Articles, Ergonomics

The Computer Injury That Is Not Carpal Tunnel Syndrome

Is your little finger numb?

Many computer users worry about hand problems. People with hand pain or numbness often assume they have carpal tunnel syndrome (CT). But a less known problem could be the source of the pain. Thoracic outlet syndrome hurts just as intensely as CT. It is caused by poor posture as you sit at the keyboard. The good news is that these and other computer-related injuries will go away. With good posture and work habits, you can be pain free again.

What is Thoraic Outlet Syndrome?

The thoracic outlet is a space between your collarbone and first rib. Through that space go major nerves, arteries, and veins that supply your whole upper extremity. Poor posture for a sustained period of time makes the thoracic outlet smaller and puts pressure on those nerves, arteries, and veins. This can cause pain, tingling, numbness, and weakness in your shoulders, upper arm, elbow, forearm, wrist, hand, and fingers.

What causes Thoraic Outlet Syndrome? Anything you do that pushes your body into a “C” shape with your shoulders hunched forward can cause Thoracic Outlet Syndrome (TO):
Sitting hunched over a laptop.
Leaning forward at your desk chair.
Sitting in a chair without upper back support.

How is Thoracic Outlet Syndrome different than carpal tunnel? Sitting at your desk, raise your elbows to shoulder height and point your forearms toward the ceiling. Your arms and your head should form the shape of a letter “E” lying on its side. If your hands feel odd or tingly, you could have or be at risk of TO. In carpal tunnel, there is never any problem with little finger. In TO, there are symptoms in all of the fingers and all of the hand.

How can you prevent Thoracic Outlet Syndrome? With correct posture and exercise, you can prevent or cure TO.

Sit with your upper back against the back of your chair.
Hold your head straight.
Adjust your chair correctly.

Walk to strengthen the muscles at the front and back of your spine.

Articles, Ergonomics

Carpal Tunnel Syndrome

Not a permanent injury

The words “carpal tunnel syndrome” strike fear into the hearts of knowledge workers.

What is the carpal tunnel? All the tendons that make your fingers work the keyboard go through a tunnel in your wrist made up of eight carpal bones and a thick band of ligament. Nine tendons and one nerve go through that tunnel.

Where is the carpal tunnel? To find your carpal tunnel, put one elbow at your side with your forearm and palm facing the ceiling. Take the index finger and thumb of your opposite hand and put it around your wrist as close to your hand as you can get. This is the carpal tunnel.

What creates carpal tunnel syndrome? Anything that takes up space and puts pressure on the nerve will create carpal tunnel syndrome. For example, swelling due to pregnancy can cause carpal tunnel syndrome.

Why does keying cause carpal tunnel syndrome? If you’re working without breaks, the tendons that power your fingers become hot and swollen. They take up extra space and put pressure on the nerve.

What are the symptons of carpal tunnel syndrome? Symptoms can include pain, numbness or tingling in the second and third fingers, half of the fourth finger, and the thumb. Your fingers might feel swollen.

What are NOT symptoms of carpal tunnel syndrome? If your little finger hurts, you don’t have carpal tunnel syndrome. If your wrist hurts, you probably don’t have carpal tunnel syndrome.

How can you prevent carpal tunnel syndrome? The number one cause of carpal tunnel syndrome is poor posture at the keyboard and incorrect arm position.
Keep your shoulder blades against the back of your chair.
Keep your elbows at 90 degrees and your wrists straight – not bent down or up.
Drink water while you keyboard.
Pay attention to what you’re feeling and recognize the first signs.

Is carpal tunnel syndrome permanent? No. With a change of habits, people recover. Improve your posture. Drink more water. Stretch forearms regularly. Rest between times at the keyboard.

Are you worried about carpal tunnel syndrome? Don’t procrastinate. The sooner your get help, the easier it is to cure.

Correct posture, rest and water keep your hands healthy.

Check out Kathi’s DVD “Stretch Away Neck, Shoulder, and Arm Pain”
to help establish an effective routine!


