Computer Work Postures and Injury: The Stress of Reaching for the Mouse, A Doctors’ Perspective
By Dr. Steve Jones
As we spend increasing amounts of time at our computer workstations, we need to be aware of how the design and arrangement of our equipment can impact our chances of injury. Computer ergonomics is the study and / or implementation of work station design with the purpose of reducing or eliminating physical stress.
My interest in repetitive stress syndromes began approximately 10 years ago when my practice started seeing a much greater number of people suffering from the effects of computer work. Despite all of my training and continuing education related to these types of injuries, I quickly realized that short of surgery and radical changes in the patient’s lifestyles, treatment for this type of injury was marginally successful at best.
The real solution had to be prevention and it was going to involve the application of basic ergonomic principals.
This article will address the specifics of injury resulting from postural stress secondary to use of the computer mouse.
Specifically, the following will be addressed:
What repetitive stress injuries are
What role do work station ergonomics play in injury
How reaching for the mouse sets the stage for injury
What are the symptoms of repetitive stress injury
How one can avoid mouse reaching injuries
What Exactly is a Repetitive Stress Injury?
Repetitive Stress Injury is a kind of catch all phrase for many conditions. Carpal Tunnel Syndrome, Tenosynovitis / DeQuervain's Syndrome, Tendonitis, Thoracic Outlet Syndrome, Trigger Finger, Myofascial Pain Syndrome and Chronic Sprain / Strain are some of the actual diagnosis that are rendered in my office. All of these conditions are serious and in many cases can cause great pain, permanent disability and sometimes loss of employment.
Repetitive Stress Injuries occur from repetitive movements involving a specific set of muscles and joints. RSI injuries are the result of an accumulation of stress and strain that causes irritation, inflammation, and eventually pain or other disability. A good analogy used to characterize the onset of RSI would be the “straws on the camels back” saying.
Initially, RSI affects the soft tissues of the involved joint(s). Soft tissues include muscles, nerves, ligaments and tendons. However, if left untreated for long periods of time, the involved joint can become arthritic and form bone spurs resulting in permanent damage to the joint.
While various occupations ranging from meat cutters to construction workers develop RSIs that result from the typical duties of their professions, the most frequent cause of these injuries involve computer work. The constant demand of keyboarding and mousing combined with the postural stress of confinement in an office chair with one’s neck and back held in prolonged fixed positions has resulted in an epidemic of injuries that includes hand pain, wrist pain, arm pain, neck pain, back pain and shoulder pain.
Work Station Ergonomics
The study of workstation ergonomics tells us that the objects that are used most often should be located closest to your body and accessed easily, without awkward body positions. Repeated reaching or prolonged postures that involve leaning forward from your chair are particularly stressful and fatiguing.
Many people are aware of computer ergonomics and thus have an ergonomic mouse. An ergonomic mouse is of little use if it is positioned in an area that requires reaching and stretching in order to operate it. Limiting reaching and stretching for desk items is essential to maintaining a healthy ergonomic environment.
The most frequent complaint that I have seen in my office is due to computer work is the combination of mousing and its’ inherent postural stress.
Most computer stations are designed in a way that involves the worker operating the computer mouse on a pad on the desk. Reaching to the desk for the mouse places direct stress on the joints and soft tissues of the neck, shoulder, elbow, wrist and hand. Additionally, reaching forward for the mouse stresses the lower and middle back.
So How Does Reaching for the Mouse Set the Stage for Injury?
Reaching for the mouse causes you to lean forward in your chair, extend your arm and support the weight of your body through your extended arm. The following section will discuss the particulars of each of these positions.
The stresses placed on the human frame when reaching for the mouse are easily explained. Contrary to popular belief, sitting, which most people believe is relaxing, is hard on the back. Sitting for long periods of time can cause increased pressure on the intervertebral discs of the spine.
