Dr. Dan Michael
Dr. Dan Michael

Of all the questions that patients ask me, work ergonomics and posture are near the top of the list. It is a fair set of questions because so many working people now spend a large share of their time behind a computer.

Since the pandemic, many have been designated to work from home, which creates additional challenges, some working from their living room couch, spare bedroom, dining room table — some even working from their bed. There are several key concepts that can improve your ergonomics position and practice. Most of them are free and can be used immediately, so why not start now?

Raise your hips. Having one’s hips too low — below the knee — is one common error, and it’s most made by those working from the couch. Couches tend to be lower to the ground than office chairs, and low hips put the hip joint in a semi-flexed position, shortening a group of muscles called “hip flexors,” which creates strain on the lower back. You want to keep your hip as close to 90 degrees as possible if you are going to sit for any long period of time. Whether you raise your chair or put pillows under your hips, any effort to improve will make a difference. Some may have a high desk that is not adjustable, so you may require a footrest.

Rest your elbows. Resting your forearms is a second-best option, but really the elbows should be near 90 degrees. Unlike the hips, the elbows need more flexion to protect the shoulder from overreaching. Chronic long periods of shoulder protraction to reach for a keyboard or mouse can result in shoulder pain and even injury.

Long periods of low-level tension in muscles, especially of the shoulder, can cause tendon inflammation and degeneration over time that can result in tendon tears. Secondly, the arms need to be rested on a stable surface to prevent other overuse injuries in the arm, shoulder and neck. The simple act of resting your elbows can save you from a host of injuries ranging from the head, neck, back, shoulder, arm and wrist.

Sit up, lean back, but never lean forward. Some folks attack posture with too much zeal by raising their back rest so vertically that they end up effectively leaning forward.

Leaning forward, or even attempting to become too erect, can activate the spinal muscles excessively. If you want to activate your back muscles, that is OK, but you must also then activate your core muscles without missing a moment in time.

For how do core activation, reference my previous articles on core coordination first. Every spine is unique and will have a natural resting place, and so what you should do is be away from any extremes while keeping the basic framework of ergonomics in place.

What is the basic framework of ergonomics you might ask? Basically, your feet should be rested on a flat surface; there should be evidence of 90- or 180-degree angles without much variance throughout the joints of the body. If there is variance, then it should never be under condition of muscular strain and definitely not for long periods (more than one hour). The monitor should be directly across from you, not causing your eyes to look up or down, and about 2 feet in front of you. Your arms and shoulders should be rested and not reaching. Your head should be directly above (or on top) of your shoulders, and your chair (or seat) should have a head rest, and you should be able to reach it without extending the neck backward. Your lower back should have some support, but depending on your unique spinal curves, you may need more or less than is capable by the chair. Your muscles must be relaxed, except the abdominal core muscles, which would ideally have some level of light tension to support the lower back.

Perhaps the most important part of ergonomics is actually taking a break to get up and move. Our bodies are designed to move all day, and we have not yet evolved to sit behind a computer. We may need several thousands of years to achieve it, but for now, remember to take frequent movement breaks.