In today’s digital world, many individuals spend a significant amount of time working at computer workstations. Prolonged hours of typing and mouse use can contribute to discomfort and strain to the neck, back and shoulders. With a forward head position the arms tend to endure an increased loading, leading to potential musculoskeletal issues. At SA Hand Therapy, we recognise the importance of proper ergonomics in promoting a healthy and comfortable work environment. In this blog post, we will explore ergonomic solutions and strategies to reduce the load on the arms and hands, including the use of angled keyboards, vertical mice, forearm supports and the impact of poor posture.
Maintaining a poor posture while working at a computer workstation can significantly contribute to strain on the arms and hands. Slouching or hunching forward can result in excessive reaching and over-extension of the arms, leading to increased muscle tension and potential nerve compression or tension. As the day leads on, it is common to see a more forward neck position and fatigue creeping in through the whole upper body including upper limbs.
It is essential to maintain proper alignment of the spine, shoulders, and arms to minimise strain and discomfort and starting with a good supportive ergonomic office chair is pivotal that allows the body to be close to the work surface. During some of our workstation assessments, we often need to remove arm rests from office chairs to allow the chair to be closer to the table.
Alternating positions throughout the day is also important to give certain muscles a break. In our therapy sessions we routinely educate about taking breaks and especially moving upper limbs in the opposite direction to the positions that are usually adopted for long periods. For example, a good tip might be to wave your arms in a back-stroke swimming fashion periodically. Other strategies might be moving your neck by looking up to the roof, turning your head over each shoulder and bringing your chin to the chest. These simple methods can often be done in a brief time frame and can make a large difference in the overall feeling of fatigue at the end of the day. One of the very best and often overlooked strategies is to get up and move the whole body or alternate routinely between sitting and standing. Doing this at least once an hour can make a big impact.
Typing for extended periods on a conventional flat keyboard can cause wrist extension, leading to discomfort and potential issues such as carpal tunnel syndrome, tennis elbow or radial tunnel syndrome. A conventional keyboard layout also encourages wrist deviation which can cause strain to the little finger side of the wrist. Angled keyboards, also known as ergonomic or split keyboards might be one solution to consider. They are designed to reduce wrist extension and promote a more neutral hand and wrist position. These keyboards are usually divided into two or three sections, allowing users to position their hands in a more relaxed posture. The clinical evidence for the support of these keyboards does not have strong evidence necessarily for prevention of musculoskeletal disorders, however we have found large benefit when someone does present with a specific issue. An angled keyboard is very useful when tendonitis is present.
There are several considerations with selecting the most appropriate keyboard which our therapists are skilled at discussing with you and making specific recommendations. Our resident in-house tech-nerd (Vincent Zhang) spent quite some time recently designing a custom-made set-up for one of our clients. His ingenuity lead to a 3D printed angled holder (known as a tenting kit) for half of the keyboard. Here are some images of the process and setup:
Traditional computer mice require the hand to be positioned in a pronated (palm-down) position, which can strain the muscles and tendons in the forearm and wrist. Vertical mice, on the other hand (pun intended), are ergonomically designed to allow the hand to be in a more neutral position, resembling a handshake. This design promotes a more natural alignment of the hand, wrist, and forearm, reducing the strain and potential for discomfort. When using a vertical mouse, it is generally easier to glide the mouse using the whole arm and shoulder girdle as opposed to just the wrist which is commonly observed with a conventional mouse.
Vertical mice can be particularly beneficial for individuals with pre-existing wrist or forearm conditions, such as tendonitis or carpal tunnel syndrome. There are several options on the market but we particularly like this one and hence endorse and recommend it through our online store.
Maintaining proper support for the forearms and wrists is crucial in reducing strain and promoting healthy posture during computer work. This is generally more critical for anybody with a shoulder weakness or mid forearm and elbow issue.
Ergonomic forearm supports, such as adjustable armrests or armrest attachments, provide a stable surface for the forearms, helping to relieve tension in the neck, shoulders, and upper back. There are some products that can attach to the edge of the desk surface and pivot whilst the arm is moving which take a huge amount of load off the shoulder.