Articles, Ergonomics

IT: First Line of Defense Against Computer Injuries

Small changes that can make a big difference in comfort

Last week, I visited a major law firm. One IT staff member had piled extra shoes under her workstation, tangling the cords so she couldn’t pull her keyboard forward. Piles of cord spaghetti were everywhere. Before long, I was sitting on the floor, untwisting cables. When you pay attention to all aspects of your workspace-even the cables-you can work more comfortably. When cords can move freely, it’s easy to keep your keyboard and mouse in the best positions.

IT staff members with lots of computer knowledge but little experience with muscles, tendons, joints, and bones can spread safe work habits throughout an organization. When IT staffers pay attention to ergonomics, they and their colleagues stay healthy. And I stay off the floor. Here are some ways your IT department can help prevent injuries:

Location, location, location. Expect IT to help you find the best place for your machine. If your workspace has a window, your monitor should be perpendicular to the window. In many offices, the location of electrical outlets determines the location of the computer workspace. Choose the most appropriate spot to work, then, if necessary, request that cabling and electrical outlets be changed.

Positioning. Expect IT to help you sit correctly. If a technician drops a machine on your work surface, be sure to check that monitor, keyboard, and your body are centered on the same line. If your equipment is too heavy to move, IT should reposition it.

Cord control. Expect IT to make it easy for you to change positions throughout the day. When cords are tangled and twisted, you lose flexibility to adjust the position of your equipment. IT can help you untangle and control cords.

Equipment trade–ins. Expect IT to help you choose equipment that suits your size and work habits. Even though your keyboard makes you uncomfortable, it might be just fine for the person down the hall. IT can help you exchange equipment.

Cleaning. Expect IT to help you keep your equipment clean. IT can clean your equipment or show you how. For example, request screen wipes to clean your monitor.

For smaller busineses or at home

Look at your room. Determine the ideal spot for your computer, regardless of furniture, cable, and outlets. Try to get your monitor 90 degrees to natural light.

Look at your workstation. Make sure your monitor, keyboard, and chair are centered on the same line.

Look at your cables. Are they twisted? Can you take advantage of their full length? Remember, your keyboard and mouse should be as close to your body as possible.

Look at yourself. Are you sitting in the chair, not on it? Sit all the way back in the seat and keep your shoulders back.

Look at the dust! Buy a can of duster to blow all the dust and grit out of your keyboard. Clean your screen every day.

Time to move? Your computer is easy to move. When you take time to adjust your computer’s location you can work more comfortably and prevent injury and eye strain.

Articles, Ergonomics

Crack! Twinge! Ouch! Time to adjust your workspace

Simple strategies to relieve that pain in your neck

When I visit businesses to talk about workplace safety, people want to talk about their necks. Computer workers tell me, “I’ve been to the doctor” or “I’ve had x–rays” or “I’m starting physical therapy next week”.

There’s a reason for all this pain. On my visits to offices in Boston and around New England, I see people working in postures that strain their necks and spines such as accountants perched on the edge of their desk chairs, attorneys craning their necks to see a too-high monitor, IT professionals reaching over manuals to keyboard, and receptionists twisting their heads to see paper documents.

That’s the bad news. The good news is that very small changes to the relationships among your body, your chair, your monitor, your mouse, and your keyboard can lead to a large improvement in how you feel. So if you are in pain – or want to avoid future injuries – here are some ways you can adjust the way you work:

Sit back in your chair. Use a footstool (or put a fat book on the floor) so you don’t slide forward.

Keep your keyboard close. Adjust the relationship between your keyboard and your body so you elbows fall at your sides and you’re not reaching forward.

Center your monitor. Your monitor should be straight ahead, centered on your keyboard. And make sure you’re not craning your neck up or down. Of computer workers I see with neck pain, 100% have the monitor positioned either at the wrong height or off to one side.

Use a document holder. If your work requires that you refer to paper documents, use a document holder that is in line with your monitor so your eyes – not your neck – do the work.

