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Gulf Regional Providers
Jimmy Guidry, MD
Myriam Hutchinson, MD
Brad Frick, PA-C
Shane LaHood, PA-C
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Ergonomics of the Workplace
Back injuries at work
Back pain is one of the most common work-related injuries and is often caused by ordinary work activities such as sitting in an office chair or heavy lifting. Applying ergonomic principles - the study of the workplace as it relates to the worker - can help prevent work-related back pain and back injury and help maintain a healthy back.
The goal of an ergonomics program in industry is to adapt the workplace to a specific worker, dependent on the job description, required tasks and physical make up of the employee performing those tasks. Two types of situations typically cause people to begin having back pain or to sustain a back injury while on the job:
- Non-accidental injury, where pain arises as a result of normal activities and requirements of the task. Poor body mechanics (such as slouching in an office chair), prolonged activity, repetitive motions, and fatigue are major contributors to these injuries. This may occur from sitting in an office chair or standing for too long in one position.
- Accidental injury results when an unexpected event triggers injury during the task. A load that slips or shifts as it is being lifted, and a slip and fall or hitting one’s head on a cabinet door are typical examples. These accidents can jolt the neck, back and other joints with resulting muscle strain or tearing of soft tissue in the back.
Back injury from physically demanding jobs
Occupations that are physically demanding and require repetitive lifting (such as in nursing or heavy industry) are at greatest risk for both non-accidental and accidental back injury. For example, many healthcare workers have back problems because patients are of different stature and weight with varying needs. Often, the patients need help changing position, rising from a chair and walking. Similarly, the physical effort needed on an accident or fire scene to release a trapped person or save a life is unpredictable. The same problems occur in the construction industry where consistencies of tasks are a challenge.
Office chair back injuries
People who sit most of the day, such as those who work at a computer while sitting in an office chair, are also at high risk for non-accidental back injury. Office ergonomics, or computer ergonomics, can help minimize the risk of repetitive injury, such as carpal tunnel syndrome, and the risks associated with prolonged sitting in an office chair, such as neck strain, lower back pain and leg pain.
This article and other related ones summarize the use of ergonomic concepts, mechanical devices and good body mechanics (biomechanics) that can contribute to reducing back injuries in the work environment for many jobs. Importantly, staying physically fit, strong and flexible improves the likelihood of avoiding back injuries in all types of work environments.
Prevent back injury
There are certain basic ergonomic guidelines that may help an employee avoid back pain or back injury:
Develop a job description based on the forces present in a particular work environment, the time spent performing the task and the biomechanics (which define human motions and seated posture in an office chair) used in the task.
Use body posture as a tool that can be changed to meet the job demands with minimum stress on the muscles, ligaments, bones and joints.
Learn and use appropriate body mechanics to limit extra mechanical stress in completing the task.
Maintain fitness and flexibility and develop a reserve of strength.
Identifying poor posture and risks
Many potentially harmful situations that lead to back injury can be identified and avoided by following four basic rules of thumb:
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Prolonged static posture is the enemy. The healthy body can only tolerate staying in one position for about 20 minutes. That is why sitting on an airplane, at a desk in an office chair, or at a movie theatre becomes uncomfortable after a short time. Standing in one place, such as standing on a concrete floor at an assembly line for extended periods of time tends to cause back pain. Holding the same position slowly diminishes elasticity in the soft tissues (muscles ligaments and tendons in the back). Then, stress builds up and causes back discomfort and/or leg discomfort.
The solution is simple. Whether you're sitting in an office chair or standing in a line, change positions frequently. Just move. Stand or sit, stretch, take a short walk. After returning to the standing or sitting posture, use an alternate posture for just a few moments and some of the tissue elasticity needed to protect the joints will return.
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Frequent or repetitive stretching to the end range of motion or awkward, angled postures can bind the joints. Unlike jobs that require long-term seating in an office chair, jobs that require frequent repetitive motion can cause great discomfort. Such jobs involve lifting from the floor, lifting overhead, moving bulky loads, or using rotational force or twisting while handling material and which signal back injuries might be on the way.
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Heavy loads offer greater risk. If the job requires moving heavy or bulky objects, it is important to have the proper tools or get help.
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Fatigue from sitting in an office chair for days, from work or from insomnia can make people move more awkwardly. If one is overtired or feels fatigued, it is advisable to avoid lifting heavy objects alone or quickly.
If following these ergonomic rules of thumb is a frequent problem, the worker is at risk of sustaining or aggravating a back injury.
Office Chair, Posture and Driving Ergonomics Injury categories
Posture for standing, sitting in office chairs or driving
Posture is very important both at home and on the job. Back-friendly posture is a valuable component of preventing or managing back pain while performing any activity. Incorrect posture while standing for long periods of time, sitting in an office chair, and driving are all common causes of back pain.
Standing posture
Maintaining the natural curve of the spine when standing promotes “good posture”. So what does that mean? The human spine looks a little bit like an S from the side, and maintaining those two curves is important
- Keep your head directly over the shoulders (i.e. “chest out, head back”)
- Keep the shoulders directly over the pelvis
- Tighten the core abdominal muscles
- Tuck in the buttocks
- Place the feet slightly apart, with one foot positioned slightly in front of the other and knees bent just a little bit (i.e., not locked).