In recent years, ergonomisist have told us that proper sitting posture would have us sitting upright with our hips flexed at 90 degrees. As it turns out, the most up to date studies show that a slightly reclined sitting posture with the hips flexed at 100 to 115 degrees is ideal if you have to sit at a desk. If your mouse is not positioned close enough to your body, you will have to reach for it. Reaching for your mouse stresses your back by reducing the angle of your hips.
Next, we have to look at the effects of reaching on the neck and shoulder.
When the mouse is being operated at a distance that makes the operator reach, the shoulder extends forward and the shoulder blade abducts (rotates forward). This position stretches the muscle groups that connect the medial portion of your shoulder blade to your spine and the superior portion of your shoulder blade to your neck. In the short term, this stretch aggravates the affected muscle groups causing spasm, fatigue, headaches and stiffness in the neck and shoulder. In the long term, this position creates a condition called a “stretch weakness” resulting in muscular imbalance, trigger points and chronic variations of the conditions listed in the prior sentence.
Lastly, placing the mouse too far away, too low, or too much on one side can cause shoulder, wrist, elbow, and forearm discomfort. When the operator is forced to reach for the mouse, his / her body weight shifts forward and ultimately results in weight bearing stress on the extended arm. Spending prolonged periods of time leaning on an extended arm is an unnatural and destructive posture that will eventually lead to the development of a repetitive stress syndrome; likely resulting disorders would include tendonitis of the wrist, elbow or shoulder.
What are the Common Symptoms?
· Tightness, discomfort, stiffness, soreness or burning in the hands, wrists, fingers, forearms, or elbows
· Tingling, coldness, night pain or numbness in the hands, especially around the base of the thumb
· Clumsiness or loss of strength in the hands
· Pain in the neck, shoulders, wrists, hands or back that is associated with using the computer
How Can You Avoid Injuries Related to Reaching for the Mouse?
The following recommendations are applicable to both home office ergonomics as well as ergonomics in the office.
1) Placing the input device directly in your immediate reach zone offers natural comfort and maximum hand-eye coordination. The use of a platform for the mouse is preferable. Some models of mouse platforms attach directly to your chair.
2) Your chair should have arm rests that are adjustable.
3) Your wrist should be either in a neutral position or flexed slightly downward when operating both your mouse and your keyboard. For this reason, if you select a mouse platform that attaches to your chair, adjustability of the platform is of primary importance.
4) Consider using a high quality office chair with adjustable armrests and lumbar supports. It should also allow some degree of recline.
5) Make sure that the upper arm and elbow are as close to the body and as relaxed as possible for mouse use - avoid overreaching.
6) Hold the mouse lightly, don't grip it hard or squeeze it. Place the pointing device where you don't have to reach up or over very far to use it. The closer you can place it to your body the better.
Steve,
Writers Bio
Dr. Steven R. Jones is a licensed Chiropractor in the state of California. He received his doctorate from Palmer College of Chiropractic-West in Sunnyvale, California. Dr. Jones has treated his patients for over 15 years at his own San Diego Chiropractic practice.
Dr. Jones is accepting new patients and would be happy to consult with you regarding your chiropractic needs.
Call Steve Jones at
(619) 280 0554
San Diego Chiropractic
Ergonomic Office Equipment Website to learn more about or Buy Ergo Nav, the Ergonomic Mouse Pad
or Visit Ergonomic Blog, "Ergonomically Yours" And read the latest News in the Ergonomic World.
Better Health Steve Jones
Oct 19, 2009
Oct 9, 2009
Chiropractic Care is Safe
Chiropractic Care is Safe
As a Doctor of Chiropractic, I often deal with new patients who carry an unreasonable fear concerning chiropractic treatment. I currently practice in San Diego, California and have been in practice for 15 years. At this point in my life, I keep in close contact with 8 friends that I made in school. There are another 10 or so that I speak with 2 or 3 times per year. All but one of these doctors has been in full time practice for at least 15 years. Out of all of these doctors, not one of them has had a patient sue them for treatment related injuries. One of these doctors knows a doctor who was sued by a patient for an injury. That patient was injured in the doctor’s office after they tripped over his welcome mat and suffered a broken arm.
