If you are suffering from headaches, back ache, neck, wrist and/or shoulder pain it may have something to do with your posture and your workstation setup. Making small changes to your workstation setup can reduce or prevent injuries associated with sitting at your desk. With further technological advances, people are using computer workstations more frequently and with increasing duration. A large proportion of the population, particularly in Canberra, are spending the majority of their working day using a computer workstation.
At Sport and Spinal Physiotherapy we often treat people for chronic back, neck or arm pain that can be directly associated with a poor computer workstation setup. Furthermore, computer use is not just limited to work which further increases the effect of a poor workstation. How often do you come home from work and use your home computer, laptop or phone for social media, shopping, checking the weather, email, communicating with friends and family or playing games?
The aim of this article is to provide you with tips to ensure your workstation is set up appropriately to help prevent injury or soreness that is all too commonly associated with a poorly set up workstation.
The most common musculoskeletal injuries associated with a poor workstation are neck/shoulder injuries, arm injuries (including the elbow, forearm and wrist) and lower back injuries (Griffiths et al. 2012). However, the impact of a poor workstation includes more than just injury. A poor workstation has also been associated with general discomfort, reduced productivity, interrupted sleep, reduced quality of working life and reduced quality of work.
The major risk factors for computer workstations associated with neck and shoulder complaints include (Kiss et al. 2012):
- Completing 25 hours or more computer work per week
- Working more than 1 hour on a computer without interruption
- Use of a mouse for half or more of the working time
- Reaching far for the mouse
- Limited or no forearm support
- Use of separate wrist support
If just one of the risks factors above is applicable to you then this article can help reduce your risk of developing an injury associated with a poor workstation.
1. Workstation Seat Depth
The seat depth should ideally provide a clearance of at least 5cm between edge of the seat and the back of the lower leg. This is to ensure adequate support of the lower body, prevent excessive activation of the lower limbs and back and prevent compression of the popliteal fossa. Always ensure you are sitting as far back in the chair as possible to ensure adequate lumbar support is maintained.
2. Seat Width
The seat width is highly dependent on your personal preference. It is important to have a seat that provides adequate support whilst also not having a seat that is too large.
3. Seat Height/Angle
The seat height should generally be set to ensure the knees and ankles are kept at approximately 90 degree angles. The seat angle should be adjusted to open up the angle between the trunk and the thigh making it easier to maintain lumbar lordosis.
4. Arm Rests
Arm rests can be great if they are in the correct position, however, if they are not set up correctly they can actually promote poor posture. The best arm rests are height adjustable and preferably adjustable in other directions. Arm rests should create forearm support whilst still allowing for neutral positioning of the shoulders, elbows and wrists at 90 degrees and allowing you to maintain correct upper back posture. If arm rest are non-adjustable they cause you to adopt unnatural positions of your shoulders, elbows, wrists or back. Arm rests become even more important with new technology including tablets and mobile phones. With adequately positioned arm rests you can support your arms (taking pressure of neck and shoulder muscles) and have the device at a higher level (preventing excessive neck flexion associated with neck pain and headaches).
5. Workstation Forearm Support
The traditional approach has been to type with no forearm support and there is still some support for this when referring to skilled touch typists. However, forearm support is now recommended for general typing. This can be achieved by using correctly positioned arm rests (as discussed above) or the workstation surface (the desk). The whole forearm should be supported evenly on the arm rest/work surface. This support allows you to relax your shoulders and neck, reducing discomfort and preventing injuries to these areas. There are a few other key points to ensure you are using forearm support correctly. The armrests/work desk needs to be at an adequate height to maintain correct posture and prevent slouching to ensure arms are supported, the keyboard also has to be relatively flat (lowering keyboard stilts helps) to prevent excessive wrist extension (often associated with wrist/arm discomfort).
6. Screen Height
The height of the screen is a dynamic interplay between the oculomotor system and the musculoskeletal system. The two common complaints regarding screens are neck pain and visual discomfort, depending on which complaint is more applicable to you will often change the ideal height for your screen. The screen should generally be positioned at a height to maintain neutral neck posture (approximately having you eye line 2/3 of the way up the screen). However, if you are having neck complaints I often suggest that people adjust the screen height to their personal preference and comfort. If you are experiencing visual discomfort try lowering your screen as this places less strain on your eye musculature.
7. Screen distance
The distance the screen should be placed from you is simply as far back as possible whilst being able to comfortably see the screen.
8. Dual Screens
When using dual screens the position of each screen will depend on the percentage of use for each screen. If one screen is used the majority of the time and the other only occasionally, the predominately used screen is placed directly in front with the second screen placed to the side. If both screens are used for a similar duration then they should be placed together (directly side by side) with you eye line in the middle of the screens. The screens should then be positioned as far back as comfortable, therefore only a small turn of the neck or body is required to see each screen and this is relatively even left to right.
9. Workstation Keyboard
The keyboard selection is largely dependent on individual preference and comfort. Key principles to remember are to lower the keyboard stilts to prevent excessive wrist extension (often associated with wrist and arm discomfort/injuries) and position the keyboard back enough on the desk to obtain adequate forearm support.
Similarly to the keyboard selection, mouse selection is dependent on individual preference and comfort. Key principles to remember are having the mouse as close as possible to prevent excessive overreaching. Mouse settings such as the mouse speed, acceleration and shadowing can also be adjusted to suit your preference. If you are experiencing significant discomfort in one arm, why not try learning to use the mouse in the other hand. This can help to balance the work load between each arm. Start with simple tasks (like checking emails) and then slowly progress the use of your non-dominant hand.
