After treating thousands of patients over 25+ years, there are two things that I have learned. First is that human nature drives people to want to help themselves get better. The second thing I have learned is that people are highly motivated to help themselves when they are in pain, but that enthusiasm quickly drops off as soon as the pain goes away.
Ergonomics is one of the most common topics patients ask about, and it is primarily regarding workplace physiological stress. This arises from repetitive postures, motions, and habits that people develop at work. This point is demonstrated by the millions of dollars that companies spend to improve workplace environments for their employees, but this doesn’t solve everything.
For acute relief, I typically recommend that the patient sit, sleep, walk, stand etc in whichever position feels the most comfortable – but not more than an hour at a time unless sleeping. For the prevention of pain returning, or new conditions developing, I recommend the following:
1.Daytime 2. Evening Time 3. Night Time
Find an ergonomic area of your lifestyle that you most want to improve in EACH of the thirds. Practice and master that area for each third of the day, then move on to a new one. For example, evaluating your sleeping position/pillow/mattress for the night time, or your shoes for the day if you are on your feet a lot. An example of the evening time would be how you watch TV, or what position you read a book in, etc…
One of the most common questions with ergonomics is sleep. A good basis is to stay off your stomach. Sleeping on your back with a cervical neck pillow to support your head, neck, and shoulders equally. If sleeping on your side, having a pillow between your knees, and hugging a pillow will give you proper support. Your mattress should be soft enough (air, foam, water, pillowtop) to conform to the curves of your body while providing adequate support without sagging down. If purchasing a new bed, finding one that has a return policy is optimum. It takes multiple nights to tell how a mattress will work for you.
Sitting is to our spine as sugar is to our teeth. It puts massive loads on our lumbar discs and spinal joints. Adequate hamstring flexibility will help minimize pelvic and lumbar disc loading. It doesn’t matter if you’re sitting at the computer, driving, reading a book, watching TV…it is important to be aware that you are not leaning to one side, not hunched forward, and keep items in front of you high enough so you are not looking down. Another thing to pay attention to is that the computer, the tv, or any other items should be directly in front of you – not off to the side. Consider an ergonomic friendly mouse. Check your desk height vs. your chair height so that it feels comfortable for you.
In a chair, or while driving, having a wedge to sit on will put your lumbar spine into an increased curve state (which is a good thing). Also consider a curved lumbar support that rests against the back of your chair, behind your lower back. If you sit a lot, it is important to really test different chairs to find one that gives you a proper and comfortable posture.
If you are on your feet for long periods of time during the day, whether at work or at home, proper shoes with cushion and arch support are a necessity. Foot orthotics are crucial in this regard. Typical shoe soles wear out within a few months (even though they can still look new), and you lose that support and cushion – which transfers all that force and impact to your body. Good quality foot orthotics are designed to last longer (usually 1-2 years) and offer much better support.
If you are standing in one place for long periods of time, you can shift the loads from foot to foot. Do this by shifting weight to each foot, putting a foot up on something and switching back and forth. If you work on your feet in the same area, consider a wellness mat which will reduce impact and loads all the way up your body.
Vacuuming/sweeping/raking are other common concerns. One way to minimize undue stress to your back, shoulders, and neck is to pretend your elbows are stuck to your side. Also, move your feet with each motion (pretend you are dancing with the vacuum/broom/rake). Do not stand in place with your feet planted, which is what most people do. You shouldn’t be reaching way out, and pulling back. Your body should be making most of the movement, with your elbows close to your sides.
The key with this is to break it down into manageable parts, and work on one at a time until you master it. If you try to be 100% in every area all at once, its becomes overwhelming and people give up. By making realistic, stepping stone goals, you can master your ergonomics at home, work, recreation, and more.
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