Maintain your space. Once a month or so check your office setup to make sure you’re still working safely. Equipment gets moved, you get busy, the next thing you know, your neck hurts at the end of the day.

Notice that I haven’t said a word about buying new equipment. Modest changes in your position and your relationship to your equipment often make all the difference.


Growing Bodies and Backpacks

How to carry the load safely

As they head off to school to learn 21st century mathematics and science, do your children look like Neanderthals, hunched over under a heavy load? For growing bodies, backpacks that are too large or too heavy can lead to long-term back problems. If you’re buying a new backpack, shop with these guidelines in mind:

The pack should fit the child. Don’t buy a full-size pack for a first grader, expecting her to grow into it. With the shoulder straps adjusted, the pack should fit vertically between your student’s shoulders and the top of their hips.

Choose a pack with shoulder straps. That takes stress off the shoulders.

Choose a pack with a waist strap, padded if possible. The waist strap keeps the load close to your child’s body, reducing strain on the spine.

Choose a pack without wheels. Wheels are not a solution. They force the child to twist his or her spine, add weight and can cause falls on stairs.

Teach your child to use his or her backpack correctly:

Pack correctly. Backpacks should weigh no more than 10% to 15% of your child’s body weight. The median weight for a 9–year-old boy is about 60 pounds; that means his backpack should weight no more than 6 to 9 pounds.

Load correctly. The heaviest items should be closest to the child’s back.

Lift correctly. You child should use both hands and bend her knees to pick up the backpack. Put one shoulder strap over one shoulder and then the other.

Wear correctly. Both straps should be snug on top of the shoulders. Everyone, including fashion-conscious teens, should use the waist strap. The backpack should be against your child’s back at all times. There should be no space between the pack and his back. When wearing the backpack, your child should be able to stand and walk upright. Ears should be aligned over shoulders and shoulders over hips.

Many children visit the emergency room with neck pain and headaches from using backpacks incorrectly. And faulty posture during childhood causes wear and tear on the tissues of the spinal column, which can result in back pain later in life. To prevent these problems, help your child to carry less and to carry a backpack correctly. Remind your children to wear both straps and to stand up like a 21st century man or woman.


Resolved to Join a Gym?

Make the most of your resolution

Are you joining a gym? Whether you are starting, returning to, or continuing an exercise program, here are some suggestions for exercising consistently and safely.

Choose your gym strategically. If the gym is not with 10 to 15 minutes of your home or work, don’t sign up. Find a gym you pass on the way to work or home.

Is the gym clean? Is there a complete line of equipment available? You should be able to work a balance of muscle groups.

Does the equipment fit your height? Are you 5’4″ or shorter or 6’2″ or taller? Most gyms do not have equipment that adapts outside these ranges, particularly for smaller people.

Will qualified employees teach you to use the machines correctly? Good gyms give you an introduction to the equipment.

Do you have a particular problem with your head or back or neck? Are the gym’s employees qualified to understand the problem?

Do the exercisers at the gym look happy? If people look miserable because they are straining and struggling, gym members could be at greater risk of injury.

Tips for the gym

Go to exercise. Don’t go to read a book. Exercise promotes a sense of relaxation and muscle awareness. When you read, it throws off your body position and body awareness.

Let go on the treadmill. If you have to hang on, the speed is too fast. As soon as you hang on, you twist, which can lead to back injuries.

Do what is appropriate for you. Don’t try to compete with the person next to you.

Choose age–appropriate classes. Understand what your want to do for your body and make sure you’re with the right age group.

Go eay on the weights. After a certain point, upping the weight is not that beneficial. It’s more important to exercise a balance of muscle groups and to stretch before and after.

If you miss a week at the gym, don’t start where you left off. Back down a bit. Ask for help. Double check to be sure you are using machines correctly.

Away from the gym

Stretch every day. When you’re stretching you also build strength. Stretching promotes good body mechanics, which help you avoid injury. See my video for home exercises.

