Friday, November 14, 2008

An osteopathic perspective of your office

(You can find a french translation of this article Here)
I really wonder if I should write this post. In fact if you read this post you can be pretty sure that you will save hundreds of pounds in physiotherapy, chiropractic or osteopathy...

The aim is to give you a few advices to properly sit in front of your computer. Each time I read something about it, I have never been satisfied with the given answers.

Many of our patients work sitting in front of a computer. Because of poor advices, awareness, and common sense the worker quickly develop the "mouse syndrome" (I first heard this term from D. McGinn one of my teacher). In fact working behind a screen more than 8 hrs a day is become a new form of slavery. The office furniture quickly become a huge money making industry to promote ergonomic chairs, ergonomic tables, ergonomic keyboards, ergonomic mouse, erg... OK I think you understand. Well in fact for the advice I will give you, you will need: a decent size table, a decent chair (adjustable height), and a "grandma" cushion (not too small not too thick 40cm*25cm).

The Mouse Syndrome:
No it is not a state in which the patient develop a long tail, some fur and an increase appetite for cheese. The mouse syndrome is a series of signs and symptom that a typical office worker tends to develop.
-neck pain
-upper back pain
-shoulder pain
-Thoracic outlet syndrome
-carpal tunnel syndrome

Analysis of the typical posture in an office:

Too often the employee slouch in his chair which because of its price is generally quite comfortable, but in fact wrongly comfortable. When you slough you:
-decrease your lumbar lordosis (decrease extension of low back) which feels good because you stretch some muscles but in fact you over stretch for 8 hrs a day your ligaments , capsules and discs of your low back.
-increase of thoracic kyphosis (flexion of mid back). This leads to a poor relaxed posture which compromise greatly the function of your diaphragm. In fact your diaphragm cannot contract properly because it sits on your abdominal organs. This obliges you to breathe with your upper chest and use breathing accessories muscles: scalenes, SCM and some intercostals muscles. The scalenes are muscles which are attached from the neck to the first ribs. Their contractions induce some tension in the neck and elevates the first rib: A fantastic cocktail for neck, shoulder and TOS !
-Increase of the neck extension, as the patient might have a bit of wear and tear in his neck this neck extension is precipitating some neck pain and headaches.
-Only the wrists or first third of the forearm is resting on the desk. By doing so you need to carry the weight of your arms and forearms. And which muscles do so ? your trapezius and levator scapulae muscle! Well known muscles for their tendency to give neck and shoulder pain !
-Tendency to use the mouse moving all the arm and shoulder. The shoulder is not made to do some precise movements but wide ones. if you try to do precise movement with your shoulder you need to contract all the muscles of the shoulder! Mouse Syndrome.

Analysis of a better posture at work:

So what is this secret posture ? well the secret of the pain free posture is... is... Arghhhh...
Only joking !
-Sit right back on your chair, not your back but your buttocks. Now lean forward and insert the grandma cushion down your low back. Now straighten up. How do you feel? if you have the good size cushion you should feel being straight without any effort. The cushion should be situated at the upper part of your low back, if this make sense. Don't try to force your shoulders to touch the back of the chair. Just sit straight.
-Now come closer to your desk, a bit more, a bit more. Be close enough from the desk to have 2 inches between your stomach and the desk.
-Your feet should be flat on the flour with a nice 90deg angle at your knees. Add a foot rest if your legs are too short.
-Now rest your two forearms on the desk, your keyboard should be at least 25 to 30 cm away from the edge of the desk. Adjust the height of your chair to feel your shoulder relaxed and your arms/forearms resting comfortably on the desk. You should be pretty comfortable in this posture and should feel your shoulder much more relax than earlier. In fact you don't carry the weight of your arms anymore, but the desk does it for you !
-The mouse is situated at the same level than your keyboard. Have your mouse sensitive enough so that you can run through the screen only using your wrist.
-The screen should be standing at least 45cm away from the edge of the desk. I would recommend a 17 or 19 inches flat screen.

Fantastic ! you now know the secret not to come back to see us that often!

Another recommendation would be to adopt a more abdominal breathing.
Try to breathe in for 3 sec and out for 3 sec, between the two hold your breath for 1 to 2 sec.
Each time you breathe in avoid to breathe with your chest but pushing out your abdomen. When you breathe out pull in your stomach and contract your abdominal muscles and pelvic muscles firmly, and when you breathe in just relax them. Doing this will promote a good breathing, a better digestion, a firmer abdo belt, decrease your stress and being more focus on your work !

Take Care,