If this posture is new it may feel strange at first, but after awhile it will feel natural. If it feels too weak or tiring, use light weights or elastic bands to work the muscles between the shoulder blades (e.g. rhomboids and middle trapezius). It will quickly get easier.
If standing on a concrete floor is required at work, it is best to wear shoes with good support and cushioning. A rubber mat placed on the concrete floor will ease pressure on the back and enhance the favorable ergonomic conditions. Use a railing or box to prop one foot up while standing to help take pressure off the back. This standing position takes some practice. Remember to change feet and positions every 20 minutes.
Office Chair Sitting Posture
Posture is important for sitting in office chairs and at a workstation. Many of us spend hours in front of the computer, resulting in back pain or neck pain. Much of this pain may be avoided by a combination of:
- Adopting a user-friendly workstation by adjusting the office chair, computer and desk positioning
- Modifying sitting posture in an office chair. Many people sit towards the front of their chair and end up hunching forward to look at their computer screen. The better seated posture is to sit back in the office chair and utilize the chair’s lumbar support to keep the head and neck erect.
- Taking stretch breaks and walking breaks if sitting in an office chair for long periods of time.
A consistent, comfortable workstation depends on where the computer screen is situated, where the hands and feet are placed, and the kind of office chair.
- Choose the surface height for the desk (standing, sitting or semi-seated) best for the task to be performed. Architects and draftsman may want a higher surface for drawing while computer entry work could be seated or standing, depending on the need to use other tools or references. The specific height of the work surface will also need to vary based on the height of the individual worker.
- Adjust the seat of the office chair so that the work surface is “elbow high.” A fist should be able to pass easily behind the calf and in front of the seat edge to keep the back of the legs from being pressed too hard and the feet from swelling. Two fingers should slip easily under each thigh. If not, use a couple of telephone books or a footrest to raise the knees level with the hips. The backrest of the office chair should push the low back forward slightly. If these adjustments cannot be adequately made with the existing office chair, a different make or type of chair may be considered.
- Fit the height of the computer screen. Sit comfortably in the newly adjusted office chair. Close both eyes and relax. Then, slowly reopen them. Where the gaze initially focuses should be when the eyes open is the place to put the center of the computer screen. The screen can be raised using books or a stand if needed.
Driving Posture To and From Work
Regardless of travel time to and from work, one’s seated posture while driving can either contribute to or alleviate back discomfort. Similar to those that sit in an office chair for hours, those with extensive commutes (an hour or more each way) can have an adverse impact on their back.
First and foremost, it is important to sit with the knees level with the hips. Either a rolled up towel or a commercial back support placed between the lower back and the back of the seat for more comfort and support of the natural inward curve of the low back.
Drivers are advised to sit at a comfortable distance from the steering wheel. Reaching increases the pressure on the lumbar spine and can stress the neck, shoulder and wrist, so sitting too far away can aggravate back pain. However, sitting too close can increase risk of injury from the car’s airbag. According to the National Highway Traffic Safety Administration, drivers (and front-seat passengers) should buckle their seat belts and keep about 10 inches between the center of the air bag cover and their breastbone to reduce the risk of air bag injury yet still be protected by the air bag in the event of a collision.
Good posture combined with body mechanics (the way activities are performed throughout the day can substantially improve the way one’s back and neck feels at the end of the workday.
Manual Material Handling to Prevent Back Injury
Any job that involves heavy labor or manual material handling may be in a high-risk category. Manual material handling entails lifting, but also usually includes climbing, pushing, pulling and pivoting, all of which pose the risk of injury to the back.
Lifting from the floor places strain on the structures in the lumbar spine. Ergonomic lifting techniques involve the use of a diagonal foot position, and getting as close to the load as possible. The load should be kept as close to the body as possible when standing up.
It is easier to move loads that are waist high than ones that are on the floor. Stacking pallets to raise the height of the load is one ergonomic solution. A scissors lift will mechanically raise the load to a comfortable lifting level. Repetitive lifting from the floor is particularly risky, so try to get the material off the floor.
Keep all loads as close to one’s center of gravity as possible. Carrying loads on one shoulder is safer for long and narrow material. This would include construction material or rolls of carpet.
- When lifting anything with a handle, place one hand on one knee to get additional leverage and use a diagonal foot position. Carrying two objects of the same weight will balance the load as long as the weight of the load is reasonable.
When climbing with a load, “three-point” contact is important for safety. This means two hands and a foot or both feet and a hand must be in contact with the ladder or stairs at all times. If the load is bulky, get another person or a mechanical device to assist.
Manual material handling may require pushing or pulling. Pushing is generally easier on the back than pulling. It is important to use both the arms and legs to provide the leverage to start the push.
- A handle would ideally be waist high for ease of pushing
- If it is necessary to pull, avoid twisting the lower back
- Sometimes, for very large loads, turning around and using the back to push against an object allows the legs to provide maximum force while protecting the low back from strain or twisting.
The opposite of twisting is pivoting. Pivoting means moving the shoulders, hips and feet with the load in front at all times. The lower back is not designed to torque or repetitive twisting. Whether using a shovel or moving material or products, always avoid twisting the back.
Practicing these techniques, both at work and at home, will go a long way to help prevent back injury and protect the structures in the low back.
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