Tanya Coats Occupational Therapy

Advice on Desk Posture

I sit at a desk most of the workday, keyboarding. My wrists and elbows are always aching. Is there anything I can do?

If you spend most of your day at a desk, your work station should be evaluated and adjusted to ensure proper positioning and desk posture. Your work station should be set up specifically for you. There are many symptoms that may occur from sitting at a poorly designed work station. These symptoms include fatigue or soreness of wrists, elbows, neck, scapular region and lower back. Eventually, if these signs aren’t addressed, you may start to experience pain or numbness and tingling in these areas. If your work station is shared, it should be adjustable to fit the needs of all who use that workstation.

What should my work station look like?

Proper workstation assessment should include looking at the height of your chair, the type of keyboard and mouse you’re using, and position of your monitor. Proper height of your chair should allow ankles, knees, hips and elbows to rest at 90 degrees. Shoulders should be relaxed and wrists in a neutral position. The monitor should be placed directly in front of you with the first line on the screen at eye level. This prevents the unwanted neck rotation or positioning the neck in too much flexion or extension. The keyboard and mouse are placed in front of you in a position that allows the shoulders to be relaxed and elbows positioned at 90 degrees. This reduces the stress on our extensor tendons in our wrists and elbows. Overreaching for the keyboard places stress on the muscles that lift the wrist and can cause tendonitis at your elbows. Overreaching will also overstretch the muscles around your shoulder blades and tighten your pectoral muscles. Over time, improper computer monitor height and overreaching for your keyboard and mouse will cause you to have a rounded shoulder and forward head posture.

Placing the wrists in a neutral position is very important in preventing tendonitis at the wrist and preventing carpal tunnel syndrome. Ergonomic keyboards do a nice job of placing the wrists in a neutral position. Typical keyboards place your wrists in an extended and deviated position. Over time, this position can lead to overuse injuries, such as wrist tendonitis. Prolonged positions with the wrist slightly flexed or resting the wrists on a hard surface can contribute to carpal tunnel syndrome. If the keyboard is too high, individuals may flex their elbows well beyond 90 degrees, causing cubital tunnel syndrome. Elevation of the shoulders to compensate for a high keyboard can overwork the upper trapezius muscle, causing fatigue and trigger points.

If you spend an extended period of time at your work station, it’s important that the work station is set up to fit you. There are an abundance of ergonomic work station options to fit your needs. Whether it’s ergonomic computer equipment or modification of your current work station, a certified hand therapist can help address these issues.  A certified hand therapist can also give you exercises to help prevent or decrease overuse symptoms.

If you need help with this, please feel free to contact me for an assessment.

Article Reference: ASSH|Hand Care

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