Intro: It's Your Health Radio, a special podcast series presented by Henry Mayo Newhall Hospital. Here's Melanie Cole.

Melanie Cole, MS (Host): Welcome to It's Your Health Radio with Henry Mayo Newhall Hospital. I'm Melanie Cole. And we're talking about ergonomics today. Does your job require you spend a lot of time in front of a computer? Does your job require you sit a lot? Sometimes when that happens, you start to notice little aches and pains and you think to yourself, "Well, I'm not doing anything to damage," but those aches and pains can really start to build up and there's a reason for them. And we're going to learn about that today.

Joining me is John Jay Lee. He's an occupational therapist and Certified Ergonomics Assessment Specialist at Henry Mayo Newhall Hospital's Physical Therapy. John, it's such a pleasure to have you join us. Before we talk about common injuries, things you see, I'd like you to start by explaining what ergonomics is for the listeners, because not everybody knows that word.

John Lee: Thank you, Melanie. Thanks for that introduction. Ergonomics, when I explain this part of my job outside of the hand therapy that I do most of the week, ergonomics has really just been going around the hospital, going to different coworkers who have certain requests about their workspace, and they usually complain about certain issues about their workspace. And then, I go over there. The issue isn't too much with how they manage their work area, but it's their terrible postures. It's just how they can manage their workspace overall. And it's me being able to kind of guide them through healthy habits and routines of how to navigate working throughout the day without causing too much repetitive stress and any kind of awkward posture. So in terms of how I define ergonomics, I would say that it's promoting efficient and safe work.

Melanie Cole, MS: Rock on! That's a good definition. So when we think of those injuries, these repetitive injuries you mentioned, what are the most common that you see in people who have jobs that require them to sit in front of computers all day?

John Lee: It's a lot of lower back pain, and we don't like using the word pain in the hospital, it's discomfort usually. And that's usually when you see very few cases, do you notice anyone who has actual pain? That's a case where you might have to refer them to a professional PT, rehab in that sense. So, I actually do see a couple coworkers who do mention that they do need those services. But outside of that, yeah, it's a lot of repetitive strain on their back or their shoulders, neck.

Melanie Cole, MS: So, we think of these things, low back pain, arm pain. There's even something now called text thumb and mouse elbow. So, these are things that I think people are not even realizing is happening to them. When you see these people, do you have tips? What do you say to them when you first walk up and you look at their workspace and maybe their desk is a little too low and their computer's a little too low, so they're looking down or it's a little too high, so they're looking up. And then, you know, their necks going to hurt pretty quickly after that. What do you say? How do you assess that workspace, John?

John Lee: Yeah. It's really different for every single person This is where my hand therapy skills really come into play really effectively. Every time I go up to someone, let's say like they have carpal tunnel syndrome on top of all their issues with lower back pain, I would teach them some really good stretches that they could do to implement and stretch out their median nerves to treat that carpal tunnel. So, that's one classic example.

Melanie Cole, MS: Now, let's talk about posture, because you mentioned it and it's such an important aspect. People sit, they're hunched over or their chair is not really very supportive. What do you recommend for good posture? I mean, I'm somebody who sits behind the microphone and I'm constantly readjusting myself and getting up and sitting back down. What do you recommend for posture, John? Because that's really something that contributes to this epidemic of low back problems that we see.

John Lee: The way I like to describe it is you want your head, shoulders, and hip to be in one straight line. So, one imaginary straight line, just imagine that. Oftentimes you have a lot of people who try to correct their posture just by bringing their torso up so they match their shoulders and hip in one line. But most of the time, you might see-- I like to say like a little discrepancy. There's like a little bit of tilt with their chin forward, so they don't really have that chin tilt back to have their head align with their shoulders and hip. And that causes a lot of really bad strain on the neck. And the way I like to describe it is the head is as heavy as a bowling ball or small watermelon. And every time your head is going forward, a lot of research shows you that even if it's about like half an inch forward, that's going to add about five pounds of strain on your neck. That's already causing a lot-- especially if your head's only about an inch forward, that's already like 10 pounds of strain on your neck.

Melanie Cole, MS: So, do you recommend that we supplement some of those positions if we don't have the best chair? And we're going to talk about employers and really providing better chairs. But do you recommend that we supplement with pillows, braces? Like if your chair doesn't get your neck, I mean, it's hard to sit up straight all day, but if you have something behind your neck or a pillow-- I'm very short, John. So for me, because I need my feet flat on the floor, which is really important to have that angle, I need a little step stool at the base of my chair because my feet don't touch the ground.

John Lee: It's really valuable to keep your feet flat on the ground when you're using any kind of chair. So, I might bring a foot rest in for someone who has shorter legs, especially for the chair that they're in. To answer your question about pillows and any kind of wedges that people might use to provide cushions, I'm not a hundred percent a fan of them. I do see that they work in some scenarios where it really does prop someone up. It provides a lot of lower back cushion. But as for seat cushions, I'm not too much of a fan of that because some textures of the pillows, they might be sinking in. That's not really what you want. You want something a bit more stable and that's going to give you more stability to be able to perform your actions.

