily activities:

• If possible, don’t take the elevator. Walking up and down stairs helps burn off unwanted calories and also helps to keep those leg muscles in shape.
• When going to a shopping center, don’t always look for the closest spot. Walking to and from shopping is a great form of exercise that can be incorporated into your everyday life.
• Don’t park yourself in one position for more than 30 to 60 minutes. Get up and move around as much as possible to maintain proper muscle tone and avoid static postures that lead to joint and spinal pain.

You don’t have to run or ride a bicycle to stay fit. Many people enjoy walking because it is less stress on the musculoskeletal system and gives you time to think about things and clear your mind of stress.

To help fight the effects of aging and avoid traumatizing and overusing the body, Gomez offers the following suggestions:

• Since alignment is critical to one’s performance in the fight against gravity, be aware of your posture as you sit and stand, while working and playing. Keep your chest lifted in front and your shoulder blades together in back to avoid neck and shoulder problems. A forward head or round back may cause problems in the neck, arms or hands.
• When doing repetitive work with the hands, stop every hour or so and put hands down on a table with fingers spread, elbows locked, and lean on your hands for 30 seconds to avoid carpal tunnel tightening.
• Drink plenty of water before exercising. Water allows your liver to break down stored fat to make glycogen, which fuels your muscles so they continue to work without getting overheated and fatigued.
• When sitting at the computer, always have your arms properly supported.
• Keep your back straight when bending over so that you don’t bend from the waist. Use the hips and knees to get you close to the floor.
• Never lift something heavy and twist to put it down to the side. Always turn to face your work.

Keeping Older Workers Healthy

Thanks to the huge Baby Boomer population, workers 55 and older are the fastest-growing segment of the American work force, according to a 1995 report by the Bureau of Labor Statistics and the U.S. Bureau of the Census. And people are not just living longer; they’re also working longer than ever before.

“Actual retirement age—the age at which people stop working—will go up in all developed countries to 75 for healthy people, who are the great majority,” writes Peter F. Drucker in his 1998 book, “On the Profession of Management.” In light of these trends, Congress passed a new law in 2000, the Senior Citizens’ Freedom to Work Act (H.R.5), which allows workers who have reached full retirement age (age 65 in 2000) to work without being penalized by Social Security. Under the new law, retirees who are 65 to 70 years of age can receive their full benefits no matter how much they earn.

With more “silver-collar” workers on the horizon, it will be increasingly important for companies to keep their employees healthy and productive. PTPN members offer the following suggestions to companies with older workers:

• “A supervised fitness program developed by physical therapists and medical personnel is important in maintaining the highest quality fitness and therefore the highest quality of life possible as people age. At our office, we not only perform a total musculoskeletal evaluation with areas of concern and concentration, but also follow appropriate ACSM (American College of Sports Medicine) cardiac risk protocols and clearances by physicians and cardiologists to develop a plan of exercise for each individual client.” (Paul Roubal, Ph.D, PT, Physical Therapy Specialists, Troy, Michigan)
• “I have been teaching yoga to seniors for over a year now and the feedback is amazing. Not only does yoga improve balance, but it improves strength, flexibility, and improved function of internal organs, e.g., digestive system, urinary system. Yoga is not an instant fitness program, but a living process and a process of living healthily.” (Kokila Patel, PT, Tri-City Physical Therapy, Union City/Fremont, CA)
• “Some of the osteopathic and acupuncture/acupressure techniques I use as a physical therapist help boost the immune system. I’m also a qi gong (pronounced chee kong)—Chinese energetic exercise—instructor, and I teach my students specific exercise forms to improve the immune system and develop stronger minds and bodies.” (Sheila Yonemoto, PT, Yonemoto Physical Therapy, Alhambra, California)
• “Since older workers need longer recovery times than younger employees, taking breaks from repetitive daily tasks or sharing repetitive tasks allows their muscles the needed time to recuperate. Employers should have specific programs that focus on flexibility training and need to make sure their employees’ ergonomic set-ups are correct.” (Timothy Spooner, PT, Spooner Physical Therapy, Scottsdale, Arizona)

• “As a physical therapist credentialed in the McKenzie method, emphasis is placed on maintaining correct posture to prevent abnormal stresses on the musculoskeletal structures. One of the biggest problems is the lack of interruption of posture removing the prolonged stresses from the tissues. People have a tendency to function in one position for days, months, and even years. Companies should let their employees have organized stretch breaks. I have had the opportunity to develop musculoskeletal wellness programs for companies and senior groups, and there is a simple set of exercises that can be done in a short period of time. For example, workers who sit at a computer hunched over with a forward head need to perform chin tuck exercises, or individuals who sit for long periods of time need to perform standing back bends causing movement in the opposite direction of the long term stress.” (Barry G. Inglett, PT, Wayne Physical Therapy & Spine Center, Pompton Lakes, New Jersey)
• “The biggest problem we see is older workers who aren’t physically able to do their jobs safely. We conduct 'fit for duty' tests based upon what their job requires, and then we put them on specific behavior modification programs designed around the weaknesses that are exposed. Injured workers undergo a 'return to work' test to make sure they can safely perform their jobs.” (Jeffrey Petersen, PT, Inglish and Petersen Physical Therapy, Mesa, Arizona)
• "Employers could arrange for health care providers to give in-house lectures to educate employees on topics of health interest. Additionally, employers can promote fitness through company-sponsored sports teams and recreational activities such as company walks or other events.” (Maureen Becker, DPT, DeVita/Becker Physical Therapy, Staten Island, New York)
• “One way companies can promote good health for baby boomers and older workers as well as everyone else is to choose health plans that let employees see practitioners from many different disciplines, including physical therapists, osteopaths, chiropractors, massage therapists and others. There are practitioners in these fields who practice an integrated approach and utilize a variety of methods including craniosacral therapy, visceral manipulation, the Feldenkrais method, myofascial release, and others. These therapies actually work to improve the body’s ability to heal, adapt, and function better, and give people an alternative to drugs and treatments that may have minimal benefits and significant side effects.” (Ralph Havens, PT, OCS, Mission Hills Physical Therapy, San Diego, California)