At a risk prevention seminar that I attended three years ago, the instructor stated that in a group of 25 chiropractors that practice for 20 years seeing an average of 100 patients per week, that one of these doctors would have a patient suffer from a serious injury related to treatment. That is equal to 1 serious injury in every 2.6 million chiropractic adjustments. When these numbers are compared to the dangers of Tylenol use, one can see how safe chiropractic care actually is. Just in the United States and the United Kingdom, each year there are 300 deaths and 130,000 emergency room visits as a direct result of Tylenol use.
The rest of this document is a compilation of facts regarding the safety of chiropractic treatment.
Chiropractic is Safe.
Records form insurance and court cases have constantly shown that chiropractic is the safest portal of entry health care available to the public today. Although no healthcare procedures are 100% safe, chiropractic stands on its record of safety and effectiveness unmatched in healthcare. To learn more about the safety record of chiropractic please visit the website Chiropractic Is Safe at www.chiropracticissafe.org.
Chiropractic is the fastest-growing and second-largest primary health care profession.
There are approximately 60,000 doctors of chiropractic (DCs) in active practice in the United States spread from rural areas to inner cities. More than 10,000 students are currently enrolled in chiropractic educational programs accredited by a federally-recognized body (CCE).
Chiropractic services are in high demand.
Tens of millions of Americans routinely opt for chiropractic services and this number is rapidly growing. In 1993, more than 30 million consumers made chiropractic a regular part of their health care program.
Doctors of Chiropractic receive extensive, demanding professional education on par with medical doctors (MDs) and osteopaths (DOs).
To receive the doctor of chiropractic degree, candidates must complete extensive undergraduate prerequisites and four years of graduate-level instruction and internship at an accredited chiropractic institution. Comprehensive knowledge of all systems of the body and diagnostic procedures enable the DC to thoroughly evaluate a patient, address disorders relating to the spine and determine the need for referral to another health care provider.
Doctors of Chiropractic are primary health care providers.
According to the Center for Studies in Health Policy, "The DC can provide all three levels of primary care interventions and therefore is a primary care provider, as are MDs and DOs. The doctor of chiropractic is a gatekeeper to the health care system and an independent practitioner who provides primary care services. The DC's office is a direct access portal of entry to the full scope of service."
Doctors of Chiropractic are licensed in all 50 states. DCs have been licensed and recognized for many decades in all states, the District of Columbia and Puerto Rico.
Chiropractic is recognized by governmental health care programs.
Chiropractic is included in Medicare, Medicaid, Federal Employees Health Care Benefits Programs, Federal Workers' Compensation and all state workers' compensation programs. Chiropractic students are qualified to receive federal student loan assistance and DCs are authorized to be commissioned as health care officers in the U.S. Armed Forces.
Chiropractic care is very effective and very safe. I hope that this article hits home with some of you who have delayed chiropractic care due to unfounded fears.
Writers Bio
Dr. Steven R. Jones is a licensed Chiropractor in the state of California. He received his doctorate from Palmer College of Chiropractic-West in Sunnyvale, California. Dr. Jones has treated his patients for over 15 years at his own San Diego Chiropractic practice.
Dr. Jones is accepting new patients and would be happy to consult with you regarding your chiropractic needs.
Call Steve Jones at
(619) 280 0554
San Diego Chiropractic
Ergonomic Office Equipment Website to learn more about or Buy Ergo Nav, the Ergonomic Mouse Pad
or Visit Ergonomic Blog, "Ergonomically Yours" And read the latest News in the Ergonomic World.
