This post will evolve rather continuously over time, as there is a wealth of tactics we can share for you to consider. We will try to section this per body part.
Also be aware that you cannot ELIMINATE ergo hazards; you can only DILUTE the severity of the ergo hazards somewhat, and that is often enough.
Also, the greatest source of ergo suggestions is among the workers doing the work! Just ask them. Our job then becomes one of inviting, validating, communicating employee suggestions… so common.
And when ergo hazards cannot be adequately improved, we fall back to job task rotation (to reduce hazard EXPOSURE TIME) and specific targeted MICRO-STRETCH that match and reverse the effects of the hazards, by restoring blood supply to loaded tissues.
1. NECK and Thoracic Outlet-Inlet (PROXIMAL risk factors)… sustained sitting, sustained standing, forward head posture habits, staring at the computer screen , prolonged driving… TACTICS: Have an adjustable chair. It does not matter how it is fitted (contrary to the obsessions of some ergonomists who seek to impose perfect posture). Posture VARIETY is far more important than posture perfection. Posture stresses at the neck-shoulder girdle contribute mightily to risks of developing MSDs thorughout upper extremity. Reptitive motion risks at hand become less risky when neck posture stresses are reduced.
It is the TIME spent in one posture that is more critical than awkward posture. Key to seating is to CHANGE seat fit often, even if only to change seat height 2″ every half hour. Better yet, use Vari-Desk to allow worker to switch between sit vs stand often (sit-to-stand option is very effective). The key is POSTURE VARIETY !
Motivation training to BE AN INCH TALLER to correct a posture habit. MSD School training should teach WHY as well as how, to motivate compliance, by showing them all the nasty effects of forward head and sitting. MICRO-STRETCHES at scaleni and chin-tuck axial extension stretches.
2. Seek UPPER EXTREMITY SUPPORT on padded desk surface to reduce UE loading at neck-thoracic outlet. Place desktop computer in corner if available for more UE surface area. Simply push keyboard in on desk and pad surface in front of it. BEST option ismon a corner-desk setup (pic below) where keyboad-monitor place innthencorner, thus providing full bilateral forearm support on the adjacent desks.
3. And avoid BIFOCAL eyeglasses on computer work (requires excessive flex at upper thor with secondary hyperextend head on neck… severe FHP). Switch to single-vision reading glasses set for a slightly longer focus distance than used for book reading (slightly lower diopter). This is a very coomon risk, usually overlooked.
4. SHOULDER reaching… Seek to at least mildly reduce HEIGHT reached, horizontal DISTANCE reached, TIME spent reaching, REPETITION of reach, LOAD in hands when reaching. Move reach closer, or mover worker closer. An inch or two less high or less far can be critical. Use CODMAN exercise often when reaching is unavoidable.
5. TENNIS ELBOW risks… comes from loads in hand held across wrist, especially with forearm pronated or neutral (eg, just holding a cup of coffee) (extensor carpi radialis). Seek to reduce load, duration, repetition. TE stretch to wrist and digit extensors.
6. GOLFER’S ELBOW RISKS… Pronator teres load, also cubital tunnel risks… Grip (forceful, repeated, prolonged): wrist loading in supinated position (loading pronator). Again, seek to reduce these loading factors, even if only mildly. In example pictured, employer was able to replace this with lighter-weight power driver. Forearm flexor group stretch done supinated.
7. GRIP that is forceful, or prolonged (even light but prolonged), or repeated.. also loads carpal tunnel; risk based on grip force, diameter, duration, repetition, contact traction (slippery), vibration.
These are boxed heavy doors & windows, boxes fitted with ergonomically improved grip handles for lifting-moving these heavy loads.
Mouse use risks Golfer’s Elbow, while trackball use risks Tennis Elbow… So, the best optionnis to use each of these, switching between them every1-2 hrs. Posture-mvt variety reduces MSD risk… such as frequently (hourly) switching between mouse versus trackball, or flip keyboard legs (rear corners) in versus out to create slight changes in wrist posture, for wrist posture variety. “Correct Posture” (whatever that may be) is a risk when it is sustained. Postre Variety is far more healthy than posture perfection!
more to come…
8. AWKWARD WORK POSITIONS THAT ARE UNAVOIDABLE… when awkward stressful prolonged posture is unavoidable, one must frequently stop to stretch out of that position to restore blood supply to stressed structures. These workes need to “listen” to thier body formemerging discomfort, which should alert them to the need to STOP & STRETCH out that awkward posture. If they are bent forward and to the left, then they shouldmstretch backward and then to the right to counter the work posture strain. This is simple and effective… once employees are trained in this. This is one example where very specific workplace stretches are critical (and often the ONLY employee protection tactic available).
PINCH… is even worse than grip for tendon and carpal tunnel risks. Simply using padded grip-pinch surfaces ease stresses to carpal tunnel, tendon, and thumb CMC joint structures
Small grip diameter (esp this heavy)… use a padded crutch grip in hand to encircle bucket handle for wider, softer grip. Also, replace 5 gal buckets with 2 gal buckets to lighten load… and store them at safe lifting heights.. as mentioned next, below
Store your stuff to minimize handling risks… stuff you need frequently or heavy items should be stored at waist height… while stuff you need less often is stored progressively higher or lower. Here, the coffee cups are needed often, but stored very low, risking repetitive lower back forward bending strain for kitchen staff, especially when lifting a full tray of them, as shown here
CUSTOMIZED MICRO-STRETCHING set up by a PT to match the demands of each work area… very effective, but on;y if employees are effectively trained in what-how-why-when…
ARMS SUPPORTED BY WORK SURFACE… Position work and worker to gain some upper extremity support on the work surface, to reduce neck-shoulder posture “holding” demands. Important re. Thoracic outlet inputs to UE MSD
PERFECT LIFTING EVERY TIME… Get close to load; preposition feet to minimize twisting, tuck chin in and push chestbout somehatntomcreate mild inward swayback arch in lower back as you bend knee… pre-position feet to reduce arc twisted with load… then put the load back down the same way..
POSITIONING… Platforms to elevate worker can reduce height of shoulder reach elevation. Workers in this example should take time to position these platforms or ladders to minimize reach-elevation (supervisor input to make sure it happens). Also frequently CHANGE position to work with arms, to vary posture stresses at shoulders.
The Physical Therapist in the Workplace 