Something that is echoed throughout the rehab world is you want more proximal stability in order to encourage more distal mobility. It's by having more proximal midline stability and especially having that with your main posture and your core, especially coming from your abs and keeping your whole body up with your abs, it's going to be a great way for you just to mobilize and navigate your workspace way more effectively and safely.

Melanie Cole, MS: That's really great advice, and I agree with you. Now, how do we know if the pain we're starting to feel is something ergonomically related? If it's something we can handle ourselves, or if it's something that we need to seek assistance from a professional like yourself.

John Lee: Yeah. I'd say typically a lot of people who come up to me to ask for a standing desk, they might be asking, because they're having pain in prolonged sitting periods. So typically, that's when I would detect that that might be related to them being at their workspace and not having the best posture or overall setup. Granted, like the human body's not meant to be sitting at a workspace for prolonged periods of time, the human body is meant to be out and about being very active, and ergonomics has just been such a emerging practice in that area, granted that desk jobs have only really been a thing for half a century.

Melanie Cole, MS: That's interesting. I never even really thought of it that way. And i mean, it hasn't been around that long that we've all been glued to our desks. Do you have some tips while we're glued to our desks for the employers? What can they do? Now, I'm lucky, John, because I can get up and use my treadmill, 10 minutes, 15 minutes, then I'm back at my desk. If you were to have your wishlist for employers to say, "This is what you can do to make your employees happier, healthier, stronger," and not get these pains from poor ergonomics, what would you tell them?

John Lee: I would give them a quick posture check so I could describe this in three steps. The first step is shrug your shoulders, so you shrug. And then, second step, squeeze. You squeeze your shoulder blades back. Third, drop. You drop your shoulders. And already from doing that-- so once again, shrug, squeeze, drop, you might notice your whole body's now postured really well. And I don't know if you tried that when I was just saying that.

Melanie Cole, MS: I did try it just while you were doing it. I shrugged, I retracted, and I went down. It feels good.

John Lee: Yeah. So, that's a very simple practice. As far as employers, I would recommend there be more of a supply of chairs, especially Beta Sitmatic chairs, those are honestly my favorite kind of chairs that I typically recommend. And they provide many adjustable features for different workspaces. I'd say that's helped plenty of my clients with their workspace.

In terms of standing desk, there's a bit of a caveat to that. I don't automatically jump straight into recommending or suggesting standing desks, especially for people who might say that they have any kind of lower back pain or they're having any leg issues. A lot of research actually shows that standing desks might aggravate certain conditions in that sense. That's something that I've been kind of careful recommending the standing desks. And I'd say it'll be very important for every office to invite in an ergonomic specialist to go through with everyone healthy stretching and really promoting good techniques of how to have good posture throughout the day.

Melanie Cole, MS: Well, I agree with you. I'm not a big fan of the standing desks either. Being so short, they don't really fit me either, and unless you're wearing really good shoes, you are putting that shearing force just all day standing there. You know, it's like the same kind of. Problem that chefs have standing all day. And if you're not moving while you're standing, and certainly the floor is an issue and the type of flooring, tile being harder than wood, carpet being different for different shoes, I'm kind of there with you, John. But I want to tell the listeners that we were talking off the air about mouses, and I have this penguin mouse that changed my life. So, I think having a professional like you assess is one of the most important things that people can do. Do you have a final thought? Your best advice, John. This is you're speaking to people now who are sitting at their desks. Give them your very best advice and what you say every day.

John Lee: I want everyone to know, keep your wrist in neutral position. A very prevalent thing that I see all across many desk workers is just really bad carpal tunnel. It's a really great habit to correct how your wrist is positioned, and that goes for most of your joints. I'd say it's a really good thing to not keep them in one position for a long time and continue to integrate stretches throughout the day, continue to pay attention to your posture. Call people out and make sure that, especially for all desk workers who are sitting for more than 90% of the day, that they could integrate way more movement. The human body is not meant to be sitting for a prolonged period of time.

Melanie Cole, MS: Well, it definitely isn't. And I agree with you, John. And I think employers need to really have someone like you on hand that can walk around and help their employees and, you know, eye level computers. And just as John was saying, there's repetitive stress movements that get really, really-- they build up in your system and can become incredibly painful. You've given us a lot of great information today.

Thank you so much for joining us, and you can visit the Henry Mayo Newhall Hospital online health library to see seven ways to create an ergonomic workspace, just go to library.henrymayo.com and type the word ergonomics into the search box.

That concludes this episode of It's Your Health Radio with Henry Mayo Newhall Hospital. Please always remember to subscribe, rate, and review It's Your Health Radio on Apple Podcast, Spotify, iHeart, and Pandora. Until next time, I'm Melanie Cole.