Better Health Steve Jones
As a Doctor of Chiropractic, I often deal with new patients who carry an unreasonable fear concerning chiropractic treatment. I currently practice in San Diego, California and have been in practice for 15 years. At this point in my life, I keep in close contact with 8 friends that I made in school. There are another 10 or so that I speak with 2 or 3 times per year. All but one of these doctors has been in full time practice for at least 15 years. Out of all of these doctors, not one of them has had a patient sue them for treatment related injuries. One of these doctors knows a doctor who was sued by a patient for an injury. That patient was injured in the doctor’s office after they tripped over his welcome mat and suffered a broken arm.
At a risk prevention seminar that I attended three years ago, the instructor stated that in a group of 25 chiropractors that practice for 20 years seeing an average of 100 patients per week, that one of these doctors would have a patient suffer from a serious injury related to treatment. That is equal to 1 serious injury in every 2.6 million chiropractic adjustments. When these numbers are compared to the dangers of Tylenol use, one can see how safe chiropractic care actually is. Just in the United States and the United Kingdom, each year there are 300 deaths and 130,000 emergency room visits as a direct result of Tylenol use.
The rest of this document is a compilation of facts regarding the safety of chiropractic treatment.
Chiropractic is Safe.
Records form insurance and court cases have constantly shown that chiropractic is the safest portal of entry health care available to the public today. Although no healthcare procedures are 100% safe, chiropractic stands on its record of safety and effectiveness unmatched in healthcare. To learn more about the safety record of chiropractic please visit the website Chiropractic Is Safe at www.chiropracticissafe.org.
Chiropractic is the fastest-growing and second-largest primary health care profession.
There are approximately 60,000 doctors of chiropractic (DCs) in active practice in the United States spread from rural areas to inner cities. More than 10,000 students are currently enrolled in chiropractic educational programs accredited by a federally-recognized body (CCE).
Chiropractic services are in high demand.
Tens of millions of Americans routinely opt for chiropractic services and this number is rapidly growing. In 1993, more than 30 million consumers made chiropractic a regular part of their health care program.
Doctors of Chiropractic receive extensive, demanding professional education on par with medical doctors (MDs) and osteopaths (DOs).
To receive the doctor of chiropractic degree, candidates must complete extensive undergraduate prerequisites and four years of graduate-level instruction and internship at an accredited chiropractic institution. Comprehensive knowledge of all systems of the body and diagnostic procedures enable the DC to thoroughly evaluate a patient, address disorders relating to the spine and determine the need for referral to another health care provider.
Doctors of Chiropractic are primary health care providers.
According to the Center for Studies in Health Policy, "The DC can provide all three levels of primary care interventions and therefore is a primary care provider, as are MDs and DOs. The doctor of chiropractic is a gatekeeper to the health care system and an independent practitioner who provides primary care services. The DC's office is a direct access portal of entry to the full scope of service."
Doctors of Chiropractic are licensed in all 50 states. DCs have been licensed and recognized for many decades in all states, the District of Columbia and Puerto Rico.
Chiropractic is recognized by governmental health care programs.
Chiropractic is included in Medicare, Medicaid, Federal Employees Health Care Benefits Programs, Federal Workers' Compensation and all state workers' compensation programs. Chiropractic students are qualified to receive federal student loan assistance and DCs are authorized to be commissioned as health care officers in the U.S. Armed Forces.
Chiropractic care is very effective and very safe. I hope that this article hits home with some of you who have delayed chiropractic care due to unfounded fears.
Writers Bio
Dr. Steven R. Jones is a licensed Chiropractor in the state of California. He received his doctorate from Palmer College of Chiropractic-West in Sunnyvale, California. Dr. Jones has treated his patients for over 15 years at his own San Diego Chiropractic practice.
Dr. Jones is accepting new patients and would be happy to consult with you regarding your chiropractic needs.
Call Steve Jones at
(619) 280 0554
San Diego Chiropractic
Ergonomic Office Equipment Website to learn more about or Buy Ergo Nav, the Ergonomic Mouse Pad
or Visit Ergonomic Blog, "Ergonomically Yours" And read the latest News in the Ergonomic World.
Better Health Steve Jones
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