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Desk related issues - Part 1 of 2


Ergonomic influence on musculoskeletal disorders for desk workers.


Muscle imbalances can affect the way we move in almost every activity of daily life. When we have muscle compensation, we will either over activate or under activate various muscle groups which can ultimately lead to some form of discomfort or pain. Back and neck pain, headaches, shoulder and arm pain are common computer / desk related issues. Furthermore, muscle and joint conditions can be aggravated by poor workstation and desk setup, bad posture and prolonged sitting.


Studies show that prolonged sitting at a desk increases biomechanical stress on the back, neck, and upper limbs (Pillastrini et al., 2007). Forward head position (bending of the neck), shoulder abduction angle when using a computer mouse are major contributors to upper body musculoskeletal disorders (Marcus et al., 2002).


In their studies, Hakala (2010) and Lindegård et al., (2012) have shown that poor posture, repetition of computer tasks such as typing, use of a mouse and sitting for long periods increase symptoms in the neck, upper limbs, thoracic spine and low back.


Incorrect posture can lead to many associated aches and pains along with muscle imbalances throughout the body. Mobility with soft tissue therapy and correct postural strengthening exercises through biokinetics can help alleviate many of these desk related aches and pains.


A survey taken in 2006 in the United Kingdom which indicated that prolonged bending of the neck was a risk factor for neck, shoulder, elbow, and forearm pain (Sim et al., 2006). Apart from individual suffering and a decrease in the quality of life, these disorders place a heavy economic burden on society due to costs connected to long term sick leave, decreased work performance and reduced productivity (Bostrum et al., 2008; Hagburg et al., 2007).


In 2014 the BBC business website reported that, “Almost 31 million days of work were lost the previous year due to back, neck and muscle problems, according to the Office for National Statistics (ONS)”.


Can poor posture affect your sporting activity?


As shown in research thoracic stiffness contributes to reduced shoulder mobility, compensatory movement patterns, strain, overuse, and injury, (Crawford and Jull, 2009; Theisen et al., 2010).


During activity such as running and swimming, stiffness through the thoracic (torso) and shoulders can inhibit your ability to have a tall spine and reduces mobility. Many people are hunched and rotated that they can no longer get their arms into a position that allows a relaxed backward movement. According to Hammer and Delp (2013) forcing the arm backward is likely to cause tension and create excessive torso rotation, this in turn can affect your running or swimming technique leading to reduced speed or injury. Suvarnnato et al., (2013) suggest that increased shoulder and thoracic mobility leads to easier more relaxed movement of the neck and arms along with a decrease in neck and shoulder pain.


Furthermore, that hamstring discomfort or pain you feel could be the result of your stiff, tight thoracic spine.


If you are going to start exercising, why not make exercise tailored to what your identified weaknesses are. Why not utilise that 20 mins at the gym by working on scapulothoracic rather than something nonspecific? If you keep doing the same exercises you are reinforcing the same poor biomechanics. By doing this you’re increasing the chance of the discomfort becoming worse or at best remaining constant.


How can soft tissue therapy and biokinetics help?


When it comes to postural correction it is important to focus on stretching and lengthening the short tight muscles along with strengthening the weak over stretched muscles. According to Pain and Voight (2013) before a strengthening programme is started, it is vital to attain normal flexibility in the muscles and normal joint mobility. Tightness or adaptative shortening can affect and even hinder activation of the opposing (antagonist) muscle groups. It is therefore important to combine the skill sets of soft tissue therapy, which can work on mobility and flexibility throughout the body and the biomechanical analysis and knowledge of a Biokineticist with the focus on strengthening.


An In-depth Postural analysis with associated muscle strength tests can help determine where imbalances occur. In congruence with this, one can start to develop body awareness and be educated on the correct way to re-set the posture and ultimately assist with many of these desks related pains.


Lee and Kim (2016) investigated the effect of thoracic mobility combined with deep cervical flexor muscle training on cervical and thoracic range of movement and pain. They found that mobility and muscle training was more effective than other approaches at improving range of movement, strength, endurance and the reduction of neck pain. Strengthening the muscles surrounding the scapula, spine and core is very important when it comes to postural correction.


In studies conducted by Crawford and Jull, (2009) and Suvarnnato et al (2013). soft tissue therapy has shown to increase thoracic and shoulder mobility thereby reducing the risk of upper body strains or injury and bringing balance back to the body.


#deskinjuries #deskposture #softtissuemassage #biokinetics #strengtheningandconditioning #deskassessment


References

Miller, Joe. (2014). BBC business website, Is back, neck and muscle pain hurting the UK economy? BBC business online at [https://www.bbc.co.uk/news/business-26338889].