Do some physical work. Both an elliptical machine and your vacuum give you the benefits of cardiovascular exercise.

Walk or bike outdoors. Swim. Your own body is the best piece of exercise equipment.

When you can’t get to the gym, keep walking and stretching. If you make a big effort and then skip a few days, you lose the benefits of exercise. Try for consistent, everyday exercise.


The Secret to Improving Your Golf Game

What the pros might not tell you

A lot of people are afraid to play golf. They think it’s bad for their backs. But you can play golf safely and without pain if you pay attention to your posture. This is the secret: If your posture is good, you’ll play better. Good posture improves your swing. Good posture in golf requires that you keep your spine straight . Don’t curve your body into a C–shape with your head hanging down.

Stretch for a Smooth, Strong Swing
Golf, like every athletic activity, requires flexibility, strength, endurance, and the ability to relax. Stretching helps you keep your posture correct and your swing strong. Stretch before you play and between holes. You need flexible strong hip muscles to turn your hips.
Stretch your hip flexors by slowing raising your foot toward your buttocks. Hold your toes and feel the stretch in the front of your thigh.
Pull in your abdominal muscles as you walk the course. You need strong trunk muscles to hold your spine stable.
Reach your hands around your shoulders and give yourself a hug. You need flexible and strong shoulder muscles to swing your upper arms.

For more stretches, see Fairbend DVDs.

What Causes Golf Injuries
For one thing, clubs. To avoid injury, treat your clubs like any heavy item: your printer, a big bag of garden mulch. Remember:
Keep heavy items close to your body.
Don’t lift and twist at the same time, look straight ahead, first lift your clubs, then turn.
Bend your knees to lift.

Golf Mania
Golf is good for you because it involves varied motions and walking. But sometimes, enthusiasm for the sport leads to injuries:
Play golf only when the temperature is above 50 degrees. In cold weather, your muscles don’t warm up and you’re more prone to injury.
At the practice range, vary your shots to avoid repetitive motion injuries. Don’t practice the same swing 100 times.
No matter how eager you are to play, stretch first. Don’t jump out of your car, sprint to the first tee, and swing. (Don’t “grip” the club and “rip” your muscle.)


Living Easy, Avoiding Injury

Four tips for keeping active all summer

And the livin’ is easy
Fish are jumpin’
And the cotton is high”When these lyrics were written, summer living was indeed easy. In pre–air–conditioning 1935, people slowed down for summer. Fast-forward 74 years and summer is fun, but not necessarily relaxing. We golf. We waterski, swim, boat. Jog, bike, hike, play pickup baseball. Carry picnic coolers. Haul compost. Play tennis. Then, we get hurt.

What causes summer injuries?
Many adults are fairly sedentary during the winter. When summer comes, they dive into a full pool of activities. Suddenly, they are swinging, lifting, jumping, reaching in ways they haven’t since the previous August. Children, who are active during the year, get summer injuries when they overspecialize. Camps and clinics that focus on one favorite activity all day for a week or weeks at a time are dangerous for children in the growth spurt years.

How to avoid summer injuries
It’s very simple to avoid summer injuries, but also surprisingly hard. Here are four things you can do:

Alternate activity and rest. After strenuous exercise, your body needs time to recover and rest the tissues. You know that. But faced with 14 days straight of glorious summer weather, the temptation to overdo it on the golf course or in the garden or on the ball field is strong. That’s when you should take a break. Take a day off, even if it’s not raining.

Drink water. No one expects to get dehydrated. But it’s very common in summer, for both children and adults. You need water to avoid injuries to your muscles and tendons and also to regulate your body temperature. Old and young alike should drink water. In hot weather, you should drink 16 ounces of water 15 to 30 minutes before exercising. While exercising, drink small amounts of water frequently.

Wear sensible shoes. This doesn’t mean “ugly” shoes but rather shoes appropriate for the activity. Flip flops are fine to wear to dinner. They’re not fine for errands and gardening.

