Two years after his first ergonomic assessment Mark was still suffering. His employer had followed the recommendations of the ergonomist, purchasing a new chair and keyboard, lowering the monitor, and installing an adjustable workstation with a slant table. Yet, with all these changes, Mark continued to complain of severe and chronic neck pain, tingling down his arms, and aching in his forearm. In fact, his discomfort had increased.
Mark’s story is, unfortunately, a very common one. Why, after spending so much money and making the ergonomic corrections, do Mark and thousands of other workers still suffer from computer-related disorders? State and federal health and safety agencies, along with employers and workers, struggle to find the answer. In the United States, OSHA’s proposed ergonomic guidelines met with strong opposition by those who think that ergonomic adjustments are insufficient to preventing this workplace epidemic. If it is not just ergonomics, then what causes computer-related injuries?
Work Style and Awareness
Research at the Institute for Holistic Healing Studies at San Francisco State University by Erik Peper, Ph.D., and colleagues shows that an employee working at the computer usually holds chronic, unnecessary muscle tension. The researchers used biofeedback to objectively measure muscle tension, respiration patterns and hand temperature. They found that 95% of employees studied automatically raised their shoulders as well as maintained low-level tension in their forearms while keyboarding and mousing. Sustaining a posture of tension—raised shoulders, arms reaching forward, quick breathing, and, sometimes, cool fingers—inhibits the body from relaxation and places one at risk of injury. Think about how often you wait in anticipation, with your arm extended, ready to click the mouse button. As you read this article on the internet, are your shoulders raised? Are you are breathing?
Equally important to chronic tension is the lack of awareness. In many cases, employees are captured by their work and are unaware of, or ignore, physical discomfort until they hurt. Almost all employees studied thought that their muscles were relaxed when they were sitting correctly at the computer. However, the actual physiological data showed a different picture. Even when resting on the wrist rest, they did not totally relax their arms and shoulders.
The graph in Figure 1 is from a biofeedback session in which muscle tension in the neck, shoulders and forearms was recorded, as well as respiration rate from the chest and abdomen. This graph demonstrates a common pattern found in computer workers: unnecessary tension in the shoulders, rapid breathing and a lack of breaks when working.
Figure 1. A representative recording of a person working at the computer. Note how the neck and shoulder muscle tension increases, the forearm muscle tension remains up (no micro-breaks) and the respiration rate increases. Yet the person is totally unaware of the major physiological changes.
No Breaks and Increased Stress
Muscles are designed to alternate between tension and relaxation. When held in chronic contraction, discomfort and referred pain is more likely to occur. Working at the computer without a break is analogous to holding your arm out in front of you for a very long time without rest. How long could you hold your arm up without developing discomfort? Five minutes? Ten minutes?
The ‘conscientious’ employee who does not take breaks—micro, large movement or lunch—denies himself regeneration. In addition, the near visual stress of working at the monitor tends to increase arousal and chest breathing, exacerbating the tension in the upper back, neck and shoulders, as well as decreasing peripheral circulation. This lack of breaks, added tension, and increased arousal leads to an injurious cycle of discomfort and higher reactivity to work stress.
New Employee Training in a Systems Perspective
Prevention and remediation of computer-related disorders must address the whole picture in a systems perspective, utilizing real-time, objective measurements. Biofeedback provides objective measurements, takes the guesswork out of ergonomics and helps employees observe and change their work habits. A systems approach to prevention should include ergonomics as well as training in work style, somatic (mind/body) awareness, regeneration, stress management, vision care and fitness.
Employee computer training should expand to include how to work at the computer while maintaining health and productivity, and emphasize the above seven components of healthy computing. We urge employers to add this segment to new employee training. A 9-month follow-up of employees who participated in a 6-week training session utilizing biofeedback found that symptoms decreased by 73%. When employees develop awareness and acquire the skills to work healthfully at their peak, this alarming epidemic will dissolve.
Reduce computer-related discomfort with the following tips:
- Take micro-breaks. Every 30 seconds drop your hands to your lap and let your shoulders relax for one second, then continue working.
- Breathe slower and more in your abdomen instead of your chest.
- Take large movement breaks. Every 20 minutes get up and move.
- Use a split keyboard without the number pad, if your work allows it, so that the mouse is more central.
- Blink at the end of every sentence or every column of numbers.
- Mentally scan you body; relax unnecessary tension.
- Check your stress level. If you feel stressed, take action steps to eliminate the stress, such as asking for help with your projects.
- Exercise daily; remember that computing is an athletic event and maintaining fitness will help prevent injury.
About the Authors:
Erik Peper, Ph.D. and Katherine Hughes Gibney provide workplace training and consultation in injury prevention, and produce the weekly Healthy Computing Email Tips‘. Their recently published book, Healthy Computing with Muscle Biofeedback, A Practical Manual for Preventing Repetitive Motion Injury, provides detailed instructions in training employees. Contact them at Work Solutions USA, 2236 Derby Street, Berkeley, CA 94705. Telephone: 510 841 7227; Fax: 510 658 9801. worksolusa@aol.com.