Workstation Ergonomics: Adapting to Working From Home

Now more than ever, we’re seeing injuries that are a result of sitting for long periods of time in less than ideal postures. Due to the pandemic, employees are required to work from home from their makeshift desk, putting them in positions and postures that are aggravating their low back and/or neck. The goal of this article is to lay out some basic principles that you can do at home to prevent low back pain or an exacerbation of back pain. We know that there is a limited amount of space/resources in your home, especially if you’re trying to seclude yourself from children and maybe even your spouse… Given these restrictions, we still believe that we can guide you in your workstation that spares the back from postures that may create pain. We’ve created 3 general principles, first is the posture by which you’re in, second is to understand what creep is and how to avoid it, and last is movement routines to implement during and after sitting. When abided by these basic principles, you should be able to create any desk anywhere and remain pain free. Let’s get started!

I’m sure we’ve all heard that sitting with the knees and hips at 90º, which isn’t a bad position to be in. It’s when we stay in this position for the entire time. When we are in a sustained position for a long period of time, we end up increasing the likelihood of loading a single tissue for a longer period of time with our own weight, this increases the risk of damaging one tissue with microtrauma, which can lead to injury (small trauma accumulated over a period of time). Research tells us that sitting actually increases the intradiscal pressure more than standing and actually weakens the tissue in the back of the disc that keeps the disc material contained. Sitting in a stooped position for a long period of time actually causes the disc material (nucleus pulposus) to migrate backward. The majority of disc herniations actually occur on the backside of the disc, sitting in a stooped position for a long duration encourages this type of herniation (normal anatomy figure 2).The best posture to have when sitting isn’t just one position, but to vary positions you’re in; we can do this by changing positions about every 15 minutes and to not be in a single position or sitting for that matter for longer than 50 minutes (figure 1).

Figure 1: Variable positions that are acceptable, note the goal is to not stay in one of these positions for greater than 15 minutes. Notice how the rib cage is positioned over the pelvis in all of these positions.

Figure 2: This represents a nucleus pulposus that has migrated back and finally herniated and impinging on the nerve.

“Creep” is a process that occurs to tissues (muscles, ligaments, and tendons) when they are put under the load of your weight in a position for a sustained period of time, the tissues conform to the lengthened position they are in, same as a deck that over the years has lost its structural integrity and is now bowing in the middle. When this process occurs it results in laxity in the joints themself and a short-to-moderate long term instability to the low back joints. The root of all evil is this process, when talking about injuries that occur during or after sitting. The kryptonite to this process is spinal motion, particularly movement that is in the opposite direction we were in for the long duration. With the already migrating disc material and instability present, this is setting up a recipe for a disc herniation (disc herniation demonstrated in figure 3). What we encourage in the office to patients is to create a neutral spine. A neutral spine creates an equal tissue tension and pressure down on the disc, lessening the chance of a migration of disc material, laxity in the ligaments, tendons, muscles, joints, and ultimately reducing the amount of instability in the low back. 

Figure 3: Represents a stooped posture while at a workstation. Note the rounding of the back.

Movement is the way we can combat having to sit for long durations of time, here we will map out the movements you can do to reduce your chances of acquiring low back pain. The first movement is to simply stand up and place hands on the low back and extend back fulcruming over your hands, from this position inhale and as you exhale extend further over your hands. This exercise encourages the migration of the disc material back towards the center of the disc. The second exercise is called the cat/cow, this movement helps to reduce stiffness in the joints of the spine and, taking the spine through a healthy, normal range of motion. This third exercise is designed to fire abdominal wall muscles, this muscle activation can release chemicals that act as an analgesic and can suppress pain in the low back. Repeat each exercise 2-3 sets with each break at 6-8 reps per set.

Figure 4: The top row is standing extensions, inhale and on the exhale fulcrum further over your hands; this is one rep. The middle row is the cat/cow, increase the curve in the low back and then round the back out; this is one rep. The last row represents the abdominal wall muscle exercises, first while on your side stagger the top leg in front of the bottom leg, place elbow and forearm right under the shoulder and lift the torso and hips directly towards the ceiling; hold for 8 seconds for each side and this is one rep. Then flip to your back, bend one knee to where one foot is flat on the ground, make fists with your hands and place them under the chin, lift the head and the upper back; hold for 8 seconds each side and this is one rep. 

We hope you find great success using these principles to reduce your chances of acquiring low back pain. If you have any trouble with movement based exercises, let us know and we can help you modify them to make them safe and effective for you. If you have any questions or concerns, don’t hesitate to reach out to us through Facebook or give us a call or text.