Working from home, and using a laptop? Here are some handy tips to avoid pain and injury

If you are sitting at the kitchen table using your laptop - you may need to find a new desk

Working from home

There are many ways you can avoid injury and RSI (Repetitive Strain Injury) when having to work from home

Many of you now find yourselves on a laptop working from home, and you are probably trying to remember how the office was set up.

Those of you lucky enough to have a spare room to convert into an office will be able to recreate your office set up. The following is some advice and tips of how to avoid injury and RSI (Repetitive Strain Injury) during this time.

Working on a laptop continuously can create many issues for the user if the ergonomic set up is not correct.

A laptop is not meant for 7 hours of continuous use in an office environment without the following adjustments.

A separate keyboard and mouse are needed to maintain the wrists in their neutral position i.e. hands not held up or down, when using the keys but maintaining a continuous straight line with the forearm. The elbow is bent to 90 degrees and placed at your side when typing or using the mouse. Place the mouse beside the keyboard and if the mousing task exceeds the keying task, move the keyboard to one side, usually the left bringing the mouse in line with your forearm. 

Margo Birmingham, Letterkenny Physiotherapy, Acupuncture & Sports Injury Clinic

Manual Handling advises we keep our arms close to our side when performing tasks. Operating the keyboard and mouse falls into this category too. Incorrect position of the mouse and keyboard can cause ache and strain initially and eventually pain in the shoulder joint and wrist joint.

Avoid using the mouse with a straight elbow .This position brings the shoulder joint forward which in turn brings the shoulder blade forward and causes you to lean to that side of your chair.  

Pain can develop in the following areas; shoulder joint pain, pain down the front of the arm to the thumb, pain in the back of the upper arm, pain on top of the shoulder travelling to the side of the neck, pain between the shoulder blade and spine, pain at the base of the shoulder blade, pain in the low back and headaches.

Essentially you could call this incorrect movement reaching and if you are reaching for any item on your desk or in your home, it is necessary to avoid it. At home bring the item down from the top shelf or use a step ladder. Avoid standing on a chair or a stool. Many serious injuries are caused by falling from a height.

The laptop needs to be raised on a docking station or stand, if at home, several books can improvise and the top of the screen should be level with your eyes. To achieve the correct distance between yourself and the screen, sit on your chair with you back in contact with the upright back support and reach your right arm forwards and your middle finger should touch the screen. This is the maximum distance that the screen should be away from you.

Peering and leaning forward to see the screen may mean that it is too far away or you may need your eyes tested. These incorrect positions repeated over several hours can cause neck pain and headaches.  Check your screen distance with the middle finger reach test.

If you do not have a swivel chair at home to sit on, it would be very important to find one. Perhaps you can take one from your office or borrow one or purchase one on line. 

The correct use of the swivel chair prevents twisting of the spine from the neck to the base of the back. This prevents repetitive strain on the spinal joints, discs, ligaments and muscles.  To facilitate ease of swivelling on the chair, the feet must be supported either by the floor or by a footstool. A deep book can replace the footstool temporarily. 

To decide if you need a footstool, sit on your swivel chair with your low back firmly against the back support of the chair. The height of the chair may need adjusting up or down to keep your elbows bent to the 90 degrees position which will keep the wrists in a straight line with the keyboard. This is always important to check. Then if your feet do not reach the ground, use a footstool or book to support the feet.

The knees should be opposite the hips but try to avoid having them higher. Firm support under your feet helps maintain upright posture when seated on the chair and maintains your low back in contact with the back support of the chair. 

If you have been crossing your legs, putting your feet on the swivel legs or sitting with your leg under you, your back and feet probably need more support. Even leaning your elbow on the desk suggests you need more support when seated.

It is essential to maintain the constant low back support with the upright back support of the chair. Use a slim cushion or rolled up hand towel to help you maintain this position. If your swivel chair is on carpet at home, it may not swivel easily and if it is on a wooden floor, or tiles, it may be difficult to control.  Using a slim door mat under the chair at your desk can facilitate correction.

