Care Of Hands And Arms For Computer Users

Care of hands and arms for computer users 8-Mar-2009 Angel Rivera [email_address] www.AngelicalTouch.com Model and Pictures by Victor Rivera

Agenda
Objectives
My qualifications
Caveats
Problem
Posture and Mechanics
Setup of workstation
Exercises
Devices / products
Self-massage

Objectives
To share information on:
The causes of fatigue and discomfort of the hands and arms while using computer keyboards and mice.
Recommendations on how to provide relief:
Adjusting a better posture
Taking frequent breaks
Considering ergonomic devices
Exercise
Self-massage

My qualifications
Why do I think that I can talk about this topic?
Several years ago I had a lot of pain and discomfort in the hands and I took a long-term approach that is working for me.
I am a licensed massage therapist.

Caveats
I cannot diagnose a condition, nor prescribe treatment.
Although, I can offer recommendations.
I am providing information on products and I give specific examples for illustration purposes.
I do not have any financial interest on them.
I am not an ergonomics “expert”.
I am providing techniques that are working for me.

Problem
Many people who use computers for many hours a day are feeling discomfort and pain in different parts of the body due to the continuous and long term use of computers.
This presentation concentrates on the upper extremities: arms, forearms, wrists, hands.
Note: A commonly used (and sometimes a catch-all) term for pain condition of the wrist is:
Carpal Tunnel Syndrome

Causes of fatigue and discomfort
The 3 main causes of computer-related fatigue and discomfort are:
Repetitive motion , which causes overuse of muscles
Improper body positioning , which causes lack of oxygen to the muscles
Staying in the same position for long periods of time

Reducing fatigue and discomfort
To reduce fatigue and discomfort and possible musculoskeletal disorder it is important do:
Understand how to avoid awkward body postures
Setup your workstation properly
Practice safe work habits to increase circulation
Maintain a neutral position while working
Alternate tasks - move your body throughout the day
Use ergonomic devices and auxiliary products
Do stretch exercises
Do self – massage on the affected areas

Muscle anatomy http://training.seer.cancer.gov/module_anatomy/images/illu_muscle_structure.jpg

Muscle contraction
A muscle is a set of bundles of bundles of muscle fibers (each fiber is a long cell – visualize a single thread in a spider web).
A muscle fiber is able to contract upon a nerve impulse.
Blood vessels are inside the bundles and provide nutrients and remote waste products to muscle fibers.
During contraction, the blood vessels are squeezed and their flow capacity is diminished.
A muscle that is contracted for too long, it is not receiving enough nourishment and is accumulating waste products.
Therefore, to provide proper blood flow, it is necessary to reduce the muscle contraction by avoiding being a long time in a single position, by alternating tasks, doing exercise and self-massage.

Neck and Upper Back – awkward postures
Forward head posture is a common cause of discomfort in the upper back and in the neck muscles.
It can compress the nerves that run from the neck into the arms, which may cause pain in the arms and hands.

Neck and Upper Back – Solution
Maintain a neck posture by keeping aligned the ears with shoulders and hips.
This posture reduces the amount of work required of upper back and neck muscles.

Shoulder – awkward posture
Sustained reaching forward with the shoulders can compress blood vessels and nerves that travel through the shoulder.

Shoulder - Solution
Maintain a neutral shoulder position (relaxed, elbow at side, not over reaching).
This position allows proper circulation to arm and hand.

Forearm/Wrists awkward posture
Wrists bent upward: extension
Wrists bent downward: flexion
Wrists bent to the side: deviation (illustrated)

Forearm/Wrist - Solution
Maintain a neutral position:
Elbow rests as your side, bent around 90 degrees.
Wrist stays flat, with middle finger aligned with forearm
May need to use split keyboard

Devices and products
There are input devices that allow a more ‘neutral’ position for the wrist (diagonal, not parallel) when using these devices:
Ergonomic keyboard
Ergonomic mouse
Wrist braces to stabilize the wrist, such as:
“ ACE Wrist brace with rigid splint”
Beware! Many companies and products use the “ergonomic” buzzword for products that are not really ergonomic.