Wrist rests come in many shapes, sizes and materials. Some attach directly to a keyboard and others are stand-alone. Gel or foam supports can be used and placed in front of a mouse helping to reduce to pressure on the palm. A key principle of deciding if a wrist rest is suitable is trying to better understand the upper limb problem. If there are no specific issues and the wrist support feels comfortable and takes some pressure of the hard surface of a table, then it’s probably appropriate. On the other hand (pun intended again,) if there is a specific hand or upper limb concern, a thorough assessment is likely indicated, and a wrist support may or may not be needed. Wrist supports may cause the keyboard or mouse to be positioned further away from the body and therefore could be a contributor to higher loading to the hands and fingers.
Improper monitor placement can contribute to poor posture and strain on the eyes. This in turn can cause a forwardly tilted neck. The top third of the monitor should be at eye level, allowing for a comfortable gaze without straining the neck or shoulders. The distance of the monitor should be ideally at an arm’s length away from your body. Additionally, utilising a document holder can prevent excessive head and neck movement when referencing printed materials while working on the computer. By keeping the documents at eye level and within a comfortable viewing distance, the load on the arms and hands can be minimised.
Taking regular breaks and incorporating stretching and nerve gliding / neural mobilisation exercises can help alleviate tension and reduce strain on the arms and hands. Simple stretches, such as wrist flexion and extension, finger stretches, and shoulder rolls, can promote blood circulation and release muscle tension. A nerve glide that we typically prescribe involves arm movements that mimic a ‘ballerina dancing’ or ‘throwing a frisbee’.
Setting reminders to take short breaks throughout the workday can also help prevent prolonged static postures and allow for rest and recovery.
People come in all shapes and sizes and there are very few one-size-fit-all solutions. However, proper tailored ergonomics plays a vital role in reducing strain and promoting comfort during computer work. Implementing ergonomic solutions such as angled keyboards, vertical mice, forearm supports, and appropriate monitor placement can significantly alleviate the load on the arms and hands particularly when there is an existing problem. Using modified and ergonomic equipment might reduce the risk of potential musculoskeletal and/or nerve related issues. At SA Hand Therapy in Adelaide, we emphasise the importance of creating a tailored workstation setup that prioritises optimal posture and ergonomics to support long-term hand and upper limb health. If you would like to discuss your work situation we can do this in clinic. We love to see video footage and pictures of workstations and in some cases recommend coming out to your workstation to give it the full once-over! A worksite assessment is probably one of the best investments that you or your company could make given how long many of us sit at a computer.
Further recommended resources:
References:
Alnahdi, A. H., & Aldayel, A. Y. (2020). Effectiveness of ergonomic interventions on musculoskeletal disorders among computer users: A systematic review. Work, 67(4), 869-877. DOI: 10.3233/WOR-203250
Australian Government Department of Health. (2020). Ergonomics and Musculoskeletal Disorders. Retrieved from https://www.health.gov.au/health-topics/ergonomics-and-musculoskeletal-disorders
Gittoes, M. J. (2020). Musculoskeletal disorders and ergonomic interventions in the workplace: A scoping review. Safety and Health at Work, 11(4), 403-416. DOI: 10.1016/j.shaw.2020.09.006
Johnson, M., Hush, J., Davenport, T., & Stanton, R. (2021). Ergonomic interventions for reducing musculoskeletal symptoms in office workers: A systematic review and meta-analysis. Journal of Occupational Rehabilitation, 31(1), 1-25. DOI: 10.1007/s10926-020-09916-w
Safe Work Australia. (2022). Ergonomic Principles and Checklists for the Selection of Office Furniture and Equipment. Retrieved from https://www.safeworkaustralia.gov.au/doc/ergonomic-principles-and-checklists-selection-office-furniture-and-equipment
Straker, L., Mathiassen, S. E., & Skoffer, B. (2019). Sitting and standing at work: The Australian 2011 National Working Conditions Survey. Applied Ergonomics, 81, 102894. DOI: 10.1016/j.apergo.2019.102894