Bostrom M, Dellve L, Thomee S, Hagberg M. (2008). Risk factors for generally reduced productivity-a prospective cohort study of young adults with neck or upper-extremity musculoskeletal symptoms. Scandinavian Journal of Work Environmental Health, 34(2), pp. 120–132.


Christina Theisen, Ad van Wagensveld, Nina Timmesfeild, Turgay Efe, Thomas J Heyse, Susanne Fuchs-Winkelmann, Markus D Schofer. (2010). Co-occurrence of impingement syndrome of the shoulder and restricted range of motion in the thoracic spine - a prospective study with ultrasound-based motion analysis, BMC musculoskeletal disorders, Published online 2010 Jun 29. doi: 10.1186/1471-2474-11-135


Crawford, H. Jull, G. (2009) The influence of thoracic posture and movement on range of arm elevation, Journal of Physiotherapy Theory and Practice; an International Journal of Physical Therapy, 9(3), pp. 143-148.


Hakala, P. Saarni, L. Ketola, R. Rahkola, E. Salminen, J. Rimpele, A. (2010). Computer-associated health complaints and sources of ergonomic instructions in computer-related issues among Finnish adolescents: A cross-sectional study, BMC Public Health, 10(11).


Hagberg M, Vilhemsson R, Tornqvist EW, Toomingas A. (2007). Incidence of self-reported reduced productivity owing to musculoskeletal symptoms: association with workplace and individual factors among computer users. Ergonomics, 50(11), pp. 1820–1834.


Hamner, S. Delp, S. (2013). Muscle contributions to fore-aft and vertical body mass centre accelerations over a range of running speeds, journal of biomechanics, 46(4), pp. 780–787.

Kwan-woo Lee, won-Ho Kim. (2016). Effect of thoracic manipulation and deep craniocervical flexor training on pain, mobility, strength, and disability of the neck of patients with chronic nonspecific neck pain: a randomized clinical trial, The Journal of Physical Therapy Science, 28; pp. 175-180.


Lindegård A, Wahlström J, Hagberg M. Vilhelmsson, R. Toomingas, A. Torngvist, E. (2012). Perceived exertion, comfort and working technique in professional computer users and associations with the incidence of neck and upper extremity symptoms BMC Musculoskeletal Disorders, 13(38).


Mainenti, M. Felicio, L. Rodrigues, E. Ribeiro da Silva, D. Vigario dos santos, P. (2014). Pain, Work-related Characteristics, and Psychosocial Factors among Computer Workers at a University Center, Journal of Physical Therapy Science, 26(4), pp. 567-573.


Marcus, M. Gerr, F. Monteilh, C. Ortiz, D. Gentry, E. Cohen, S. Edwards, A. Ensor, C. Kleinbaum, D. (2002). A prospective study of computer users: II. Postural risk factors for musculoskeletal symptoms and disorders, American Journal of Industrial Medicine, 41, pp. 236–249.


Noudeh, Y. vatankhah, N. Baradaran, H. (2012). Reduction of Current Migraine Headache Pain Following Neck Massage and Spinal Manipulation, international Journal of Therapeutic Massage & Bodywork, 5(1), pp. 5-13.


Paine and Voight ML, The Role of the Scapula,International Journal of Sports Physical Therapy, 2013, 8(5): 617–629.


Pillastrini, P. Mugnai, R. Farneti, C. Bertozzi, L. Bonfiglioli, R. Curti, S. Mattioli, S. Violante, F. (2007). Evaluation of Two Preventive Interventions for Reducing Musculoskeletal Complaints in Operators of Video Display Terminals, Physical Therapy, 87(5), pp. 536-544.


Sim, J. Lacey, R. Lewis, M. (2006). The impact of workplace risk factors on the occurrence of neck and upper limb pain: a general population study. BMC Public Health, 6, 234.

Suvarnnato, T. Puntumetakul, R. Kaber, D. Boucaut, R. Boonphakob, Y. Arayawichanon, P. Chatchawan, U. (2013) The Effects of Thoracic Manipulation Versus Mobilization for Chronic Neck Pain: a Randomized Controlled Trial Pilot Study, Journal of Physical Therapy Science, 25(7), pp. 865–871.


Vincent, C. Maign, J. Fischhoff, C. Lanlo, O. Dagenais, S. (2013). Systematic review of manual therapies for nonspecific neck pain, Joint Bone Spine, 80(5), pp. 508-51.

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