Work habits
Maintaining a neutral body position is critical.
However, long sustained periods in any position, including a neutral position, may also lead to fatigue or pain.
You need to take breaks from your neutral position by rotating tasks and moving your body:
Stand up while talking on the phone
Walk to colleague's offices rather than emailing (when possible)
Break up keyboard-intensive tasks by returning calls, hand writing notes.
Perform mini-break stretches for a few minutes each hour

Workstation setup, general concepts
Arrange your workspace so that your body can work in a safe neutral position to enhance vital circulation and limit overuse.
Neutral Spine: Ears, Shoulders, & Hips Aligned, with a Small Low Back Arch
Neutral Shoulders: Relaxed by Your Sides, Not Reaching
Neutral Elbows: At Right Angles (90 Degrees)
Neutral Wrists: Flat, In Line with Forearms

Workstation – adjustable chair
Use an adjustable chair:
Height - up and down
Tilt – back and forward
Considering the amount of time that you spend sitting using a computer, an adjustable chair is a good investment on your health!

Workstation Setup - typing
Proper keyboard and mouse positioning will facilitate proper typing:
Type with your hands and fingers floating over the keys
Use larger arm and shoulder muscles, rather than your forearm and wrist muscles.
Do not rest your wrists on any surface, including wrists rests (to avoid pressing on the carpal tunnel)

Workstation Setup - mouse
If you are right handed, notice the long distance that your hand has to travel from keyboard to mouse.
Consider using the mouse on the left.
It takes a couple of hours to adjust to use it with the left hand.

Exercises
Performing brief stretches for 1-2 minutes every hour throughout the day is one of the most effective ways to increase circulation and reduce fatigue and discomfort.
Hold each stretch 5-10 seconds
To increase strength, weight lifting is recommended
The following web page has a good set of stretches for computer users: http://login.remedyint.com/ergoanswers/micro_stretch.html

Stretching – Shoulder shrugs
Stand or sit straight up, arms relaxed by your side
Slow roll shoulders straight up towards your ears
Squeeze your shoulders together, and let them roll down and back.
Repeat 5 times

Stretching – Wrist Extensors
Helps reduce forearm and wrist fatigue
1: Straighten your right arm out in front of you
2: Point your fingers towards floor
3: Use your left hand to mildly stretch the right wrist further; slowly rotate right fingers to point away from your body
4: Hold 10 seconds
5: Switch sides

Stretching – Wrist Flexors
Helps to reduce forearm and wrist fatigue
1: Straighten your left arm out in front of you.
2: Bend your wrist backwards, and point your fingers upwards.
3: Use your right hand to mildly stretch the bending wrist further.
4: Hold for 5 to 10 seconds.
5: Switch sides.

Stretching - Fingers
Place finger tips together in a prayer position at chin level.
Slowly move your hands from chin level to chest level.
Slowly rotate fingers to point towards your chest.
Hold stretch for 5 to 10 seconds, release slowly.

Self-massage
You can do some self-massage techniques on your arms:
Do general stroking with thumb or fingers
Avoid grasping with your thumb and fingers:
uses all the muscles of the hand and forearm, causing more expense of energy and possibly more discomfort
Use a tennis ball or a racquet ball to provide release on tensed muscles

Self-massage objectives
It breaks the feedback loop that maintains muscle contraction.
It increases circulation that has been restricted by the contracted tissue.
It directly stretches the knotted muscle fibers.

Massage with a tennis ball Apply your weight against a wall Slowly press the ball against the muscle

References
http://ehs.concordia.ca/pdf/ih/ergonomics.manual.pdf Concordia Univ. Office Ergonomics Manual
http://www.pc.ibm.com/ww/healthycomputing/vdt4.html Healthy Computing (Lenovo)
http://login.remedyint.com/ergoanswers/index.html ErgoAnswers - guide to comfortable computing
http://www.triggerpointbook.com/index.html The Trigger Point Therapy Workbook

Questions and Answers
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Care Of Hands And Arms For Computer Users

by Angel Rivera on Mar 01, 2009

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