Stop if you feel pain. That’s stop – s, t, o, p – stop. This is difficult when you’re having fun. You might think, “Oh, it’s just a little twinge,” or “I’m sure that will feel better in the morning”. But pain is a protective mechanism. Even if it’s just five more holes or one more match, stop.

Best approach to summer injuries: Prevention
The best way to deal with summer injuries is not to get them. Stretch before activities. Take a break. Drink water. Wear the right shoes. Stop the minute you feel pain. Then, you can have fun in the sun, from today all the way through summer to Labor Day.


A Boston Marathon for the Rest of Us

Start to finish in 26 days

Like many people who walk for regular exercise, I find that getting out the door can be the most difficult moment of my routine. Then, I remind myself of all the benefits of such a simple activity as walking. If you have trouble sticking to a walking routine, I propose that you join me in our own version of the Boston Marathon.

Here’s how it works:
Walk one mile outdoors every day for 26 days. On the 26th day, add an extra one-fifth of a mile. Your total for these 26 days will be 26 miles and 385 yards, the official distance of the Boston Marathon.

Most people can walk a mile in about 20 minutes. Every day for 26 days, leave your home or office and walk outside for 10 minutes. Then walk back to your starting point. Follow this schedule and imagine where we’ll be:

Day 1: Mile 0, we’re at the start line in Hopkinton.
Mile 0 advice: Like runners at the starting line, hydrate. Drink water before and after your walks.

Day 13: Mile 12.5, we pass through the Wellesley College “scream tunnel” of cheering students.
Mile 12.5 advice: Like the runners at Wellesley, get encouragement. Tell a friend your goal to walk every day and check in as you make progress.

Day 20: Mile 19, we run by the statue of Johnny Kelley, who ran the Marathon 61 times.
Mile 19 advice: Like Johnny the Elder, count the times you exercise. A simple tic mark on your calendar will encourage you to walk more often.

Day 26: Mile 25 to the finish. We pass the Citgo sign, the crowd goes wild as we turn the corner at Hereford Street, we burst over the finish line at the Boston Public Library.
Mile 26 advice: Use your imagination when you exercise. I hope visualizing the Boston Marathon will help you walk every day this month.

Running the Boston Marathon may be glamorous, but walking is still the best exercise you can get. Walk every day, and you’ll enjoy a ripe old age, like the 113-year-old marathon.


Why I Walk Every Day

And why you should, too

Whatever your exercise program, you should walk outdoors every day. But don’t take my word for it. Listen to these philosophers:

“Walking is man’s best medicine.”
Hippocrates, the Greek physician and founder of medicine knew his stuff. In the intervening 2,500 years, medical researchers have noted that walking reduces the risk of heart disease and diabetes, lowers blood pressure, wards off dementia, reduces obesity, and strengthens muscles.

“An early-morning walk is a blessing for the whole day.”
Henry David Thoreau understood that walking is good not only for your body but also for your spirit. People who walk sleep better and have more energy. They have fewer symptoms of anxiety and depression.

“Walking is the best possible exercise. Habituate yourself to walk very far.”
As Thomas Jefferson advised, make walking a habit. Try to walk every day at the same time. You can slip a few minutes of walking into a busy day by parking farther away or walking to the next-closest subway stop. There’s more benefit in a half-hour walk every day than in a run once a week.

“Take a two–mile walk every morning before breakfast.”
Harry S. Truman knew that you can walk anywhere, even if you’re the President. You don’t need special clothing or equipment. You can walk in most types of weather. Walking is free.

“No problem is so formidable that you can’t wall away from it.”
Feeling stressed? Get outdoors. And Charles M. Schulz would suggest that you take Snoopy with you. If you don’t have a dog, offer to walk a neighbor’s pet. Or make a regular date with a human friend to keep you both walking every day.

“A penny saved is a penny earned.”
Benjamin Franklin never drove but he would adise you to save gas. Save on medical bills, massages, physical therapy. Walk.