11. Workstation Desks
Desks should be at an adequate height in relation to the chair to maintain neutral positioning of the upper and lower limbs whilst at an adequate height to maintain posture and provide forearm support. Therefore, height adjustable desks are important to allow for this correct positioning. Desks are also recommended to be at least 90cm in depth (to allow adequate room for all equipment (screens and keyboards) whilst also ensuring room for forearm support.
12. Overall workstation layout
The computer workstation should be organised based on your individual needs. The most important principle is to avoid excessive overreaching for equipment (most commonly the mouse). For example, if you use your mouse predominately throughout the day ensure your mouse is positioned to reduce excessive reaching movements (you may even slightly move your keyboard when not in use to accommodate this). Conversely, if you rarely use your phone this can be positioned further away from your reach to allow more room for other, more frequently used equipment.
13. Facilitating movement
Not everyone has the financial capacity to have a sit-stand desk. However, this does not mean you cannot get the benefits associated with a sit-stand desk. Other ways you can promote postural change and movement include; periodically standing for work, having standing meetings, walk to talk to people when able (instead of calling, messaging or emailing), move printers and other equipment a further distance from your workstation to promote increased walking.
1. Sit-Stand desks
Sit-stand desks have been around for a little while now and we have previously discussed the benefits of using a sit-stand desk. Read this article about the benefits of a sit-stand desk.
The major benefits of a sit-stand desk are that they provide you with postural variety. Sit-stand desks have been associated with a decrease in musculoskeletal complaints, enhanced cognitive performance and a considerable impact on cardiovascular disease and type 2 diabetes.
A large question that I often get asked now that sit-stand desks are becoming more common is, “How long should I stand for”? The ideal length of standing time is approximately 25 to 33% of your desk bound time (Husemann et al. 2009). This should ideally be spread across a single hour. Therefore, you would stand for approximately 15-20 minutes and then sit for 40-45 minutes. However, I also explain to people that everyone is different and that quite often just having the choice to change your working position can influence musculoskeletal complaints. Therefore, I give this as a guide and allow people to modify according to their personal preference.
2. Dynamic seating
Dynamic seating is a relatively new concept which follows a similar principal to Sit-Stand desks in that they promote movement. The concept of dynamic seating is that you change your seating position regularly as you change the task that you are completing. For example, when sitting and typing at a desk you would be sitting upright, with a good posture and a firm back support. Conversely, when talking on the phone a dynamic seat will allow you to lean back (opening up the hip angle and taking pressure off your back). The seating incorporates adjustable seats, back rests, arm rests, lumbar support and seat depth. There are dials to increase and decrease the resistance of support. These features help to promote increased movement, adopt different positions and prevent static postures.
3. Blue light filters
Blue light filters are becoming more popular with the increased use of computers and other devices. Blue light has been linked to the production of a specific wavelength that reduces the release of melatonin – a hormone responsible in regulating sleep cycles. Blue light has also been associated with headache and migraine symptoms. Blue light filters are designed to reduce the amount of blue light emitted by a device. Blue light filters can be placed directly over a screen or can be incorporated into glasses. The latest update to Apples operating system (iOS 9.3) even includes a feature to reduce the blue light production during different time periods for those of us that use technology at night.
4. General Advice
In addition to the specific advice regarding computer workstation set-up there are many little things that can make a significant difference throughout prolonged use of a computer workstation. Tips include:
- Take regular rest/stretch breaks every 30-40 minutes to alternate posture from sitting to standing and avoid maintaining prolonged static postures.
- Vary your work tasks where possible to assist with providing postural variation.
- Incorporate micropauses into your work routine.
- Remain well hydrated and eat nutritionally throughout the day.
- Incorporate stretching into your breaks.
A workstation can be specifically adjusted for particular injuries. An example of this is for intervertebral disc injuries. The chair can be adjusted to further increase the angle of the hips to greater than 90 degrees. This has been shown to decrease the load placed on the intervertebral discs. This can be done by adjusting the back rest incline/tilt or adjusting the seat tilt downwards. However, this may not be appropriate for other back injuries.
Speech Recognition Software
The last item of new equipment is voice recognition software. There has been major improvements in this area in recent years with some of the latest software working very effectively. With some practice and basic training you can now talk and the computer will type what you are saying. If you are often typing for long periods then voice recognition software can help give your neck, shoulders arms and back a rest. I often get people to trial this on their phones to see how effective and easy the technology has become.
The points outlined in this report are a guide to setting up a workstation to help prevent injury. If you are experiencing any ongoing or severe symptoms you should be assessed by a physiotherapist at Sport and Spinal Physiotherapy. We can assess your symptoms and help provide exercises to improve your posture and ability to work more effectively throughout the working day. We currently have a FREE Posture Check (assessment only) available at our City practice. Call 6262 4464 to book your FREE appointment.
Griffiths, K. L., Mackey, M. G., Adamson, B. J., & Pepper, K. L. (2012). Prevalence and risk factors for musculoskeletal symptoms with computer based work across occupations. Work, 42(4), 533-541.
Husemann, B., Von Mach, C. Y., Borsotto, D., Zepf, K. I., & Scharnbacher, J. (2009). Comparisons of musculoskeletal complaints and data entry between a sitting and a sit-stand workstation paradigm. Human Factors: The Journal of the Human Factors and Ergonomics Society, 51(3), 310-320.
Kiss, P., De Meester, M., Kruse, A., Chavée, B., & Braeckman, L. (2012). Neck and shoulder complaints in computer workers and associated easy to assess occupational factors—a large-scale cross-sectional multivariate study. International archives of occupational and environmental health, 85(2), 197-206.