If you are sitting at the kitchen table using your lap top continuously, I would advise you to change tables if you can. The kitchen table is too tall for prolonged computer use and elbows cannot be maintained at the right angled position and hands are higher than your elbows when you are typing.

These incorrect postural positions can lead to chronic strain and pain in the low back, mid back, neck and shoulder areas. Headaches can be the first symptom of neck pain. These headaches get worse as your working day continues and many people do not seek advice until the headache wakes them from sleeping at night.  

Support at the Lumbar Spine or Low Back maintains good erect head posture. Our heads are heavy weighing between 5 to 7 kgs. The neck and shoulder girdle muscles fatigue easily holding this weight above them. This fatigue can cause strain and eventual pain in these muscles. This can be prevented by maintaining low back support from your swivel chair.  Check if the back support of your chair can be adjusted in height.

Persistent headaches will require you to visit to your GP for pain relief and management. Several sessions of Physiotherapy are needed to resolve the headaches and neck pain. This can be helped also by doing a routine check of your computer set up daily.

Frequent breaks are essential and now the extra demands of working from home require more frequent breaks if your ergonomic set up is not favourable. If you have to take phone calls and not needing to look at the screen at the same time, stand up and walk around to take the call. Alternatively put the upright back support of the swivel chair on the incline and lie back on the chair and answer the call. The call may take 5 to 10 minutes but you have rested and stretched your body for that period. 

If you are using the phone continuously and keying at the same time, a head set is needed.  Avoid holding the phone between your ear and your shoulder. Headsets are easily available or if you are using a mobile phone, hands free is essential.

Frequent movement and change of position negates the feeling of tiredness in the muscles and joints. Take your coffee break outside for 10 minutes and walk around, getting fresh air and change of posture.

The following should be avoided long term if you are doing them currently.

 - Peering into the screen or leaning forward to look at the screen. This position can cause headaches and neck pain. Correct it by adjusting the distance of your screen and change the tilt angle on the screen and perhaps an eye test.

 - Twisting right or left with your neck, always use the swivel chair to turn your body. Apply the same to your back. Chronic twisting causes many repetitive strain injuries in the muscles, joints and discs.  Sit at your desk so that your sternum or chest bone is opposite the screen and you have a good upright posture.

 - Avoid reaching at your desk, remember elbows close to your side always, preventing many serious injuries in your neck, shoulder and arm both at the computer and at home.

- Try not to place or pick things up from the floor while seated at your desk.   If you have to keep files near you, improvise with another chair beside you or if you were lucky enough to have a trolley with wheels, similar to the hostess trolley. Avoid twisting and reaching behind you to retrieve files. Swivel around.

- Try not to have the lap top on your knees on the couch even if it is only for 30minutes. This done daily, weekly and monthly can cause very fixed, incorrect neck and upper back postures with recurring pain , that are difficult to correct. 

Transferring information from the desk to the screen can cause you to twist your head frequently. If you do not have a document holder at home, use a cook book stand or an A4 clipboard and it may need to be raised so that it is at eye level and placed right beside your screen so that with a flicker of your eyes, you can read the material you need to type.

Staying in the same posture for long periods causes stiffness and aches in the muscles. Even when we wake in the morning, we like to stretch our bodies.

The 2km walk that we are allowed to do is brilliant for computer users at the end of each working day and maybe fit it in during lunchtime so that you can start the afternoon session with renewed energy and stretch in your body. 

The 2km walk can alleviate and neutralise all the incorrect positions and stretch and mobilise the muscles and joints that have been under constant load and strain daily. Plus we can get our 15 minutes of sunshine which in turns increases Vitamin D in our bodies, essential for bone and muscle health.


Margo Birmingham MISCP, CPPP is a Chartered Physiotherapist and VDU Assessor. She's the owner of Letterkenny Physiotherapy, Acupuncture & Sports Injury Clinic. 

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